Goldberg Anxiety Research Articles

Effect of adding interferential current stimulation to exercise on outcomes in primary care patients with chronic neck pain: a randomized controlled trial

Objective: To evaluate the effect of adding interferential current stimulation to exercise on pain, disability, psychological status and range of motion in patients with neck pain. Design: A single-blinded randomized controlled trial. Setting: Primary care physiotherapy units. Subjects: A total of 84 patients diagnosed with non-specific mechanical neck pain. This sample was divided into two groups randomly: experimental (n = 42) versus control group (n = 42). Interventions: Patients in both groups had a supervised therapeutic exercise programme, with the experimental group having additional interferential current stimulation treatment. Main measures: The main measures used were intensity of neck pain according to the Visual Analogue Scale; the degree of disability according to the Neck Disability Index and the CORE Outcome Measure; anxiety and depression levels according to the Goldberg scale; apprehension as measured by the Personal Psychological Apprehension scale; and the range of motion of the cervical spine. The sample was evaluated at baseline and posttreatment (10 sessions/two weeks). Results: Statistically significant differences between groups at posttreatment were observed for Visual Analogue Scale (2.73 ± 1.24 vs 4.99 ± 1.56), Neck Disability Index scores (10.60 ± 4.77 vs 18.45 ± 9.04), CORE Outcome Measure scores (19.18 ± 9.99 vs 35.12 ± 13.36), Goldberg total score (6.17 ± 4.27 vs 7.90 ± 4.87), Goldberg Anxiety subscale, Personal Psychological Apprehension Scale scores (28.17 ± 9.61 vs 26.29 ± 11.14) and active and passive right rotation. Conclusions: Adding interferential current stimulation to exercise resulted in better immediate outcome across a range of measures.

Pre-pregnancy body mass index and the risk of antenatal depression and anxiety

BackgroundWhile the physical health risks of obesity during pregnancy for women are well understood, little is known about the mental health implications. The aim of this study was to investigate the relationship between pre-pregnancy body mass index (BMI) and symptoms of antenatal depression and anxiety. MethodsSecondary analysis of cross-sectional data contributed by the younger cohort (born 1973–78) of the Australian Longitudinal Study of Women’s Health who were pregnant at the time of the survey (Waves 4–6: aged 28–39years). Primary outcomes were symptoms of depression (Center for Epidemiologic Studies Depression Scale 10 score≥10) and anxiety (Goldberg Anxiety Scale score≥6). BMI was assessed using self-reported pre-pregnancy weight and height. Demographic characteristics, psychosocial factors, health behaviors and reproductive history were assessed using study-specific and standardized measures. Multivariable regression models were used to examine the associations between predictors and outcome scores. ResultsThe mean pre-pregnancy BMI of the 1621 women included in the analysis was 24.9kg/m2; more than a third (39.8%) were overweight or obese. More than one in ten (15.4%) had depressive symptoms, and a quarter (25.0%) had anxiety symptoms. Higher pre-pregnancy BMI and certain sociodemographic characteristics including not having a paid job were significantly related to higher antenatal depression and anxiety scores. ConclusionsHigh pre-pregnancy BMI is significantly associated with an increased risk of antenatal depression and anxiety. Consistent with clinical practice guidelines, women with high pre-pregnancy BMI should be screened and assessed for depression and anxiety, and where appropriate provided with clinical referral pathways and support.

Psychometric Properties of The Goldberg Anxiety and Depression Scale (GADS) In Ecuadorian Population.

The objective of the present study was to analyze the psychometric properties of validity and reliability of the Goldberg Anxiety and Depression Scale (GADS) in Ecuadorian university students, since a cultural validation of the instrument has not been found in Ecuador. The study population consisted of a non-probabilistic sample of 600 participants (59.6% women and 40.4% men, M = 21 years, SD = 2.82). The factorial structure was examined with the method of extraction by Parallel Analysis of unweighted least squares (ULS) and of prominent rotation. In both, internal consistency was evaluated by Cronbach’s alpha coefficients and composite reliability. Like the original version, both subscales have a factorial structure of one dimension and are considered good in terms of reliability, which concludes that the scale meets the criteria of validity and reliability in Ecuador.

