Publications

2018

De Koning, E.J., Timmermans, E.J., Van Schoor , N.M., Stubbs, B., Van den Kommer, T.N., Dennison, E.M., Limongi, F., Castell, M.V., Edwards, M.H., Queipo, R., Cooper, C. (2018). Within-Person Pain Variability and Mental Health in Older Adults With Osteoarthritis: An Analysis Across 6 European Cohorts. The Journal of Pain, 19, 6, 690-698. >Full Text.
Pain is a key symptom of osteoarthritis (OA) and has been linked to poor mental health. Pain fluctuates over time within individuals, but a paucity of studies have considered day-to-day fluctuations of joint pain in relation to affective symptoms in older persons with OA. This study investigated the relationship of pain severity as well as within-person pain variability with anxiety and depression symptoms in 832 older adults with OA who participated in the European Project on OSteoArthritis (EPOSA): a 6-country cohort study. Affective symptoms were examined with the Hospital Anxiety and Depression Scale, pain severity was assessed with the Western Ontario and McMaster Universities OA Index and the Australian/Canadian Hand Osteoarthritis Index, and intraindividual pain variability was measured using pain calendars assessed at baseline, 6, and 12 to 18 months. Age-stratified multiple linear regression analyses adjusted for relevant confounders showed that more pain was associated with more affective symptoms in older-old participants (74.1–85 years). Moreover older-old participants experienced fewer symptoms of anxiety (ratio = .85, 95% confidence interval [CI], .77–.94), depression (ratio = .90, 95% CI, .82–.98), and total affective symptoms (ratio = .87, 95% CI, .79–.94) if their pain fluctuated more. No such association was evident in younger-old participants (65–74.0 years). These findings imply that stable pain levels are more detrimental to mental health than fluctuating pain levels in older persons. Perspective: This study showed that more severe and stable joint pain levels were associated with anxiety and depressive symptoms in older persons with OA. These findings emphasize the importance of measuring pain in OA at multiple time points, because joint pain fluctuations may be an indicator for the presence of affective symptoms.
De Zwart, F., Brunekreef, B., Timmermans, E.J., Deeg, D.J.H., Gehring, U. (2018). Air Pollution and Performance-Based Physical Functioning in Dutch Older Adults Environmental Health Perspectives, 126, 1, 017009. >Full Text.
Background: Functional limitations are a major cause for needing care and institutionalization among older adults. Exposure to air pollution has been suggested to be associated with increased functional limitations in older people. Objective: Our objective was to assess the association between air pollution and physical functioning in Dutch older adults. Methods: We analyzed data on performance-based (walking speed, ability to rise from a chair, putting on and taking off a cardigan, balance test) and self-reported physical functioning for 1,762 participants of the Longitudinal Aging Study Amsterdam, who participated in measurement cycles performed in 2005/2006, 2008/2009, and 2011/2012. Annual average outdoor air pollution concentrations [nitrogen dioxide (NO2), nitrogen oxides (NOx), particulate matter with diameters ≤2.5 μm (PM2.5), ≤10 μm (PM10), and 2.5–10 μm (PMcoarse), and PM2.5 absorbance] at the home address at the start of the first measurement cycle were estimated using land-use regression models. Analyses were performed using mixed models with random participant intercepts adjusting for potential confounders. Results: Exposure to most air pollutants was associated with reduced performance-based physical functioning; for example, an interquartile range increase in NO2 exposure was associated with a 0.22 (95% confidence interval: 0.03, 0.42) lower performance test score in fully adjusted models, equivalent to the difference in performance score between participants who differed by 9 mo in age. Exposure to air pollution was generally not statistically significantly associated with self-reported functional limitations, and not associated with a faster decline in performance-based physical functioning over the study period. Conclusion: This study suggests that exposure to air pollution may adversely affect physical performance of older adults in the Netherlands.
Drewelies, J., Deeg, D.J.H., Huisman, M., Gerstorf, D. (2018). Perceived constraints in late midlife: Cohort differences in the Longitudinal Aging Study Amsterdam (LASA). Psychology and Aging, 33, 5, 754-768. >Full Text.
Life span psychological and life course sociological perspectives have long acknowledged the role of historical and sociocultural contexts for individuals' functioning and development. Secular increases favoring older adults in later born cohorts are widely documented for fluid cognitive performance and well-being. However, less is known about secular trends in further key resources of psychosocial functioning, such as perceptions of constraints, and how these are driven by and associated with well-established and probably interrelated secular trends in several individual difference characteristics, including sociodemographic, religiosity, physical health, cognitive, and social variables. To examine these questions, we compared data from 2 independent local samples of the Longitudinal Aging Study Amsterdam (LASA) obtained 20 years apart, in 1992-1993 (n1992-1993 = 795; age = 55-65 years) versus in 2012-2013 (n2012-2013 = 819; age = 55-65 years). Results revealed that in late midlife, people today perceive fewer constraints than did same-aged peers 20 years ago. These secular trends remained after covarying for individual and cohort differences in physical health, performance-based measures of cognitive functioning (memory), quantitative and qualitative indicators of social support, and self-esteem. The effect size was in the moderate range (d = -.20). We conclude that secular trends such as perceptions of constraints in people's lives generalize to key psychosocial resources across adulthood and old age. We discuss potential underlying mechanisms and consider practical implications of our findings.
Franssen, F.M.E., Smid, D.E., Deeg, D.J.H., Huisman, M., Poppelaars, J.L., Wouters, E.F.M., Spruit, M.A. (2018). The physical, mental, and social impact of COPD in a population-based sample: results from the Longitudinal Aging Study Amsterdam. NPJ Primary Care Respiratory Medicine, 10, 28 (1), 30. >Full Text.
Chronic obstructive pulmonary disease (COPD) is associated with substantial health impact that may already become apparent in early disease. This study aims to examine the features of subjects with COPD in a Dutch population-based sample and compare their physical status, mental status, and social status to non-COPD subjects. This study made use of Longitudinal Aging Study Amsterdam (LASA) data. Demographics, clinical characteristics, self-reported diseases, post-bronchodilator spirometry, physical, mental, and social status were assessed. A number of 810 subjects (50.5% male, mean age 60.5 ± 2.9 years) were included. Subjects with COPD (n = 68, mean FEV1 67.6 [IQR 60.4-80.4] %.) had a slower walking speed than non-COPD subjects, p = 0.033. When compared to non-COPD subjects, COPD subjects gave a lower rating on their health (physical subscale of SF-12: 15 [IQR 16.0-19.0] vs. 18 [IQR 11.0-17.0] points) and life (EQ5D VAS: 75 [IQR 70.0-90.0] vs. 80 points [IQR 65.0-85.5]) surveys. COPD subjects also had a more impaired disease-specific health status (CAT: 9.5 ± 5.9 vs. 6.7 ± 5.2, respectively), were less likely to have a partner (69% vs. 84%, respectively) and received emotional support less often (24% vs. 36%, respectively) compared to non-COPD subjects (All comparisons p < 0.001). In a population-based sample, subjects with COPD had a reduced physical performance, a more impaired disease-specific health status and were more socially deprived compared to non-COPD subjects. These impairments need to be taken into consideration when setting up a management program for patients with mild COPD.
Hoogendijk, E.O., Rockwood, K., Theou, O., Armstrong, J.J., Onwuteaka-Philipsen, B.D., Deeg, D.J.H., Huisman, M. (2018). Tracking changes in frailty throughout later life: results from a 17-year longitudinal study in the Netherlands. Age and Ageing, 47, 727-733. >Full Text.
Background: to better understand the development of frailty with ageing requires longitudinal studies over an extended time period. Objective: to investigate changes in the degree of frailty during later life, and the extent to which changes are determined by socio-demographic characteristics. Methods: six measurement waves of 1,659 Dutch older adults aged 65 years and over in the Longitudinal Aging Study Amsterdam (LASA) yielded 5,211 observations over 17 years. At each wave, the degree of frailty was measured with a 32-item frailty index (FI), employing the deficit accumulation approach. Socio-demographic characteristics included age, sex, educational level and partner status. Generalized Estimating Equation (GEE) analyses were performed to study longitudinal frailty trajectories. Results: higher baseline FI scores were observed in older people, women, and those with lower education or without partner. The overall mean FI score at baseline was 0.17, and increased to 0.39 after 17 years. The average doubling time in the number of deficits was 12.6 years, and this was similar in those aged 65–74 years and those aged 75+. Partner status was associated with changes over time in FI score, whereas sex and educational level were not. Conclusions: this longitudinal study showed that the degree of frailty increased with ageing, faster than the age-related increase previously observed in cross-sectional studies. Even so, the rate of deficit accumulation was relatively stable during later life.
Hoogendijk, E.O., Heymans, M.W., Deeg, D.J.H., Huisman, M. (2018). Socioeconomic Inequalities in Frailty among Older Adults: Results from a 10-Year Longitudinal Study in the Netherlands. Gerontology, 64, 157-164. >Full Text.
Background: Frailty is an important risk factor for adverse outcomes in older people. Substantial variation in frailty prevalence between socioeconomic groups exists, but longitudinal evidence for the association between socioeconomic position (SEP) and frailty is scarce. Objective: To investigate the course of socioeconomic inequalities in frailty among older adults during 10 years of follow-up. Methods: Data were used from the Longitudinal Aging Study Amsterdam ( n = 1,509). Frailty was measured with the functional domains approach, based on deficiencies in four domains: physical, nutritive, cognitive, and sensory. Mixed-model analyses were performed to estimate the course of frailty and its association with SEP during a 10-year follow-up. We investigated whether similar patterns of associations held in different scenarios, comparing results of survivor analyses with those based on two imputation methods accounting for dropout due to death (substitution of first missing value and missing values imputed with a prediction model). Results: All scenarios showed a linear increase in frailty with aging (survivor analyses OR = 1.87, 95% CI = 1.66–2.11) and associations of low education and low income with frailty (adjusted OR for low education = 1.76, 95% CI = 1.05–2.97; adjusted OR for low income = 1.90, 95% CI = 1.20–3.01; both for survivor analyses). Sex-stratified analyses indicated that socioeconomic inequalities were mainly present in men, not in women. Similar patterns of associations of SEP with frailty were observed in all scenarios, but the increase in frailty prevalence over time differed substantially between the scenarios. There were no statistically significant interactions between time and SEP on frailty (all scenarios), suggesting that inequalities in frailty did not increase or decrease during follow- up. Conclusion: SEP inequalities in frailty among older adults were observed, mainly among men, and persisted during 10 years of follow-up.
Jacobs, M.T., Broese van Groenou, M.I., Aartsen, M.J., Deeg, D.J.H. (2018). Diversity in Older Adults' Care Networks: The Added Value of Individual Beliefs and Social Network Proximity. The Journals of Gerontology: Series B, 73, 2, 326-336. >Full Text.
Objectives: Policy reforms in long-term care require an increased share of informal caregivers in elderly care. This may be more feasible for older adults who (believe they) can organize the care themselves and have a local social network. This study describes care network types, how they vary in the share of informal caregivers, and examines associations with characteristics of community-dwelling older adults, including individual beliefs and network proximity. Method: Latent class analyses were applied to a subsample of older care receivers (N = 491) from the Longitudinal Aging Study Amsterdam, in order to identify homogeneous subgroups of people with similar care networks. Multinomial regression analysis explored associations between network type and care receiver characteristics. Results: Privately paid, coresidential, large informal, and publicly paid care network types were distinguished. Variation in informal care appeared mostly related to health, partner status, income, and proximity of children. Proximity of other potential informal caregivers did not affect the network type. Perceived control of care was highest in the privately paid network. Discussion: The results suggest that local (non-)kin could be mobilized more often in coresidential networks. Increasing informal or alternative care in publicly paid networks is less likely, due to limited social and financial resources.
Jeuring, H.W., Comijs, H.C., Deeg, D.J.H., Hoogendijk, E.O., Beekman, A.T.F., Stek, M.L., Huisman, M. (2018). Secular trends in excess mortality of late-life depression. Journal of Affective Disorders, 234, 28-33. >Full Text.
Background: Late-life depression is associated with premature mortality, however, little is known whether excess mortality rates of depression have changed over time. This study aims to identify and explain secular trends in excess mortality of major depressive disorder (MDD) and subthreshold depression (SUBD). Methods: Cohort-sequential-longitudinal study of 4084 community-dwelling older adults in the Netherlands based on data from the Longitudinal Aging Study Amsterdam (LASA). Six measurement cycles were included from 1992/93 until 2008/09, each linked to the overall 5-year mortality, covering a 16-year time span. MDD and SUBD were identified using a two-stage screening procedure with the Center for Epidemiological Studies Depression Scale and the Diagnostic Interview Schedule. Age and sex were covariates. Education, health and lifestyle factors, and use of antidepressants were included as putative explanatory factors. Generalized Estimating Equations was used to investigate the association between the interaction ‘Depression ×Time’ and 5-year mortality, and to find explanatory factors for the trend. Results: A downward trend in excess mortality of MDD was found (OR = .92, 95%-CI:.85–.99, P = .04), adjusted for age and sex, which could not be explained by education, health and lifestyle factors, nor antidepressants use. Sex differences in the trend were not found (P= .77). No trend in excess mortality of SUBD was found (OR = 1.01, 95%-CI: .97–1.04, P = .65). Limitations: The findings do not imply a similar trend for other countries. Conclusions: The results indicate a favorable development in excess mortality of community-dwelling older adults with MDD, while those with SUBD do not show a clear trend in excess mortality.
Jeuring, H.W., Comijs, H.C., Deeg, D.J.H., Stek, M.L., Huisman, M., Beekman, A.T.F. (2018). Secular trends in the prevalence of major and subthreshold depression among 55-64-year olds over 20 years. Psychological Medicine, 48, 11, 1824-1834. >Full Text.
Background: Studying secular trends in the exposure to risk and protective factors of depression and whether these trends are associated with secular trends in the prevalence of depression is important to estimate future healthcare demands and to identify targets for prevention. Methods: Three birth cohorts of 55-64-year olds from the population-based Longitudinal Aging Study Amsterdam were examined using identical methods in 1992 (n = 944), 2002 (n = 964) and 2012 (n = 957). A two-stage screening design was used to identify subthreshold depression (SUBD) and major depressive disorder (MDD). Multinomial logistic regression analyses were used to identify secular trends in depression prevalence and to identify factors from the biopsychosocial domains of functioning that were associated with these trends. Resiults: Compared with 1992, MDD became more prevalent in 2002 (OR 1.90, 95% CI 1.10-3.28, p = 0.022) and 2012 (OR 1.80, 95% CI 1.03-3.14, p = 0.039). This was largely attributable to an increase in the prevalence of chronic diseases and functional limitations. Socioeconomic and psychosocial improvements, including an increase in labor market participation, social support and mastery, hampered MDD rates to rise more and were also associated with a 32% decline of SUBD-rates in 2012 as compared with 2002 (OR 0.68, 95% CI 0.48-0.96, p = 0.03). Conclusions: Among late middle-aged adults, there is a substantial net increase of MDD, which is associated with deteriorating physical health. If morbidity and disability continue to increase, a further expansion of MDD rates may be expected. Improving socioeconomic and psychosocial conditions may benefit public health, as these factors were protective against a higher prevalence of both MDD and SUBD.
Kleipool, E.E.F., Hoogendijk, E.O., Trappenburg, M.C., Handoko, M.L., Huisman, M., Peters, M.J.L., Muller, M.J. (2018). Frailty in Older Adults with Cardiovascular Disease: Cause, Effect or Both? Aging and Disease, 9, 489-497. >Full Text.
Cardiovascular disease (CVD) has been associated with an increased risk of frailty, but the direction of the association remains unclear. This study set out to examine the bidirectional longitudinal association between CVD and frailty over an extended period of time. Data are from 1432 older adults (aged 65-88yrs) of the Longitudinal Aging Study Amsterdam (LASA), who were followed for 17 years. At baseline and follow-up, CVD was assessed through self-report, medication use and medical records, and classified as angina pectoris, myocardial infarction, heart failure (HF), stroke, and peripheral artery disease. Throughout the study, frailty was assessed using Fried’s frailty criteria. Cox regression models showed that patients with HF had an increased frailty risk (HR 2.7; 95%CI: 1.5-5.1) after a median follow-up of 8.4 yrs. This finding was independent of potential confounders (age, sex, several comorbidities). Examinations of the reverse association revealed that frail older adults were not at risk of incident CVD. Of all older adults with CVD, those with HF have an increased risk of frailty and frail older adults do not have an increased risk of CVD. Our findings emphasize the need for cardiac rehabilitation programs evaluating the effect of physical exercise programs in order to prevent frailty and therewith improve quality of life and independence of care in CVD patients.
Legdeur, N., Heymans, M.W., Comijs, H.C., Huisman, M., Maier, A.B., Visser, P.J. (2018). Age dependency of risk factors for cognitive decline. BMC Geriatrics, 18, 187, 1-10. >Full Text.
