Maastricht Questionnaire Research Articles

Experience of pyridoxin and glutamic acid use in effective correction of the main asthenia manifestations

Introduction. Asthenia manifestation treatment is an urgent problem due to its high frequency in outpatients.Аim. To evaluate in a controlled randomized clinical trial the efficacy and tolerability of the course use of a combination of pyridoxine and glutamic acid in patients with asthenic complaints.Materials and methods. 50 outpatients with main asthenia manifestations were included in the study if they complied inclusion criteria and signed the informed consent. After randomization, in group 1 a combined supplement with 2.5 mg of pyridoxin and 100 mg of glutamic acid (Metabovit® Life Energy, MNPK “BIOTIKI”) was added to therapy 1 tablet a day sublingually, in group 2 patients received basic therapy for chronic diseases only. The duration of observation was 21 days. Before and after the end of the study all patients underwent neuropsychological examination, which included the questionnaires: Multidimensional Fatigue Inventory (MFI-20), a Reader stress test (adopted by O.Kopina), a questionnaire on the level of life exhaustion (The Maastricht Questionnaire), a “Schulte tables” test with working efficiency evaluation.Results. In the group of patients receiving Metabovit® Life Energy 1 tablet a day, in comparison with the control group (p < 0.001) the overall score on the MFI-20 self-questionnaire decreased and amounted to 29 [26; 30]; Δ MFI-20 was equal to -22 [-27; -16]; the results reached normative values for most participants; improved time the performance of the “Schulte tables” test decreased by more than 9 seconds; stress levels decreased by almost 30% in men and 20% in women; the indicator of life exhaustion decreased by 60%. In patients in the control group, no significant changes in the studied indicators were detected by the end of the follow-up.Conclusion. In the group of patients who received the biologically active food supplement Metabovit® Life Energy, there was a significant positive dynamics and regression of most of the symptoms of asthenia, in comparison with the control group.

Psychometric evaluation of Maastricht clinical teaching questionnaire based on the cognitive apprenticeship model.

The Maastricht Clinical Teaching Questionnaire is a valid and reliable instrument for measuring the quality of clinical teaching. This study was aimed at translation and psychometric evaluation of the Persian version of this questionnaire to evaluate clinical teaching based on the cognitive apprenticeship model. The translation of the questionnaire was performed according to Guillemins framework. Reliability was examined by calculating Cronbach's alpha coefficient. Confirmatory factor analysis was studied among 120 medical students. Content validity was assessed by calculating the content validity index and content validity ratio. Face validity was evaluated by conducting interviews with students using concurrent verbal probing and thinking aloud. Cronbach's alpha coefficient for the whole scale was 0.95. The content validity index was 0.92, and the content validity ratio was 0.82. Confirmatory factor analysis resulted in a seven-factor model and demonstrated an adequate fit with the data. The Persian version of the Maastricht Clinical Teaching Questionnaire with seven factors including modeling, coaching, scaffolding, articulation, reflection, exploration, and learning environment appears to be a valid and reliable instrument for the evaluation of clinical teaching in Iranian universities of medical sciences.

Features of neuropsychological characteristics of patients with arterial hypertension

Introduction. The significant pathogenetic effect of arterial hypertension on the development of cognitive and psycho-emotional disorders, on the one hand, and the lack of algorithms for identifying and managing patients with comorbid neurocognitive disorders in therapeutic practice, on the other hand, determines the relevance of studying this problem.Aim. To study neuropsychological characteristics of patients with arterial hypertension in therapeutic practice. Materials and methods. A total of 508 patients with arterial hypertension were enrolled in the study. All study participants underwent the clinical examination and neuropsychological tests: Montreal Cognitive Assessment Scale (MoCA test), Schulte tables, Categorical Verbal Fluency Test, Tracking Test, MFI-20 asthenia self-assessment questionnaire, Reeder's Test, Maastricht Questionnaire, and Hospital Anxiety and Depression Scale (HADS). Results. The analysis of neuropsychological testing results of patients with hypertension showed that almost all the techniques identified deviations from the reference ranges in most of the study subjects. 85% of patients had decreased total score of cognitive functions assessed in terms of MoCA test scores, 83% of patients showed increased time in performing tracking test part A and 74% patients showed increased time in performing part B, and there was also a large difference between the time spent on performing parts B and A of the test; 49% of patients demonstrated decreased speed in performing the Schulte test. Th psycho-emotional state test results showed a high level of psycho-emotional stress in 80.5%, vital exhaustion in 78% and fatigue in 96% of patients. Conclusions. In this study, the neuropsychological testing results of patients with hypertension showed decreased total scores of cognitive functions and individual parameters of the cognitive spectrum, such as attention focusing, information processing speed, memory, speech function and executive functions combined with a high level of psycho-emotional stress, fatigue and anxiety.

