Depressive symptoms and incident cognitive impairment in cognitively well-functioning older men and women.

Objectives: To investigate whether the effect of depressive symptoms on the risk of cognitive decline and incident cognitive impairment (CI) in cognitively well-functioning older persons differed between men and women and whether sex differences in cerebrovascular factors might explain this.

Design: Prospective cohort study.

Setting: General community.

Cognitive function and brain structure correlations in healthy elderly East Asians.

We investigated the effect of age and health variables known to modulate cognitive aging on several measures of cognitive performance and brain volume in a cohort of healthy, non-demented persons of Chinese descent aged between 55 and 86 years. 248 subjects contributed combined neuropsychological, MR imaging, health and socio-demographic information. Speed of processing showed the largest age-related decline.

Determinants of successful aging using a multidimensional definition among Chinese elderly in Singapore.

Objective: Most studies of successful aging have used restricted definitions based on the absence of disability and identified a small number of predictors. The authors aimed to examine whether a broad multidimensional definition of successful aging has good construct validity and identified a wider range of predictors that are relevant for multifaceted interventions.

Methods: Cross-sectional and longitudinal data analyses were performed on 1,281 community-living Chinese elderly of 65 years and above in the Singapore Longitudinal Aging Study cohort.

Depressive symptoms, physician visits and hospitalization among community-dwelling older adults.

Background: The relationship between depressive symptoms and health service use among older people is not well understood. In this study we examined the two-way relationships between depressive symptoms and hospitalization and/or physician visits by older adults.

Methods: In a one-year follow-up study of 973 community-dwelling older adults in the Singapore Longitudinal Aging Studies (SLAS), depressive symptoms (15-item Geriatric Depression Scale score > or =5) were assessed at baseline and one year later.

Improving treatment access and primary care referrals for depression in a national community-based outreach programme for the elderly.

Background: Mental illness is highly prevalent and disabling, but is under-treated. Outreach services attempt to overcome system and personal barriers to care, but there are few reports of their effects in improving access and use of mental health services. In the Community-based Early Psychiatric Interventional Strategy (CEPIS) programme in Singapore, community nurses routinely screened seniors for depressive symptoms, and provided psychoeducation and referral for primary care treatment.

Vitamin B-12, apolipoprotein E genotype, and cognitive performance in community-living older adults: evidence of a gene-micronutrient interaction.

Background: The relation between vitamin B-12 and cognitive function in older adults is unclear. Limited evidence suggests that the relation is modulated by apolipoprotein E epsilon4. Hence, it is important to further examine this gene-nutrient interaction.

APOE-epsilon4, depressive symptoms, and cognitive decline in Chinese older adults: Singapore Longitudinal Aging Studies.

Background: The precise relationship between depression and cognitive decline in older adults is unclear. We investigated the influence of apolipoprotein E (APOE)-epsilon4 genotype in modulating the effect of depressive symptoms on cognitive decline.

Methods: Prospective cohort study of 1,487 cognitively high-functioning Chinese older adults.

Determinants of mental health service use in the national mental health survey of the elderly in Singapore.

Background: Despite high prevalence of mental health problems, only a minority of elderly people seek treatment. Although need-for-care factors are primary determinants of mental health service use, personal predisposing or enabling factors including health beliefs are important but are not well studied.

Method: In the National Mental Health Survey of Elderly in Singapore, 2003, 1092 older adults aged 60 and above were interviewed for diagnosis of mental disorders (using Geriatric Mental State) and treatment, and their health beliefs about the curability of mental illness, embarrassment and stigma, easiness discussing mental problems, effectiveness and safety of treatment and trust in professionals.

Co-morbid association of depression and COPD: a population-based study.

Objectives: Depression occurs commonly among patients with COPD, but the independent association of depression and COPD and the effect of depression on COPD outcomes are not well established.

Method: A population sample of 2402 Chinese aged >or=55 with and without COPD (characteristic symptoms of chronic cough, sputum or breathlessness and airflow obstruction and FEV(1)/FVC<0.70) was assessed on Geriatric Depression Scale (score>or=5), dependence on basic activities of daily living (ADL), SF-12 health status, smoking and medication behaviour.