Background: Risk factors for cognitive decline might depend on chronological age. The aim of the study was to explore the age dependency of risk factors for cognitive decline in cognitively healthy subjects aged 55–85 years at baseline. Methods: We included 2527 cognitively healthy subjects from the Longitudinal Aging Study Amsterdam (LASA). Median follow-up was 9.1 (IQR: 3.2–19.0) years. The association of genetic and cardiovascular risk factors, depressive symptoms, inflammation markers and lifestyle risk factors with decline in MMSE and memory function was tested using spline regression analyses. Results: Subjects were on average 70.1 (SD 8.8) years old at baseline. Based on a spline regression model, we divided our sample in three age groups: ≤70 years (young-old), > 70–80 years (old) and > 80 years (oldest-old). The association of LDL cholesterol, homocysteine, hypertension, history of stroke, depressive symptoms, interleukin-6, a1-antichymotrypsin, alcohol use and smoking with cognitive decline significantly differed between the age groups. In general, the presence of these risk factors was associated with less cognitive decline in the oldest-old group compared to the young-old and old group. Conclusions: The negative effect of various risk factors on cognitive decline decreases with higher age. A combination of epidemiological factors, such as the selection towards healthier subjects during follow-up, but also risk factor specific features, for example ensuring the cerebral blood flow in case of hypertension, explain this diminished association at higher age. It is important to take these age differences into account when applying preventive strategies to avert cognitive decline.
Looijaard, S.M.L.M., Slee-Valentijn, M.S., Groeneveldt, L.N., Deeg, D.J.H., Huisman, M., Maier, A.B. (2018). Do older individuals who are diagnosed with cancer have worse physical performance prior to diagnosis compared to matched controls? A longitudinal cohort study. BMC Geriatrics, 18, 166. >Full Text.
Background: Impaired physical performance is highly prevalent in older cancer patients and is associated with cancer-related outcomes such as mortality and chemotherapy-related toxicity. Physical performance might already decline prior to the cancer diagnosis due to undiagnosed disease. This study aimed to assess whether the physical performance of community-dwelling individuals prior to cancer diagnosis is worse compared to matched controls who are not diagnosed with cancer. Methods: The study sample was selected from the Longitudinal Aging Study Amsterdam, a longitudinal study on a nationally representative sample of the Dutch older population. Physical performance of initially cancer-free individuals aged 55–84 years who were diagnosed with cancer during 10 or 20 years of follow-up was compared to the physical performance of controls who were not diagnosed with cancer. For controls, the physical performance measurements of the cycle with a median age closest to the cancer group were used. The time interval between physical performance measurements and the report of cancer was 2 to 4 years. Groups were compared using logistic and linear regression analysis. Results: The study sample included 1735 individuals with a median age of 68.7 [interquartile range 63.3–76.4] years. During follow-up, 414 (23.9%) individuals were diagnosed with cancer. Handgrip strength, gait speed, chair stand ability, chair stand test time and ability to put on and take off a cardigan did not differ between groups. Individuals prior to cancer diagnosis were more likely to complete the tandem balance test. Conclusions: Physical performance of individuals 2 to 4 years prior to report of cancer diagnosis is not lower compared to controls. This suggests that physical performance may not be influenced by cancer before diagnosis.
Marees, A.T., Hammerschlag, A.R., Bastarache, L., de Kluiver, H., Vorspan, F., van den Brink, W., Smit, D.J., Denys, D., Gamazon, E.R., Stringa, N. (2018). Exploring the role of low-frequency and rare exonic variants in alcohol and tobacco use. Drug and Alcohol Dependence, 188, 94-101. >Full Text.
Background: Alcohol and tobacco use are heritable phenotypes. However, only a small number of common genetic variants have been identified, and common variants account for a modest proportion of the heritability. Therefore, this study aims to investigate the role of low-frequency and rare variants in alcohol and tobacco use. Methods: We meta-analyzed ExomeChip association results from eight discovery cohorts and included 12,466 subjects and 7432 smokers in the analysis of alcohol consumption and tobacco use, respectively. The ExomeChip interrogates low-frequency and rare exonic variants, and in addition a small pool of common variants. We investigated top variants in an independent sample in which ICD-9 diagnoses of “alcoholism” (N = 25,508) and “tobacco use disorder” (N = 27,068) had been assessed. In addition to the single variant analysis, we performed gene-based, polygenic risk score (PRS), and pathway analyses. Results: The meta-analysis did not yield exome-wide significant results. When we jointly analyzed our top results with the independent sample, no low-frequency or rare variants reached significance for alcohol consumption or tobacco use. However, two common variants that were present on the ExomeChip, rs16969968 (p = 2.39 × 10−7) and rs8034191 (p = 6.31 × 10−7) located in CHRNA5 and AGPHD1 at 15q25.1, showed evidence for association with tobacco use. Discussion: Low-frequency and rare exonic variants with large effects do not play a major role in alcohol and tobacco use, nor does the aggregate effect of ExomeChip variants. However, our results confirmed the role of the CHRNA5-CHRNA3-CHRNB4 cluster of nicotinic acetylcholine receptor subunit genes in tobacco use.
Pronk, M., Deeg, D.J.H., Kramer, S.E. (2018). Explaining Discrepancies Between the Digit Triplet Speech-in-Noise Test Score and Self-Reported Hearing Problems in Older Adults. Journal of Speech Language and Hearing Research, 61, 4, 986-999. >Full Text.
Purpose: The purpose of this study is to determine which demographic, health-related, mood, personality, or social factors predict discrepancies between older adults’ functional speech-in-noise test result and their self-reported hearing problems. Method: Data of 1,061 respondents from the Longitudinal Aging Study Amsterdam were used (ages ranged from 57 to 95 years). Functional hearing problems were measured using a digit triplet speech-in-noise test. Five questions were used to assess self-reported hearing problems. Scores of both hearing measures were dichotomized. Two discrepancy outcomes were created: (a) being unaware: those with functional but without self-reported problems (reference is aware: those with functional and self-reported problems); (b) reporting false complaints: those without functional but with self-reported problems (reference is well: those without functional and self-reported hearing problems). Two multivariable prediction models (logistic regression) were built with 19 candidate predictors. The speech reception threshold in noise was kept (forced) as a predictor in both models. Results: Persons with higher self-efficacy (to initiate behavior) and higher self-esteem had a higher odds to being unaware than persons with lower self-efficacy scores (odds ratio [OR] = 1.13 and 1.11, respectively). Women had a higher odds than men (OR = 1.47). Persons with more chronic diseases and persons with worse (i.e., higher) speech-in-noise reception thresholds in noise had a lower odds to being unaware (OR = 0.85 and 0.91, respectively) than persons with less diseases and better thresholds, respectively. A higher odds to reporting false complaints was predicted by more depressive symptoms (OR = 1.06), more chronic diseases (OR = 1.21), and a larger social network (OR = 1.02). Persons with higher selfefficacy (to complete behavior) had a lower odds (OR = 0.86), whereas persons with higher self-esteem had a higher odds to report false complaints (OR = 1.21). The explained variance of both prediction models was small (Nagelkerke R2 = .11 for the unaware model, and .10 for the false complaints model). Conclusions: The findings suggest that a small proportion of the discrepancies between older individuals’ results on a speech-in-noise screening test and their self-reports of hearing problems can be explained by the unique context of these individuals. The likelihood of discrepancies partly depends on a person’s health (chronic diseases), demographics (gender), personality (self-efficacy to initiate behavior and to persist in adversity, self-esteem), mood (depressive symptoms), and social situation (social network size). Implications are discussed.
Reinders, I., Van Schoor , N.M., Deeg, D.J.H., Huisman, M., Visser, M. (2018). Trends in leefstijl van 55-64 jarigen in de periode 1992-2013. Geron, 20, 1, 69-72.
Wereldwijd neemt het aantal mensen die 60 jaar en ouder zijn toe. Daarnaast neemt ook de gemiddelde levensverwachting toe. Echter, het aantal gezonde levensjaren neemt niet met dezelfde snelheid toe. Dit is mogelijk te verklaren door een ongezondere leefstijl van huidige generaties.
Robitaille, A., van den Hout, A., Machado, R.J.M., Bennett, D.A., Cukić, I., Deary, I.J., Hofer, S.M., Hoogendijk, E.O., Huisman, M., Johansson, B., Koval, A.V., van den Noordt, M., Piccinin, A.M. (2018). Transitions across cognitive states and death among older adults in relation to education: A multistate survival model using data from six longitudinal studies. Alzheimer`s & Dementia, 14, 462-472. >Full Text.
Introduction: This study examines the role of educational attainment, an indicator of cognitive reserve, on transitions in later life between cognitive states (normal Mini-Mental State Examination (MMSE), mild MMSE impairment, and severe MMSE impairment) and death. Methods: Analysis of six international longitudinal studies was performed using a coordinated approach. Multistate survival models were used to estimate the transition patterns via different cognitive states. Life expectancies were estimated. Results: Across most studies, a higher level of educationwas associated with a lower risk of transitioning fromnormalMMSEtomildMMSEimpairment butwas not associated with other transitions. Those with higher levels of education and socioeconomic status had longer nonimpaired life expectancies. Discussion: This study highlights the importance of education in later life and that early life experiences can delay later compromised cognitive health. This study also demonstrates the feasibility and benefit in conducting coordinated analysis across multiple studies to validate findings.
Schaap, L.A., Van Schoor , N.M., Lips, P.T.A., Visser, M. (2018). Associations of Sarcopenia Definitions, and Their Components, With the Incidence of Recurrent Falling and Fractures: The Longitudinal Aging Study Amsterdam. The Journals of Gerontology: Medical Sciences, 73, 9, 1199-1204. >Full Text.
Background: The aim was to investigate the associations of sarcopenia as defined by European Working Group on Sarcopenia in Older People (EWGSOP) and Foundation for the National Institutes of Health (FNIH) Sarcopenia Project, and their underlying components, with the incidence of recurrent falling and fractures. Methods: In 498 older men and women (mean age = 75.2 [SD = 6.4]) from the Longitudinal Aging Study Amsterdam (LASA), the sarcopenia components lean mass (DXA), handgrip strength (handheld dynamometer), and gait speed were measured. Data on falls (3-year follow-up) and fractures (10-year follow-up) were collected. Cox regression analyses were performed, adjusting for age, sex, and total body fat. Results: Recurrent falling occurred in 130 persons and 60 persons experienced a fracture during follow-up. Participants who were identified as sarcopenic based on the FNIH definitions had a more than 2-fold increased risk to become a recurrent faller. There was no association between sarcopenia based on the EWGSOP definition and incidence of recurrent falling. When the sarcopenia components were examined individually, only a low grip strength was associated with incidence of recurrent falling, independent of a low lean mass or a slow gait speed. Sarcopenia according to both definitions was not associated with incident fractures, which may be caused by low statistical power. Conclusion: Sarcopenia according to the FNIH definitions, but not according to the EWGSOP definition was associated with recurrent falling. When examining the individual components, only a low grip strength was independently associated with recurrent falling. No associations between sarcopenia with incidence of fractures were found.
Schilling, O.K., Deeg, D.J.H., Huisman, M. (2018). Affective well-being in the last years of life: The role of health decline. Psychology and Aging, 33, 5, 739-753. >Full Text.
Adding to recent evidence of terminal decline in affective well-being, this study examined the role of physical health in accounting for time-to-death-related changes in positive affect (PA) and negative affect (NA). We distinguished effects of preterminal health levels predicting levels ("preserved differentiation") and terminal changes ("differential preservation") and of terminal health declines predicting terminal changes ("terminal reactivity") of affective well-being in the terminal period of life. Data were used from the first cohort of the Longitudinal Aging Study Amsterdam, including 3-yearly measurements from 1992-1993 to 2011-2012 (N = 2310, age = 55-85 at baseline). Measures of PA and NA were derived from the Center for Epidemiologic Studies Depression Scale. Health measures included self-rated health, self-reported functional limitations, and gait speed. Exponential time-to-death-related trajectories in PA and NA were analyzed with mixed regression models. Results confirmed accelerated time-to-death-related decline of PA and increase of NA. Regarding health effects, the findings support terminal reactivity, in that the amount of end-of-life changes in affective well-being was closely linked to the concurrent terminal changes in health. Preterminal health levels did not predict the amount of terminal changes in affective well-being; however, reaching the final years of life with better levels of functional health appeared to promote longer maintenance of better levels of affective well-being and terminal declines more "compressed" to a shorter period prior to death. The findings point to needs to strengthen individuals' resources to compensate for health losses at the end of their life span.
Timmermans, E.J., Lakerveld, J., Beulens, J.W., Boomsma, D.I., Kramer, S.E., Oosterman, M., Willemsen, G., Stam, M., Nijpels, G., Deeg, D.J.H., Penninx, B.W.J.H., Huisman, M. (2018). Cohort profile: the Geoscience and Health Cohort Consortium (GECCO) in the Netherlands. BMJ Open, 8, e021597. >Full Text.
Purpose: In the Netherlands, a great variety of objectively measured geo-data is available, but these data are scattered and measured at varying spatial and temporal scales. The centralisation of these geo-data and the linkage of these data to individual-level data from longitudinal cohort studies enable large-scale epidemiological research on the impact of the environment on public health in the Netherlands. In the Geoscience and Health Cohort Consortium (GECCO), six large-scale and ongoing cohort studies have been enriched with a variety of existing geo-data. Here, we introduce GECCO by describing: (1) the phenotypes of the involved cohort studies, (2) the collected geo-data and their sources, (3) the methodology that was used to link the collected geo-data to individual cohort studies, (4) the similarity of commonly used geo-data between our consortium and the nationwide situation in the Netherlands and (5) the distribution of geo-data within our consortium. Participants: GECCO includes participants from six prospective cohort studies (eg, 44 657 respondents (18–100 years) in 2006) and it covers all municipalities in the Netherlands. Using postal code information of the participants, geo-data on the address-level, postal codelevel as well as neighbourhood-level could be linked to individual-level cohort data. Findings to date: The geo-data could be successfully linked to almost all respondents of all cohort studies, with successful data-linkage rates ranging from 97.1% to 100.0% between cohort studies. The results show variability in geo-data within and across cohorts. GECCO increases power of analyses, provides opportunities for cross-checking and replication, ensures sufficient geographical variation in environmental determinants and allows for nuanced analyses on specific subgroups. Future plans: GECCO offers unique opportunities for (longitudinal) studies on the complex relationships between the environment and health outcomes. For example, GECCO will be used for further research on environmental determinants of physical/psychosocial functioning and lifestyle behaviours.
Timmermans, E.J., Gehring, U., De Zwart, F., Brunekreef, B., Deeg, D.J.H. (2018). Luchtvervuiling en fysiek functioneren van ouderen in Nederland. Gerōn, 20, 2, 72-74.
No abstract available.
Trajanoska, K., Morris, J.A., Oei, H.L.D.W., Zheng, H.F., Evans, D.M., Kiel, D.P., Ohlsson, C., Richards, J.B., Rivadeneira, F.F., GEFOS/GENOMOS consortium (2018). Assessment of the genetic and clinical determinants of fracture risk: genome wide association and mendelian randomisation study. British Medical Journal, 362, k3225. >Full Text.
Objectives: To identify the genetic determinants of fracture risk and assess the role of 15 clinical risk factors on osteoporotic fracture risk. Design: Meta-analysis of genome wide association studies (GWAS) and a two-sample mendelian randomisation approach. Setting: 25 cohorts from Europe, United States, east Asia, and Australia with genome wide genotyping and fracture data. Participants: A discovery set of 37 857 fracture cases and 227 116 controls; with replication in up to 147 200 fracture cases and 150 085 controls. Fracture cases were defined as individuals (>18 years old) who had fractures at any skeletal site confirmed by medical, radiological, or questionnaire reports. Instrumental variable analyses were performed to estimate effects of 15 selected clinical risk factors for fracture in a two-sample mendelian randomisation framework, using the largest previously published GWAS meta-analysis of each risk factor. Results: Of 15 fracture associated loci identified, all were also associated with bone mineral density and mapped to genes clustering in pathways known to be critical to bone biology (eg, SOST, WNT16, and ESR1) or novel pathways (FAM210A, GRB10, and ETS2). Mendelian randomisation analyses showed a clear effect of bone mineral density on fracture risk. One standard deviation decrease in genetically determined bone mineral density of the femoral neck was associated with a 55% increase in fracture risk (odds ratio 1.55 (95% confidence interval 1.48 to 1.63; P=1.5×10-68). Hand grip strength was inversely associated with fracture risk, but this result was not significant after multiple testing correction. The remaining clinical risk factors (including vitamin D levels) showed no evidence for an effect on fracture. Conclusions: This large scale GWAS meta-analysis for fracture identified 15 genetic determinants of fracture, all of which also influenced bone mineral density. Among the clinical risk factors for fracture assessed, only bone mineral density showed a major causal effect on fracture. Genetic predisposition to lower levels of vitamin D and estimated calcium intake from dairy sources were not associated with fracture risk.