Stress-Related Exhaustion, Polygenic Cognitive Potential, and Cognitive Test Performance – A General Population Study

BackgroundWe investigated whether stress-related exhaustion (chronic or short-term, and co-occurring with depression or not) is related to cognitive performance and whether polygenic cognitive potential modifies these associations.MethodsThe participants were from the Young Finns Study (N = 541–1273). Stress-related exhaustion was assessed using the Maastricht Questionnaire, depressive symptoms with the Beck Depression Inventory, and cognitive performance with subtests of the Cambridge Neuropsychological Test Automated Battery, measuring visuospatial learning, reaction time, sustained attention, and executive function. Cognitive performance and depression were assessed in 2011, and exhaustion in 2001, 2007, and 2011. A polygenic score for cognitive potential was calculated based on a GWAS on intelligence.ResultsHigh stress-related exhaustion, especially chronic, was associated with slower reaction time. Only clinical levels of depression were related to slower reaction time. Polygenic cognitive potential did not modify these associations. There were no differences in cognitive performance between individuals with co-occurring exhaustion and depression vs. those with only either condition.ConclusionStress-related exhaustion, especially if chronic, seems to relate to slower reactions. Co-occurring exhaustion and depression may not have additive effects on cognitive performance. High polygenic cognitive potential may not protect from or predispose to harmful effects of exhaustion or depression on reaction time.

Soundscape Awareness Intervention Reduced Neuropsychiatric Symptoms in Nursing Home Residents With Dementia: A Cluster-Randomized Trial With MoSART.

Auditory environments as perceived by an individual, also called soundscapes, are often suboptimal for nursing home residents. Poor soundscapes have been associated with neuropsychiatric symptoms (NPS). We evaluated the effect of the Mobile Soundscape Appraisal and Recording Technology sound awareness intervention (MoSART+) on NPS in nursing home residents with dementia. A 15-month, stepped-wedge, cluster-randomized trial. Every 3months, a nursing home switched from care as usual to the use of the intervention. The 3-month MoSART+ intervention involved ambassador training, staff performing sound measurements with the MoSART application, meetings, and implementation of microinterventions. The goal was to raise awareness about soundscapes and their influence on residents. We included 110 residents with dementia in 5 Dutch nursing homes. Exclusion criteria were palliative sedation and deafness. The primary outcome was NPS severity measured with the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) by the resident's primary nurse. Secondary outcomes were quality of life (QUALIDEM), psychotropic drug use (ATC), staff workload (workload questionnaire), and staff job satisfaction (Maastricht Questionnaire of Job Satisfaction). The mean age of the residents (n= 97) at enrollment was 86.5 ± 6.7years, and 76 were female (76.8%). The mean NPI-NH score was 17.5 ± 17.3. One nursing home did not implement the intervention because of staff shortages. Intention-to-treat analysis showed a clinically relevant reduction in NPS between the study groups (-8.0, 95% CI -11.7,-2.6). There was no clear effect on quality of life [odds ratio (OR) 2.8, 95% CI -0.7, 6.3], psychotropic drug use (1.2, 95% CI 0.9, 1.7), staff workload (-0.3, 95% CI -0.3, 0.8), or staff job satisfaction (-0.2, 95% CI -1.2, 0.7). MoSART+ empowered staff to adapt the local soundscape, and the intervention effectively reduced staff-reported levels of NPS in nursing home residents with dementia. Nursing homes should consider implementing interventions to improve the soundscape.

