Association of childhood maltreatment and cortisol with the severity and stability of depression symptoms

Background: Little is known about patterns of depression symptoms over time in older adults. This study aims to assess the association of childhood maltreatment and cortisol levels with latent classes of depression symptoms over ten years in older adults. Methods: A total of 752 participants (mean age 61.7±9.5, female 18%) in the Second Manifestations of ARTerial disease-Memory, depression and aging (SMART-Medea) study provided up to twenty measures of depression symptoms over ten years based on the Patient Health Questionnaire-9 (PHQ-9). At baseline, salivary cortisol was measured, and childhood maltreatment was assessed. Responses to the PHQ-9 were indicators in a latent class analysis. Multinomial regression determined associations between class membership and cortisol and maltreatment, adjusting for age, sex, and education. Results: Four distinct classes were identified; never depressed (n=275, 37%), energy/sleep difficulties (n=237, 32%), mild depression symptoms (n=152, 20%) and fluctuating severe depression (n=88, 12%). Childhood maltreatment was associated with mild depression symptoms (OR=1.95, 95% CI: 1.17-3.25) and fluctuating severe depression (OR=3.50, 95% CI: 1.99-6.15). Blunted morning cortisol was associated with energy/sleep difficulties (OR=0.98, 95% CI: 0.95-1.00) and fluctuating severe depression (OR=0.96, 95% CI: 0.92-0.99). There was no evidence for interaction between maltreatment and cortisol. Limitations: There is limited generalizability due to the cohort consisting of participants with atherosclerosis and being mostly male. This study utilizes retrospective self-reporting of childhood maltreatment. Conclusion: Childhood maltreatment and blunted morning cortisol independently contribute to a worse depression course. Blunted morning cortisol may contribute to sub-clinical depression symptoms, specifically difficulties with energy levels and sleep

Concrete and Abstract Words in Alzheimer's Disease: The influence of categories on processing

In the literature there are conflicting reports concerning whether noun and verb processing differ in patients with Alzheimer’s disease (AD). A number of researchers have pointed out that neither nouns nor verbs should be treated as uniform categories (e.g., Martin, 2007; Jonkers & Bastiaanse, 2007). With respect to word processing in AD, the importance of subdivisions of these categories according to semantic features, such as living versus non-living objects or actions with an instrument versus actions without an instrument has been demonstrated (e.g., Almor et al., 2009). The current study explores the importance of semantic features and imageability by studying word processing for various categories of concrete and abstract nouns and verbs. The hypotheses are based on the embodied cognition framework, according to which different semantic features of objects and actions relate to different neuroanatomical distribution underlying networks for various categories of nouns and verbs. A total of 13 native Dutch speakers who had been clinically diagnosed with mild AD and 16 healthy controls from the same local community were tested via a semantic similarity judgment task on different categories within concrete and abstract nouns and verbs. In sum, the results show that it is indeed the case that a distinction can be made within concrete nouns and concrete verbs and it is assumed that this is caused by the influence of different semantic features of words. The current results support the account of semantic features in the discussion on noun and verb processing, the theory of embodied cognition in the discussion on semantic representation, and the dual-coding theory in the discussion on the concreteness effect. In addition, it appears that the feature of imageability is very important to take into account because manipulation of this feature is of influence on the accuracy and reaction times in semantic processing.

Patient-reported outcomes to assess dyspnoea in interstitial lung disease and pulmonary hypertension: a systematic literature review of measurement properties

OBJECTIVE: This COnsensus-based Standards for the selection of health measurement INstruments (COSMIN)-based systematic review aims to identify and summarise the quality of measurement properties of dyspnoea-specific patient-reported outcome measures (PROMs) for patients with interstitial lung disease (ILD), pulmonary hypertension (PH) or connective tissue diseases (CTDs). METHODS AND RESULTS: Relevant articles in PubMed and Embase were screened. Based on COSMIN analysis and the Grading of Recommendations, Assessment, Development and Evaluation approach, overall rating and level of evidence were assessed to formulate recommendations. We identified 26 publications on 10 PROMs. For patients with ILD, including CTD-associated ILD, nine PROMs were evaluated, of which the Dyspnea-12 (D12), EXACT-Respiratory Symptoms Idiopathic Pulmonary Fibrosis Breathlessness subscale (ERS-IPF-B), King's Brief Interstitial Lung Disease Health Status Questionnaire breathlessness and activities subscale (KBILD-B) and the University of California San Diego Shortness of Breath Questionnaire (UCSD-SOBQ) had high-quality evidence for sufficient internal consistency, without high-quality evidence of insufficient measurement properties. We reached this same conclusion regarding the D12 for use in patients with PH, including CTD-associated PH. Most PROMs in this systematic review have moderate- or low-quality evidence on construct validity and responsiveness. CONCLUSION: Four dyspnoea-specific PROMs, D12, ERS-IPF-B, KBILD-B and UCSD-SOBQ, can be recommended for use in patients with ILD, including CTD-associated ILD. Of these four, the D12, despite the limited evidence and the lack of evidence on several important domains, is also suitable for use in patients with PH, including CTD-associated PH