Van Ballegooijen, A.J., van Putten, S.R., Visser, M., Beulens, J.W., Hoogendijk, E.O. (2018). Vitamin K status and physical decline in older adults-The Longitudinal Aging Study Amsterdam. Maturitas, 113, 73-79. >Full Text.
Objective: We examined the association between vitamin K status and physical functioning over 13 years in the Longitudinal Aging Study Amsterdam. Study design: Longitudinal cohort study of 633 community-dwelling adults from the Longitudinal Aging Study Amsterdam (LASA) aged 55–65 years (54% women). Main outcome measures: At baseline (2002–2003), plasma desphospho-uncarboxylated matrix Gla protein (dpucMGP) was measured with a sandwich ELISA as a marker of vitamin K status. The outcome measures handgrip strength, calf circumference, self-reported functional limitations and functional performance were obtained at baseline and four follow-up examinations. We used generalized estimating equations to determine the relationship between dp-ucMGP tertiles and the various outcome measurements after adjusting for potential confounders. The lowest dp-ucMGP tertile reflects a high vitamin K status and was the reference. Results: Mean dp-ucMGP was 376 ± 233 pmol/L and mean follow-up was 11.1 years. Participants showed a decline in the outcome measures over time. Compared with the lowest tertile, the highest dp-ucMGP tertile had: lower handgrip strength, 1.1 kg (95% confidence interval (−2.1, −0.1; P-trend<0.001); smaller calf circumference, −0.5 cm (−0.9 −0.1; P-trend=0.018); and, only among women, a 0.7-point poorer functional performance score (−1.1, −0.3; P-interaction=0.002). Dp-ucMGP was not related to self-reported functional limitations. No interaction effects between time and dp-ucMGP were observed. Conclusions: Low vitamin K status was associated with lower handgrip strength, smaller calf circumference, and, in women only, with poorer functional performance score. A low vitamin K status was however not related to the 13-year decline in these measures.
Van den Kommer, T.N., Deeg, D.J.H., Van der Flier, W.M., Comijs, H.C. (2018). Time Trend in Persistent Cognitive Decline: Results From the Longitudinal Aging Study Amsterdam. The Journals of Gerontology: Series B, 73, S1, S57-S64. >Full Text.
Objective: To study time trends in the incidence of persistent cognitive decline (PCD), and whether an increase or decrease is explained by changes in well-known risk factors of dementia. Method: Data from the Longitudinal Aging Study Amsterdam over a period of 20 years were used. Subsamples of 65–88 year-olds were selected at 7 waves, with numbers ranging from 1,800 to 1,165. Within-person change in cognitive functioning was used to determine PCD. In logistic generalized estimating equations (GEE), time (0, 3, 6, 9, 13, and 16 years) was the main predictor of 3-year PCD incidence. Explanatory variables were lagged one wave before incident PCD and included in separate models. Results: PCD incidence was 2.5% at first, and 3.4% at last follow-up. GEE showed a positive time trend for PCD incidence [Exp(B)time = 1.042; p < .001]. None of the explanatory variables significantly changed the strength of the regression coefficient of linear time. Higher age, lower education, diabetes mellitus, smoking, lower body-mass index, and lower level of physical activity were associated with higher incidence of PCD. Conclusion: An increase in PCD incidence over time was found. Although well-known risk factors were associated with incidence per se, they did not explain the increase in incidence of PCD.
Van Schoor , N.M., Heymans, M.W., Lips, P.T.A. (2018). Vitamin D status in relation to physical performance, falls and fractures in the Longitudinal Aging Study Amsterdam: A reanalysis of previous findings using standardized serum 25-hydroxyvitamin D values. Journal of Steroid Biochemistry and Molecular Biology, 177, 255-260. > Full Text.
The Longitudinal Aging Study Amsterdam (LASA) is an ongoing prospective cohort study in a representative sample of Dutch older persons. In previous LASA studies, lower serum 25-hydroxyvitamin D (25(OH)D) values, as assessed by a competitive protein binding assay or radioimmunoassay, have been associated with decreased physical functioning, falls and fractures. Recently, serum 25(OHD) values in LASA were standardized using the Vitamin D Standardization Program (VDSP) protocol as part of the European ODIN project. In the current manuscript, the influence of standardizing serum 25(OH)D values will be discussed using the associations with physical functioning, falls and fractures as examples.
Van Tilburg, T.G., Klok, J. (2018). Trend in prevalentie van eenzaamheid onder ouderen. In Cretien van Campen, Frieke Vonk, Theo van Tilburg (eds.), Kwetsbaar en eenzaam? Risico's en bescherming in de ouder wordende bevolking. (pp. 35-45). Den Haag: Sociaal en Cultureel Planbureau.
No abstract available.
Van Tilburg, T.G., Iedema, J., Klok, J. (2018). Veranderingen in eenzaamheid in de tweede levenshelft. In Cretien van Campen, Frieke Vonk, Theo van Tilburg (eds.), Kwetsbaar en eenzaam? Risico's en bescherming in de ouder wordende bevolking. (pp. 46-53) Den Haag: Sociaal en Cultureel Planbureau.
No abstract available.
Wijnhoven, H.A.H., Elstgeest, L.E.M., De Vet, H.C.W., Nicolaou, M., Snijder, M.B., Visser, M. (2018). Development and validation of a short food questionnaire to screen for low protein intake in community-dwelling older adults: The Protein Screener 55+ (Pro55+). Plos One, 13, 5, e0196406, 1-15. >Full Text.
In old age, sufficient protein intake is important to preserve muscle mass and function. Around 50% of older adults (65+ y) consumes ≤1.0 g/kg adjusted body weight (BW)/day (d). There is no rapid method available to screen for low protein intake in old age. Therefore, we aimed to develop and validate a short food questionnaire to screen for low protein intake in community-dwelling older adults. We used data of 1348 older men and women (56–101 y) of the LASA study (the Netherlands) to develop the questionnaire and data of 563 older men and women (55–71 y) of the HELIUS study (the Netherlands) for external validation. In both samples, protein intake was measured by the 238-item semi-quantitative HELIUS food frequency questionnaire (FFQ). Multivariable logistic regression analysis was used to predict protein intake ≤1.0 g/kg adjusted BW/d (based on the HELIUS FFQ). Candidate predictor variables were FFQ questions on frequency and amount of intake of specific foods. In both samples, 30% had a protein intake ≤1.0 g/kg adjusted BW/d. Our final model included adjusted body weight and 10 questions on the consumption (amount on average day or frequency in 4 weeks) of: slices of bread (number); glasses of milk (number); meat with warm meal (portion size); cheese (amount and frequency); dairy products (like yoghurt) (frequency); egg(s) (frequency); pasta/noodles (frequency); fish (frequency); and nuts/peanuts (frequency). The area under the receiver operating characteristic curve (AUC) was 0.889 (95% CI 0.870–0.907). The calibration slope was 1.03 (optimal slope 1.00). At a cut-off of ≤0.8 g/kg adjusted BW/d, the AUC was 0.916 (96% CI 0.897–0.936). Applying the regression equation to the HELIUS sample, the AUC was 0.856 (95% CI 0.824–0.888) and the calibration slope 0.92. Regression coefficients were therefore subsequently shrunken by a linear factor 0.92. To conclude, the short food questionnaire (Pro55+) can be used to validly screen for protein intake ≤1.0 g/kg adjusted BW/d in community-dwelling older adults.
Winkens, L.H.H., Van Strien, T., Brouwer, I.A., Penninx, B.W.J.H., Visser, M., Lähteenmäki, L. (2018). Associations of mindful eating domains with depressive symptoms and depression in three European countries. Journal of Affective Disorders, 228, 26-32. >Full Text.
Objective: To examine associations of mindful eating domains with depressive symptoms and depression in three European countries. Moderation by change in appetite—with increased appetite as marker for depression with atypical features— was also tested. Methods: Data were collected in Denmark (n=1522), Spain (n=1512) and the Netherlands (n=1439). Multiple linear and logistic regression analyses segregated by country were used to test associations of four mindful eating domains (Mindful Eating Behaviour Scale; MEBS) with depressive symptoms (continuous score on the Center for Epidemiologic Studies Depression Scale; CES-D) and depression (scoring above the clinically relevant cut-off score on the CES-D, and/or use of antidepressants, and/or psychological treatment). Moderation by change in appetite was tested with bias-corrected bootstrap confidence intervals. Results: The domains Focused Eating, Eating with Awareness and Eating without Distraction were significantly negatively associated with depressive symptoms and depression in all three countries (e.g. Focused Eating Denmark: B=−0.71, 95%CI: −0.87, −0.54; OR=0.89, 95%CI: 0.86, 0.93). The domain Hunger and Satiety Cues (only measured in the Netherlands) was significantly positively associated with depressive symptoms in the adjusted models (B=0.09, 95%CI: 0.02, 0.16), but not with depression (OR=1.02, 95%CI: 0.98, 1.05). These associations were found for both people with and without increased appetite. Limitations: The cross-sectional design, which makes it impossible to draw causal conclusions. Conclusions: The present study indicates that higher scores on three mindful eating domains are consistently associated with a lower level of depressive symptoms and a lower likelihood of having depression in three European countries.

2017

Alders, P., Comijs, H.C., Deeg, D.J.H. (2017). Changes in admission to long-term care institutions in the Netherlands: comparing two cohorts over the period 1996-1999 and 2006-2009. European Journal of Ageing, 14, 123-131. >Full Text.
Using data from two cohorts, we examine to what extent a decline in institutional care in the Netherlands is associated with changes in the need for care and/or societal factors. We compared older adults, aged 65–89, who were admitted to a long-term care (LTC) institution in the period 1996-1999 and 2006-2009. Using the Andersen model, we tested per block of predisposing, enabling and need factors, which factors were significant predictors of admission to institutional care. With a Blinder–Oaxaca decomposition regression, we decomposed the difference in admission to an LTC institution between the period 1996-1999 and 2006-2009 into a part that is due to differences in health needs and other factors such as effect of policy, social values, and technology. Between 1996 and 2006, the percentage of co-residing partners and income increased and the average level of loneliness decreased significantly. The prevalence of disability, chronic diseases, however, increased. Whereas the care by partners declined, the formal care by professionals increased. Although the observed decline in the admission rate to institutional care was relatively small across the 10 years (from5.3 %in 1996-1999 to 4.5 % in 2006-2009, a 15 % decrease), the probability of admission in 2006-2009 was relatively much lower when accounting for changes in the health and social conditions of the participants: the probability was 1.7–2.1 % point lower for adults in the period 2006-2009 compared to 1996-1999, a 32–40 % decrease. Our results show that the decline in the admission rate to LTC institutions is not the result of changes in need. The decline is suggested to be the combined effect of changes in policy, technological advances and changes in social norms.
Brailean, A., Aartsen, M.J., Muniz-Terrera, G., Prince, M.J., Prina, A.M., Comijs, H.C., Huisman, M., Beekman, A.T.F. (2017). Longitudinal associations between late-life depression dimensions and cognitive functioning: a cross-domain latent growth curve analysis. Psychological Medicine, 47, 690-702. >Full Text.
Background: Cognitive impairment and depression often co-occur in older adults, but it is not clear whether depression is a risk factor for cognitive decline, a psychological reaction to cognitive decline, or whether changes in depressive symptoms correlate with changes in cognitive performance over time. The co-morbid manifestation of depression and cognitive impairment may reflect either a causal effect or a common cause, depending on the specific symptoms experienced and the cognitive functions affected. Method: The study sample comprised 1506 community-dwelling older adults aged 565 years from the Longitudinal Aging Study Amsterdam (LASA). We conducted cross-domain latent growth curve analyses to examine longitudinal associations between late-life depression dimensions (i.e. depressed affect, positive affect, and somatic symptoms) and specific domains of cognitive functioning (i.e. processing speed, inductive reasoning, immediate recall, and delayed recall). Results: Poorer delayed recall performance at baseline predicted a steeper increase in depressed affect over time. Steeper decline in processing speed correlated with a steeper increase in somatic symptoms of depression over time. Conclusions: Our findings suggest a prospective association between memory function and depressed affect, whereby older adults may experience an increase in depressed affect in reaction to poor memory function. Somatic symptoms of depression increased concurrently with declining processing speed, which may reflect common neurodegenerative processes. Our findings do not support the hypothesis that depression symptoms may be a risk factor for cognitive decline in the general population. These findings have potential implications for the treatment of late-life depression and for the prognosis of cognitive outcomes.
De Koning, E.J., Verweij, L.M., Lips, P.T.A., Beekman, A.T.F., Comijs, H.C., Van Schoor , N.M. (2017). The relationship between serum 25(OH)D levels and anxiety symptoms in older persons: Results from the Longitudinal Aging Study Amsterdam. Journal of Psychosomatic Research, 97, 90-95. >Full Text.
Objective: Low serum 25-hydroxyvitamin D levels (25(OH)D<50nmol/L) are common in older persons and associated with depressive symptoms. Depression and anxiety are highly interrelated, but only very few studies examined the association between 25(OH)D and anxiety. This study investigated whether 25(OH)D levels are related to anxiety symptoms in older persons, both cross-sectionally and over time. Methods: Data from two samples of a large population-based cohort study were used (sample 1: N=1259, 64-88years; sample 2: N=892, 60-98years). Anxiety symptoms were measured with the Hospital Anxiety and Depression Scale - Anxiety subscale at baseline and after three years; serum 25(OH)D was measured at baseline. Cross-sectional and longitudinal relationships between 25(OH)D and anxiety were examined using logistic regression analysis, taking into account relevant confounding variables. Results: Of the participants, 48.0% (sample 1) and 26.4% (sample 2) had 25(OH)D levels <50nmol/L, whereas 8.1% (sample 1) and 6.5% (sample 2) had clinically relevant anxiety symptoms. Cross-sectionally, persons with 25(OH)D<50nmol/L experienced more anxiety symptoms than persons with 25(OH)D≥50nmol/L (sample 1: OR=1.55; 95% CI: 1.03-2.32, p=0.035; sample 2: OR=1.74; 95% CI: 1.03-2.96, p=0.040). However, after adjustment for demographic and lifestyle variables and depressive symptoms, significant associations were no longer observed (p=0.25-0.72). Similarly, 25(OH)D levels were not significantly related to anxiety symptoms after three years in both samples. Conclusions: After adjustment for confounding, there was no cross-sectional or longitudinal association between 25(OH)D levels and anxiety symptoms, independently from depression, in two large samples of older persons.
Ellwardt, L., Aartsen, M.J., Van Tilburg, T.G. (2017). Types of non-kin networks and their association with survival in late adulthood: A latent class approach. The Journals of Gerontology: Series B, 72, 694-705. >Full Text.
Objectives: Integration into social networks is an important determinant of health and survival in late adulthood. We first identify different types of non-kin networks among older adults and second, investigate the association of these types with survival rates. Method: Official register information on mortality is combined with data from the Longitudinal Aging Study Amsterdam (LASA). The sample includes 2,440 Dutch respondents aged 54-85 at baseline in 1992 and six follow-ups covering a time span of 20 years. Using latent class analysis, respondents are classified into distinct types of non-kin networks, based on differences in number and variation of non-kin relations, social support received from non-kin, and contact frequency with non-kin. Next, membership in network types is related to mortality in a Cox proportional hazard regression model. Results: There are four latent types of non-kin networks that vary in network size and support. These types differ in their associations with mortality, independent of sociodemographic and health confounders. Older adults integrated into networks high in both number and variation of supportive non-kin contacts have higher chances of survival than older adults embedded in networks low in either amount or variation of support or both. Discussion: A combination of structural and functional network characteristics should be taken into account when developing intervention programs aiming at increasing social integration outside the family network.
Elstgeest, L.E.M., Brouwer, I.A., Penninx, B.W.J.H., Van Schoor , N.M., Visser, M. (2017). Vitamins and plant ingredients. Vitamin B12, homocysteine and depressive symptoms: a longitudinal study among older adults. European Journal of Clinical Nutrition, 71, 468-475. >Full Text.
Background/Objectives: The roles of vitamin B12 and homocysteine concentration in depression are not clear. We investigated cross-sectional and prospective associations of serum vitamin B12 and plasma homocysteine with depressive symptoms in Dutch older adults. Subjects/Methods: In the Longitudinal Aging Study Amsterdam (LASA), blood was collected in 1995/1996 among 1352 men and women aged greater than or equal to65 years. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D) six times from 1995/1996 to 2011/2012. Multiple linear regression and mixed models were used to assess whether vitamin B12 and homocysteine were associated with severity at baseline and course of depressive symptoms over 16 years. Cox regression analyses were performed for the associations with incidence of depression (CES-D greater than or equal to16 and/or antidepressant use). All analyses were adjusted for sociodemographic characteristics and lifestyle factors. Results: Vitamin B12 was neither cross-sectionally (n=1205) nor prospectively (n=1012) associated with depressive symptoms (adjusted β for CES-D over time, lowest versus highest quartile: −0.04 (95% confidence interval (CI): −0.15−0.06)). We also found no association with incident depression (n=853), except for a higher risk of depression over time in younger participants (aged 64.8–73.4 years; continuous vitamin B12, adjusted hazard ratio per s.d.: 1.38 (95% CI: 1.10–1.72)). For homocysteine, no associations were found, except for a lower risk of depression in younger participants. Conclusions: Our study did not confirm earlier shown associations of serum vitamin B12 and plasma homocysteine with severity and course of depressive symptoms and incidence of depression in older adults. Further research into the influence of homocysteine metabolism on mental health is needed.