MO190: Experiences of Being a Living Kidney-Donor-Perceived and Measured Stress Levels before and after Kidney Donation

Abstract BACKGROUND AND AIMS Living kidney donation is the preferred kidney replacement therapy considering graft function and survival rates. To donate a kidney is a life-changing experience, and there is a diverse spectrum of emotions connected to this process. The aim of this study was to investigate kidney donors' perceived and measured stress levels before and after donation. Furthermore, to investigate if the level of perceived stress could be linked to the degree of metabolic stress measured using saliva cortisol, serum glucose and insulin levels. METHOD A prospective observational study including 83 patients (46 ± 10.9 years, 63% women), who donated a kidney at Sahlgrenska University Hospital, Gothenburg, during 2009–2010. Three self-rating surveys concerning stress (Everyday Life Stress Scale), vital exhaustion (Maastricht Questionnaire of vital exhaustion) and depressive symptoms (Depressive Mood Scale) were answered on the day before surgery, and then 2 and 6 months after kidney donation (see score details, Table 1). Blood samples of insulin, glucose and saliva cortisol were collected at the same time points. Statistical analyses were carried out to investigate changes over time, potential gender differences, and correlations between laboratory data and survey results. RESULTS Kidney donors generally scored low in self-rating stress mean 15.5 and depression symptom scales mean 10.8 pre-donation. The Maastricht's questionnaire showed a trend toward significant gender difference at 2 months; women mean score was 32.1 ± 9.3 and men 35.8 ± 6.9, P = .092. At 6 months, there was a significant gender difference in self-reported vital exhaustion, where women scored higher 36.9 ± 7.1 than men 30.7 ± 11.6; P = .037 and a near significant difference on the Depressive Mood Scale, 12.2 ± 12.5 versus 6.4 ± 8.2 at 6 months; P = .058. No significant difference over time in experienced well-being (Everyday Life Stress Scale) was found, 15.6 ± 8.2 vs 14.3 ± 7.6, P = .554. Data are displayed in detail in Table 1 and Figure 1. No correlations between metabolic stress measured as salivary cortisol (morning, noon and evening) and HOMA-IR, and perceived stress were found. CONCLUSION Kidney donors self-reported stress level and depressive symptoms did not change pre-donation to 6 months after donation. However, women reported more feelings of exhaustion and stress than men did at 6 months post-donation. In the future, a more structured psychosocial follow-up of kidney donors after at least 6 months is suggested.

Sex differences in the association of vital exhaustion with regional fat deposition and subclinical cardiovascular disease risk

ObjectiveVital exhaustion (VE) is more strongly associated with cardiovascular disease (CVD) risk for women than men. This study examined whether sex differences in associations of VE with CVD risk markers are accounted for by unique associations of VE with regional adiposity. MethodsThe study enrolled 143 persons (18–55 years) without diagnosed conditions. VE was assessed by the Maastricht questionnaire. CVD indices were measured using the euglycemic-hyperinsulinemia clamp, resting blood pressure, and blood draws. Regional adiposity was measured using computed tomography and 2-D echocardiography. This cross-sectional study employed a path analysis approach, including relevant covariates. ResultsOf the cohort, aged 38.7 ± 8.4 years, 65% were men, and 41% were obese. The final model had excellent fit (χ2(36) = 36.5, p = .45; RMSEA = 0.009, CFI = 0.999). For women, but not men, the model indicated paths from VE to: 1) lower insulin sensitivity (B = −0.10, p = .04), and higher total cholesterol to HDL ratio (B = 0.12, p = .09), triglycerides (B = 0.10, p = .08), and C-reactive protein (B = 0.08, p = .09) through visceral adiposity; 2) higher mean arterial pressure (B = 0.14, p = .04), lower insulin sensitivity (B = −0.09, p = .08), and higher C-reactive protein (B = 0.12, p = .07) through subcutaneous adiposity; 3) lower insulin sensitivity (B = −0.07, p = .08) and higher total cholesterol to HDL ratio (B = 0.16, p = .03) through liver adiposity; and 4) higher C-reactive protein (B = 0.08, p = .09) through epicardial adiposity. ConclusionResults extend prior evidence by showing that the association of VE with CVD risk in women is linked with specific regional adiposity elevation. Further study of adiposity-related mechanisms in women who experience early decline in vitality may inform clinical targets for CVD prevention.