Neurological, Cognitive, and Psychological Findings Among Survivors of Ebola Virus Disease From the 1995 Ebola Outbreak in Kikwit, Democratic Republic of Congo: A Cross-sectional Study

Clinical sequelae of Ebola virus disease (EVD) have not been described more than 3 years postoutbreak. We examined survivors and close contacts from the 1995 Ebola outbreak in Kikwit, Democratic Republic of Congo (DRC), and determined prevalence of abnormal neurological, cognitive, and psychological findings and their association with EVD survivorship. From August to September 2017, we conducted a cross-sectional study in Kikwit, DRC. Over 2 decades after the EVD outbreak, we recruited EVD survivors and close contacts from the outbreak to undergo physical examination and culturally adapted versions of the Folstein mini-mental status exam (MMSE) and Goldberg anxiety and depression scale (GADS). We estimated the strength of relationships between EVD survivorship and health outcomes using linear regression models by comparing survivors versus close contacts, adjusting for age, sex, educational level, marital status, and healthcare worker status. We enrolled 20 EVD survivors and 187 close contacts. Among the 20 EVD survivors, 4 (20%) reported at least 1 abnormal neurological symptom, and 3 (15%) had an abnormal neurological examination. Among the 187 close contacts, 14 (11%) reported at least 1 abnormal neurologic symptom, and 9 (5%) had an abnormal neurological examination. EVD survivors had lower mean MMSE and higher mean GADS scores as compared to close contacts (MMSE: adjusted coefficient: -1.85; 95% confidence interval [CI]: -3.63, -0.07; GADS: adjusted coefficient: 3.91; 95% CI: 1.76, 6.04). EVD survivors can have lower cognitive scores and more symptoms of depression and anxiety than close contacts more than 2 decades after Ebola virus outbreaks.

Variation in symptoms of depression and anxiety in midlife women by menopausal status

ObjectivesTo examine the association between menopausal status and the risk of symptoms of depression and anxiety in a community-based sample of Australian midlife women. Study designFemale participants (mean age 50.6±1.5) who were premenopausal (n=237), perimenopausal (n=249) or naturally postmenopausal (n=225) were drawn from the Personality and Total Health (PATH) Through Life Project, a longitudinal study. Main outcome measuresSymptoms of depression and anxiety were measured using the Goldberg Depression Scale and Goldberg Anxiety Scale. Generalised linear regression models with a negative binomial log link were used. ResultsRelative to premenopause and after adjusting for all relevant covariates, being perimenopausal was associated with increased risk of greater symptoms of depression (incidence rate ratio [IRR]=1.29, p=0.001), while being postmenopausal was associated with increased risk of greater symptoms of anxiety (IRR=1.15, p=0.041). Being perimenopausal or postmenopausal was associated with an increased risk of greater symptoms of depression (IRR=1.35, p=0.008; IRR=1.31, p=0.029) and anxiety (IRR=1.22, p=0.030; IRR=1.32, p=0.006) in women without a history of probable major depressive disorder or generalised anxiety disorder. Risk of symptoms did not differ with menopausal status in women with this history. ConclusionsMenopausal status is associated with the risk of symptoms of depression and anxiety. There is a greater likelihood of increased symptoms of depression during perimenopause and symptoms of anxiety during postmenopause. In women without a history of depression or anxiety, the perimenopause and postmenopausal stages are associated with increased risk of greater symptoms of anxiety and depression relative to premenopause.

Study protocol for a randomised controlled trial of ultrasound-guided pulsed radiofrequency of the genicular nerves in the treatment of patients with osteoarthritis knee pain

IntroductionThe goals for the management of patients with osteoarthritis (OA) of the knee are to control pain and to minimise disability. Because the number of patients will increase as the...