Somatic and non-affective symptoms of old age depression: ethnic differences among Chinese, Indians and Malays.

Background: Somatic and other non-affective symptomatology characterizes late life depression and contributes to its under-diagnosis, especially in some ethnic groups.

Objectives: We examined variations in non-affective presentation and its health and functional significance across different ethnic groups of Chinese, Malays and Indians.

Method: We analyzed data from the National Mental Health Survey for Elderly, a population-based cross-sectional study of older adults aged 60 and above (N = 1092).

Albumin, apolipoprotein E-epsilon4 and cognitive decline in community-dwelling Chinese older adults.

Objectives: To examine the association between serum albumin and cognitive impairment and decline in community-living older adults.

Designs: Population-based cohort study, followed up to 2 years; serum albumin, apolipoprotein E (APOE)-epsilon4, and cognitive impairment measured at baseline and cognitive decline (> or =2-point drop in Mini-Mental State Examination (MMSE) score). Odds ratios were controlled for age, sex, education, medical comorbidity, hypertension, diabetes mellitus, cardiac disease, stroke, smoking, alcohol drinking, depression, APOE-epsilon4, nutritional status, body mass index, anemia, glomerular filtration rate, and baseline MMSE.

Y-Box-binding protein-1 is a promising predictive marker of radioresistance and chemoradioresistance in nasopharyngeal cancer.

The Y-Box-binding protein-1, a member of the cold-shock domain DNA- and RNA-binding protein superfamily, is known to mediate chemoresistance. The aim of this study was to determine the expression of Y-Box-binding protein-1 in nasopharyngeal cancer in vitro and in tumor tissue samples as well as analyze the clinicopathological significance of Y-Box-binding protein-1 expression in nasopharyngeal cancer, in particular as a predictor of outcome after treatment. The Y-Box-binding protein-1 expression profile was evaluated at the mRNA and protein levels in poorly differentiated CNE-2 nasopharyngeal cancer cells by real-time RT-PCR, western blot analysis and immunohistochemistry.

Orthostatic hypotension, hypotension and cognitive status: early comorbid markers of primary dementia?

Objective: Few studies have explored the relationship between orthostatic hypotension (OH) and cognition. The aim of this study was to examine the association of OH with cognitive impairment and decline in a cohort of Chinese elderly, and its effect modification by blood pressure (BP) status at baseline.

Method: Among 2,321 community-living older adults, free of cardiovascular disease and stroke, baseline BP measurements were used to determine the presence of OH and categorize participants as hypotensives, normotensives or hypertensives.

Association between depressive symptoms and use of HMG-CoA reductase inhibitors (statins), corticosteroids and histamine H(2) receptor antagonists in community-dwelling older persons: cross-sectional analysis of a population-based cohort.

Background: Strong evidence supporting the existence of causal associations of drug use with depression is often lacking from empirical studies. Limited evidence suggests an inverse association of use of HMG-CoA reductase inhibitors (statins) with depressive symptoms. Sparse and sometimes conflicting data in this respect have also been reported for corticosteroids, histamine H(2) receptor antagonists and antihypertensive agents.

Tea consumption and cognitive impairment and decline in older Chinese adults.

Background: Laboratory research suggests that tea has potential neurocognitive protective effects, but this is not established in humans.

Objective: We aimed to examine the relation between tea intake and cognitive impairment and decline.

Design: Among community-living Chinese adults aged > or = 55 y in the Singapore Longitudinal Ageing Studies cohort, we measured tea consumption at baseline and administered the Mini-Mental State Examination (MMSE) at baseline and 1-2 y later.

Metabolic syndrome and cognitive decline in chinese older adults: results from the singapore longitudinal ageing studies.

Objective: To determine the association of the metabolic syndrome (MS) with cognitive decline in a Chinese older population.

Methods: In a prospective cohort study of 1,352 community-living Chinese older adults without cognitive impairment (Mini Mental State Examination, MMSE <24) and without cardiovascular disease and stroke, the authors assessed baseline MS (defined according to International Diabetic Federation Criteria). Cognitive decline was predefined as at least 2-point drop in MMSE score at follow-up 1-2 years after baseline assessment.