Psychosocial factors and subsequent risk of hospitalizations with peripheral artery disease: The Atherosclerosis Risk in Communities (ARIC) Study

Background and aimsPsychosocial factors are associated with increased risk of cardiovascular disease (CVD). However, associations with peripheral artery disease (PAD) remain uncharacterized. We aimed to compare associations of psychosocial factors with the risk of PAD and two other major atherosclerotic CVD: coronary heart disease (CHD) and ischemic stroke, in the Atherosclerosis Risk in Communities (ARIC) Study. MethodsIn 11,104 participants (mean age 56.7 [SD 5.7] years) without a clinical history of PAD and CHD/stroke at baseline (1990–1992), we evaluated four psychosocial domains: depressive/fatigue symptoms by the Maastricht Questionnaire, social support by the Interpersonal Evaluation List, social networks by the Lubben Scale, and trait anger by the Spielberger Scale. PAD was defined as hospitalizations with diagnosis or related procedures. CHD included adjudicated coronary heart disease and stroke included ischemic stroke. ResultsWe observed 397 PAD and 1940 CHD/stroke events during a median follow-up of 23.1 years. Higher depressive/fatigue symptoms and less social support were significantly associated with incident PAD (adjusted hazard ratios for top vs. bottom quartile 1.65 [95%CI, 1.25–2.19] and 1.40 [1.05–1.87], respectively). When these factors were simultaneously modeled, only depressive/fatigue symptoms remained significant. Incident CHD/stroke was not associated with either of depressive/fatigue symptoms or social support. Social networks and trait anger were not independently associated with PAD or CHD/stroke. ConclusionsDepressive/fatigue symptoms and social support (especially the former) were independently associated with the risk of hospitalizations with PAD but not CHD/stroke in the general population. Our results support the importance of depressive/fatigue symptoms in vascular health and suggest the need of including PAD when studying the impact of psychosocial factors on CVD.

Associations between APOE-, COMT Val108/158Met- and BDNF Val66Met polymorphisms and variations in depressive and anxiety symptoms, sense of coherence and vital exhaustion in the real-life setting of mandatory basic military training.

Apolipoprotein E (APOE) ε, catechol-O-methytranferase (COMT) Val108/158Met and brain-derived neurotrophic factor (BDNF) Val66Met single nucleotide polymorphisms (SNPs) were shown to affect stress perception and response. The present study explored possible associations between these SNPs and changes in subclinical anxiety- and depressive symptoms, sense of coherence (SOC) and vital exhaustion (VE) during compulsory basic military training. The study encompassed 179 conscripts of a training base in Greece. The neuropsychiatric assessment was based on the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Antonovsky SOC scale and the Maastricht Questionnaire. It was conducted at three time points of the 19-day basic military training: on day one (baseline), day six (follow-up I) and day 13 (follow-up II). Statistical analyses included Mann-Whitney test, Chi-square test and cross-sectional time series regression models based on the Skillings-Mack statistic. APOE ε4 non-carriers encountered significant changes in anxiety- and depressive symptoms and SOC (in all cases P < 0.001) over the observation period, whilst ε4 carriers did not. The changes in anxiety, depressive symptoms and SOC attained statistical significance in both BDNF Met66 carriers (in all cases P < 0.001) and non-carriers (P = 0.036; < 0.001; < 0.001, respectively) as well as in COMT Met108/158 carriers (P = 0.004; < 0.001; < 0.001, respectively) and non-carriers (P = 0.02; 0.01; 0.021, respectively. Changes over time in VE were not significant (P > 0.05). The observed resistance of APOE ε4 carriers vs non-carriers to changes in anxiety- and depressive symptoms and SOC when exposed to a stressful environment may point to superior coping capacities of healthy young men carrying the ε4 allele.

Abstract 12891: Psychosocial Factors at Middle Age and Zero Coronary or Extra-coronary Calcium at Older Age: The Atherosclerosis Risk in Communities (ARIC) Study