Validation of the Spanish version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS)

BackgroundPreoperative anxiety is a frequent and challenging problem with deleterious effects on the development of surgical procedures and postoperative outcomes. To prevent and treat preoperative anxiety effectively, the level of anxiety of patients needs to be assessed through valid and reliable measuring instruments. One such measurement tool is the Amsterdam Preoperative Anxiety and Information Scale (APAIS), of which a Spanish version has not been validated yet.ObjectiveTo perform a Spanish cultural adaptation and empirical validation of the APAIS for assessing preoperative anxiety in the Spanish population.MethodsA two-step forward/back translation of the APAIS scale was performed to ensure a reliable Spanish cultural adaptation. The final Spanish version of the APAIS questionnaire was administered to 529 patients between the ages of 18 to 70 undergoing elective surgery at hospitals of the Agencia Sanitaria Costa del Sol (Spain). Cronbach’s alpha, homogeneity index, intra-class correlation coefficient, and confirmatory factor analysis were calculated to assess internal consistency and criteria and construct validity.ResultsConfirmatory factor analysis showed that a one-factor model was better fitted than a two-factor model, with good fitting patterns (root mean square error of approximation: 0.05, normed-fit index: 0.99, goodness-of-fit statistic: 0.99). The questionnaire showed high internal consistency (Cronbach’s alpha: 0.84) and a good correlation with the Goldberg Anxiety Scale (CCI: 0.62 (95% CI: 0.55 to 0.68).ConclusionsThe Spanish version of the APAIS is a valid and reliable preoperative anxiety measurement tool and shows psychometric properties similar to those obtained by similar previous studies.

Association between anxiety and severe quality-of-life impairment in postmenopausal women: analysis of a multicenter Latin American cross-sectional study.

To evaluate associations between anxiety and severe impairment of quality of life (QoL) in Latin American postmenopausal women. This was a secondary analysis of a multicenter cross-sectional study among postmenopausal women aged 40 to 59 from 11 Latin American countries. We evaluated anxiety (The Goldberg Depression and Anxiety Scale), and QoL (Menopause Rating Scale [MRS]), and included sociodemographic, clinical, lifestyle, and anthropometric variables in the analysis. Poisson family generalized linear models with robust standard errors were used to estimate prevalence ratios (PRs) and 95% CIs. There were two adjusted models: a statistical model that included variables associated with the outcomes in bivariate analyses, and an epidemiologic model that included potentially confounding variables from literature review. Data from 3,503 women were included; 61.9% had anxiety (Goldberg). Severe QoL impairment (total MRS score ≥17) was present in 13.7% of women, as well as severe symptoms (MRS subscales): urogenital (25.5%), psychological (18.5%), and somatic (4.5%). Anxiety was independently associated with severe QoL impairment and severe symptoms in the epidemiological (MRS total score: PR 3.6, 95% CI, 2.6-5.0; somatic: 5.1, 95% CI, 2.6-10.1; psychological: 2.8, 95% CI, 2.2-3.6; and urogenital: 1.4, 95% CI, 1.2-1.6) and the statistical model (MRS total score: PR 3.5, 95% CI, 2.6-4.9; somatic: 5.0, 95% CI, 2.5-9.9; psychological: 2.9, 95% CI, 2.2-3.7; and urogenital: 1.4; 95% CI, 1.2-1.6). In this postmenopausal Latin American sample, anxiety was independently associated with severe QoL impairment. Hence, screening for anxiety in this population is important.

