Sex-specific depressive symptoms as markers of pre-Alzheimer dementia: findings from the Three-City cohort study

International audienceLate-life depression, as a potential marker of pre-dementia, has seldom been explored by symptom dimension and sex, despite sexual dimorphic differences. This study aimed to examine whether specific depressive dimensions were associated with pre-Alzheimer's disease dementia (pre-AD), separately for women and men. Data were drawn from 5617 (58% women) community-dwellers aged 65+ recruited in 1999-2000 and followed at 2-year intervals for 12 years. We used Cox proportional hazard models to study associations between time-dependent Centre for Epidemiologic Studies-Depression Scale (CES-D) symptom dimensions (namely somatic, depressed, positive affect, and interpersonal challenge) and pre-AD, defined retrospectively from validated diagnoses established 3.5 (IQR: 3.2-4.0) years onwards. Analyses were performed according to overall depressive symptomatology (DS+: CES-D score ≥ 16) and antidepressant/anxiolytic medication use (AA). Results indicated that in DS+ women only, all four dimensions were significantly associated with pre-AD in the AA-group, in particular somatic item 'Mind' and depressed affect items 'Depressed' and 'Blues'. The most depression-specific dimension, depressed affect, was also significantly associated with pre-AD in the DS-AA-women (HR:1.28, 95%CI: 1.12;1.47). In both sexes, in the DS-groups somatic affect was the most robust pre-AD marker, irrespective of treatment (women: HR = 1.22, 95%CI: 1.08;1.38; men: HR = 1.30, 95%CI: 1.14;1.48). Our findings highlight sex-specific associations between depressive symptom dimensions and pre-AD, modulated by depressive symptomatology and treatment. Assessment of specific symptom dimensions taking into account overall symptomatology and treatment could help identify and target high-risk AD-dementia profiles for interventions

The CES-D Scale: A self-report depression scale for research in the general population

The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The new scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test-retest repeatability. Validity was established by patterns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of depression

Gender Differences in Parental Strain

This article examines gender differences in the strains associated with parenting. We hypothesize that due to the different role experiences of being a parent, mothers are more likely than fathers to experience greater role strain. Women who parent are more likely than their male counterparts to be exposed to strain-inducing experiences because they spend more time in child care and other household chores, because they are more likely to be doing so as a “single-parent,” because they are more likely to be juggling family responsibilities and work commitments, and because being a parent has greater role salience for women. We also hypothesize that by taking into account the different role experiences of mothers and fathers we can partially account for the expected gender differences in parental strain. These hypotheses are explored using survey data from a probability sample of Detroit parents obtained in 1982-83 (n = 1,040) which assessed their parental role experiences and psychological well-being. The results confirm the hypothesized difference between mothers and fathers in reported strain, among both blacks and whites, with mothers expressing significantly greater role demands and parental strain than fathers. We find, however, that little of this difference is attributable to the differential role experiences we analyzed. We conclude that gender differences in parental strain may be linked more strongly to “gender role” than “parental role,” in that women are socialized more than men into taking responsibilities for relationships and are therefore more likely to experience the greater stresses associated with intimacy and emotional involvement with others. The greater strains of parenting felt by mothers as opposed to fathers may, thus, be due as much to the differential orientations they bring to the parental role as it is due to the objectively-assessed differences in role experience.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67967/2/10.1177_019251389010004004.pd

Employment, Parental Responsibility, and Psychological Distress

This article uses panel data from 745 married women in the Detroit Metropolitan Area to examine the mental health effects of employment and parenting status changes. Contrary to popular belief, the transition to parenting is not directly related to increases in psychological distress. Changes in employment status, however, are. Women who significantly increase their labor force participation report lower levels of psychological distress over the study period, while women who significantly decrease their labor force participation report higher psychological distress. The effects of labor force changes on mental health are not all modified by parenting status or changes in parenting status. The transition to parenting and increased parenting responsibilities, however, are indirectly related to increased psychological distress insofar as they result in decreased labor force participation. The implications of these results are used to evaluate four competing perspectives on the relationship between roles, stress, and psychological functioning.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66791/2/10.1177_019251389010004006.pd