Background: Psychosocial factors are associated with atherosclerotic disease. However, their link to “healthy cardiovascular aging” is unknown. Aim: We aimed to comprehensively investigate the association of psychosocial factors at middle age with zero coronary artery calcium (CAC) or extra-coronary calcium (ECC) at age ≥75 years in the ARIC study. Methods: We studied 1,935 participants free of coronary heart disease history, who completed a psychosocial evaluation in 1990-1992 (mean age 53 [SD 4] years) and a cardiac computed tomography scan in 2018-2019. We assessed trait anger by the Spielberger Trait Anger Scale, depressive symptoms by the Maastricht Questionnaire, social support by the Interpersonal Support Evaluation List, and social network by the Lubben Social Network Scale. CAC/ECC was quantified by the Agatston score, and ECC included aortic valve ring, aortic valve, mitral valve, and ascending and descending aorta calcium. Results: The proportion of participants with zero calcium was 10 % for coronary artery, 15 % for aortic valve ring, 54 % for aortic valve, 52 % for mitral valve, 74 % for ascending aorta, and 11 % for descending aorta. Less trait anger was independently associated with zero CAC and aortic valve calcium (odds ratios [ORs] for one SD decrement of the score, 1.21 [95%CI, 1.02-1.45] and 1.16 [95%CI, 1.05-1.28], respectively) ( Figure A ). Less depressive symptoms, more social support, and larger social network were not positively associated with zero CAC or ECC ( Figure B-D ). The associations of less trait anger with zero CAC and aortic valve calcium remained significant when we applied inverse probability weighting to account for attrition. Conclusions: Among the psychosocial factors at middle age, only less trait anger was independently associated with zero CAC and aortic valve calcium at older age. Our findings suggest that the identification of less trait anger at middle age may be important for healthy cardiovascular aging.

A single-arm feasibility study of community-delivered Baduanjin (Qigong practice of the eight Brocades) training for frail older adults

BackgroundFrailty is a common geriatric syndrome, characterized by reduced physiologic reserve and increased vulnerability to stressors, due to cumulative decline in multiple physiological systems. We studied the feasibility of a community-delivered Baduanjin (BDJ) training program among pre-frail/frail community-dwelling older people. We examined (1) safety (adverse events) and physical and psychological effects; and (2) feasibility of recruitment, retention, adherence; recruitment efforts, and any program challenges, so as to inform future studies.MethodsOur study was a single arm pre-post study in a community setting. Sixteen-week group BDJ training (2×/week in the first 4 weeks and 3×/week thereafter) was co-designed and implemented by community-based providers in Singapore. Recruitment, attendance, and adverse events were recorded throughout the training. A participants’ survey was also administered after the training program. Effects of the intervention on physical and functional outcomes (hand grip strength, knee extension strength, Time Up and Go (TUG), Physiological Profile Assessment (PPA), 30-s Sit-to-Stand test, 6-m fast gait speed test), frailty outcomes (frailty score and status), and other outcomes (Maastricht Questionnaire (MQ), Fall Efficacy Scale (FES), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS), and EQ-5D-5L) were examined before and after the program.ResultsOf 31 older adults screened to be frail, 15 met inclusion criteria and 3 refused participation, resulting in 12 older adults (9 women) enrolled into the program. During the program, one participant was hospitalized (unrelated to BDJ training) and the other 11 (aged 77 ± 6 years; 2 frail, 9 prefrail at baseline) completed the program with average overall attendance of 89%. Most (89%) of the 44 training sessions had attendance > 80%. The program received positive feedback with no training-related adverse events. Participants either reversed (n = 2) or maintained (n = 9) their frailty statuses. There post-training outcomes in hand grip strength, knee extension strength, TUG, MQ, FES, MoCA, GDS, and EQ-5D-5L index score appeared to be better. The reduction of frailty and PPA fall risk scores was of moderate-to-large effect size.ConclusionsCommunity-delivered BDJ training program was safe and feasible for prefrail/frail older adults with the potential to improve physical and cognitive function, reduce fall risk, improve psychological well-being, and reverse frailty status.

Benson’s Relaxation for Fatigue Patient with Coronary Artery Disease

Fatigue is the major symptoms in patients with coronary artery disease, during recovery period after cardiac events and during cardiac rehabilitation. Benson’s relaxation is one of relaxation as modalities therapy to reduce fatigue, however few studies related to this technique in planned intervention. This study was to measure the effectiveness of Benson’s relaxation in fatigue of coronary artery disease patients during cardiac rehabilitation. It was a quasi-experimental pretest posttest control group design. This study included 29 respondents in Dr.M. Djamil Hospital were assigned to intervention group which receiving Benson’s relaxation technique (n=15) and control group with routine care (n=14). Benson’s relaxation technique was administered for 5 days 2 times a day, each 20 minutes to intervention group. Fatigue was measured using Maastricht Questionnaire (MQ). The result indicated significant reduction in mean of fatigue between intervention and control group (p value &lt; 0,001). The study concluded that Benson’s relaxation technique is an effective non-pharmacological intervention to reduce fatigue in coronary artery disease patients. Keywords: Benson’s relaxation; fatigue; coronary artery disease