Ham, A.C., Broer, L., Swart, K.M.A., Enneman, A.W., Van Dijk, S.C., van Wijngaarden, J.P., Van der Zwaluw, N.L., Brouwer-Brolsma, E.M., Dhonukshe-Rutten, R.A.M., Van Schoor , N.M., Zillikens, M.C. (2017). CYP2C9 Genotypes Modify Benzodiazepine-Related Fall Risk: Original Results From Three Studies With Meta-Analysis. Journal of the American Medical Directors Association, 18, 1, 88e1–88e15 >Full Text.
Objective: To investigate whether the CYP2C9*2 and *3 variants modify benzodiazepine-related fall risk. Design: Three prospective studies; the Rotterdam Study, B-PROOF, and LASA. Setting: Community-dwelling individuals living in or near five Dutch cities. Participants: There were 11,485 participants aged ≥55 years. Measurements: Fall incidents were recorded prospectively. Benzodiazepine use was determined using pharmacy dispensing records or interviews. Cox proportional hazard models adjusted for age and sex were applied to determine the association between benzodiazepine use and fall risk stratified for CYP2C9 genotype and comparing benzodiazepine users to nonusers. The results of the three studies were combined applying meta-analysis. Within benzodiazepine users, the association between genotypes and fall risk was also assessed. Results: Three thousand seven hundred five participants (32%) encountered a fall during 91,996 follow-up years, and 4% to 15% (depending on the study population) used benzodiazepines. CYP2C9 variants had frequencies of 13% for the *2 allele and 6% for the *3 allele. Compared to nonusers, current benzodiazepine use was associated with an 18% to 36% increased fall risk across studies with a combined hazard ratio (HR) = 1.26 (95% confidence interval [CI], 1.13; 1.40). CYP2C9*2 or *3 allele variants modified benzodiazepine-related fall risk. Compared to nonusers, those carrying a CYP2C9*2 or *3 allele and using benzodiazepines had a 45% increased fall risk (HR, 1.45 95% CI, 1.21; 1.73), whereas CYP2C9*1 homozygotes using benzodiazepines had no increased fall risk (HR, 1.14; 95% CI, 0.90; 1.45). Within benzodiazepine users, having a CYP2C9*2 or *3 allele was associated with an increased fall risk (HR, 1.35; 95% CI, 1.06; 1.72). Additionally, we observed an allele dose effect; heterozygous allele carriers had a fall risk of (HR = 1.30; 95% CI, 1.05; 1.61), and homozygous allele carriers of (HR = 1.91 95% CI, 1.23; 2.96). Conclusions: CYP2C9*2 and *3 allele variants modify benzodiazepine-related fall risk. Those using benzodiazepines and having reduced CYP2C9 enzyme activity based on their genotype are at increased fall risk. In clinical practice, genotyping might be considered for elderly patients with an indication for benzodiazepine use. However, because the exact role of CYP2C9 in benzodiazepine metabolism is still unclear, additional research is warranted.
Holwerda, T.J. (2017). Burden of loneliness and depression in late life. PhD Dissertation, VU University Amsterdam.
No abstract available.
Hoogendijk, E.O., Huisman, M., Van Ballegooijen, A.J. (2017). The role of frailty in explaining the association between the metabolic syndrome and mortality in older adults. Experimental Gerontology, 91, 5-8. >Full Text.
The association between the metabolic syndrome (MetS) and adverse outcomes in older adults may be explained by other health conditions. This study examined the role of frailty in explaining the association between MetS and mortality, independent of comorbidity. Data were used from 1247 men and women aged ≥ 65 years of the Longitudinal Aging Study Amsterdam. MetS was assessed using the definition of the US National Cholesterol Education Program. Frailty was measured by the frailty phenotype. Mortality was monitored from 1995 until 2015. Associations of MetS with 19-year all-cause mortality were assessed using Cox proportional hazard models. MetS was present in 37% of the participants. In a model adjusted for age, sex and educational level hazard ratios of mortality were significantly higher in people with MetS (HR = 1.23, 95% CI = 1.08–1.40). After adjusting for frailty the association of MetS with mortality reduced, but remained statistically significant (HR = 1.15, 95% CI = 1.01–1.31). The presence of chronic diseases (cardiovascular diseases and diabetes) explained a larger part of the relationship between MetS and mortality (HR = 1.12, 95% CI = 0.98–1.28). These results show that physical frailty has a smaller contribution to the explanation of the association between MetS and 19-year all-cause mortality than the presence of chronic diseases.
Hoogendijk, E.O., Theou, O., Rockwood, K., Onwuteaka-Philipsen, B.D., Deeg, D.J.H., Huisman, M. (2017). Development and validation of a frailty index in the Longitudinal Aging Study Amsterdam. Aging Clinical and Experimental Research, 29, 927-933. >Full Text.
Background: Frailty is a state of increased vulnerability to adverse outcomes. The frailty index (FI), defined by the deficit accumulation approach, is a sensitive instrument to measure levels of frailty, and therefore important for longitudinal studies of aging. Aims: To develop an FI in the Longitudinal Aging Study Amsterdam (LASA), and to examine the predictive validity of this FI for 19-year mortality. Methods: LASA is an ongoing study among Dutch older adults, based on a nationally representative sample. A 32-item FI (LASA–FI) was developed at the second LASA measurement wave (1995–1996) among 2218 people aged 57–88 years. An FI score between 0 and 1 was calculated for each individual. The LASA–FI included health deficits from the physical, mental and cognitive domain and can be constructed for most LASA measurement waves. Associations with 19-year mortality were assessed using Kaplan– Meier curves and Cox proportional hazards models. Results: The mean LASA–FI score was 0.19 (SD = 0.12), with a 99% upper limit of 0.53. Scores were higher in women than men (women = 0.20, SD = 0.13 vs. men = 0.17, SD = 0.11, p\0.001). The average age-related increase in the log-transformed LASA–FI score was 3.5% per year. In a model adjusted for age and sex, the FI score was significantly associated with 19-year all-cause mortality (HR per 0.01 = 1.03, 95% CI 1.03–1.04, p\0.001). Discussion/conclusions: The key characteristics of the LASA–FI were in line with findings from previous FI studies in population-based samples of older people. The LASA–FI score was associated with mortality and may serve as an internal and external reference value.
Hoogendijk, E.O., Deeg, D.J.H., Huisman, M. (2017). Trends in sociale-, emotionele- en gezondheidsproblematiek van Nederlandse ouderen tussen 1992 en 2012. Gerõn 3, 71-74. >Full Text.
Op welke aspecten gaat het beter met de Nederlandse ouderen? Op welke aspecten gaat het juist slechter? Veranderingen in het functioneren van ouderen op bevolkingsniveau kunnen de context schetsen waarin het beleid in de langdurige zorg, maatschappelijke ondersteuning en preventief beleid van de Nederlandse overheid moet plaatsvinden.
Houtjes, W., Deeg, D.J.H., Van de Ven, P., Van Meijel, B., Van Tilburg, T.G., Beekman, A.T.F. (2017). Is the naturalistic course of depression in older people related to received support over time? Results from a longitudinal population-based study. International Journal of Geriatric Psychiatry, 32, 6, 657-663. >Full Text.
Objectives: To test the interrelation of the naturalistic course of depression in older people with long-term support received. Design: Longitudinal cohort study. Methods: A sample of 277 adults age 55-85 years participating in the Longitudinal Aging Study Amsterdam, with clinically relevant depressive symptoms at baseline (scores ≥16 on the Center for Epidemiological Studies Depression Scale) were followed up over a period of 13 years. General estimating equations were used to examine the relation between depression course and emotional/instrumental support received over time. In addition, partner status, gender, and age were tested as modifiers. Results: A 2-way interaction between depression courses types and time showed significant differences in instrumental support received over time in older people with a late-life depression. Three-way interactions showed that associations between depression course and support variables were modified by gender and partner status. Conclusion: Both men and singles, with a chronic course of depression may be at risk to lose emotional and instrumental support over time. Professional attention is needed to prevent a chronic course of late-life depression, and to preserve personal social networks.
Klaming, R., Veltman, D.J., Comijs, H.C. (2017). The impact of personality on memory function in older adults-results from the Longitudinal Aging Study Amsterdam. International Journal of Geriatric Psychiatry, 32, 7, 798-804. >Full Text.
Objective: The aim of the study was to explore associations between memory function and the personality constructs mastery, self-efficacy, and neuroticism in a large cohort of older adults over a 14-year period. Methods: Memory function and personality traits were assessed every three years for 14 years. Data was derived from the Longitudinal Aging Study Amsterdam (LASA). The study cohort included a total of 1966 men and women aged 65 and older at baseline. Episodic memory was assessed with a modified Dutch version of the Rey Auditory Verbal Learning Test. Personality was measured with Dutch versions of the Pearlin Mastery Scale, General Self-Efficacy Scale, and an abbreviated version of the Dutch Personality Questionnaire. All three personality questionnaires are self-rating instruments. Results: Higher levels of mastery and self-efficacy were associated with better memory function while high neuroticism was associated with poorer memory. Personality traits did not affect the rate of memory decline over time. Conclusions: Results demonstrate the role personality constructs, in particular those related to control beliefs and proneness to psychological stress, play in cognitive function in older adults, and support the development of intervention programs. Targeted training has the potential to promote a sense of control over life outcomes and to lower stress in older adults who are at risk for impaired memory function.
Klaming, R., Annesec, J., Veltman, D.J., Comijs, H.C. (2017). Episodic memory function is affected by lifestyle factors: a 14-year follow-up study in an elderly population. Aging, Neuropsychology, and Cognition, 24, 5, 528-542. >Full Text.
Understanding the relationship between memory function and lifestyle offers great opportunities for promoting beneficial lifestyle choices to foster healthy cognitive aging and for the development of intervention programs for older adults. We studied a cohort of older adults (age 65 and older) enrolled in the Longitudinal Aging Study Amsterdam, an ongoing prospective population-based research project. A total of 1,966 men and women participated in an episodic memory test every 3 years over a period of 14 years. Lifestyle habits were repeatedly assessed using self-report measures. Physical activity, light-to-moderate alcohol consumption, difficulties staying asleep, and social engagement were associated with better memory function over the course of 14 years. In contrast, smoking and long sleep duration were associated with worse memory function. These findings suggest that certain lifestyle factors can have long-term protective or harmful effects on memory function in aging individuals.
Klok, J., Van Tilburg, T.G., Suanet, B.A., Fokkema, C.M. (2017). Transnational aging among older Turkish and Moroccan migrants in the Netherlands: Determinants of transnational behavior and transnational belonging. Transnational Social Review, 7, 25-40. >Full Text.
This study investigates how resources and constraints (location of family, gender, income, cultural distance to society of settlement, and health) impact the experience of two interrelated dimensions of transnational aging: transnational behavior and transnational belonging. We specify transnational behavior by visitation of the country of origin and transnational belonging by emotional attachment to the country of origin and consideration of return migration. Data come from the Longitudinal Aging Study Amsterdam with interviews held between 2013 and 2014 with 264 Turkish migrants and 205 Moroccan migrants, aged 55–66. Regression analyses reveal that transnational belonging and behavior are explained by different factors. Family-in-laws’ location and gender only play a role in explaining transnational belonging, while cultural distance and self-rated health affect both dimensions, and subjective income only impacts transnational behavior. Results from the stratified analysis show that for Turkish migrants, family location, cultural distance, and health are important in considering return migration, whereas for Moroccan migrants, only cultural distance plays a role. We conclude that the distinction between transnational belonging and behavior is useful in understanding transnational aging and that our resources and constraints approach extends our view on older migrants.
Klok, J., Van Tilburg, T.G., Suanet, B.A., Fokkema, C.M. (2017). National and transnational belonging among Turkish and Moroccan older migrants in the Netherlands: protective against loneliness? European Journal of Ageing, 14, 4, 341-351. >Full Text.
This research investigates how a sense of belonging functions as protective mechanism against loneliness. Inspired by the work of Berry (1980) on acculturation strategies (i.e. integration, assimilation, separation and marginalization), we distinguish migrants who feel a relatively strong or weak sense of belonging to larger society and those who feel a strong or weak belonging to the “own group.” We expect that more national belonging contributes to less loneliness. We add a transnational perspective by arguing that feelings of belonging to the own group can take place in the country of settlement, but can also be transnational, i.e. a feeling of belonging to the country of origin. Transnational belonging can protect against loneliness, as it acknowledges the importance of place attachment. Using data from the Longitudinal Aging Study Amsterdam on older migrants aged 55–66, we employ latent class analysis and find five national belonging clusters, interpretable in terms of Berry’s acculturation strategies. Further analyses reveal mixed evidence: some aspects of transnational belonging vary with belonging to the own group, but other aspects point to a third dimension of belonging. Regression analysis shows that those marginalized are loneliest and that a transnational sense of belonging contributes to more loneliness. We conclude that Berry’s (1980) typology is useful for interpreting older migrants’ national belonging and that a transnational sense of belonging is apparent among older migrants, but needs to be explored further.
Kok, A., Aartsen, M.J., Deeg, D.J.H., Huisman, M. (2017). The Effects of Life Events and Socioeconomic Position in Childhood and Adulthood on Successful Aging. Journals of Gerontology B Psychological Sciences and Social, 72, 2, 268-278. >Full Text.
Objectives: Building on social stress theory, this study has 2 aims. First, we aim to estimate the effects of stressful life events in childhood and adulthood on Successful Aging (SA). Second, we examine how unequal exposure to such life events between individuals with different socioeconomic position (SEP) contributes to socioeconomic inequalities in SA. Method: We used 16-year longitudinal data from 2,185 respondents aged 55–85 years in 1992 in the Dutch nationally representative Longitudinal Aging Study Amsterdam. Measurement of SA was based on earlier work, in which we integrated trajectories in 9 indicators of functioning into an index of SA. Using path analysis, we investigated direct and indirect effects of parental and adulthood SEP as well as of self-reported childhood and adulthood life events on SA. Results: Almost all included life events had negative direct effects on SA. Parental SEP had no direct effect on SA, whereas adulthood SEP had. Higher Parental SEP increased the likelihood of parental problems and parental death in childhood, resulting in negative indirect effects on SA. Higher adulthood SEP had both positive and negative indirect effects on SA, through increasing the likelihood of divorce and unemployment, but decreasing the likelihood of occupational disability. Discussion: SEP and particular stressful life events are largely, but not entirely independent predictors of SA. We found that high and low SEP may increase exposure to particular events that negatively affect SA. Findings suggest that low (childhood) SEP and stressful life events are interrelated factors that may limit individual opportunities to age successfully.
Kok, A., Aartsen, M.J., Deeg, D.J.H., Huisman, M. (2017). Capturing the Diversity of Successful Aging: An Operational Definition Based on 16-Year Trajectories of Functioning. The Gerontologist, 57, 2, 240-251. >Full Text.
Purpose of the Study : To determine the prevalence and extent of successful aging (SA) when various suggestions proposed in the previous literature for improving models of SA are incorporated into one holistic operational definition. These suggestions include defining and measuring SA as a developmental process, including subjective indicators alongside more objective ones, and expressing SA on a continuum. Design and Methods : Data were used from 2,241 respondents in the Longitudinal Aging Study Amsterdam, a multidisciplinary study in a nationally representative sample of older adults in the Netherlands. Latent class growth analysis was used to identify successful 16-year trajectories within nine indicators of physical, cognitive, emotional, and social functioning. SA was quantified as the number of indicators in which individual respondents showed successful trajectories (range 0-9). Results : Successful trajectories were characterized by stability, limited decline, or even improvement of functioning over time. Of the respondents, 39.6% of men and 29.3% of women were successful in at least seven indicators; 7% of men and 11% of women were successful in less than three indicators. Proportions of successful respondents were largest in life satisfaction (>85%) and smallest in social activity (<25%). Correlations of success between separate indicators were low to moderate (range r = .02-.37). Implications : Many older adults age relatively successfully, but the character of successful functioning over time varies between indicators, and the combinations of successful indicators vary between individuals.
Korten, N.C.M., Comijs, H.C., Penninx, B.W.J.H., Deeg, D.J.H. (2017). Perceived stress and cognitive function in older adults: which aspect of perceived stress is important? International Journal of Geriatric Psychiatry, 32, 4, 439-445. >Full Text.
