High Rates Of Major Depression In Seniors, Ethnic Groups, US

Main Category: Depression
Also Included In: Seniors / Aging;  Anxiety / Stress
Article Date: 12 Jul 2013 - 1:00 PDT Current ratings for:
High Rates Of Major Depression In Seniors, Ethnic Groups, US

Major depression is a serious public health problem among older adults in the United States, but tends to affect ethnic groups differently, finds new research led by a Michigan State University scholar.

According to a survey of nearly 2,000 people aged 50 and older, whites and blacks of Caribbean descent experience much higher rates of major depression than African-Americans.

Amanda Toler Woodward, lead investigator on the study and MSU associate professor of social work, said the findings, taken as a whole, suggest major depression among older people is worse than many believe and has serious implications as the massive baby boomer generation ages.

Elderly people often have other health and mental issues that make it difficult to diagnose and treat major depression, Woodward said. In addition, there is a dearth of clinicians trained in geriatric mental health.

"It is clear that major depression is a significant public health issue among older people," said Woodward, whose study appears in the research journal Anxiety and Depression.

The study examined rates of major depression among three ethnic groups - whites, African-Americans and black Caribbeans- making it the first comprehensive examination of major depression among older blacks.

Specifically, the researchers found:

About 24 percent of whites aged 50 and older experienced major depressive symptoms at least once during their lifetime, and 9 percent experienced major depression in the previous 12 months. About 17 percent of older African-Americans experienced major depression during their lifetime, with 7 percent experiencing major depression in the previous 12 months. About 23 percent of older black Caribbeans experienced major depression during their lifetime, and 15 percent experienced major depressive symptoms in the previous 12 months.

While the study didn't measure why black Caribbeans had significantly higher rates of major depression than African-Americans, Woodward said it may have to do with negative experiences related to immigration such as being separated from family and friends and adapting to U.S. culture.

The number of black Caribbean immigrants in the United States has doubled in the past decade, to more than 3 million.

"This data shows that black Caribbeans and African-Americans are not as similar as one may think, and when we're thinking about diagnoses and treatment we shouldn't lump them together," Woodward said.

Older black men of Caribbean descent reported much higher rates of major depression than older black women of Caribbean descent. The runs counter to the other ethnic groups - whites and African-Americans - which saw women report higher rates of major depression.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our depression section for the latest news on this subject.

Woodward’s co-investigators were Robert Taylor, Jamie Abelson and Niki Matusko from the University of Michigan.

Michigan State University

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Rates Of Decline In Aging And Alzheimer's Disease Higher For Women

Main Category: Alzheimer's / Dementia
Also Included In: Seniors / Aging;  Women's Health / Gynecology
Article Date: 12 Jul 2013 - 0:00 PDT Current ratings for:
Rates Of Decline In Aging And Alzheimer's Disease Higher For Women

The rates of regional brain loss and cognitive decline caused by aging and the early stages of Alzheimer's disease (AD) are higher for women and for people with a key genetic risk factor for AD, say researchers at the University of California, San Diego School of Medicine in a study published online in the American Journal of Neuroradiology.

The linkage between APOE e4 - which codes for a protein involved in binding lipids or fats in the lymphatic and circulatory systems - was already documented as the strongest known genetic risk factor for sporadic AD, the most common form of the disease. But the connection between the sex of a person and AD has been less-well recognized, according to the UC San Diego scientists.

"APOE e4 has been known to lower the age of onset and increase the risk of getting the disease," said the study's first author Dominic Holland, PhD, a researcher in the Department of Neurosciences at UC San Diego School of Medicine. "Previously we showed that the lower the age, the higher the rates of decline in AD. So it was important to examine the differential effects of age and APOE e4 on rates of decline, and to do this across the diagnostic spectrum for multiple clinical measures and brain regions, which had not been done before."

The scientists evaluated 688 men and women over the age of 65 participating in the Alzheimer's Disease Neuroimaging Initiative, a longitudinal, multi-institution study to track the progression of AD and its effects upon the structures and functions of the brain. They found that women with mild cognitive impairment (a condition precursory to AD diagnosis) experienced higher rates of cognitive decline than men; and that all women, regardless of whether or not they showed signs of dementia, experienced greater regional brain loss over time than did men. The magnitude of the sex effect was as large as that of the APOE e4 allele.

"Assuming larger population-based samples reflect the higher rates of decline for women than men, the question becomes what is so different about women," said Holland. Hormonal differences or change seems an obvious place to start, but Holland said this is largely unknown territory - at least regarding AD.

"Another important finding of this study is that men and women did not differ in the level of biomarkers of Alzheimer's disease pathology," said co-author Linda McEvoy, PhD, an associate professor in the UCSD Department of Radiology. "This suggests that brain volume loss in women may also be caused by factors other than Alzheimer's disease, or that in women, these pathologies are more toxic. We clearly need more research on how an individual's sex affects AD pathogenesis."