Abstract P365: Psychosocial Factors and Subsequent Risk of Peripheral Artery Disease: The Atherosclerosis Risk in Communities (ARIC) Study

Background and aims: Psychosocial factors such as depression, character traits, and lack of social support have been associated with increased risk of cardiovascular disease (CVD). However, data of peripheral artery disease (PAD) in this regard are sparse. Since risk factor profiles differ across atherosclerotic CVD (ASCVD) subtypes, to appreciate the contribution of psychosocial factors to overall ASCVD, we aimed to comprehensively explore the association of psychosocial factors with the risk of PAD and ASCVD in a community cohort. Methods: We included 12,090 participants from the Atherosclerosis Risk in Communities (ARIC) Study (mean age 56.7 [SD 5.7] years) free of PAD and ASCVD at baseline (1990-1992). Depressive symptom was evaluated by the Maastricht Questionnaire (MQ). Trait anger was assessed by the Spielberger Trait Anger Scale. Social support was measured by the Interpersonal Support Evaluation List, while the extent of social networks was evaluated by the Lubben Social Network Scale. PAD events were defined as hospitalizations with PAD diagnosis and procedures. ASCVD included adjudicated myocardial infarction, fatal coronary disease, and ischemic stroke events. Results: We observed 429 PAD and 2,539 ASCVD events during a median follow-up of 23.1 years. The cumulative incidence of PAD was highest in the highest quartile of MQ score. This association remained after adjusting for traditional CVD risk factors, socioeconomic status, and physical activity. A weaker association was observed for ASCVD. Social support also showed independent association with incident PAD, but not with ASCVD. Trait anger and social network were not significantly associated with either PAD or ASCVD (Table). Conclusions: Psychosocial factors demonstrated more evident associations with PAD than ASCVD. Our results suggest the importance of considering PAD when assessing the overall impact of those factors on CVD. Future studies are needed to explore potential mechanisms behind our observation.

Association of Self-Perceived Health with Social and Psychological Environment, the Mode of Life and Cardiovascular Risk Markers in Middle-Aged Men – Residents of Moscow

Aim. Estimation of the correlation of self-perceived health (SPH) with social and psychological environment, lifestyle and cardiovascular risk markers in middle-aged men.Material and methods. A total of 301 men aged 41-44 years were examined. The study included clinical examination and interrogation using a standard form. Physical activity was estimated with the help of the International Physical Activity Questionnaires, the level of psychosocial stress – with the Reeder scale, signs of vital exhaustion with the Maastricht Questionnaire Vital Exhaustion Scale. To evaluate the mode and quality of life the questionnaire developed by I.A. Gundarev was used. All the examined people were divided in three groups according to the distribution of SPH rates by tertiles: the group 1 (from 7 to 60 scores) – bad health, the group 2 (61-79 scores) – satisfactory and the group 3 (80-100 scores) – good health.Results. Parameters of the social and psychological environment of middle-aged men were the basic determinates of their health self-perception, at that majority of the indices of the quality and mode of life were independent of family material well-being. Bad SPH in middle-aged men was determined by such parameters as: increased blood pressure (BP), abdominal obesity, excessive alcohol consumption, psychosocial stress, vital exhaustion, low physical activity. Material wealth influenced systolic BP level, the waist/hips circumference ratio, a number of cigarettes per day and thus the SPH status. The most significant determinants of SPH were the level of personal happiness, nervous stress at work, support by family, sports activities, working conditions, total cholesterol level, satisfaction with own work.Conclusion. When working on programs focused on public health improvement the social, psychological and behavioral determinants of health selfperception must be considered.