Effect of Air Pollution on Anxiety and Depression in Adults: A Cross-Sectional Study

Background The association between exposure to air pollutants and mental disorders and its symptoms among adults has been suggested, although results are not consistent. The aim of this study was to analyze the association between exposure to air pollution and presence of symptoms of anxiety and depression, history of anxiety and depression disorders, and history of medication use (including benzodiazepines and antidepressants) in adults living in Barcelona. Methods A total of 958 adults (45 to 74 years old) residents in Barcelona, many of them offspring of Alzheimer disease patients from the ALFA (Alzheimer and Families) study, were included. We used Land Use Regression (LUR) models to estimate residential exposure to PM2.5, PM2.5 absorbance (PM2.5 abs), PM10, PM coarse, NO2 and NOx, measured in 2009. Between 2013 and 2014 participants answered the Goldberg Anxiety and Depression Scale (GADS) to evaluate the presence of symptoms of anxiety and depression. Additionally, self-reported history of anxiety and depression disorders and related medication use was recorded. Results In the city of Barcelona we observed an increased risk of psychiatric history of anxiety and depression disorders (occurring between 2009 and 2014) with increasing air pollution [e.g. for each 5 μg/m3 PM2.5 increase, an increased risk of depression of 4.55 (95% CI; 1.74, 11.87) was reported]. The same pattern was observed for the rest of the evaluated pollutants, showing significant associations for depression. Such associations were consistent with an increased risk of taking medication (occurring between 2009 and 2014) in relation to higher concentrations of air pollutants [e.g. for each 20 μg/m3 NOx increase, an increased risk of antidepressants use of 1.22 (1.04, 1.44) was reported]. However, no clear pattern of association was found for anxiety and depression symptoms measured with the GADS. Conclusions Our study shows that increasing exposure to air pollution may increase the risk of anxiety and depression and related medication intake. Further studies are needed to replicate our results and confirm this association.

Anxiety symptoms and risk of cognitive decline in older community-dwelling men.

Previous research regarding anxiety as a predictor of future cognitive decline in older adults is limited and inconsistent. We examined the independent relationship between anxiety symptoms and subsequent cognitive decline. We included 2,818 community-dwelling older men (mean age = 76.1, SD ±5.3 years) who were followed on an average for 3.4 years. We assessed anxiety symptoms at baseline using the Goldberg Anxiety Scale (GAS; range = 0-9). We assessed cognitive function at baseline and at two subsequent visits using the Modified Mini-Mental State Examination (3MS; global cognition) and the Trails B test (executive function). At baseline, there were 690 (24%) men with mild anxiety symptoms (GAS 1-4) and 226 (8%) men with moderate/severe symptoms (GAS 5-9). Men with anxiety symptoms were more likely to have depressed mood, poor sleep, more chronic medical conditions, and more impairment in activities of daily living compared to those with no anxiety symptoms. Compared to those with no anxiety symptoms at baseline, men with any anxiety symptoms were more likely to have substantial worsening in Trails B completion time (OR = 1.56, 95% CI 1.19, 2.05). The association was attenuated after adjusting for potential confounders, including depression and poor sleep, but remained significant (OR = 1.40, 95% CI 1.04, 1.88). In cognitively healthy older men, mild anxiety symptoms may potentially predict future decline in executive functioning. Anxiety is likely a manifestation of an underlying neurodegenerative process rather than a cause.

Anxiety symptoms and risk of dementia and mild cognitive impairment in the oldest old women

ABSTRACTObjectives: Research is limited and findings conflict regarding anxiety as a predictor of future cognitive decline in the oldest old persons. We examined the relationship between levels of and changes in anxiety symptoms, and subsequent dementia and mild cognitive impairment (MCI) in the oldest old women. Method: We conducted secondary analyses of data collected from 1425 community-dwelling women (mean age = 82.8, SD ±3.1 years) followed on average for five years. The Goldberg Anxiety Scale was used to assess anxiety symptoms at baseline, and an expert clinical panel adjudicated dementia and MCI at follow-up. Participants with probable cognitive impairment at baseline were excluded. Results: At baseline, 190 (13%) women had moderate/severe anxiety symptoms and 403 (28%) had mild anxiety symptoms. Compared with those with no anxiety symptoms at baseline, women with mild anxiety symptoms were more likely to develop dementia at follow-up (multivariable-adjusted odds ratio = 1.66, 95% confidence interval 1.12–2.45). No significant association was observed between anxiety symptoms and MCI. Conclusion: In the oldest old women, our findings suggest that mild anxiety symptoms may predict future risk of dementia, but not MCI. Future studies should explore potential biological mechanisms underlying associations of anxiety with cognitive impairment.

