The prevalence of psychological distress and common mental disorders has been shown to peak in midlife but analyses have ignored the association of poor material circumstances with prevalence. This ...study aimed to test the hypothesis that the midlife prevalence peak occurs only in lower-income households.
Pooled data were used from the annual Health Survey for England, a nationally representative cross-sectional study, on community-dwelling individuals aged ≥ 16 years from years 1997 to 2006 (n=100 457). 12-item General Health Questionnaire scores, reported mental illness diagnoses and receipt of relevant medication were assessed in relation to household income and age. Analyses were separated by gender and adjusted for age, ethnicity, smoking, social class, education and co-morbidities.
Prevalence of psychological distress, diagnoses and treatments rose with age until early middle age and declined subsequently. In analyses conducted separately by income categories, this pattern was marked in low-income groups but absent in high-income groups. Income-related inequalities in the prevalence of psychological distress were greatest in midlife; for example, in men aged 45-54 years the odds ratio of receiving psychiatric medication in the lowest income group compared with the highest was 7.50 95% confidence interval (CI) 4.24-13.27 and in women aged 45-54 years the odds ratio of reporting mental illness was 10.25 (95% CI 6.16-17.05).
An increased prevalence of psychological distress, common mental disorder diagnoses and treatment in midlife is not a universal phenomenon but is found only in those in low-income households. This implies the phenomenon is not inevitable but is potentially manageable or preventable.
Background: there is evidence of a U-shaped association between alcohol consumption and physical health outcomes in older people, such that moderate drinking is associated with better outcomes than ...abstinence or heavy drinking, but whether moderate drinking in older people is associated with better cognition and mental health than non-drinking has not been explored. Objective: to assess the relationship between drinking and cognitive health in middle-aged and older people. Design: prospective observational study. Setting/Participants: six thousand and five individuals aged 50 and over who participated in Wave 1 of the English Longitudinal Study of Ageing (ELSA) and who were not problem drinkers. Exposure and outcome variables: we examined cognitive function, subjective well-being, and depressive symptoms, and compared the risks associated with having never drunk alcohol, having quit drinking, and drinking at <1, <2 and >2 drinks per day. Results: for both men and women, better cognition and subjective well-being, and fewer depressive symptoms, were associated with moderate levels of alcohol consumption than with never having drunk any. Conclusions: in middle-aged and older men and women, moderate levels of alcohol consumption are associated with better cognitive health than abstinence.
To measure the risk of periretirement age disability associated with five different anthropometric measures of body mass and shape, and to compare the measures in this group, the peak age group of ...obesity prevalence.
Longitudinal study of Health Survey for England 1998 respondents followed-up in the English Longitudinal Study of Ageing in 2002.
National population sample of 1030 women and 888 men aged 55-74 years.
Five baseline exposure measures (weight (WT), body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-hip ratio (WHR)) at baseline, and disability outcomes (measured gait speed, self-reported mobility problems, instrumental and ordinary activities of daily living (I/ADLs)) after 5 years.
Individually, the heaviest quartile of WC and WHR predicted disability using all outcomes in men. In women, the heaviest category of each of the five exposure measures predicted disability, for each of the outcomes. In competing measures models, WC was included in the best fit model of tested mobility disability in men (odds ratio (OR) 2.4; 95% confidence interval (CI) 1.4-4.1; P<0.05) and women (OR 3.0; 95% CI 1.9-4.8; P<0.001), adjusted for age, height, smoking, social class, and education. WC was also included in the best fit model of all self-reported disabilities in men, and for self-reported I/ADL disabilities in women.
Across the periretirement age period, body mass and shape are major determinants of disability, with increases in WC, a marker for abdominal obesity, best predicting risk for most disability outcomes. This result adds to the case for WC to be used in estimates of obesity-related health risks for epidemiological monitoring and clinical care.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Interleukin-6 (IL-6) is a key inflammatory cytokine, signalling to most tissues by binding to a soluble IL-6 receptor (sIL-6r), making a complex with gp130. We used 1273 subjects (mean age 68 years) ...from the InCHIANTI Italian cohort to study common variation in the IL-6r locus and associations with interleukin 6 receptor (IL-6r), IL-6, gp130 and a battery of inflammatory markers. The rs4537545 single nucleotide polymorphism (SNP) tags the functional non-synonymous Asp358Ala variant (rs8192284) in IL-6r (r(2)=0.89, n=343). Individuals homozygous for the rs4537545 SNP minor allele (frequency 40%) had a doubling of IL-6r levels (132.48 pg/ml, 95% CI 125.13-140.27) compared to the common allele homozygous group (68.31 pg/ml, 95% CI 65.35-71.41): in per allele regression models, the rs4537545 SNP accounted for 20% of the variance in sIL-6r, with P=5.1 x 10(-62). The minor allele of rs4537545 was also associated with higher circulating IL-6 levels (P=1.9 x 10(-4)). There was no association of this variant with serum levels of gp130 or with any of the studied pro- and anti-inflammatory markers. A common variant of the IL-6r gene results in major changes in IL-6r and IL-6 serum levels, but with no apparent effect on gp130 levels or on inflammatory status in the general population.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Degradation of metallic materials can decrease mechanical properties of metal constructions and components in thermal power plants during their operation and consequently lead to loss of safety and ...reliability. It is difficult to remove material from the pressure system of the equipment being operated. Therefore, the effort is to design, produce and subsequently install exposure channels, which will allow to remove and evaluate samples of exposed material without intervention into the pressure system. The exposure device for pressures and steam temperature in supercritical blocks, which would contain sufficient test material to produce conventional test specimens, is unrealistic in size, energy and economics. The way is to optimize the dimensions of the exposure device according to the miniaturized test specimens, which, in addition to the tensile test and the structural evaluation, can also carry out other required tests, such as bending impact tests with transition temperature, fracture toughness and fatigue tests. This paper deals with optimization of test specimens for the internal dimensions of the exposure device and shows the applicability of small sample methodologies for selected materials.