SMOKING AND VITAL EXHAUSTION IN INDUSTRIAL WORKERS IN SOUTHERN URAL

Aim: To study associations between smoking and vital exhaustion among workers of a large factory in Southern Ural. Methods: A cross-sectional study of 1 101 employees of one of the enterprises of the Southern Ural was performed. Smoking status was established by a questionnaire and expressed as a number of cigarettes smoked per day. Height, weight, resting heart rate and charge heart rate, systolic and diastolic blood pressure were measured. Self-administered questionnaire was used to study the presence of angina, chronic bronchitis and neurological complaints. Vital exhaustion was studied by the abridged version of the Maastricht questionnaire. Categorical variables were analyzed by Pearson's chi-squared statistics using IBM SPSS software, v.22.0. Results: At the time of the survey, 25.6 % of women and 52.3 % of men smoked daily. Altogether, 18.0 % of the women and 9.6 % of men have average or high level of vital exhausion. No statistically significant association between smoking and vital exhaustion was observed in either men (р = 0.287) or women (р = 0.720). Conclusions: A cross-sectional study could not determine a statistically significant relationship between smoking and vital exhaustion among workers of a factory.

Vital Exhaustion and Incidence of Dementia: Results from the Copenhagen City Heart Study.

Background:Psychological distress is potentially linked to the risk of dementia through neurologic and cardiovascular mechanisms. Vital exhaustion (VE) is a mental state of psychological distress, which could be a risk factor for dementia.Objective: To investigate whether VE is a risk factor for dementia in later life.Methods:We used data from 6,807 participants attending the third survey of the Copenhagen City Heart Study in 1991–1994. VE was assessed by 17 symptoms (score: 0–17) from the Maastricht Questionnaire. Information on dementia was obtained from national registers. Risk time for dementia was counted from five years after VE assessment for participants > 55 years at the time of VE assessment. For younger participants, risk time for dementia was counted from the year they turned 60 years and onwards. Participants were followed until 2016. We used Poisson regression to calculate incidence rate ratios (IRR) and their 95% confidence intervals (CI).Results:During an average follow-up of 10 years, 872 participants were registered with dementia. We found a dose-response relation between the number of VE symptoms and the incidence of dementia. For every additional VE symptom, the dementia incidence increased by 2% (IRR = 1.024; 95% CI: 1.004–1.043). Adjustment for socio-demographic and health-related factors did not change the results substantially. Neither did stratification by age, sex, educational level, and marital status.Conclusion:We found evidence that VE is a risk factor for dementia. Our sensitivity analyses supported that this association was not only due to VE being a potential prodromal sign of dementia.

M8 - ASSOCIATION OF POLYMORPHISM RS2278749 GENE ARNTL WITH SOME COMPONENTS OF AFFECTIVE DISORDERS AND SLEEP DISTURBANCES IN MALE POPULATION 25–44 YEARS IN RUSSIA / SIBERIA

Background To study the association of polymorphism rs2278749 gene ARNTL with some components of affective disorders and sleep disorders in the male population 25–44 years in Russia / Siberia (Novosibirsk). Methods In 2014–2016 GG It surveyed a random representative sample of the male population 25–44 years, one of the districts of Novosibirsk. Randomly selected 200 men had a mean age of 35.5 years, who underwent psychosocial testing. Testing conducted by questionnaire 4-item Jenkins Sleep Questionnaire». Test anxiety and depression conducted modified questionnaires of the Welsh Depression subscale of the MMPI and Bendig Anxiety subscale of the MMPI, the study of the life of exhaustion conducted questionnaires The Maastricht Questionnaire (MQ). Questionnaire Knowledge and attitude towards their health was also proposed. The men included in the study, studied the frequency distribution of genotypes of rs2278749 ARNTL gene. Differences in the frequency distribution of genotypes of rs2278749 ARNTL gene were evaluated by Chi square (X2) test between groups. The values of p ≤ 0,05 were considered statistically significant. Results It was found that the most common genotype rs2278749 ARNTL gene was homozygous C / C genotype - 74,9%, C / T genotype was at - 22.3%, 2.8% - genotype T / T. It was revealed that carriers of the genotype C / T more likely experience serious conflicts in the family, more experienced their frustration, they often have disturbing dreams, and they wake up tired and exhausted, in addition, they often met the high level of the life of exhaustion, and they soon became frustrated. Carriers of genotype T / T often took the trouble to heart and were more punctual. On the other hand, the carriers C / C genotype were more hostile, were inclined not trust anyone, almost never accept negative situations close the heart and much less experienced disturbing dreams. Discussion It was determined that the genotype C / T ARNTL gene associated with sleep disorders in the Siberian population.