Stagnant or Successful, Carefree or Anxious? Australian University Students' Goals and Beliefs About Adulthood and Their Current Well‐being

ObjectiveThis article questions an assumption that modern young adults are unwilling to grow up, do not wish to take on traditional adult roles, and experience their current lives as carefree. Goals and beliefs for adulthood, and current mental health, were assessed.MethodsA total of 518 Australian university students aged 18–25 (73% female, mean age 19 years, 72% Australian born) completed surveys of their goals for age 40, the goals they believed significant others held for them, and their views of life now and in the future, as well as standard assessments of mental health and well‐being (Center for Epidemiologic Studies Depression Scale 10; Goldberg anxiety subscale, Life Orientation Test—Revised, Perceived Stress Scale, and Multidimensional Scale of Perceived Social Support).ResultsStudents overwhelmingly aspired to “traditional” adult roles: over 90% wanted to be married, with children, and to be in paid employment. Their highest priorities were finishing education, finding a life partner, and finding satisfying work. They generally selected positive adjectives to describe their futures, but selected negative adjectives to describe their current lives, and reported high levels of depressive symptoms, anxiety, and stress.ConclusionsFindings suggest that these modern young adults are not leading carefree lives, nor are they reluctant to “grow up.” Aspirations for family and employment, coupled with positive views of the future, are encouraging, while high levels of depressive symptoms, anxiety, and stress are cause for concern. Clinical responses to young people need to acknowledge instability that can result from spending extended periods of time “in‐between.”

Anxiety and Depression in Tension-Type Headache: A Population-Based Study.

Although tension-type headache (TTH) is a frequent type of headache disorder and imposes a significant burden, there is scant information about the prevalence and impact of comorbid anxiety and depression among individuals with TTH. We investigated the prevalence and clinical impact of anxiety and depression among patients with TTH in the general population. We recruited Korean participants aged 19–69 years using a two-stage clustered random sampling method. To identify the presence of headache type, anxiety, and depression, we used a semi-structured interview using certain questionnaires. To assess the level of anxiety and depression, we used the Goldberg Anxiety Scale and Patient Health Questionnaire-9, respectively. Among 2,695 participants, 570 people (21.2%) had TTH during previous 1 year. In participants with TTH, the prevalence of anxiety (9.5% vs. 5.3%, p = 0.001) and depression (4.2% vs. 1.8%, p = 0.001) was significantly higher than that of non-headache participants. The prevalence of anxiety among TTH participants with >15 attacks per month [21.4%, odds ratio (OR): 4.0] and 1–14 attacks per month (13.1%, OR: 2.2) was higher than that in those with <1 attack per month (6.4%), however this tendency was not observed in participants with depression. Visual Analogue Scale (VAS) score [median 5.0 vs. 4.0, p = 0.010] and Headache Impact Test-6 (HIT-6) score [median 45.5 vs. 42.0, p < 0.001] were significantly higher among those with anxiety. Furthermore, VAS scores [median 5.0 vs. 4.0, p = 0.010] and HIT-6 scores [median 45.5 vs. 42.0, p = 0.027] were also significantly higher among TTH patients with depression than among those without depression. In conclusion, anxiety and depression were more prevalent in participants with TTH than in non-headache participants. These two conditions were associated with an exacerbation of headache symptoms in individuals with TTH.