Objective: Few studies examined the association between perceived stress and cognitive function in older adults. This study will examine which aspects of perceived stress especially impact cognitive function. Methods: Cross-sectional data of 1099 older adults between 64 and 100 years from the Longitudinal Aging Study Amsterdam were used. Perceived stress and its subscales perceived helplessness and perceived self-efficacy were measured with the Perceived Stress Scale. Cognitive function was assessed regarding memory, processing speed and executive function. Univariate and multivariate linear regression analyses were performed between the stress measures and the domains of cognitive function. Results: Perceived stress was associated with worse processing speed, direct and delayed recall, semantic fluency and digit span backwards (range β = -0.10; -0.11; p < 0.01). The subscale perceived helplessness showed negative associations only with processing speed (β = -0.06, p < 0.05) and delayed recall (β = -0.06, p < 0.05), which became nonsignificant after the adjustment for depressive symptoms or sense of mastery. The subscale perceived self-efficacy was significantly associated with better cognitive function, also after adjustment for depressive symptoms or sense of mastery (range β = 0.10; 0.18; p < 0.01). Conclusions: In older adults, especially perceived self-efficacy showed independent associations with a broad range of cognitive functions. Perceived self-efficacy might be an important factor in reducing stress and the prevention of cognitive decline.
Marouli, E., Graff, M., Medina-Gomez, C., Lo, K.S., Wood, A.R., Kjaer, T.R., Fine, R.S., Lu, Y., Schurmann, C., Highland, H.M. (2017). Rare and low-frequency coding variants alter human adult height. Nature, 542, 186-190. >Full Text.
Height is a highly heritable, classic polygenic trait with approximately 700 common associated variants identified through genome-wide association studies so far. Here, we report 83 height-associated coding variants with lower minor-allele frequencies (in the range of 0.1–4.8%) and effects of up to 2 centimetres per allele (such as those in IHH, STC2, AR and CRISPLD2), greater than ten times the average effect of common variants. In functional follow-up studies, rare height-increasing alleles of STC2 (giving an increase of 1–2 centimetres per allele) compromised proteolytic inhibition of PAPP-A and increased cleavage of IGFBP-4 in vitro, resulting in higher bioavailability of insulin-like growth factors. These 83 height-associated variants overlap genes that are mutated in monogenic growth disorders and highlight new biological candidates (such as ADAMTS3, IL11RA and NOX4) and pathways (such as proteoglycan and glycosaminoglycan synthesis) involved in growth. Our results demonstrate that sufficiently large sample sizes can uncover rare and low-frequency variants of moderate-to-large effect associated with polygenic human phenotypes, and that these variants implicate relevant genes and pathways.
Portrait, F.R.M., van Wingerden, T.F., Deeg, D.J.H. (2017). Early life undernutrition and adult height: The Dutch famine of 1944-45. Economics & Human Biology, 27, part B, 339-348. >Full Text.
Current research shows strong associations between adult height and several positive outcomes such as higher cognitive skills, better earning capacity, increased chance of marriage and better health. It is therefore relevant to investigate the determinants of adult height. There is mixed evidence on the effects of undernutrition during early life on adult height. Therefore, our study aims at assessing the impact of undernutrition during gestation and at ages younger than 15 on adult height. We used data from the Longitudinal Aging Study Amsterdam. Exposure to undernutrition was determined by place of residence during the Dutch famine during World War II. Included respondents were born between 15 May 1930 and 1 November 1945 and lived in the northern part of the Netherlands during the famine period (n=1008). Exposure data was collected using interviews and questionnaires and adult height was measured. Exposed and non-exposed respondents were classified in the age categories pregnancy- age 1 (n=85), age 1-5 (n=323), age 6-10 (n=326) or puberty (age 11-15, n=274). Linear regression analyses were used to test the associations of adult height with exposure. The robustness of the regression results was tested with sensitivity analyses. In the models adjusted for covariates (i.e., number of siblings, education level of parents, and year of birth) and stratified by gender, adult height was significantly shorter for females exposed at ages younger than 1 (-4.45cm [-7.44--1.47]) or at ages younger than 2 (-4.08cm [-7.20--0.94]). The results for males were only borderline significant for exposure under age 1 (-3.16 [-6.82-0.49]) and significant for exposure under age 2 (-4.09cm [-7.20--0.96]). Exposure to the Dutch famine at other ages was not consistently significantly associated with adult height. In terms of public health relevance, the study's results further underpin the importance of supporting pregnant women and young parents exposed to undernutrition.
Pronk, M., Stam, M., Kramer, S.E. (2017). Continuing to adapt to and live with hearing loss. In V. Manchaiah, B. Danermark (Eds.), The experience of hearing loss. Journey through aural rehabilitation. (pp.133-144). London, Routledge: Taylor & Francis Group. > Full Text.
No abstract available.
Sanders, J.B., Bremmer, M.A., Comijs, H.C., Van de Ven, P., Deeg, D.J.H., Beekman, A.T.F. (2017). Gait Speed and Processing Speed as Clinical Markers for Geriatric Health Outcomes. The American Journal of Geriatric Psychiatry, 25, 4, 374-385. >Full Text.
Objective: This study investigates the independent and combined potential of slowed gait speed and slowed processing speed as predictors of adverse health outcomes.The role of depressive symptoms in these associations is also investigated. Methods: In the prospective cohort study, using the Longitudinal Aging Study Amsterdam database, three study samples for each outcome variable were defined: persistent cognitive decline (PCD; N = 1,271, 13 years of follow-up), falls (N = 1,282, 6 years of followup), and mortality (N = 1,559, age 74.9 ± 5.8, 21 years of follow-up).At baseline, gait speed (6-m walk with a turn at 3 m), processing speed (coding task), depressive symptoms (Center for Epidemiologic Studies Depression Scale), and basic demographic data were assessed.Also, time to PCD, falls, and mortality were assessed. Cox (for PCD and mortality) and stratified Cox (for falls) regression models were used. Results: Slowed processing speed predicted PCD (HR: 7.8; 95% CI: 3.3–18.8), slowed gait speed predicted falls (HR: 1.3; 95% CI: 1.0–1.5), and both measures predicted mortality (gait speed HR: 2.1; 95% CI: 1.6–2.6; processing speed HR: 1.9; 95% CI: 1.6–2.4). Each association remained significant after adjusting for the other slowing symptom. Slowed processing speed only predicted falls in the presence of slowed gait (interaction).A slowing sum score that combines both slowing symptoms predicted all three outcomes. The associations were not influenced by depressive symptoms. Conclusion: Slowing of thought is as relevant as slowing of movement to predict adverse health outcomes, because they seem to represent separate underlying pathologies.
Sanders, J.B. (2017). Slowing and depressive symptoms in aging people. PhD Dissertation, VU University Amsterdam.
No abstract available.
Scholte, R., Van den Berg, G.J., Lindeboom, M., Deeg, D.J.H. (2017). Does the Size of the Effect of Adverse Events at High Ages on Daily-Life Physical Functioning Depend on the Economic Conditions Around Birth? Health Economics, 26, 86–103. >Full Text.
This paper considers determinants of physical functional limitations in daily-life activities at high ages. Specifically, we quantify the extent to which the impact of adverse life events on this outcome is larger in case of exposure to adverse economic conditions early in life. Adverse life events include bereavement, severe illness in the family, and the onset of chronic diseases. We use a longitudinal data set of individuals born in the first decades of the 20th century. The business cycle around birth is used as an indicator of economic conditions early in life. We find that the extent to which functional limitations suffer from the onset of chronic diseases is larger if the individual was born in a recession. The long-run effect of economic conditions early in life on functional limitations at high ages runs primarily via this life event.
Smid, D.E., Spruit, M.A., Deeg, D.J.H., Huisman, M., Poppelaars, J.L., Wouters, E.F.M., Franssen, F.M.E. (2017). How to determine an impaired health status in COPD: Results from a population-based study. The Netherlands Journal of Medicine, 75, 4, 151-157. > Full Text.
Background: Chronic obstructive pulmonary disease (COPD) is associated with a significantly impaired health status and lost work productivity across all degrees of airflow limitation. The current study investigated whether an impaired health status is better represented by the recommended COPD Assessment Test (CAT) cut-point of 10 points, or the 95th percentile of the CAT score in a non-COPD population. Additionally, the impact of COPD on health status in a Dutch population, after stratification for work status, was measured. Methods: Demographics, clinical characteristics, post-bronchodilator spirometry, and CAT were assessed in subjects from the Longitudinal Aging Study Amsterdam (LASA), a large Dutch population-based study. Normative values for the CAT score were described by percentiles using the mean, standard deviation, median and range. Results: In total, 810 COPD and non-COPD subjects (50.4% male, mean age 60.5 ±; 2.9 years) were analysed. Significant differences were observed in CAT scores between non-COPD and COPD subjects (6.7 ±; 5.2 vs. 9.5 ±; 5.9, p < 0.001 respectively). The proportion of COPD subjects with an impaired health status differed between applying the CAT ≥ 10 cut-point (50.0%) and applying the 95th percentile of CAT in non-COPD subjects (> 18 cut-point; 7.6%). Higher CAT scores were seen in working COPD patients compared with working non-COPD subjects (9.3 ±; 5.2 vs. 6.0 ±; 4.6, p < 0.001). Conclusion: We suggest a CAT cut-point of > 18 points to indicate an impaired health status in COPD. This would imply an adaptation of the current GOLD classification of the disease.
Stijntjes, M., Aartsen, M.J., Taekema, D.G., Gussekloo, J., Huisman, M., Meskers, C.G.M., De Craen, A.J.M., Maier, A.B. (2017). Temporal Relationship Between Cognitive and Physical Performance in Middle-Aged to Oldest Old People. The Journals of Gerontology A Biological Sciences, 72, 5, 662-668. >Full Text.
Background: Cognitive and physical impairment frequently co-occur in older people. The aim of this study was to assess the temporal order of these age-related changes in cognitive and physical performance and to assess whether a relationship was different across specific cognitive and physical domains and age groups. Methods: Cognitive domains included global, executive, and memory function; physical domains included gait speed and handgrip strength. These domains were assessed in two population-based longitudinal cohorts covering the age ranges of 55-64, 65-74, 75-85, and 85-90 years with a follow-up of 5-12 years. Cross-lagged panel models were applied to assess the temporal relationships between the different cognitive and physical domains adjusting for age, sex, education, comorbidity, depressive symptoms, and physical activity. Results: Over all age groups, poorer executive function was associated with a steeper decline in gait speed (p < .05). From the age of 85 years, this relationship was found across all cognitive and physical domains (p < .02). From the age of 65 years, slower gait speed and/or weaker handgrip strength were associated with steeper declines in global cognitive function (p < .02), with statistically significant results across all cognitive domains in the age group of 75-85 years (p < .04). Conclusions: The temporal relationship between cognitive and physical performance differs across domains and age, suggesting a specific rather than a general relationship. This emphasizes the importance of repeated measurements on different domains and encourages future research to the development of domain- and age-specific interventions.
Suanet, B.A., Antonucci, T.C. (2017). Cohort Differences in Received Social Support in Later Life: The Role of Network Type . Journal of Gerontology: Social Sciences, 72, 4, 706-715. >Full Text.
Objectives: The objective is to assess cohort differences in received emotional and instrumental support in relation to network types. The main guiding hypothesis is that due to increased salience of non-kin with recent social change, those in friend-focused and diverse network types receive more support in later birth cohorts than earlier birth cohorts. Method: Data from the Longitudinal Aging Study Amsterdam are employed. We investigate cohort differences in total received emotional and instrumental support in a series of linear regression models comparing birth cohorts aged 55–64, 65–74, 75–84, and 85–94 across three time periods (1992, 2002, and 2012). Results: Four network types (friend, family, restricted, and diverse) are identified. Friend-focused networks are more common in later birth cohorts, restrictive networks less common. Those in friend-focused networks in later cohorts report receiving more emotional and instrumental support. No differences in received support are evident upon diverse networks. Discussion: The increased salience of non-kin is reflected in an increase in received emotional and instrumental support in friend-focused networks in later birth cohorts. The preponderance of non-kin in networks should not be perceived as a deficit model for social relationships as restrictive networks are declining across birth cohorts.
Thomése, G.C.F., Da Roit, B. (2017). Decentralisaties kunnen zorgongelijkheid juist verkleinen. Sociale Vraagstukken, 10 februari 2017. > Full Text.
De vrees is dat door de zorgdecentralisaties juist de kwetsbaarste groepen minder hulp krijgen. Eerdere ervaringen tonen eerder het tegendeel aan, concluderen Fleur Thomese en Barbara Da Roit op basis van onderzoek naar de oude Wmo.
Timmermans, E.J. (2017). The impact of the outdoor physical environment on older adults with osteoarthritis. PhD Dissertation, VU University Amsterdam.
No abstract available.
Van Ballegooijen, A.J., Cepelis, A., Visser, M., Brouwer, I.A., Van Schoor , N.M., Beulens, J.W. (2017). Joint Association of Low Vitamin D and Vitamin K Status With Blood Pressure and Hypertension. Hypertension, 69, 6, 1165-1172 >Full Text.
Low vitamin D and K status are both associated with an increased cardiovascular risk. New evidence from experimental studies on bone health suggest an interaction between vitamin D and K; however, a joint association with vascular health outcomes is largely unknown. To prospectively investigate whether the combination of low vitamin D and K status is associated with higher systolic and diastolic blood pressure in 402 participants and with incident hypertension in 231 participants free of hypertension at baseline. We used data from a subsample of the Longitudinal Aging Study Amsterdam, a population-based cohort of Dutch participants aged 55 to 65 years. Vitamin D and K status were assessed by 25-hydroxyvitamin D and dp-ucMGP (dephosphorylated uncarboxylated matrix gla protein) concentrations (high dp-ucMGP is indicative for low vitamin K status) in stored samples from 2002 to 2003. Vitamin D and K status were categorized into 25-hydroxyvitamin D <50/≥50 mmol/L and median dp-ucMGP <323/≥323 pmol/L. During a median follow-up of 6.4 years, 62% of the participants (n=143) developed hypertension. The combination of low vitamin D and K status was associated with increased systolic 4.8 mm Hg (95% confidence interval, 0.1-9.5) and diastolic 3.1 mm Hg (95% confidence interval, 0.5-5.7) blood pressure compared with high vitamin D and K status (P for interaction =0.013 for systolic blood pressure and 0.068 for diastolic blood pressure). A similar trend was seen for incident hypertension: hazard ratio=1.62 (95% confidence interval, 0.96-2.73) for the low vitamin D and K group. The combination of low vitamin D and K status was associated with increased blood pressure and a trend for greater hypertension risk.
van Campen, C., Iedema, J., Broese van Groenou, M.I., Deeg, D.J.H. (2017). Langer zelfstandig. Ouder worden met hulpbronnen, ondersteuning en zorg. Sociaal en Cultureel Planbureau, Den Haag, februari 2017. > Full Text.
Het kabinet beoogt met de hervorming van de langdurige zorg de trend te versterken dat ouderen langer zelfstandig blijven wonen en niet of later naar een zorginstelling verhuizen. Veel Nederlandse burgers van 65 jaar en ouder redden het om lang zelfstandig in eigen buurt en huis te blijven wonen, met uiteenlopende vormen van zorg en ondersteuning. In deze studie laat het Sociaal en Cultureel Planbureau zien van welke zorg, voorzieningen, persoonlijke en sociale hulpbronnen 65-plussers gebruikmaken en hoe lang ze daarmee zelfstandig blijven wonen voor ze naar een verzorgings- of verpleeghuis verhuizen of overlijden.
Van Leeuwen, D.M., van de Bunt, F., De Ruiter, C.J., Van Schoor , N.M., Deeg, D.J.H., Emanuel, K.S. (2017). Functioning Without Cartilage: Older People With Radiographic Knee Osteoarthritis Who Self-Report No Functional Limitations Do Score Lower on a Performance Battery. Journal of Aging and Physical Activity, 25, 570-575. >Full Text.
The majority of the older population shows signs of radiographic knee osteoarthritis. However, many remain without functional complaints for a long period. This study aims to find early functional changes associated with stages of radiographic knee osteoarthritis. A group of older people without self-reported complaints was divided in two groups: knee osteoarthritis (K&L = 2–4, N = 29) and control (K&L = 0–1, N = 31). Muscle function was assessed with voluntary and electrically-stimulated isometric knee contractions, including a fatigue test. Physical functioning was assessed with a 6-min walk test (6MWT), a stair climb test (SCT), and a short performance battery. There were no differences in muscle function parameters, 6MWT, and SCT between groups. A clinically relevant lower score on the performance battery was found in participants with knee osteoarthritis. In conclusion, even when older people indicate to have no functional limitations, a decline in functional outcome can be measured with a physical performance battery.
Van Vliet, M.J.G., Huisman, M., Deeg, D.J.H. (2017). Decreasing Hospital Length of Stay: Effects on Daily Functioning in Older Adults. Journal of the American Geriatrics Society, 65, 6, 1214-1221. >Full Text.
