Predicting Self-Related Health among the Aged

Markides, Kyriakos S.; Martin, Harry W.

doi:10.1177/016402757911006

Cited by 42 publications

(15 citation statements)

References 16 publications

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“…Self report measures have demonstrated good reliability, validity, and agreement with physician's diagnoses [42]. Nonetheless health assessments were dependent on the participants' ability to accurately recall medical diagnoses and also on their seeking health care.…”

Section: Discussionmentioning

confidence: 99%

Depressive Symptoms Moderate the Influence of the ApolipoproteinE ɛ4 Allele on Cognitive Decline in a Sample of Community Dwelling Older Adults

Corsentino

Sawyer

Sachs‐Ericsson

et al. 2009

The American Journal of Geriatric Psychiatry

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Objectives-The APOE ε4 allele and a history of depression are each separate risk factors for cognitive decline (CD). However, little research has investigated whether a history of depression influences the relationship between APOE ε4 and CD. The present study examined whether depressive symptoms had greater influence on subsequent CD among participants with APOE ε4 than those without the allele. Design-Prospective six year longitudinal study. Setting-Community in-home interviews. Participants-A biracial sample of community dwelling older adults (N=1992) from the Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE).Measurements-Data were drawn from Waves 1 and 3 of the EPESE, which were conducted 6 years apart. Cognitive functioning and depressive symptoms were assessed at both waves, and APOE genotyping was completed during the Wave 3 assessment.Results-Regression analyses revealed that depressive symptoms and the APOE ε4 allele independently predicted CD. Importantly, the influence of depressive symptoms on CD was greater for individuals with the APOE ε4 allele compared to those without the allele.Conclusion-Depressive symptoms and the APOE ε4 allele are independent contributors to CD. Moreover, the influence of depressive symptoms on CD is greater among individuals with the APOE ε4 allele. Depression and the APOE ε4 allele may act together in disrupting neurological functioning, which may in turn lower an individual's cognitive reserve capacity. Given the efficacious treatments currently available for depression, future research should investigate the extent to which interventions for depression may reduce the risk for subsequent CD. Keywords APOE; depressive symptoms; cognitive declineCognitive decline (CD) is a significantly increasing problem as individuals age. Mild cognitive impairment affects between 22% and 56% of older adults [1,2], and the prevalence of dementia NIH Public Access Author ManuscriptAm J Geriatr Psychiatry. Author manuscript; available in PMC 2010 February 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript in individuals 65 years and older is approximately 6 to 10%. Further, the prevalence of dementia climbs above 30% among individuals over age 85 [3]. Given the pervasiveness of cognitive impairment in our society, further investigation of factors that influence the onset and course of CD is merited. Identifying such factors may lead to greater insight into ways to prevent or slow the progression of CD. Two variables that have each been individually identified as placing a person at an increased risk for CD are the apolipoproteinE ε4 allele (APOE ε4) and a history of depression or depressive symptoms. APOE ε4 is the most widely recognized genetic risk factor for Alzheimer's disease (AD) [4][5][6]. Nevertheless, other environmental or biological factors are also likely operating to influence CD. In particular, there is growing evidence that a history of depression may increase the risk for CD [7]. Although many studies have exa...

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Section: Discussionmentioning

confidence: 99%

Depressive Symptoms Moderate the Influence of the ApolipoproteinE ɛ4 Allele on Cognitive Decline in a Sample of Community Dwelling Older Adults

Corsentino

Sawyer

Sachs‐Ericsson

et al. 2009

The American Journal of Geriatric Psychiatry

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show abstract

“…Further, as the APOE 4 allele may increase the risk of some health problems associated with CD, the relationship between APOE genotype and CD may be explained in part by unreported physical health problems. However, it is important to note that studies have found that objective measures are the strongest predictors of singleitem self-report measures of health among the elderly [40] and that such single-item self-report measures have good reliability [41] and validity [42] in this population.…”

Section: Discussionmentioning

confidence: 99%

Racial Differences in the Influence of the APOE Epsilon 4 Allele on Cognitive Decline in a Sample of Community-Dwelling Older Adults

et al. 2008

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Background: Most, but not all, past studies have suggested that the APOE genotype is a risk factor for dementia in whites but not African Americans. This paper first describes explanations as to why some studies may have failed to detect the effect of APOE genotype in African American samples. Briefly, studies have been limited by various methodological problems including small sample sizes, dichotomous measures of cognitive functioning (which tend to be less sensitive to change), and racial bias in assessing demented status. Objective: This paper suggests methods for increasing the likelihood that genuine racial differences will be identified when examining genetic risk factors. Further, we test our model of racial differences in the relationship of APOE genotype and cognitive decline (CD) in a large prospective community sample. Methods: Building on the work of Fillenbaum and colleagues [J Am Geriatr Soc 2001;49:1148–1155], we used data from the Duke EPESE study collected in four waves over a 10-year period (n = 2,076) to illustrate methods which may better assess racial differences in the influence of the APOE ε4 allele on CD. We used multilevel models for repeated measures to examine racial differences in participants’ increase in errors on a continuous measure of cognitive functioning as they aged. Results: We found the APOE ε4 allele to predict CD for both African Americans and whites. Having at least one ε4 allele predicted more cognitive errors at wave 1 and a faster rate of decline for both African Americans and whites over time. While African Americans experienced a faster rate of CD than whites, there was no additional increase in CD from being both African American and a carrier of the ε4 allele. Conclusion: The study points to several common methodological issues that arise when examining racial differences in genetic influences on health-related outcomes. Further, the study’s results highlight the importance of including both African Americans and Caucasians in research concerning the contribution of APOE genotype to CD.

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“…Responses were coded 0 (absent) or 1 (present) and items were summed to obtain a cumulative health problem variable. Single‐item self‐report measures of health are associated with objective measures of health 46…”

Section: Methodsmentioning

confidence: 99%

Implications of comorbid alcohol dependence among individuals with social anxiety disorder

et al. 2008

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Background-Social anxiety disorder (SAD) is highly comorbid with alcohol use disorders (AUD) yet the nature of this comorbidity remains unclear. To better understand these associations, we first examined whether SAD was related to AUD above and beyond relevant covariates. Second, we examined the psychosocial impairment associated with the comorbidity of SAD and AUD versus SAD without AUD. Third, the temporal sequencing of SAD and AUD among comorbid individuals was examined.

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Predicting Self-Related Health among the Aged

Cited by 42 publications

References 16 publications

Depressive Symptoms Moderate the Influence of the ApolipoproteinE ɛ4 Allele on Cognitive Decline in a Sample of Community Dwelling Older Adults

Depressive Symptoms Moderate the Influence of the ApolipoproteinE ɛ4 Allele on Cognitive Decline in a Sample of Community Dwelling Older Adults

Racial Differences in the Influence of the APOE Epsilon 4 Allele on Cognitive Decline in a Sample of Community-Dwelling Older Adults

Implications of comorbid alcohol dependence among individuals with social anxiety disorder

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