The influence of age, anxiety and concern about falling on postural sway when standing at an elevated level

Psychological processes may influence balance and contribute to the risk of falls in older people. While a self-reported fear of falling is associated with increased postural sway, inducing fear using an elevated platform can lead to reduced sway, suggesting different underlying mechanisms whereby fear may influence balance control. This study examined changes in postural sway, muscle activity and physiological measures of arousal while standing on a 65cm elevated platform, compared to floor level, in young and older adults. The older adults were classified as fall concerned or not fall concerned based on the Falls Efficacy Scale-International and anxious or not anxious based on the Goldberg Anxiety Scale. Fall concern did not affect the physiological and sway response to the elevated platform. In response to the postural threat, the anxious participants increased their sway frequency (p=0.001) but did not reduce sway range (p=0.674). Conversely, non-anxious participants showed an adaptive tightening of balance control, effectively reducing sway range in the elevated condition (p<0.001). Generalised anxiety in older adults appears to differentially affect postural control strategies under threatening conditions.

Sobrecarga del cuidador informal de pacientes inmovilizados en una zona de salud urbana

Introducción y objetivo: El síndrome de cansancio del cuidador es un fenómeno cada vez más relevante en el ámbito sociosanitario. Las características de la población afectada condicionan su aparición y gravedad. El objetivo de este estudio es describir el grado de sobrecarga y deterioro de la salud mental en el cuidador informal de pacientes inmovilizados en una Zona Básica de Salud (ZBS), así como los factores relacionados.&lt;br /&gt;Material y método: Se llevó a cabo un estudio descriptivo transversal sobre la totalidad de cuidadores informales de pacientes inmovilizados. Los datos fueron obtenidos mediante entrevista telefónica estructurada. Se emplearon los test Indice de Esfuerzo del Cuidador (IEC) y Goldberg (subescalas ansiedad y depresión).&lt;br /&gt;Resultados: La edad media del paciente inmovilizado (n=202) fue de 85,75 años (Desviación Estándar, DE, 10,79) con predominio (79,7%) del sexo femenino. La población de cuidadores informales (n=60) presenta un 65% de mujeres, con edad media de 62,32 años (DE 4,2). El valor medio de IEC es de 7,17 (DE 3,83). Las mujeres cuidadoras presentan peor estado de salud que los hombres cuidadores en todas las escalas (IEC, Goldberg-Ansiedad y Goldberg-Depresión). El valor de IEC aumenta si la cuidadora principal es hija o pareja del paciente, si tiene estudios superiores, y si no recibe apoyo informal en el cuidado.&lt;br /&gt;Conclusión: Las cuidadoras informales presentan elevadas tasas de cansancio del cuidador. Los equipos de atención primaria tienen una labor fundamental en la identificación de los cuidadores más afectados y sus factores de riesgo para el desarrollo de intervenciones específicas.&lt;br /&gt;&lt;br /&gt;

Sedentary lifestyle in middle-aged women is associated with severe menopausal symptoms and obesity

The aim of the study was to evaluate the association between sedentary lifestyle and the severity of menopausal symptoms and obesity in middle-aged women. The Menopause Rating Scale, the Goldberg Anxiety and Depression Scale, and the Athens Insomnia Scale were administered to 6,079 Latin American women aged 40 to 59 years. Sedentary lifestyle was defined as fewer than three weekly, 30-minute periods of physical activity. Sedentary women had more severe menopausal symptoms (total Menopause Rating Scale score: 9.57 ± 6.71 vs 8.01 ± 6.27 points, P < 0.0001) and more depressive symptoms (Goldberg), anxiety (Goldberg), and insomnia (Athens Scale) compared with non-sedentary women. They also had greater mean waist circumference (86.2 ± 12.3 vs 84.3 ± 1.8 cm, P < 0.0001) and a higher prevalence of obesity (20.9% vs 14.3%, P < 0.0001). Logistic regression analysis showed that both obesity (odds ratio [OR] 1.52; 95% CI, 1.32-1.76) and severe menopausal symptoms (OR 1.28; 95% CI, 1.06-1.53), including insomnia and depressive mood, were positively associated with a sedentary lifestyle. Having a stable partner (OR 0.85; 95% CI, 0.76-0.96), using hormone therapy (OR 0.75; 95% CI, 0.64-0.87) and having a higher educational level (OR 0.66; 95% CI, 0.60-0.74) were negatively related to sedentary lifestyle. There was a high prevalence of sedentary lifestyle in this middle-aged Latin American female sample which was associated with more severe menopausal symptoms and obesity.

