Publications by authors named "Almar Kok"

Background: Chronic diseases may negatively interfere with the course of depression. Our aim was to examine whether the association between chronic disease and course of depression is moderated by mastery.

Method: N = 1146 persons, aged 18-88, with depressive disorder according to DSM-IV criteria were followed for two years.

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  • This study examined the link between plasma biomarkers indicating endothelial dysfunction and cognitive performance in a sample of 9,414 older adults from the Netherlands, aged 57 to 93 years.
  • Researchers created a composite score from three specific biomarkers and assessed various cognitive functions like executive function and memory.
  • Results indicated a small, consistent association between higher endothelial dysfunction scores and poorer cognitive performance, but no evidence suggested that these markers influenced cognitive decline over time.
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Objectives: To gain insight into the longitudinal, reciprocal associations between depressive symptoms and sexual satisfaction as well as the potential moderating roles of gender and perceived importance of sexuality.

Method: We analyzed longitudinal data from 2113 participants of the Longitudinal Ageing Study Amsterdam (LASA) with an initial age range of 54-93 years, using Generalized Estimating Equations (GEE).

Results: There were no significant associations between baseline depressive symptoms and change in sexual satisfaction, nor between baseline sexual satisfaction and change in depressive symptoms.

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  • The study investigates how health behaviors like smoking, physical inactivity, and alcohol use may mediate the relationship between depression, anxiety, and different types of cancer, including lung and breast cancer.
  • Utilizing data from 18 cohorts with a total of 319,613 participants, the researchers performed two-stage meta-analyses to analyze these associations and calculate the mediating effects.
  • Results showed that smoking and physical inactivity significantly mediated links between depression, anxiety, and lung cancer, highlighting the importance of smoking cessation programs for individuals dealing with mental health issues.
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  • The study investigates how peak expiratory flow rate (PEFR), an indicator of health outcomes, changes with age among older adults in a 13-year follow-up.
  • It identifies three declining PEFR trajectories in older men (high, intermediate, low) and two in women (high, low), with different prevalence rates and notable health characteristics linked to each trajectory.
  • The findings suggest that a single PEFR measurement can predict an older adult's likely health trajectory, as differences in PEFR trajectories are mainly based on initial levels rather than the rate of decline.
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Spousal bereavement is associated with health declines and increased mortality risk, but its specific impact on physical and cognitive capabilities is less studied. A historical cohort study design was applied including married Tromsø study participants (N=5739) aged 50-70 years with baseline self-reported overall health and health-related factors and measured capability (grip strength, finger tapping, digit symbol coding, and short-term recall) at follow-up. Participants had data from Tromsø4 (1994-1995) and Tromsø5 (2001), or Tromsø6 (2007-2008) and Tromsø7 (2015-2016).

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Background: Depressive symptoms are associated with an increased risk of Alzheimer's disease (AD). There has been a recent emergence in plasma biomarkers for AD pathophysiology, such as amyloid-beta (Aβ) and phosphorylated tau (p-tau), as well as for axonal damage (neurofilament light, NfL) and astrocytic activation (glial fibrillary acidic protein, GFAP). Hypothesizing that depressive symptoms may occur along the AD process, we investigated associations between plasma biomarkers of AD with depressive symptoms in individuals without dementia.

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Objectives: Despite expanding knowledge about the internal and external resources that contribute to resilience among individuals who have experienced depression, the long-term accessibility and protectiveness of these resources across different stressors is unknown. We investigated whether and how the resilience resources of individuals who previously recovered from late-life depression remained protective during the COVID-19 pandemic.

Methods: We used a sequential explanatory mixed methods design.

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In this cohort profile article we describe the lifetime major depressive disorder (MDD) database that has been established as part of the BIObanks Netherlands Internet Collaboration (BIONIC). Across the Netherlands we collected data on () lifetime MDD diagnosis in 132,850 Dutch individuals. Currently, = 66,684 of these also have genomewide single nucleotide polymorphism (SNP) data.

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Objectives: To investigate the daily life experiences of sleep, mood, and pain in relation to appetite in community-dwelling older adults aged 75 years and older, stratified by sex.

Design: Existing data from a daily experience study embedded in the Longitudinal Aging Study Amsterdam (LASA) among the oldest-old (≥75 years).

Setting: LASA is an ongoing cohort study of a nationally representative sample of older adults aged ≥55 years from three culturally distinct regions in the Netherlands.

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  • The study investigates the role of psychosocial factors, like depression and anxiety, in how health behaviors (such as smoking and alcohol use) influence cancer incidence.
  • Utilizing data from 437,827 participants and 22 cohorts, researchers performed meta-analyses to assess potential interactions between psychosocial factors and health behaviors across various types of cancer.
  • Results showed no significant interactions or clear patterns; the risk of cancer linked to health behaviors appeared consistent regardless of the presence of psychosocial stress.
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Introduction: Although clinical guidelines regard prophylactic medication as the cornerstone of treatment, it is estimated almost half of patients with bipolar disorder (BD) live without medication. This group is underrepresented in research but can provide indispensable knowledge on natural course, resilience and self-management strategies. We aim to describe the clinical phenotype of patients diagnosed with BD who have discontinued maintenance treatment.

