Cognitive Function in an Elderly Population: Interaction Between Vitamin B12 Status, Depression, and Apolipoprotein E {Varepsilon}4: The Hordaland Homocysteine Study.

Cognitive Function in an Elderly Population: Interaction Between Vitamin B12 Status, Depression, and Apolipoprotein E {varepsilon}4: The Hordaland Homocysteine Study.

Filed under: Depression Treatment

Psychosom Med. 2012 Dec 4;
Vogiatzoglou A, Smith AD, Nurk E, Drevon CA, Ueland PM, Vollset SE, Nygaard HA, Engedal K, Tell GS, Refsum H

ObjectiveTo investigate the cross-sectional relation between metabolic markers of vitamin B(12) status and cognitive performance, and possible effect modification by the presence of depression and apolipoprotein E (ApoE) ?4.MethodsThis is a population-based study of 1935 participants, aged 71 to 74 years, from Norway. Participants were administered a cognitive test battery, and vitamin B(12) status was assessed by measurements of plasma vitamin B(12), holotranscobalamin (holoTC), methylmalonic acid (MMA), and total homocysteine.ResultsThe geometric mean (95% confidence interval) for vitamin B(12) was 348 pM (341-354), whereas 5.9% of participants had vitamin B(12) levels lower than 200 pM. In linear regression analyses, holoTC (p = .039) and the holoTC/vitamin B(12) ratio (p = .013) were positively related, whereas MMA (p = .010) was inversely related, to global cognition, after adjustment for sex, education, ApoE status, plasma creatinine, and history of diabetes, cardiovascular disease, hypertension, and depression. Among those positive for ApoE ?4, but not among those without the ?4 allele, plasma vitamin B(12) was positively associated with global cognition (p = .015), whereas MMA was inversely related to global cognition (p = .036) and executive function (p = .014). In participants with depression, MMA was inversely associated with global cognition (p < .001) and episodic memory (p = .001).ConclusionsAmong the well-nourished elderly, low vitamin B(12) status is associated with cognitive deficit, particularly in those with the ApoE ?4 allele or with depression. HubMed – depression

Smoking and intention to quit in deprived areas of Glasgow: is it related to housing improvements and neighbourhood regeneration because of improved mental health?

Filed under: Depression Treatment

J Epidemiol Community Health. 2012 Dec 4;
Bond L, Egan M, Kearns A, Clark J, Tannahill C

BACKGROUND: People living in areas of multiple deprivation are more likely to smoke and less likely to quit smoking. This study examines the effect on smoking and intention to quit smoking for those who have experienced housing improvements (HI) in deprived areas of Glasgow, UK, and investigates whether such effects can be explained by improved mental health. METHODS: Quasi-experimental, 2-year longitudinal study, comparing residents’ smoking and intention to quit smoking for HI group (n=545) with non-HI group (n=517), adjusting for baseline (2006) sociodemographic factors and smoking status. SF-12 mental health scores were used to assess mental health, along with self-reported experience of, and General Practitioner (GP) consultations for, anxiety and depression in the last 12 months. RESULTS: There was no relationship between smoking and HI, adjusting for baseline rates (OR=0.97, 95% CI 0.57 to 1.67, p=0.918). We found an association between intention to quit and HI, which remained significant after adjusting for sociodemographics and previous intention to quit (OR 2.16, 95% CI 1.12 to 4.16, p=0.022). We found no consistent evidence that this association was attenuated by improvement in our three mental health measures. CONCLUSIONS: Providing residents in disadvantaged areas with better housing may prompt them to consider quitting smoking. However, few people actually quit, indicating that residential improvements or changes to the physical environment may not be sufficient drivers of personal behavioural change. It would make sense to link health services to housing regeneration projects to support changes in health behaviours at a time when environmental change appears to make behavioural change more likely.
HubMed – depression

Evaluation of an Agency-Based Occupational Therapy Intervention to Facilitate Aging in Place.

Filed under: Depression Treatment

Gerontologist. 2012 Dec 4;
Sheffield C, Smith CA, Becker M

PURPOSE: The United States faces a growing population of older adults and accompanying functional disabilities, coupled with constrained public resources and diminishing informal supports. A variety of interventions that aim to improve client outcomes have been studied, but to date, there is limited translational research that examines the efficacy of moving such interventions from clinical trials to agency settings.Methods: A randomized controlled trial was conducted to evaluate a restorative occupational therapy intervention relative to “usual care” among community-dwelling older adults. The intervention included a detailed assessment from a person-environment perspective and provision of adaptive equipment and home modifications where appropriate. The intervention (n = 31) and control groups (n = 29) were evaluated at 3 months and assessed for changes in functional status, home safety, falls, health-related quality of life (HRQoL; EQ5D), depression, social support, and fear of falling; a 4 subgroup analysis also examined outcomes by waiting list status. An informal economic evaluation compared the intervention to usual care. RESULTS: Findings indicated improvements in home safety (p < .0005, b = -15.87), HRQoL (p = .03, b = 0.08), and fear of falling (p < .05, b = 2.22). Findings did not show improvement in functional status or reduction in actual falls. The intervention resulted in a 39% reduction in recommended hours of personal care, which if implemented, could result in significant cost savings. IMPLICATIONS: The study adds to the growing literature of occupational therapy interventions for older adults, and the findings support the concept that restorative approaches can be successfully implemented in public agencies. HubMed – depression

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