Associations of impaired sleep quality, insomnia, and sleepiness with epilepsy: A questionnaire-based case-control study.

The purpose of this study was to document the frequency of sleep problems including poor sleep quality, excessive daytime sleepiness, and insomnia in subjects with epilepsy compared with healthy controls and to determine the factors associated with these sleep disturbances. We recruited 180 patients with epilepsy (age: 43.2 ± 15.6 years, men: 50.0%) and 2836 healthy subjects (age: 44.5 ± 15.0 years, men: 49.8%). Sleep and the anxiety/mood profiles were measured using the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Goldberg Anxiety Scale, and Patient Health Questionnaire-9 depression scale. Associations of sleep problems with epilepsy and other factors were tested by multiple logistic regression analysis, adjusted for age, gender, body mass index, alcohol intake, smoking, perceived sleep insufficiency, and habitual snoring. Sleep disturbances were more common in the group with epilepsy than in the controls (53.3% vs. 25.5%; p<0.001). Poor sleep quality, excessive daytime sleepiness, and insomnia were significantly associated with epilepsy (odds ratio [95% confidence interval]: 3.52 [2.45-5.05], 2.10 [1.41-3.12], 5.91 [3.43-10.16], respectively). Depressive mood, anxiety, and perceived sleep insufficiency contributed to the presence of sleep disturbances. In the group with epilepsy, seizure remission for the past year related to a lower frequency of insomnia, whereas age, sex, type of epilepsy, and number of antiepileptic drugs were not correlated with sleep problems. Epilepsy was significantly associated with the higher frequency of sleep disturbances, which supports the importance of screening sleep problems in patients with epilepsy and providing available intervention.

Reaction Time Measures Predict Incident Dementia in Community-Living Older Adults: The Sydney Memory and Ageing Study

To examine the utility of intraindividual variability of reaction times (IIVRT) and mean reaction time (RT) as behavioral markers of incident all-cause dementia. A longitudinal cohort study followed biennially for 4 years, the community-based Sydney Memory and Ageing Study, 861 initially nondemented participants aged 70-90. Incident all-cause dementia determined by consensus, RT measures from simple and complex tasks, Mini-Mental State Exam and neuropsychological tests, Geriatric Depression Scale and Goldberg Anxiety Scale, cardiovascular risk score, apolipoprotein ε4 status, and the Bayer ADL Scale were used. Associations of baseline IIVRT and mean RT with time to dementia were evaluated with hazard ratios (HRs) using Cox proportional-hazards models with and without controlling for dementia risk factors. Forty-eight cases developed dementia. Greater complex IIVRT predicted a 40% (HR: 1.43) and mean RT a 50%-60% (simple RT: HR 1.53; complex RT: HR 1.59) per standard deviation increased risk of developing dementia, remaining significant after controlling for age, education, sex, general cognitive function, mood, cerebrovascular disease, and genetic susceptibility. Prediction of incident dementia using demographical information and RT measures combined was comparable with several traditional neuropsychological measures (AUC 0.75), although lower than a full neuropsychological battery (AUC 0.90). Prediction of functional decline by RT measures combined was equal to the neuropsychological battery (multiple Rs of .233 and .238, respectively). Brief RT measures provided information on risk of imminent dementia and functional decline within 4 years in older adults at a population level, with mean RT the stronger predictor.

Electro-acupuncture for treatment of knee pain from osteoarthritis and the possible endocrinology changes: a study protocol for a randomized controlled trial.