Holland acknowledged that the paper likely raises more questions than it answers. "There are many factors that may affect the sex differences we observed, such as whether the women in this study may have had higher rates of diabetes or insulin resistance than the men. We also do not know how the use of hormone replacement therapy, reproductive history or years since menopause may have affected these differences. All these issues need to be examined. There is no prevailing theory."

But he said that just as APOE e4 status identifies individuals at greater risk of AD, the sex of a person might prove an important determinant in future treatment as well. Currently, there is no cure for AD or any existing therapies that slow or stop disease progression.

"The biggest impact might be down the road when disease-modifying therapies become available," said Holland. "What works best for men might not work best for women. The same may be true for e4 carriers versus non-carriers."

He added that results also feed back into clinical trial design. The sex-makeup of the sample will affect the rates of decline for both natural progression (the placebo component) and, likely, the degree of disease modification in participants receiving therapy. So a sex-based sub-analysis might be appropriate.

"Additionally, in clinical practice it may be important to expect higher rates of decline for women patients, to help anticipate when stages of decline that significantly alter quality of life would be reached."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our alzheimer's / dementia section for the latest news on this subject.

Co-authors include Rahul S. Desikan, Department of Radiology, and Anders M. Dale, Departments of Radiology and Neurosciences, UC San Diego.

This research was funded, in part, by National Institutes of Health grants R01AG031224, R01AG22381, U54NS056883, P50NS22343 and P50MH081755; National Institute on Aging grant K01AG029218; and NIH-National Institute of Biomedical Imaging and Bioengineering grant T32 EB005970.

University of California - San Diego

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Upward Trend Of Fertility Halted By Rising Unemployment Rates In European Countries

Main Category: Public Health
Also Included In: Fertility
Article Date: 12 Jul 2013 - 0:00 PDT Current ratings for:
Upward Trend Of Fertility Halted By Rising Unemployment Rates In European Countries

The economic crisis has put measurable pressure on birth rates in Europe over the last decade. On average, the more the unemployment rose, the greater the decrease in fertility compared to the number of children per women expected without the crisis. This is the result of a new study performed by the Max Planck Institute for Demographic Research (MPIDR) in Rostock, Germany. MPIDR demographers Michaela Kreyenfeld, Joshua Goldstein and Aiva Jasilioniene have just published their analysis together with Deniz Karaman Orsal of the Leuphana University, Lüneburg, in the open access journal Demographic Research (online).

The largest effect was seen in young adults. Europeans under the age of 25 have especially refrained from having children in the face of rising unemployment rates. The drop of children per woman was strongest for first births. That means, over the last decade young Europeans have particularly postponed family formation.

Whether this leads to less children throughout their life is an open question. Right now most might just intend to postpone when they have children, not if they have children. "Fertility plans can be revised more easily at younger ages than at ages where the biological limits of fertility are approaching," says MPIDR demographer Michaela Kreyenfeld. In fact, among those over 40, birth rates of first children didn't change due to rising unemployment.

If and how economic conditions influence fertility is one of the big open questions in demographic research. The new MPIDR study proves that the extent of joblessness in a contemporary European country does in fact have an effect on birth rates.

However, the strength of this connection varies since factors such as family policies and job security are different for every nation. For example, the birth rates in southern Europe are most strongly affected by higher unemployment. "This is reflective of the especially unstable job situation at the beginning of the working life in the southern countries," says demographer Kreyenfeld.

The consequences of the recession appear beginning around 2008. "The financial crisis hit Europe at a time when birth rates in many countries had just began rising again," says Michaela Kreyenfeld. The MPIDR had observed in earlier studies that the era of very low fertility in Europe had come to an end and that there had been a trend reversal from falling to increasing birth rates. "In some countries the crisis has just put a halt on the upward trend, in others birth rates actually declined," says Kreyenfeld. A noticeable setback occurred, for instance, in Spain, Hungary, Ireland, Croatia and Latvia. Spain experienced a particularly distinct change. Starting at a rate of 1.24 children per woman at the beginning of the millennium, fertility had risen every single year, reaching 1.47 in 2008. In 2009, however, the birth rate dropped to 1.40 after the unemployment rate jumped from 8.3 percent in 2008 to 11.3 percent in 2009. Spanish fertility continued falling to 1.36 in 2011 (no more recent data is available).

Formerly growing rates came to a halt in countries such as the Czech Republic, Poland, the United Kingdom and Italy. Some nations seemed to experience only weak or no effect from rising joblessness, like Russia or Lithuania. In Germany, Austria and Switzerland the analysis did not yield significant results. In these countries unemployment rates did not rise much or not at all. For Germany they even fell. (Charts with birth rates and unemployment rates for all 28 countries can be found on an additional data sheet online.)

The researchers used data from 2001 to 2010 for their study (some countries up to 2011). It is possible that the negative effects of the crisis on birth rates continue.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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NH professors sign petition to restore lower student loan interest rates

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