The role of vital exhaustion in predicting the recurrence of vascular events: A longitudinal study

Background/objectiveThe aim of this study was to examine the role of vital exhaustion in predicting the recurrence of vascular events. MethodThe sample comprised of 816 individuals (65.3% female, Mage=43.2 years, SD=14.7 years), 395 (48.4%) of whom reported treatment for the reoccurrence of a vascular event during the four-year follow-up period. Concurrent effects of baseline vital exhaustion (measured by a shortened version of the Maastricht Questionnaire), depression (assessed by a shortened version of the BDI), anxiety (assessed by the HADS), and hostility (assessed by a shortened version of the Cook-Medley Hostility Scale) in predicting the recurrence of T2 vascular events were examined. The analyses were also controlled for traditional risk factors, such as age, education, body mass index, smoking, alcohol use, and lack of physical activity. ResultsThe regression analyses showed that vital exhaustion scores significantly predicted the reoccurrence of vascular events even after controlling for all covariates. None of the other psychological predictors (depression, anxiety, and hostility) was significant in the final model. ConclusionsThese results suggest that despite the partial conceptual overlap with several similar constructs, vital exhaustion is a distinct phenomenon that deserves consideration when planning and implementing interventions to reduce the risk of vascular diseases.

Vital exhaustion and risk of alcohol use disorders: A prospective cohort study

ObjectiveVital exhaustion is an emotional state characterized by fatigue and depressive symptoms. We examined the prospective association between vital exhaustion and risk of alcohol use disorders (AUD). Furthermore, we investigated whether cohabitation status modifies the effect of this potential association. MethodsVital exhaustion was assessed by a condensed, 17 item, version of the Maastricht Questionnaire as part of the Copenhagen City Heart Study in 1991–93. The study population consisted of 8956 individuals aged 21–93 years, who were followed for a first-time diagnosis of AUD in national registers until 2016. The mean length of follow-up was 16.6 years. ResultsDuring follow-up, AUD was diagnosed in 146 men and 103 women. For both sexes, the risk of AUD increased dose-dependently with increasing vital exhaustion. Individuals who reported high vital exhaustion had a 2- to 3-fold higher risk of AUD in both men (HR = 2.46, 95% CI: 1.40–4.29) and women (HR = 3.34, 95% CI: 1.62–6.85). A potential modifying effect of cohabitation status on the relation between vital exhaustion and AUD was found for men. ConclusionThe results showed that vital exhaustion is significantly associated with a higher risk of AUD in both men and women and that living with a cohabitee may have a protective effect among men.

Are vital exhaustion and depression independent risk factors for cardiovascular disease morbidity?

The aim of this study was to examine the concurrent effects of vital exhaustion and depression on the development of cardiovascular disease (CVD) morbidity. The sample of this representative, 4-year longitudinal study comprised 2,725 participants (43.56% male, Mage = 58.39 years, SDage = 14.39 years). Individuals being treated for hypertension (n = 277) and cardio- and/or cerebrovascular incidents (n = 131) for the first time during the follow-up period were compared with participants never treated for CVD (n = 2,317). Joint principal component analysis was conducted on the items of the vital exhaustion (shortened Maastricht Questionnaire) and depression (shortened Beck Depression Inventory) measures simultaneously resulting in 3 components representing depression, vital exhaustion, and sleep difficulties. The role of these 3 components in predicting the incidence of CVD morbidity was examined using logistic regression-controlling for traditional risk factors such as sex, age, education, body mass index, smoking, alcohol use, and physical inactivity. In the multivariate analyses, vital exhaustion (OR = 1.20, CI = 1.03-1.39, p = .021) and sleep-related problem (OR = 1.16, CI = 1.00-1.33, p = .044) scores proved to be independent predictors of treatment initiation for hypertension, while sleep-related difficulties predicted CVD event incidence (OR = 1.27, CI = 1.06-1.52, p = .009). However, depressive symptomatology factor scores were not associated with either cardiovascular outcome in the regression analyses. Vital exhaustion and depressive symptomatology showed a different pattern in their relationship with CVD incidence, with vital exhaustion being the more robust predictor. These results suggest that the 2 constructs are not identical and that vital exhaustion deserves consideration when planning and implementing interventions to reduce CVD risk. (PsycINFO Database Record