Comorbidity rates in anxiety and depressive disorders were very high, indicating that it is advisable to assess both disorders routinely regardless of the primary reason for consultation. This is especially important since comorbid patients showed a specific vulnerability pattern, with more childhood trauma, neuroticism, and higher severity and duration of symptoms.

No abstract

This population-based study showed that the serum inflammatory protein alpha1-antichymotrypsin is associated with cognitive decline in older persons, whereas C-reactive protein, interleukin-6, and albumin are not.

This study showed a large number of unmet needs in dementia. Reasons for unmet needs are lack of knowledge about the existing service offer, a threshold to using services and insufficient services offer. These results provide a good starting point for improving community care for people with dementia.

OBJECTIVE -Recent evidence suggests that the metabolic syndrome and inflammation affect cognitive decline in old age and that they reinforce each other. However, it is not known what the roles of the individual components of the metabolic syndrome on cognition are. RESULTS -Of the sample, 36.3% had metabolic syndrome. Metabolic syndrome was significantly associated with all cognitive measures (P Ͻ 0.05). Of the individual components, hyperglycemia was most strongly and significantly associated with cognitive function (multivariate adjusted models; B values, indicating differences in scores between both groups, ranging from Ϫ0.38 to Ϫ1.21). There was a significant interaction between metabolic syndrome and inflammation on cognition (P Ͻ 0.01-0.09). Metabolic syndrome was negatively associated with cognition in subjects with high inflammation (highest tertile for both CRP and ACT; B values ranging from Ϫ0.86 to Ϫ1.94, P Ͻ 0.05), whereas an association was absent in subjects with low inflammation (B values ranging from Ϫ0.10 to Ϫ0.70). RESEARCH DESIGN AND METHODSCONCLUSIONS -Subjects with metabolic syndrome showed poorer cognitive performance than subjects without metabolic syndrome, especially those with high levels of inflammation. Hyperglycemia was the main contributor of the association of metabolic syndrome with cognition.

The Longitudinal Aging Study Amsterdam (LASA) is an ongoing longitudinal study of older adults in the Netherlands, which started in 1992. LASA is focused on the determinants, trajectories and consequences of physical, cognitive, emotional and social functioning. The study is based on a nationally representative sample of older adults aged 55 years and over. The findings of the LASA study have been reported in over 450 publications so far (see www.lasa-vu.nl). In this article we describe the background and the design of the LASA study, and provide an update of the methods. In addition, we provide a summary of the major findings from the period 2011-2015.

Article abstract-Objective: To investigate to what extent subjective memory complaints and APOE-⑀4 allele carriage predict future cognitive decline in cognitively intact elderly persons, by evaluating both their separate and combined effects. Methods: We selected 1,168 subjects from the population-based Longitudinal Aging Study Amsterdam who were 62 to 85 years of age and had no obvious cognitive impairment at baseline (Mini-Mental State Examination [MMSE] score, Ն27). Memory complaints and APOE phenotypes were assessed at baseline. MMSE, the Auditory Verbal Learning Test (memory: immediate recall and delayed recall), and the Alphabet Coding Task-15 (information processing speed) were used to study cognitive decline. Follow-up data were collected after 3 and 6 years. Data were analyzed with generalized estimating equations, adjusted for age, sex, education, and depression. Results: Baseline memory complaints were reported by 25.5% of the cognitively intact elderly persons. Overall, 25.3% of the subjects were carriers of at least one APOE-⑀4 allele. Memory complaints were associated with a greater rate of decline in all cognitive measures, except immediate recall. In addition, APOE-⑀4 allele carriers had a greater rate of cognitive decline shown by MMSE scores and slower information processing speeds after 6 years. The effects of both memory complaints and APOE-⑀4 allele carriage were additive: subjects with both factors had a two times higher cognitive decline than did subjects without both factors. Conclusions: Both memory complaints and APOE-⑀4 allele carriage predict cognitive decline at an early stage. This finding highlights the importance of subjective memory complaints, which are important even at an early stage when objective tests are still unable to detect cognitive deficits and are especially important for elderly carriers of the APOE-⑀4 allele because they have an additional risk. NEUROLOGY 2001;57:2217-2222 Elderly persons with memory complaints are often depressed. 1,2 However, many population-based studies have reported that subjective memory complaints may predict future dementia. [3][4][5][6] Memory complaints also predict faster cognitive decline in elderly persons with mild cognitive impairment 7 as well as in elderly persons with normal cognition. 8 It is important to know which elderly persons will develop mild cognitive impairment as an early stage of dementia, because intervention may soon be feasible. 9 Because memory complaints can be easily assessed, they can identify persons who are at risk.Small et al. 10 studied individuals with mild memory complaints and found a higher proportion of memory complaints among APOE-⑀4 allele carriers than among non-APOE-⑀4 allele carriers. The APOE-⑀4 allele is the major known genetic risk factor for AD 11 and has been associated with objective cognitive decline. 12-17 Based on the findings of the cross-sectional study by Small et al., 10 prospective studies should include both APOE-⑀4 allele carriage and subjective memory complaints to determine how we...

This study shows that depression and anxiety are major public health problems in visually impaired older adults. Research on psychotherapeutic and psychopharmacologic interventions to improve depression and anxiety in this population is warranted. (http://www.trialregister.nl number, NTR3296.).