Objectives: To examine the effects of decreasing hospital length of stay (HLOS) on change in functioning from prehospital admission to posthospital discharge in older cohorts. Design: Cohort-sequential design. Setting: Nationwide, older population-based Longitudinal Aging Study Amsterdam (LASA). Participants: Individuals aged 68 and older with any hospital admission according to national medical registry data: two 10-year age groups (68-77 (younger-old) and 78-87 (older-old)) in two periods (1996-99 (Period 1) and 2006-09 (Period 2)) (N = 1,212). Measurements: HLOS was the main independent variable in multinomial logistic models, dichotomized as 1 to 5 days (short) and 6 days or longer (long). Outcomes were change scores in mobility and activities in daily living (ADLs). Respondents who died during the 3-year period were assigned to a third outcome category. Results: Results for both age groups showed more hospital admissions and shorter median HLOS in Period 2 than Period 1 (P < .05). Lower odds of decline in physical functioning were found in respondents with short HLOS than in those with long HLOS (for mobility: odds ratio (OR) = 0.36, 95% confidence interval (CI) = 0.23-0.54 (younger-old) and OR = 0.47, 95% CI = 0.30-0.72 (older-old); for ADLs: OR = 0.30, 95% CI = 0.19-0.48 (younger-old) and OR = 0.30, 95% CI = 0.18-0.53 (older-old)). Adjusting for confounders did not significantly change these estimates. Period did not modify these associations. Conclusion: Because the associations of HLOS with change in mobility and ADLs were the same in both periods, hospitalized older adults had neither advantage nor disadvantage from the decrease in HLOS. In addition, in both age groups, a greater percentage experienced the better functional outcomes and lower mortality associated with short admissions, which suggests an advantage of the decrease in HLOS.
Wörn, J., Ellwardt, L., Aartsen, M.J., Huisman, M. (2017). Cognitive functioning among Dutch older adults: Do neighborhood socioeconomic status and urbanity matter? Social Science & Medicine, 187, 29-38. >Full Text.
Positive associations of neighborhood socioeconomic characteristics and older adults' cognitive functioning have been demonstrated in previous studies, but overall results have been mixed and evidence from European countries and particularly the Netherlands is scarce. We investigated the effects of socioeconomic status (SES) and urbanity of neighborhoods on four domains of cognitive functioning in a sample of 985 Dutch older adults aged 65-88 years from the Longitudinal Aging Study Amsterdam. Besides cross-sectional level differences in general cognitive functioning, processing speed, problem solving and memory, we examined cognitive decline over a period of six years. Growth models in a multilevel framework were used to simultaneously assess levels and decline of cognitive functioning. In models not adjusting for individual SES, we found some evidence of higher levels of cognitive functioning in neighborhoods with a higher SES. In the same models, urbanity generally showed positive or inversely U-shaped associations with levels of cognitive functioning. Overall, effects of neighborhood urbanity remained significant when adjusting for individual SES. In contrast, level differences by neighborhood SES were largely explained by the respondents' individual SES. This suggests that neighborhood SES does not influence levels of cognitive functioning beyond the fact that individuals with a similar SES tend to self-select into neighborhoods with a corresponding SES. No evidence of systematically faster decline in neighborhoods with lower SES or lower degrees of urbanity was found. The findings suggest that neighborhood SES has no independent effect on older adults cognitive functioning in the Netherlands. Furthermore, the study reveals that neighborhood urbanity should be considered a determinant of cognitive functioning. This finding is in line with theoretical approaches that assume beneficial effects of exposure to complex environments on cognitive functioning. We encourage further investigations into the effect of urbanity in other contexts before drawing firm conclusions.

2016

Aartsen, M.J., Huisman, M. (2016). Longitudinal Aging Study Amsterdam. In: N.A.Pachana (Ed.), Encyclopedia of Geropsychology. Singapore (pp. 1-9): Springer Science+Business Media. >Full Text.
This entry describes the general outline of the Longitudinal Aging Study Amsterdam (LASA) and highlights some recent outcomes. LASA is the first ongoing longitudinal study in the Netherlands specifically designed to study determinants of the autonomy and well-being of older persons. In LASA, four domains of functioning are distinguished: cognitive, social, emotional, and physical. The study focuses on predictors of change in these domains, on trajectories of functioning, on the interrelationship between the four domains of functioning, and on the consequences of change in functioning for the use of formal and informal care and well-being.
Berner, J.S., Aartsen, M.J., Wahlberg, M., Elmstahl, S., Berglund, J., Anderberg, P., Deeg, D.J.H. (2016). A cross-national and longitudinal study on predictors in starting and stopping Internet use (2001-2013) by Swedish and Dutch older adults 66 years and above. Gerontechnology, 14, 3,157-168. >Full Text.
No abstract available.
Bolt, E.E., Pasman, H.R.W., Deeg, D.J.H., Onwuteaka-Philipsen, B.D. (2016). From Advance Euthanasia Directive to Euthanasia: Stable Preference in Older People? Journal of the American Geriatrics Society, 64, 8, 1628-1633. >Full Text.
Objectives: To determine whether older people with advance directive for euthanasia (ADEs) are stable in their advance desire for euthanasia in the last years of life, how frequently older people with an ADE eventually request euthanasia, and what factors determine this. Design: Mortality follow-back study nested in a cohort study. Setting: The Netherlands. Participants: Proxies of deceased members of a cohort representative of Dutch older people (n = 168) and a cohort of people with advance directives (n = 154). Measurements: Data from cohort members (possession of ADE) combined with after-death proxy information on cohort members' last 3 months of life. Multiple logistic regression analysis was performed on determinants of a euthanasia request in individuals with an ADE. Results: Response rate was 65%. One hundred forty-two cohort members had an ADE at baseline. Three months before death, 87% remained stable in their desire for euthanasia; 47% eventually requested euthanasia (vs 6% without an ADE), and 16% died after euthanasia. People with an ADE were more likely to request euthanasia if they worried about loss of dignity. Conclusion: The majority of older adults who complete an ADE will have a stable preference over time, but an advance desire for euthanasia does not necessarily result in a euthanasia request. Writing an ADE may reflect a person's need for reassurance that they can request euthanasia in the future.
Boons, C.L.M., Van de Kamp, K., Deeg, D.J.H. (2016). Assistive technology and self-rated health in comparison with age peers: a longitudinal study in 55–64-year-olds. Disability and Rehabilitation: Assistive Technology, 11, 2, 117-123. >Full Text.
Purpose: To determine changes in self-rated health in comparison with age peers (SRH-AP) among 55–64-year-olds, as affected by (1) initiating, (2) ceasing, and (3) prolonging the use of assistive technology (AT). Methods: Data included two national cohorts of 55–64-year-olds from the Longitudinal Aging Study Amsterdam (total N = 1968), with baseline cycles in 1992–93 and 2002–03 and 3-year follow-ups. The effect of AT use on SRH-AP was studied in analyses of variance for repeated measurements, adjusting for age and self-reported disability. Results: Respondents using AT reported poorer SRH-AP than respondents not using AT. Over time disability increased for respondents prolonging and initiating AT use and decreased for respondents ceasing AT use. No major changes were seen in SRH-AP over time, except for a small improvement for respondents prolonging AT use. Conclusions: AT use had a negative influence on SRH-AP, but this influence subsided over time for prolonged AT use. Despite longitudinal changes in disability, there was a marked stability of SRH-AP over time which may be attributed to AT use.
Boot, C.R.L., De Kruit, A.Th.C.M., Shaw, W.S., Van der Beek, A., Deeg, D.J.H., Abma, T. (2016). Factors Important for Work Participation Among Older Workers with Depression, Cardiovascular Disease, and Osteoarthritis: A Mixed Method Study. Journal of Occupational Rehabilitation, 26, 160-172. >Full Text.
Purpose: The aim of this study was to gain insight into differences and similarities in factors important for work participation in older (58-65 years) workers among three different chronic diseases: depression (D), cardiovascular disease (C), and osteoarthritis (O). Methods: A mixed method design was used, with a qualitative part (in-depth interviews) with 14 patients with D, C or O and a quantitative part based on the 2002-2003 cohort of the Longitudinal Aging Study Amsterdam. We analysed and compared 3-year (response 93 %) predictors of paid work in 239 participants with D, C, or O using regression analyses. The qualitative findings were integrated with the quantitative findings aiming at complementarity. Results: Common factors important for work participation were: working at baseline; male gender; lower age; partner with paid work; better physical and mental health; and higher mastery scores. The qualitative analyses added autonomy in work and provided contextual information regarding the perceived importance of working as factors important for participation in paid work. For D and C, work gave purpose in life and enhanced social contacts. Participation in work was perceived as necessary to structure life only for D. Conclusion: Most factors important for work participation were similar for D, C, and O. However, the interviews revealed that for D, the context and the meaning attributed to these factors differed.
Braam, A.W., Galenkamp, H., Derkx, P., Aartsen, M.J., Deeg, D.J.H. (2016). Ten-Year Course of Cosmic Transcendence in Older Adults in the Netherlands. The International Journal of Aging and Human Development, 84, 1, 44-65. >Full Text.
Objectives: Gerotranscendence is defined as a transition from a materialistic and rationalistic perspective to a more cosmic and transcendent view of life accompanying the aging process. Would gerotranscendence levels still increase in later life? The current prospective study investigates 10-year trajectories of cosmic transcendence (a core dimension of gerotranscendence). Methods: Four interview cycles of the Longitudinal Aging Study Amsterdam with 3-year intervals from 1995 to 2006 provide data on cosmic transcendence, demographics (ages 57-85), religiousness, health, sense of mastery, and humor coping. Data are available for 2,257 respondents and 1,533 respondents in multivariate models. Results: Latent Class Growth Analysis shows three course trajectories of cosmic transcendence: stable high, intermediate with a decrease, and stable low. Higher levels are predicted by age, importance of prayer, Roman Catholic affiliation, a low sense of mastery, higher cognitive ability, and humor coping. Similar results were obtained for the respondents who died during the study (N = 378). Discussion: Although levels of cosmic transcendence do not show much change during 10 years of follow-up, the oldest respondents nonetheless attain the highest cosmic transcendence levels. An inclination toward relativism and contemplation may facilitate cosmic transcendence. However, lower cognitive ability probably impairs the development toward cosmic transcendence.
Brailean, A., Comijs, H.C., Aartsen, M.J., Prince, M.J., Prina, A.M., Beekman, A.T.F., Huisman, M. (2016). Late-life depression symptom dimensions and cognitive functioning in the Longitudinal Aging Study Amsterdam (LASA). Journal of Affective Disorders, 201, 171-178. >Full Text.
Background: Depression often co-occurs in late-life in the context of declining cognitive functions, but it is not clear whether specific depression symptom dimensions are differentially associated with cognitive abilities. Methods: The study sample comprised 3107 community-dwelling older adults from the Longitudinal Aging Study Amsterdam (LASA). We applied a Multiple Indicators Multiple Causes (MIMIC) model to examine the association between cognitive abilities and latent dimensions of the Center for Epidemiologic Studies Depression Scale (CES-D), while accounting for differential item functioning (DIF) due to age, gender and cognitive function levels. Results: A factor structure consisting of somatic symptoms, positive affect, depressed affect, and interpersonal difficulties fitted the data well. Higher levels of inductive reasoning were significantly associated with lower levels of depressed affect and somatic symptoms, whereas faster processing speed was significantly associated with lower levels of somatic symptoms. DIF due to age and gender was found, but the magnitude of the effects was small and did not alter substantive conclusions. Limitations: Due to the cross-sectional context of this investigation, the direction of influence between depression symptom levels and cognitive function levels cannot be established. Furthermore, findings are relevant to non-clinical populations, and they do not clarify whether certain DIF effects may be found only at high or low levels of depression. Conclusions: Our findings suggest differential associations between late-life depression dimensions and cognitive abilities in old age, and point towards potential etiological mechanisms that may underline these associations. These findings carry implications for the prognosis of cognitive outcomes in depressed older adults.
Broese van Groenou, M.I., Jacobs, M.T., Zwart-Olde, I., Deeg, D.J.H. (2016). Mixed care networks of community-dwelling older adults with physical health impairments in the Netherlands. Health & Social Care in the Community, 24, 1, 95-104. >Full Text.
As part of long-term care reforms, home-care organisations in the Netherlands are required to strengthen the linkage between formal and informal caregivers of home-dwelling older adults. Information on the variety in mixed care networks may help home-care organisations to develop network type-dependent strategies to connect with informal caregivers. This study first explores how structural (size, composition) and functional features (contact and task overlap between formal and informal caregivers) contribute to different types of mixed care networks. Second, it examines to what degree these network types are associated with the care recipients' characteristics. Through home-care organisations in Amsterdam, the Netherlands, we selected 74 frail home-dwelling clients who were receiving care in 2011–2012 from both informal and formal caregivers. The care networks of these older adults were identified by listing all persons providing help with five different types of tasks. This resulted in care networks comprising an average of 9.7 caregivers, of whom 67% were formal caregivers. On average, there was contact between caregivers within 34% of the formal–informal dyads, and both caregivers carried out at least one similar type of task in 29% of these dyads. A principal component analysis of size, composition, contact and task overlap showed two distinct network dimensions from which four network types were constructed: a small mixed care network, a small formal network, a large mixed network and a large formal network. Bivariate analyses showed that the care recipients’ activities of daily living level, memory problems, social network, perceived control of care and level of mastery differed significantly between these four types. The results imply that different network types require different actions from formal home-care organisations, such as mobilising the social network in small formal networks, decreasing task differentiation in large formal networks and assigning co-ordination tasks to specific dyads in large mixed care networks.
Claassens, C.T.J., Terwee, C.B., Deeg, D.J.H., Broese van Groenou, M.I., Widdershoven, G.A.M., Huisman, M. (2016). Development and validation of a questionnaire assessing the perceived control in health care among older adults with care needs in the Netherlands. Quality of Life Research, 25, 4, 859-870. >Full Text.
No abstract available.
Da Roit, B., Thomése, G.C.F. (2016). Is more local home care more (un)equal? Socioeconomic inequalities in the access to home care in Dutch municipalities before and after the implementation of the Social Support Act (WMO) in 2007. Mens en maatschappij, 91, 4, 381-403. >Full Text.
The partial decentralisation of long-term care in the Netherlands is accompanied by cutbacks, reduction of individual social rights, and increasing dependency on self-, informal and private care. Are municipalities able to ensure a better distribution of care across socio-economic groups, also in times of retrenchment, as the policy assumption seems to be? In the Dutch context there has been no debate or research around this question. Based on data from the Longitudinal Aging Study Amsterdam (LASA), this study looks at the extent to which the decentralisation of home care that took place in 2007 was associated with increasing inequalities in the access to formal care within municipalities.
Deeg, D.J.H. (2016). Gender and Physical Health in Later Life. In: Krauss Whitbourne S (ed). The Encyclopedia of Adulthood and Aging. Malden (pp 537), Oxford: John Wiley and Sons, Inc.
The existence of gender differences in health at older ages has been well established in reports from single countries as well as from cross-national research and can be summarized as “women are sicker but live longer than men.” The gender gap in health is pervasive affecting most aspects of health. This entry reviews the gender gap in the respective stages of the disablement process and explanations for it, as well as differences in the rate of development of disability in individual men and women. Women's greater longevity is believed to drive much of the gender difference in health.
Dijkstra, S. C. (2016). Socioeconomic differences in dietary intake of older adults. PhD Dissertation, VU University Amsterdam.
No abstract available.
El Hilali, J., De Koning, E.J., Van Ballegooijen, A.J., Lips, P.T.A., Sohl, E., Van Marwijk, H.W.J., Visser, M., Van Schoor , N.M. (2016). Vitamin D, PTH and the risk of overall and disease-specific mortality: Results of the Longitudinal Aging Study Amsterdam. The Journal of Steroid Biochemistry and Molecular Biology, 164, 386–394. >Full Text.
Observational studies suggest that low concentrations of serum 25-hydroxyvitamin D (25(OH)D) and high concentrations of parathyroid hormone (PTH) are associated with a higher risk of mortality. The aim of this study was to examine whether 25(OH)D and PTH concentrations are independently associated with overall and disease-specific (cardiovascular and cancer-related) mortality in a large, prospective population-based cohort of older adults. Data from 1317 men and women (65-85 years) of the Longitudinal Aging Study Amsterdam were used. Cox proportional hazard analyses were used to examine whether 25(OH)D and PTH at baseline were associated with overall mortality (with a follow-up of 18 years) and disease-specific mortality (with a follow-up of 13 years). Compared to persons in the reference category of ≥75nmol/L, persons with serum 25(OH)D <25nmol/L (HR 1.46; 95% CI: 1.12-1.91) and 25-49.9nmol/L (HR 1.24; 95% CI: 1.01-1.53) had a significantly higher risk of overall mortality, as well as men with baseline PTH concentrations ≥7pmol/L (HR 2.54 (95% CI: 1.58-4.08)), compared to the reference category of <2.33pmol/L. The relationship of 25(OH)D with overall mortality was partly mediated by PTH. Furthermore, men with PTH concentrations of ≥7pmol/L (HR 3.22; 95% CI: 1.40-7.42) had a higher risk of cardiovascular mortality, compared to the reference category. No significant associations of 25(OH)D or PTH with cancer-related mortality were observed. Both 25(OH)D and PTH should be considered as important health markers.