Physical, social and productive leisure activities, cognitive decline and interaction with APOE-epsilon 4 genotype in Chinese older adults.

Background: We evaluated the combined and differential effects of physical, social and productive activities on cognitive decline and whether they were modified by the presence of the APOE-epsilon 4 allele.

Methods: In a prospective cohort study of 1635 community-dwelling Chinese older adults aged 55 or older participating in the ongoing Singapore Longitudinal Aging Study, physical, social and productive leisure activities were assessed at baseline, and cognitive decline (at least one point drop) in MMSE scores between baseline and follow-up after one year.

Results: Cognitive decline was observed in 30% of the respondents.

Health beliefs and help seeking for depressive and anxiety disorders among urban Singaporean adults.

Objective: This study examined whether help seeking for mental problems was predicted by beliefs about mental illness and services and by family and social support.

Methods: Singaporean adults (N= 2,801) were interviewed with the Schedule for Clinical Assessment in Neuropsychiatry and with questions on mental health status, beliefs about the curability of mental illness, embarrassment and stigma, ease of discussing mental problems, effectiveness and safety of treatment, and trust in professionals.

Results: Although 10% of respondents had a depressive or anxiety disorder or combination, only 3% acknowledged having mental problems, 5% rated their mental health as fair or poor, and 6% sought help for their mental health problems.

Body mass index, waist circumference, waist-hip ratio and depressive symptoms in Chinese elderly: a population-based study.

Background: Studies that investigated the relationship between obesity and depressive symptoms in the elderly have generated conflicting findings, partly because of the use of body mass index (BMI) alone to measure obesity in the elderly. The use of BMI fails to account for varying proportions of muscle, fat and bone, and few studies have used other measures of central obesity, such as waist-hip ratio (WHR) and waist circumference (WC).

Objectives: We examined whether individually BMI, WHR and WC were consistently associated with depressive symptoms in the elderly.

Diagnostic Performance of Clock Drawing Test by CLOX in an Asian Chinese population.

Background/aims: Clock Drawing Tests are commonly used for cognitive screening, but their clinical utility has not yet been studied in Chinese Singaporeans. We examined the usefulness of a Clock Drawing Test, CLOX, in detecting dementia in our population and explored its performance in the dementia subtypes, Alzheimer's disease (AD), and the vascular composite group (VCG) of AD with cerebrovascular disease and vascular dementia.

Method: CLOX was administered to 73 subjects (49.

Low prevalence of atrial fibrillation in community-dwelling Chinese aged 55 years or older in Singapore: a population-based study.

Background: The prevalence of atrial fibrillation (AF) in Asian populations appears to be lower than that in Western populations according to limited data. We conducted a community study to (a) estimate the prevalence of AF in Chinese adults aged 55 years or older in Singapore and (b) examine associated risk factors.

Methods: We conducted a whole-survey area population screening of 1839 Chinese residents aged 55 years or older in the southeast region of Singapore with a single electrocardiographic recording.

Depression and chronic medical illnesses in Asian older adults: the role of subjective health and functional status.

Objective: Depression in elderly is reportedly associated with a number of specific chronic illnesses. Whether each of these co-morbid associations results uniquely from disease-specific psychobiological responses or is mediated by non-specific factors like subjective health and functional status is unclear.

Method: Analysis of data of 2,611 community-dwelling Chinese aged 55 and older, including depressive symptoms defined by Geriatric Depression Scale score >or= 5 and self-reports of specific chronic illnesses.

Item response bias was present in instrumental activity of daily living scale in Asian older adults.

Objective: Item response bias (also called differential item functioning, DIF) in Instrumental Activities of Daily Living (IADL) occurs when members of different groups possessing the same disability level do not have the same probability of responding positively for a given item(s). This study aimed to identify the extent of DIF by gender, age, ethnicity, and dementia groups in IADL estimates in Asian (Chinese, Malays, and Indian) elderly subjects.

Methods: Data of 1,072 noninstitutionalized elderly subjects were analyzed using Multiple-Indicator Multiple-Cause (MIMIC) latent variable modeling.