This paper studies the effect of high-pressure torsion (HPT) method at ambient temperature on mechanical properties of material. The aim is to compare copper subjected to HPT for 2, 10 and ...30-revolutions with coarse grain structured copper in a cold-rolled state. Miniaturized tensile tests were performed to evaluate anisotropy of mechanical properties within a disc product of HPT process. Also the strain rate sensitivity was examined. The results of mechanical tests demonstrate that increasing shear strain leads to ultra-fine grain structure (UFG) which resulted in increasing of material strength. The plasticity of material decreases correspondingly to that. With respect to character of HPT process, discs are known as non-homogenous products, where shear strain effect increases in radial direction from the centre section to the edge. Results show that with different number of HPT revolutions the anisotropy of mechanical behaviour is changing. With increasing number of revolutions the anisotropy within a single disc is increasing.
Alzheimer's disease is the most common cause of dementia and is a primary degenerative disease of the brain of unknown cause. Onset is usually late in life with increasing impairment of memory, ...developing gradually into a global impairment of cognition, orientation, linguistic ability and judgement. The clinical course is accompanied by growing disability and dependency on care. One of the characteristic features of the disease is the widely variable rate of progression seen in different patients. Acetylcholine is an important neurotransmitter associated with memory, and abnormalities in cholinergic neurones (including cell loss) are among the many neurological and neurochemical abnormalities that develop in AD. One approach to lessening the impact of these abnormalities is to inhibit the breakdown of acetylcholine by blocking the relevant enzyme. Tacrine was the first compound approved as a treatment for AD in the US and worked in this way, but caused severe side effects. E2020 (donepezil, Aricept) is a second generation cholinesterase inhibitor and appears to be highly specific, with relatively few side effects.
The objective of this review is to assess whether or not donepezil improves the well-being of patients with mild or moderate Alzheimer's disease.
The Cochrane Dementia and Cognitive Impairment Group Register of Clinical Trials, was searched using the terms 'donepezil', 'E2020' and 'ARICEPT'. Medline, PsychLIT and EMBASE electronic databases were searched with the above terms. Members of the Donepezil Study Group and Eisai Inc were contacted.
All unconfounded, double-blind, randomised controlled trials in which treatment with donepezil was administered for more than a day and compared with placebo in patients with Alzheimer's disease.
Data were extracted independently by the reviewers (JSB & DB), pooled where appropriate and possible, and the weighted or standardised mean differences or Peto odds ratios (95%CI) estimated. Where possible, intention-to-treat data were used.
There are 4 included trials, covering treatment of 12 or 24 weeks duration in highly selected patients. The only information available on one trial (Gauthier 1998) is a conference abstract which reports no usable results. Available outcome data cover domains including cognitive function and global clinical state, but data on several important dimensions of outcome are not available. The results of three trials suggest a small beneficial effect of donepezil in improving cognitive function: at a 5mg/day dose, improvements measured -2.6 points (95%CI -3.5 -- -1.8) on weighted mean difference, in the midrange of the 70 point ADAS-Cog scale. The results of two trials show some improvement in global clinical state (assessed by an independent clinician) in those treated with donepezil compared to placebo. The patient's own rating of their Quality of Life showed no benefit of donepezil compared with placebo. There were significantly more withdrawals before the end of treatment from the 10mg/d (but not the 5mg/d) donepezil group compared with placebo, which may have resulted in some overestimation of beneficial changes at 10mg/d in progressively declining characteristics, as last available measures were used in analyses. A variety of adverse effects were recorded, but very few patients left a trial as a direct result of the intervention.
In selected patients with mild or moderate Alzheimer's disease treated for periods of 12 or 24 weeks, donepezil produced modest improvements in cognitive function and study clinicians rated global clinical state more positively in treated patients. No improvements were present on patient self-assessed quality of life and data on many important outcomes are not available. The practical importance of these changes to patients and carers is unclear.
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