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Introduction: Educational differences in cognitive performance among older adults are well documented. Studies that explore this association typically estimate a single average effect of education on cognitive performance. We argue that the processes that contribute to the association between education and cognitive performance are unlikely to have equal effects at all levels of cognitive performance.

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Background: Despite growing concerns about mental health during the COVID-19 pandemic, particularly in people with pre-existing mental health disorders, research has shown that symptoms of depression and anxiety were generally quite stable, with modest changes in certain subgroups. However, individual differences in cumulative exposure to COVID-19 stressors have not been yet considered.

Aims: We aimed to quantify and investigate the impact of individual-level cumulative exposure to COVID-19-pandemic-related adversity on changes in depressive and anxiety symptoms and loneliness.

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  • Depression and anxiety have been studied as potential risk factors for various types of cancer, but previous research has produced inconclusive results.
  • The PSY-CA consortium analyzed data from 18 cohorts, including over 319,000 participants, to investigate the relationship between these mental health conditions and cancer incidence using detailed statistical methods.
  • The findings revealed no significant links between depression or anxiety and most cancer types, although there was a slight association with lung and smoking-related cancers, which diminished after accounting for other risk factors like smoking and alcohol consumption.
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Background: Research on the impact of ethics reflection groups (ERG) (also called moral case deliberations (MCD)) is complex and scarce. Within a larger study, two years of ERG sessions have been used as an intervention to stimulate ethical reflection about the use of coercive measures. We studied changes in: employees' attitudes regarding the use of coercion, team competence, user involvement, team cooperation and the handling of disagreement in teams.

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Purpose: Many studies report about risk factors associated with adverse changes in mental health during the COVID-19 pandemic while few studies report about protective and buffering factors, especially in older adults. We present an observational study to assess protective and buffering factors against COVID-19 related adverse mental health changes in older adults.

Methods: 899 older adults (55 +) in the Netherlands were followed from 2018/19 to two pandemic time points (June-October 2020 and March-August 2021).

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Background: Traditional cardiovascular risk indicators only partially explain cardiovascular risks in depressed persons. Depressed persons may exhibit a profile of cardiovascular risk indicators that goes beyond traditional cardiovascular risk indicators, such as symptom severity, insomnia, loneliness and neuroticism, yet research on the added value of these depression-related characteristics in predicting cardiovascular risks of depressed persons is scarce.

Methods: Data from N = 1028 depressed Dutch adults without prevalent CVD were derived from two longitudinal depression cohort studies.

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Background: Although it is known that health literacy (HL) plays an explanatory role in educational inequalities in health, it is unknown whether this role varies across age groups.

Objective: The purpose of this study was to investigate whether the mediating role of HL in educational inequalities in four health outcomes varies across age groups: age 46 to 58 years, age 59 to 71 years, and age 72 to 84 years.

Methods: We used data from the Dutch Doetinchem Cohort Study, which included 3,448 participants.

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The concept of resilience, i.e., the capacity of a system to bounce back after a stressor, is gaining interest across many fields of science, policy, and practice.

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Objective: While research found heterogeneous changes in mental health during the COVID-19 pandemic, less is known about the long-term changes in mental health in psychiatric groups. Therefore, we applied a data-driven method to detect sub-groups with distinct trajectories across two years into the pandemic in psychiatric groups, and described their differences in socio-demographic and clinical characteristics.

Method: We conducted sixteen rounds of questionnaires between April 2020 and February 2022 among participants (n = 1722) of three psychiatric case-control cohorts that started in the 2000's.

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Background: The COVID-19 pandemic gives us the unique opportunity to study the course of psychiatric symptoms and resilience in older adults with bipolar disorder (OABD) whilst experiencing a collective long lasting stressor. The aim of this study was to investigate the course of depressive, manic and anxiety symptoms in OABD during the first six months of COVID-19 and how loneliness and mastery are associated with this course. Mastery is defined as the control one experiences over one's life and environment.

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Objectives: The distinction between bipolar I disorder (BD-I) and bipolar II disorder (BD-II) has been a topic of long-lasting debate. This study examined differences between BD-I and BD-II in a large, global sample of OABD, focusing on general functioning, cognition and somatic burden as these domains are often affected in OABD.

Methods: Cross-sectional analyses were conducted with data from the Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) database.

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Synopsis of recent research by authors named "Almar Kok"

  • Almar Kok's research primarily focuses on the intersection of mental health, cognitive decline, and their relationships with both physiological and psychosocial factors in older adults, as evidenced by a series of studies exploring biomarkers of endothelial dysfunction, depressive symptoms, and their implications for cognitive and physical capabilities.
  • The findings highlight the complex interactions between mental health conditions (like depression and anxiety) and physical health outcomes, including cancer incidence and cognitive decline, suggesting that health behaviors play a significant mediating role in these associations.
  • Kok's recent work also emphasizes the importance of examining longitudinal data, revealing that the relationships between depressive symptoms and factors such as sexual satisfaction and sleep quality are nuanced, with variations seen across different demographics and psychosocial contexts.