BackgroundOsteoarthritis of the knee is a major cause of disability among adults. Electro-acupuncture is considered a potentially useful treatment for osteoarthritis. The purpose of this study is to assess the efficacy of electro-acupuncture on pain control, pain perception, plasma cortisol and beta-endorphin levels, patient-perceived quality of life, and pain medication use in patients with chronic knee pain.Methods/designThis study is a placebo-controlled, randomized, double-blind, parallel design trial. One hundred sixty out-patients who are more than 50 years old and who have osteoarthritis of the knee will be recruited from the island of Mallorca, Spain. Each participant will be randomly placed into one of two groups: (sham) electro-acupuncture non-insertion technique and real electro-acupuncture.Acupuncture treatments will be the Traditional Chinese Medicine type. The patients will be evaluated after a period of 1 month (with two weekly sessions), 3 months (with one monthly session), 6 months (with one session every 45 days), and 1 year later with follow-up sessions at the end of the study (with one session every 2 months).The primary outcomes will be based on the observed changes from the baseline of the visual analogue scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain measured at 12 weeks after the end of treatment.Also to be included in the study are the possible changes in the secondary efficacy variables from baseline as assessed by the Short Form 36 version 2 health survey (patient-perceived quality of life), patient plasma cortisol and beta-endorphin levels at the different treatment stages, the Goldberg Anxiety and Depression Scale, pain medication use, functional capacity and stiffness (WOMAC subscales), and a VAS. These variables will be assessed at 1 month, 3 months, 6 months, and 1 year after study commencement.DiscussionThe findings from this study will help to determine whether electro-acupuncture is effective for chronic knee pain management in older people and whether electro-acupuncture can deliver results for the improvement of pain relief, stiffness, and disability. The study will therefore be a major step toward understanding the roles of the hypothalamic-pituitary-adrenal axis and the endogenous opioid system in the effectiveness of electro-acupuncture for chronic pain.Trial registrationClinicalTrials.gov identifier NCT02299713 (11 Nov. 2014).

Sedentary lifestyle in middle-aged women is associated with greater climacteric symptomatology and more obesity

Background: Sedentary lifestyle increases the risk of obesity and worsens quality of life (QoL). Objectives: To evaluate the impact of sedentary lifestyle in climacteric symptomatology, QoL, and obesity. Methods: 6079women 40–59 years of age from 11 Latin American countries were studied. Their epidemiologic data and physical activity were recorded and the Menopause Rating Scale (MRS), the Goldberg Anxiety and Depression Scale and the Athens Insomnia Scale were applied. Sedentary lifestyle was defined as the performance of less than three weekly 30min physical activity sessions. Results: Sedentary women have less years of education, more children, and less stable partners. Compared with active women, those sedentary have more climacteric symptoms (score in the MRS of 9.57±6.71 vs. 8.01±6.27 points, p<0.0001), a higher percentage with severe deterioration of the QoL (16.1% vs 10.6%, p<0.0001), and use less frequently hormone therapy, HT (12.0% vs. 15.4%, p<0.0001). As far as anthropometric indices, sedentary women have greater waist circumference (86.2±12.3 cm vs. 84.3±11.8 cm,p<0.0001)andahigherprevalenceofobesity (20.9% vs. 14.3%, p<0.0001). A logistic regression analysis shows that sedentary lifestyle is independently associated with more obesity (OR 1.52; CI 95%, 1.32–1.76) and more severe menopausal symptoms (OR 1.28; CI 95%, 1.06–1.53). On the contrary, less risk of sedentary lifestyle is associated with having a stable partner (OR: 0.85; CI 95%, 0.76–0.96), use of HT (OR: 0.75; CI 95%, 0.64–0.87) and having a better educational level (OR: 0.66; CI 95%, 0.60–0.74). Conclusion: Our study shows a high prevalence of sedentary lifestyle in middle-aged women. This is associated with worse QoL due to severe climacteric symptoms and more obesity. Having a stable partner, use of HT, and a higher educational level implies a lesser risk of sedentary lifestyle.