Essink-Bot, M.L., Deeg, D.J.H., Nusselder, W. (2016). Commentaar. Naar een ouderdom met minder gebreken? Trends in gezonde levensverwachting. Nederlands Tijdschrift voor Geneeskunde, 160, D134, 1-3.
No abstract available.
Fokkema, C.M., Klok, J. (2016). Verbondenheid beschermt oudere migranten tegen ernstige eenzaamheid. DEMOS, 32, 6, 8. > Full Text.
Oudere migranten zijn vaker eenzaam dan hun Nederlandse leeftijdsgenoten. Er is nog maar weinig bekend over de specifieke oorzaken hiervan, noch wat er kan worden gedaan om zich te wapenen tegen ernstige eenzaamheid. Reden voor de Vrije Universiteit en het NIDI om een nieuw onderzoek te starten. De eerste resultaten laten zien dat Turkse en Marokkaanse oudere migranten minder sterk eenzaam zijn wanneer zij zich verbonden voelen met de Nederlandse samenleving of met hun eigen etnische groep.
Fontijn, P., Deeg, D.J.H. (2016). Gezond werken, maar ook gezond met pensioen. TPEdigitaal, 10, 1, 54-71.
Bij de verhoging van de AOW-leeftijd wordt voorbijgegaan aan de vragen of werknemers gezond genoeg blijven om door te werken tot de AOW-leeftijd en hoeveel gezonde levensjaren nog resten op de AOW-leeftijd. Het eerlijkheidsprincipe "gezond werken maar ook gezond met pensioen" vormt de basis voor dit onderzoek. In dit artikel worden twee gevolgen van een hogere AOW-leeftijd onderzocht: die voor de prevalentie van gezondheidsproblemen onder ouderen op de AOW-leeftijd (haalbaarheid) en die voor de verwachte resterende gezonde levensverwachting vanaf deze leeftijd (eerlijkheid). Voor beide aspecten worden trends geprojecteerd tot het jaar 2050.
Galenkamp, H., Gagliardi, C., Principi, A., Golinowska, S., Moreira, A., Schmidt, A.E., Winkelmann, J., Sowa, A., Van der Pas, S., Deeg, D.J.H. (2016). Predictors of social leisure activities in older Europeans with and without multimorbidity. European Journal of Ageing, 13, 129-143. >Full Text.
Older people spend much time participating in leisure activities, such as taking part in organized activities and going out, but the extent of participation may differ according to both individual and environmental resources available. Chronic health problems become more prevalent at higher ages and likely necessitate tapping different resources to maintain social participation. This paper compares predictors of participation in social leisure activities between older people with and those without multimorbidity. The European Project on Osteoarthritis (EPOSA) was conducted in Germany, UK, Italy, The Netherlands, Spain and Sweden (N = 2942, mean age 74.2 (5.2)). Multivariate regression was used to predict social leisure participation and degree of participation in people with and without multimorbidity. Fewer older people with multimorbidity participated in social leisure activities (90.6 %), compared to those without multimorbidity (93.9 %). The frequency of participation was also lower compared to people without multimorbidity. Higher socioeconomic status, widowhood, a larger network of friends, volunteering, transportation possibilities and having fewer depressive symptoms were important for (the degree of) social leisure participation. Statistically significant differences between the multimorbidity groups were observed for volunteering and driving a car, which were more important predictors of participation in those with multimorbidity. In contrast, self-reported income appeared more important for those without multimorbidity, compared to those who had multimorbidity. Policies focusing on social (network of friends), physical (physical performance) and psychological factors (depressive symptoms) and on transportation possibilities are recommended to enable all older people to participate in social leisure activities.
Galenkamp, H., Deeg, D.J.H., De Jongh, R.T., Kardaun, J.W.P.F., Huisman, M. (2016). Trend study on the association between hospital admissions and the health of Dutch older adults (1995-2009). BMJ, 6, 8: e011967. >Full Text.
Objectives: An increase in hospital admission rates in older people may reflect improved access to healthcare, but also declining health trends in the older population. Owing to a lack of individual-level data, the latter possibility has received little attention. The current study examines associations between health status and hospitalisation rates of older adults in the Netherlands. Design: Observational individual-level data linked to hospital register data. Setting: Data from 1995 to 2009 from the nationally representative Longitudinal Aging Study Amsterdam were linked to the Dutch Hospital Discharge Register. Participants: A total of 5681 observations of 2520 respondents across 4 measurement points (each with a follow-up of 36 months; ages 65-88 years). Outcome Measures: The contribution of health, demographic, psychosocial and lifestyle characteristics to time trends in hospitalisation was assessed in multivariate models. Results: Between 1995 and 2009, the percentage with 1 or more overnight admissions (planned or acute) increased slightly from 38.1% to 39.7%. This was due to an increase in acute admission only (22.2-27.0%). Increased prevalences of chronic diseases, functional limitations and polypharmacy accounted for part of the observed increase in acute admissions. In addition, a more than doubled prevalence of day admissions over time was observed (12.3-28.3%), a trend that was unrelated to changes in individual characteristics. Conclusions: This trend study showed a contribution of declines in population health to increases in acute hospital admissions. Since these declines did not provide a full explanation, healthcare reforms and increases in treatment possibilities in this period are likely to have contributed as well.
Galenkamp, H., Deeg, D.J.H. (2016). Increasing social participation of older people: are there different barriers for those in poor health? Introduction to the special section. European Journal of Ageing, 13, 2, 87-90. >Full Text.
European populations are ageing and policy makers are concerned with the growing proportion of people becoming dependent on old-age pensions and care, and what this will mean for the sustainability of countries’ social welfare systems. Against this background, policies that promote ‘active ageing’, defined as “the process of optimizing opportunities for physical, social and mental wellbeing throughout the life course in order to extend healthy life eEuropean populations are ageing and policy makers are concerned with the growing proportion of people becoming dependent on old-age pensions and care, and what this will mean for the sustainability of countries’ social welfare systems. Against this background, policies that promote ‘active ageing’, defined as “the process of optimizing opportunities for physical, social and mental wellbeing throughout the life course in order to extend healthy life expectancy, productivity and quality of life in older age” (WHO 2002) are increasingly being called for. In addition to the societal value proffered by older people’s continued engagement in the labour market and in other areas of social participation such as volunteering and caregiving, a growing body of research has shown that participation in such activities can also contribute to better health outcomes for the individual (Glass et al. 1999; Luoh and Herzog 2002; Menec 2003), which in turn contributes to the sustainability of pension and health care systems by reducing demand for their benefits and services. Efforts to increase active ageing should not only focus on promoting individual-level engagement but also on expanding opportunities for older people to remain or become involved. With a view to the emphasis on quality of life and wellbeing in the WHO definition, participation should include all kinds of activities—both the productive ones that were mentioned above and activities that are more ‘consumptive’ in nature such as leisure time activities and educational activities (Nimrod 2007; Silverstein and Parker 2002).
Herbolsheimer, F., Schaap, L.A., Edwards, M.H., Maggi, S., Otero, A., Timmermans, E.J., Denkinger, M., Van der Pas, S., Dekker, J., Cooper, C., Dennison, E.M., Van Schoor , N.M., Peter, R. (2016). Physical Activity Patterns Among Older Adults With and Without Knee Osteoarthritis in Six European Countries. Arthritis Care & Research, 68 (2), 228-236. >Full Text.
Objective: To investigate patterns of physical activity in older adults with knee osteoarthritis (OA) compared to older adults without knee OA across 6 European countries. We expect country-specific differences in the physical activity levels between persons with knee OA compared to persons without knee OA. A varying degree of physical activity levels across countries would express a facilitating or impeding influence of the social, environmental, and other contextual factors on a physically active lifestyle. Methods: Baseline cross-sectional data from the European Project on Osteoarthritis were analyzed. In total, 2,551 participants from 6 European countries (Germany, Italy, The Netherlands, Spain, Sweden, and the UK) were included. Results: Participants with knee OA were less likely to follow physical activity recommendations and had poorer overall physical activity profiles than those without knee OA (mean 62.9 versus 81.5 minutes/day, respectively; P&#8201;=&#8201;0.015). The magnitude of this difference varied across countries. Detailed analysis showed that low physical activity levels in persons with knee OA could be attributed to less everyday walking time (odds ratio 1.31, 95% confidence interval 1.07-1.62). Conclusion: This study highlighted the fact that having knee OA is associated with a varying degree of physical activity patterns in different countries. This national variation implies that low levels of physical activity among persons with knee OA cannot be explained exclusively by individual or disease-specific factors, but that social, environmental, and other contextual factors should also be taken into account.
Holwerda, T.J., Van Tilburg, T.G., Deeg, D.J.H., Schutter, N., Van, R., Dekker, J., Stek, M.L., Beekman, A.T.F., Schoevers, R.A. (2016). Impact of loneliness and depression on mortality: results from the Longitudinal Ageing Study Amsterdam. The British Journal of Psychiatry, 209, 2, 127-134. >Full Text.
Background: Loneliness is highly prevalent among older people, has serious health consequences and is an important predictor of mortality. Loneliness and depression may unfavourably interact with each other over time but data on this topic are scarce. Aims: To determine whether loneliness is associated with excess mortality after 19 years of follow-up and whether the joint effect with depression confers further excess mortality. Method: Different aspects of loneliness were measured with the De Jong Gierveld scale and depression with the Centre for Epidemiologic Studies Depression Scale in a cohort of 2878 people aged 55–85 with 19 years of follow-up. Excess mortality hypotheses were tested with Kaplan–Meier and Cox proportional hazard analyses controlling for potential confounders. Results: At follow-up loneliness and depression were associated with excess mortality in older men and women in bivariate analysis but not in multivariate analysis. In multivariate analysis, severe depression was associated with excess mortality in men who were lonely but not in women. Conclusions: Loneliness and depression are important predictors of early death in older adults. Severe depression has a strong association with excess mortality in older men who were lonely, indicating a lethal combination in this group.
Hoogendijk, E.O., Suanet, B.A., Dent, E., Deeg, D.J.H., Aartsen, M.J. (2016). Adverse effects of frailty on social functioning in older adults: Results from the Longitudinal Aging Study Amsterdam. Maturitas, 83, 45-50. >Full Text.
Objectives: The aim of this study was to examine the association between physical frailty and social functioning among older adults, cross-sectionally and prospectively over 3 years. Study design: The study sample consisted of 1115 older adults aged 65 and over from two waves of the Longitudinal Aging Study Amsterdam, a population based study. Main outcome measures: Frailty was measured at T1 (2005/2006) using the criteria of the frailty phenotype, which includes weight loss, weak grip strength, exhaustion, slow gait speed and low physical activity. Social functioning was assessed at T1 and T2 (2008/2009) and included social network size, instrumental support, emotional support, and loneliness. Results: Cross-sectional linear regression analyses adjusted for covariates (age, sex, educational level and number of chronic diseases) showed that pre-frail and frail older adults had a smaller network size and higher levels of loneliness compared to their non-frail peers. Longitudinal linear regression analyses adjusted for covariates and baseline social functioning showed that frailty was associated with an increase in loneliness over 3 years. However, the network size and levels of social support of frail older adults did not further decline over time. Conclusions: Frailty is associated with poor social functioning, and with an increase in loneliness over time. The social vulnerability of physical frail older adults should be taken into account in the care provision for frail older adults.
Hoogendijk, E.O., Deeg, D.J.H., Poppelaars, J.L., Van der Horst, M.H.L., Broese van Groenou, M.I., Comijs, H.C., Pasman, H.R.W., Van Schoor , N.M., Suanet, B.A., Thomése, G.C.F., Van Tilburg, T.G., Visser, M., Huisman, M. (2016). The Longitudinal Aging Study Amsterdam: cohort update 2016 and major findings. European Journal of Epidemiology, 31, 927-945. >Full Text.
The Longitudinal Aging Study Amsterdam (LASA) is an ongoing longitudinal study of older adults in the Netherlands, which started in 1992. LASA is focused on the determinants, trajectories and consequences of physical, cognitive, emotional and social functioning. The study is based on a nationally representative sample of older adults aged 55 years and over. The findings of the LASA study have been reported in over 450 publications so far (see www.lasa-vu.nl ). In this article we describe the background and the design of the LASA study, and provide an update of the methods. In addition, we provide a summary of the major findings from the period 2011-2015.
Jacobs, M.T. (2016). Connecting to care. The interrelationships between informal and formal caregivers in care networks of community-dwelling older adults. PhD Dissertation, VU University Amsterdam.
No abstract available.
Jeuring, H.W., Huisman, M., Comijs, H.C., Stek, M.L., Beekman, A.T.F. (2016). The long-term outcome of subthreshold depression in later life. Psychological Medicine, 46, 2855-2865. >Full Text.
Background: Subthreshold depression (SUBD) in later life is common and important as prodromal state and prominent risk factor in the development of major depressive disorder (MDD). Indicated prevention can reduce the incidence of MDD among people with SUBD substantially, but needs to be targeted to those that are truly at risk of developing MDD. Method: N = 341 eligible participants with SUBD were included from the first (1992/1993), second (1995/1996) and third (1998/1999) cycle from the Longitudinal Aging Study Amsterdam (LASA) by using a two-stage screening design. LASA is an ongoing prospective cohort study in The Netherlands among the older population (55-85 years). At baseline (1992/1993) N = 3107 participants were interviewed and follow-up cycles were conducted every 3 years until 2008/2009, resulting in maximal 17 years of observational period. The proportion of people that developed MDD, remained SUBD, or recovered from SUBD was measured and Cox proportional regression analyses were performed to investigate 29 putative predictors of MDD and recovery from SUBD. Results: N = 153 (44.9%) recovered from SUBD, N = 138 (40.5%) remained chronically SUBD, and N = 50 (14.7%) developed MDD (incidence rate 15.1/1000 person-years). Women, high neuroticism, more chronic diseases, high body mass index, smoking and less social support predicted conversion to MDD. Men, low neuroticism and absence of pain predicted recovery from SUBD. Conclusions: Although older people with SUBD are clearly at risk of developing MDD, the majority did not, even after a long and thorough follow-up. Given the risk factors that were uncovered, targeting and prevention of MDD in those at very high risk is feasible.
Kok, A., Aartsen, M.J., Deeg, D.J.H., Huisman, M. (2016). Socioeconomic inequalities in a 16-year longitudinal measurement of successful ageing. Journal of Epidemiology & Community Health, 70, 1106-1113. >Full Text.
Background: This study examines to what extent education, occupation and income are associated with the multidimensional process of successful ageing, encompassing trajectories of physical, mental and social functioning in old age. Methods: We employed 16-year longitudinal data from 2095 participants aged 55-85&#8197;years at baseline in the Dutch, nationally representative Longitudinal Aging Study Amsterdam. For 9 indicators of successful ageing, separate Latent Class Growth models were used to identify subgroups of older adults with a 'successful' trajectory. A 'Successful Aging Index' expressed the number of indicators for which individual respondents had a successful trajectory (range 0-9). Using multivariate regression models, we investigated associations between socioeconomic position and the Successful Ageing Index, and with separate indicators of successful ageing. Results: Higher education, occupational skill level and income were independently associated with higher numbers of successful trajectories. Education (&#946;=0.09) was a slightly stronger correlate of successful ageing than income (&#946;=0.08). Analyses of separate indicators of successful ageing showed that cognitive functioning, functional limitations and emotional support given were associated with all three components of socioeconomic position, while other indicators were associated with only one (eg, life satisfaction) or none (eg, social loneliness). For some indicators of successful ageing, socioeconomic inequalities were present at baseline, and also increased or decreased during follow-up. Conclusions: Education, occupation and income represent distinct socioeconomic life course factors, each of which contribute in a specific way to inequalities in successful ageing. Physical and cognitive functioning were associated more strongly with socioeconomic position than social and emotional functioning.
Koopman, C., Vaartjes, I., Blokstra, A., Verschuren, W.M.M., Visser, M., Deeg, D.J.H., Bots, M.L., Van Dis, I. (2016). Trends in risk factors for coronary heart disease in the Netherlands. BMC Public Health, 16, 1, 835. >Full Text.
Background: Favourable trends in risk factor levels in the general population may partly explain the decline in coronary heart disease (CHD) morbidity and mortality. Our aim was to present long-term national trends in established risk factors for CHD. Methods: Data were obtained from five data sources including several large scale population based surveys, cohort studies and general practitioner registers between 1988 and 2012. We applied linear regression models to age-standardized time trends to test for statistical significant trends. Analyses were stratified by sex and age (younger <65 and older ≥65 years adults). Results: The results demonstrated favourable trends in smoking (except in older women) and physical activity (except in older men). Unfavourable trends were found for body mass index (BMI) and diabetes mellitus prevalence. Although systolic blood pressure (SBP) and total cholesterol trends were favourable for older persons, SBP and total cholesterol remained stable in younger persons. Conclusions: Four out of six risk factors for CHD showed a favourable or stable trend. The rise in diabetes mellitus and BMI is worrying with respect to CHD morbidity and mortality.
