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The incidence rate of dementia in this Southern European city was slightly lower than in previous studies in North-West Europe. LTR of dementia and AD seems to be slightly increased with age. The association of illiteracy with higher LTR of AD is intriguing.

Aims/hypothesis Although several studies have reported on the association between diabetes and depression, none have used both formal psychiatric criteria and a prospective, population-based design. Therefore, it remains unclear whether diabetes is a risk factor for the development of depression. Moreover, it is not clear if this effect is influenced by other chronic diseases and functional disabilities. Methods A large (n=4,803) representative communitybased study in Spanish elderly subjects (at least 55 years of age) was conducted. The presence of major depression was assessed by means of a standardised psychiatric diagnostic interview (Automated Geriatric Examination for Computer Assisted Taxonomy). Subjects underwent a baseline assessment and a follow-up assessment after 2 and 5 years to determine the incidence of depression. Results At baseline 597 subjects (12.5%) were identified as having diabetes. Prevalence and incidence of depression in cases of diabetes were 15.4% and 16.5% respectively. Diabetes was associated with an increased risk of prevalent (odds ratio [OR]=1.47; 95% CI: 1.16-1.83) and incident (OR=1.40; 95% CI: 1.03-1.90) depression. Controlling for potential confounders did not essentially change these findings (prevalent depression: OR 1.41, 95% CI: 1.08-1.83; incident depression: OR 1.26, 95% CI: 0.90-1.77). Conclusions/interpretation In a large, representative prospective population-based sample using strict psychiatric criteria, we confirmed previous findings that diabetes is associated with an increased risk of depression. The effect on the incidence of depression suggests that diabetes may play a role in the development of depression in the elderly. The presence of comorbid medical diseases seems to decrease the effects of diabetes on the risk of prevalent depression, but to increase the risk of incident depression.

The identification of more reliable diagnostic or prognostic biomarkers in age-related neurodegenerative diseases, such as Amyotrophic Lateral Sclerosis (ALS), is urgently needed. The objective in this study was to identify more reliable prognostic biomarkers of ALS mirroring neurodegeneration that could be of help in clinical trials. A total of 268 participants from three cohorts were included in this study. The muscle and blood cohorts were analyzed in two cross-sectional studies, while the serial blood cohort was analyzed in a longitudinal study at 6-monthly intervals. Fifteen target genes and fourteen proteins involved in muscle physiology and differentiation, metabolic processes and neuromuscular junction dismantlement were studied in the three cohorts. In the muscle biopsy cohort, the risk for a higher mortality in an ALS patient that showed high Collagen type XIX, alpha 1 (COL19A1) protein levels and a fast progression of the disease was 70.5% ( P < 0.05), while in the blood cohort, this risk was 20% ( P < 0.01). In the serial blood cohort, the linear mixed model analysis showed a significant association between increasing COL19A1 gene levels along disease progression and a faster progression during the follow-up period of 24 months ( P < 0.05). Additionally, higher COL19A1 levels and a faster progression increased 17.9% the mortality risk ( P < 0.01). We provide new evidence that COL19A1 can be considered a prognostic biomarker that could help the selection of homogeneous groups of patients for upcoming clinical trial and may be pointed out as a promising therapeutic target in ALS.

Aims: Research suggests differential effects for somatic and cognitive-affective depressive symptoms in predicting health outcomes. This study evaluated differential relations with medication non-adherence among disadvantaged, and predominantly immigrant adults with suboptimally controlled Type 2 diabetes (T2D). Methods: Health plan members taking oral diabetes medication and who had A1c≥7.5% were recruited for a trial of telephonic self-management support. A subset (n=376; age, M=56.6±7.2 years; A1c M=9.1 %±1.6) completed the Patient Health Questionnaire-8 (PHQ-8). Diabetes medication adherence was measured by self-report and claims-based records. Multivariable logistic regression modeled depressive symptoms and odds of non-adherence using preintervention data. Results: A positive PHQ-8 screen (OR=2.72 [95%CI: 1.56-4.73]) and each standard deviation increase in PHQ-8 score (OR=1.40 [95%CI: 1.11-1.75]) were associated with non-adherence, with no independent effects for somatic versus cognitive-affective symptoms. Exploration of individual symptoms identified four significantly associated with non-adherence; after adjustment for likely presence of clinical depression, only fatigue was independently associated with non-adherence (OR=1.71 [95%CI: 1.06-2.77]). Conclusions: Findings support depression symptom severity as a significant correlate of medication non-adherence among disadvantaged adults with T2D. Support was limited for differential associations for symptom dimensions, but findings suggest fatigue may be associated with non-adherence independent of the likely presence of depression.

Purpose of review To provide an overview of shared dysregulation of the hypothalamic-pituitary-adrenal (HPA) and brain-gut-microbiome (BGM) axes associated with depression and type 2 diabetes (T2D). Clinical implications and future research are also discussed. Recent findings Both depression and T2D are associated with dysregulation of the HPA and BGM axes. These pathways regulate immune function, glucose metabolism, and sleep, and are altered in both illnesses. Dysregulation of homeostatic brain-body pathways may be positively influenced though different therapeutic actions, including psychotherapy, healthy eating, physical activity, sleep promotion, and certain anti-inflammatory or antidepressant medications. Summary While the causal nature of the relationship between depression and T2D remains unclear, these conditions share dysregulation of homeostatic brain-body pathways that are central to mental and physical health. Better understanding of this dysregulation may provide opportunities for interventions that could benefit both conditions. Future research should examine the additive burden of depression and T2D on HPA and BGM dysregulation, and differentiate depression from emotional distress.

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Eating Disorders (ED) have been associated with dysfunctional coping strategies, such as rumination. Promoting alternative ways of experiencing mental events, based on a mindfulness approach, might be the clue for learning more effective coping and regulatory strategies among young women with ED. This study examined the comparison between patients with ED diagnosis and healthy subjects in mindfulness, rumination and effective coping. In addition, we analyzed the independent association of those with the presence of ED. The study sample was formed by two groups of young women ranged 13–21 years: Twenty-five with an ED diagnosis and 25 healthy subjects. They were assessed by using the Freiburg Mindfulness Inventory (FMI) and the Responses Styles Questionnaire (RSQ). Our findings show that ED patients have significantly lesser average scores in mindfulness and effective coping than the healthy sample (p < .05). Also, our data concludes that mindfulness and effective coping independently predict the presence or absence of ED in young women. The study results suggest that training mindfulness abilities may contribute to making effective coping strategies more likely to occur in ED patients, which is incompatible with some eating-related symptoms. Further studies are needed, trough prospective and experimental designs, to evaluate clinical outcomes of mindfulness training among young women with ED.