Koopman, C., Vaartjes, I., Van Dis, I., Engelfriet, P., Heintjes, E.M., Blokstra, A., Bots, M.L., O Flaherty, M., Capewell, S. (2016). Explaining the Decline in Coronary Heart Disease Mortality in the Netherlands between 1997 and 2007. PLoS One, 11, 12, e0166139. >Full Text.
Objective: We set out to determine what proportion of the mortality decline from 1997 to 2007 in coronary heart disease (CHD) in the Netherlands could be attributed to advances in medical treatment and to improvements in population-wide cardiovascular risk factors. Methods: We used the IMPACT-SEC model. Nationwide information was obtained on changes between 1997 and 2007 in the use of 42 treatments and in cardiovascular risk factor levels in adults, aged 25 or over. The primary outcome was the number of CHD deaths prevented or postponed. Results: The age-standardized CHD mortality fell by 48% from 269 to 141 per 100.000, with remarkably similar relative declines across socioeconomic groups. This resulted in 11,200 fewer CHD deaths in 2007 than expected. The model was able to explain 72% of the mortality decline. Approximately 37% (95% CI: 10%-80%) of the decline was attributable to changes in acute phase and secondary prevention treatments: the largest contributions came from treating patients in the community with heart failure (11%) or chronic angina (9%). Approximately 36% (24%-67%) was attributable to decreases in risk factors: blood pressure (30%), total cholesterol levels (10%), smoking (5%) and physical inactivity (1%). Ten% more deaths could have been prevented if body mass index and diabetes would not have increased. Overall, these findings did not vary across socioeconomic groups, although within socioeconomic groups the contribution of risk factors differed. Conclusion: CHD mortality has recently halved in The Netherlands. Equally large contributions have come from the increased use of acute and secondary prevention treatments and from improvements in population risk factors (including primary prevention treatments). Increases in obesity and diabetes represent a major challenge for future prevention policies.
Kuzma, E., Soni, M., Littlejohns, T.J., Ranson, J.M., Van Schoor , N.M., Deeg, D.J.H., Comijs, H.C., Chaves, P.H.M., Kestenbaum, B.R., Kuller, L.H., Lopez, O.L. (2016). Vitamin D and memory decline: Two population-based prospective studies. Journal of Alzheimers Disease, 50, 4, 1099-1108. >Full Text.
Background: Vitamin D deficiency has been linked with dementia risk, cognitive decline, and executive dysfunction. However, the association with memory remains largely unknown. Objective: To investigate whether low serum 25-hydroxyvitamin D (25(OH)D) concentrations are associated with memory decline. Methods: We used data on 1,291 participants from the US Cardiovascular Health Study (CHS) and 915 participants from the Dutch Longitudinal Aging Study Amsterdam (LASA) who were dementia-free at baseline, had valid vitamin D measurements, and follow-up memory assessments. The Benton Visual Retention Test (in the CHS) and Rey's Auditory Verbal Learning Test (in the LASA) were used to assess visual and verbal memory, respectively. Results: In the CHS, those moderately and severely deficient in serum 25(OH)D changed -0.03 SD (95% CI: -0.06 to 0.01) and -0.10 SD (95% CI: -0.19 to -0.02) per year respectively in visual memory compared to those sufficient (p&#8202;=&#8202;0.02). In the LASA, moderate and severe deficiency in serum 25(OH)D was associated with a mean change of 0.01 SD (95% CI: -0.01 to 0.02) and -0.01 SD (95% CI: -0.04 to 0.02) per year respectively in verbal memory compared to sufficiency (p&#8202;=&#8202;0.34). Conclusions: Our findings suggest an association between severe vitamin D deficiency and visual memory decline but no association with verbal memory decline. They warrant further investigation in prospective studies assessing different memory subtypes.
Maarsingh, O.R., Henry, Y., Van de Ven, P., Deeg, D.J.H. (2016). Continuity of care in primary care and association with survival in older people: a 17-year prospective cohort study. British Journal of General Practice, 66, e531-539. >Full Text.
Background: Although continuity of care is a widely accepted core principle of primary care, the evidence about its benefits is still weak. Aim: To investigate whether continuity of care in general practice is associated with better survival in older people. Design and Setting: Data were derived from the Longitudinal Aging Study Amsterdam, an ongoing cohort study in older people in the Netherlands. The study sample consisted of 1712 older adults aged &#8805;60 years, with 3-year follow-up cycles up to 17 years (1992-2009), and mortality follow-up until 2013. Method: Continuity of care was defined as the duration of the ongoing therapeutic relationship between patient and GP. The Herfindahl-Hirschman Index was used to calculate the continuity of care (COC). A COC index value of 1 represented maximum continuity. COC index values <1 were divided into tertiles, with a fourth category for participants with maximum COC. Cox regression analysis was used to investigate the association between COC and survival time. Results: Seven hundred and forty-two participants (43.3%) reported a maximum COC. Among the 759 participants surviving 17 years, 251 (33.1%) still had the same GP. The lowest COC category (index >0-0.500) showed significantly greater mortality than those in the maximum COC category (hazard ratio (HR) = 1.20, 95% CI = 1.01 to 1.42). There were no confounders that affected this HR. Conclusion: This study demonstrates that low continuity of care in general practice is associated with a higher risk of mortality, strengthening the case for encouragement of continuity of care.
Rafiq, , Van Schoor , N.M., Sohl, E., Zillikens, M.C., Oosterwerff, M.M., Schaap, L.A., Lips, P.T.A., De Jongh, R.T. (2016). Associations of vitamin D status and vitamin D-related polymorphisms with sex hormones in older men. The Journal of Steroid Biochemistry and Molecular Biology, 164, 11–17. >Full Text.
Objective: Evidence regarding relationships of serum 25-hydroxyvitamin D (25(OH)D) with sex hormones and gonadotropin concentrations remains inconsistent. Polymorphisms in vitamin D-related genes may underly these relationships. Our aim was to examine the relationship of vitamin D status and polymorphisms in vitamin D-related genes with sex hormone and gonadotropin levels. Design and Measurements: We analysed data from the Longitudinal Aging Study Amsterdam, an ongoing population-based cohort study of older Dutch individuals (65-89 years). We included data of men with measurements of serum 25-hydroxyvitamin D (25(OH)D) (n=643) and determination of vitamin D-related gene polymorphisms (n=459). 25(OH)D concentrations were classified into four categories: <25, 25-50, 50-75 and >75nmol/L. Outcome measures were total testosterone, calculated bioavailable and free fraction testosterone, SHBG, estradiol, LH and FSH concentrations. Hypogonadism was defined as a total testosterone level <8.0nmol/L. Results: Serum 25(OH)D was positively associated with total and bioavailable testosterone levels. After adjustments for confounders, men with serum 25(OH)D less than 25 (n=56), 25-50 (n=199) and 50-75nmol/L (n=240) had lower total testosterone levels compared to men with serum 25(OH)D higher than 75nmol/L (n=148) (β (95% confidence interval): -2.1 (-3.7 to -0.4nmol/L), -0.8 (-1.9 to 0.4nmol/L) and -1.4 (-2.4 to -0.3nmol/L), respectively). For bioavailable testosterone the association was significant only for men with serum 25(OH)D less than 25nmol/L (-0.8 (-1.4 to -0.1nmol/L)) compared to men with serum 25(OH)D >75nmol/L. Serum 25(OH)D was not related to SHBG, estradiol or gonadotropin levels. Hypogonadism (n=29) was not associated with lower serum 25(OH)D. No significant differences were found in hormone levels between the different genotypes of the vitamin D-related gene polymorphisms. Also, the polymorphisms did not modify the relationships of serum 25(OH)D with sex hormones or gonadotropins. Conclusion: Vitamin D status is positively associated with testosterone levels. No association was found between vitamin D-related gene polymorphisms and hormone levels.
Sanders, J.B., Bremmer, M.A., Comijs, H.C., Deeg, D.J.H., Beekman, A.T.F. (2016). Gait Speed and the Natural Course of Depressive Symptoms in Late Life; An Independent Association With Chronicity? Journal of the American Medical Directors Association, 17, 4, 331-335. >Full Text.
Introduction: Psychomotor slowing is a core feature of depression in late life, but its prognostic value with respect to course and chronicity is unclear. We investigated whether gait speed can predict chronicity of depressive symptoms. Furthermore, we tested whether (1) cognitive slowing and (risk factors for) vascular diseases, (2) a marker of chronic inflammation, and (3) specific somatic conditions could explain this association. Methods: In the population-based Longitudinal Aging Study Amsterdam, 271 aged participants with clinically relevant depressive symptoms (Center for Epidemiologic Studies Depression Scale ≥16) were followed during a period of 6 years. With 14 successive Center for Epidemiologic Studies Depression Scale observations, 3 clinical course types of depressive symptoms were defined. RESULTS: Remission, fluctuating course, and chronic course of depressive symptoms were seen in 21%, 48%, and 30%, respectively. Slowed gait speed at baseline was associated with a chronic course of depressive symptoms using remission as the reference (odds ratio 0.56, 95% confidence interval 0.41-0.77). Processing speed and vascular risk factors explained this association only for 2%. Specific somatic comorbidity (number of chronic diseases, chronic obstructive pulmonary disease, osteoarthritis) or inflammation influenced the odds ratio. Limitation: Some variables were not measured with as much detail as would be possible in a clinical study setting. Conclusions: Slowed gait speed is a robust predictor of chronicity of depressive symptoms in late life, independent of somatic comorbidity and partly in concert with a slowed processing speed. Results suggest that slowed gait speed is an integral part of the depressive syndrome, probably a subtype associated with chronic course, independent of somatic comorbidity.
Schaap-Jonker, J., Egberink, I.J.L., Braam, A.W., Corveleyn, J.M.T. (2016). An Item Response Theory Analysis of The Questionnaire of God Representations. The International Journal for the Psychology of Religion, 26, 2, 152-166. >Full Text.
The Dutch Questionnaire of God Representations (QGR) was investigated by means of item response theory (IRT) modeling in a clinical (n = 329) and a nonclinical sample (n = 792). Through a graded responsemodel and IRT-based differential functioning techniques, detailed item-level analyses and information about measurement invariance between the clinical and nonclinical sample were obtained. On the basis of the results of the IRT analyses, a shortened version of the QGR (S-QGR) was constructed, consisting of 22 items, which functions in the same way in both the clinical and the nonclinical sample. Results indicated that the QGR consists of strong and reliable scales which are able to differentiate among persons. Psychometric characteristics of the S-QGR were adequate.
Semeijn, E. (2016). ADHD in older adults. Diagnosis, physical health and mental functioning. PhD Dissertation, VU University Amsterdam.
No abstract available.
Semeijn, E., Comijs, H.C., De Vet, H.C.W., Kooij, J.J.S., Michielsen, M., Beekman, A.T.F., Deeg, D.J.H. (2016). Lifetime stability of ADHD symptoms in older adults. ADHD Attention Deficit and Hyperactivity Disorders, 8, 1, 13-20. >Full Text.
Attention-deficit/hyperactivity disorder (ADHD) has been shown to continue into old age. Studies in children and younger adults show a reduction in hyperactive-impulsive symptoms, whereas the number of inattentive symptoms stays stable. The current study examined the lifetime stability of ADHD symptoms up to old age. Data on ADHD diagnosis and symptoms were collected in a two-phase side-study (N = 231) of the Longitudinal Aging Study Amsterdam. Paired t tests and ANCOVAs were used to analyze the data. Paired t test suggests continuity of the number of reported ADHD symptoms currently present and present in childhood. The change in the balance of inattentive/hyperactive-impulsive symptoms at present and in childhood is also the same in persons with ADHD. Finally, the difference in the change in the balance of inattentive/hyperactive-impulsive symptoms in those with and without ADHD suggests continuity throughout the life span. Our results suggest that diagnostic criteria developed for younger adults may be used among older adults. However, we collected our data retrospectively, which may have biased our results. Future research should follow larger cohorts of patients with ADHD prospectively over the life span.
Siviero, P., Zambon, S., Limongi, F., Castell, M.V., Cooper, C., Deeg, D.J.H., Denkinger, M., Dennison, E.M., Edwards, M.H., Otero, A., Pedersen, N.L., Peter, R., Queipo, R., Timmermans, E.J., Van Schoor , N.M., Maggi, S. (2016). How Hand Osteoarthritis, Comorbidity, and Pain Interact to Determine Functional Limitation in Older People: Observations From the European Project on OSteoArthritis Study. Arthritis Rheumatology, 68, 11, 2662-2670. >Full Text.
Objective: To examine the role of comorbidity and pain in the associations of hand osteoarthritis (OA) with self-reported and performance-based physical function in a general population of elderly persons. Methods: We studied data from 2,942 participants ages 65-85 years in the European Project on OSteoArthritis, a collaborative observational study of 6 European cohorts (from Germany, Italy, The Netherlands, Spain, Sweden, and the UK). Outcome measures included self-reported physical function of the hands measured by the AUStralian/CANadian Osteoarthritis Hand Index (AUSCAN) for hand OA physical function subscale and performance-based grip strength measured using a strain gauge dynamometer. Results: Comorbidity was not a confounder in the association of hand OA with self-reported and performance-based functional limitations, while the role of pain as a mediator was confirmed. Anxiety, depression, stroke, and osteoporosis were associated with AUSCAN scores reflecting more impairment. Depression and osteoporosis were associated with less grip strength. Conclusion: Although comorbidity was decidedly and independently associated with hand functional limitation, it had no effect on the relationship of hand OA with physical function. Hand OA was found to be associated with both self-reported and performance-based physical function impairment; the association was found to be partially mediated by pain, which reduced its impact.
Swinkels, J.C., Suanet, B.A., Deeg, D.J.H., Broese van Groenou, M.I. (2016). Trends in the informal and formal home-care use of older adults in the Netherlands between 1992 and 2012. Ageing & Society, 36, 9, 1870-1890. >Full Text.
This study investigates trends in, and the interdependence of, the use of informal and formal home care of community-dwelling older people over the last two decades in the context of governmental reform of long-term care services and modernisation of informal relationships. Seven observations of the Longitudinal Aging Study Amsterdam covering the time span between 1992 and 2012 were analysed using multi-level logistic regression analysis. The sample entailed 9,585 observations from 3,574 respondents, aged between 65 and 85 years and living independently at each time of measurement. Measures included formal and informal care use, health, physical and cognitive limitations, socio-demographics, partner status, social network, privately paid help and sense of mastery. Results showed that between 1992 and 2012, formal home-care use increased slightly while there was a large decrease in the use of informal care. Multivariate multi-level logistic regression analyses showed a substitution effect between formal and informal care use which decreased over time. Analyses also showed improved cognitive functioning, increased partner availability and social network size, as well as increased use of privately paid care over time. Nevertheless, these positive trends did not explain the large decrease in informal care use. The results regarding informal care use suggest a societal trend of weakened informal solidarity, reflecting increased individualisation and increased availability of formal home care. The decreased substitution effect suggests that, in agreement with current reforms of long-term care, complementary or supplementary forms of care use may be more common in the near future.
Timmermans, E.J., Schaap, L.A., Visser, M., Van der Ploeg, H.P., Wagtendonk, A.J., Van der Pas, S., Deeg, D.J.H. (2016). The association of the neighbourhood built environment with objectively measured physical activity in older adults with and without lower limb osteoarthritis. BMC Public Health, 16, 710. >Full Text.
Background: This study examined the associations of objectively measured neighbourhood built environment characteristics with objectively measured physical activity (PA) in older people with and without lower limb osteoarthritis (LLOA), and assessed whether these relationships differ between both groups. Methods: Data from the Dutch component of the European Project on OSteoArthritis were used. American College of Rheumatology classification criteria were used to diagnose LLOA (knee and/or hip osteoarthritis). Daily average time spent on total PA and separate PA intensity categories, including light PA, low-light PA, high-light PA, and moderate to vigorous PA, were measured using Actigraph GT3X accelerometers. Geographic Information Systems were used to measure street connectivity (number of street connections per km(2)) and distances (in km) to resources (health care resources, retail resources, meeting places, and public transport) within neighbourhoods. Multiple Linear Regression Analyses were used to examine the associations between measures of the neighbourhood built environment and PA, adjusted for several confounders. Results: Of all 247 participants (66-85 years), 41 (16.6 %) had LLOA. The time spent on any PA did not differ significantly between participants with and without LLOA (LLOA: Mean&#8201;=&#8201;268.3, SD&#8201;=&#8201;83.3 versus non-LLOA: Mean&#8201;=&#8201;275.8, SD&#8201;=&#8201;81.2; p&#8201;=&#8201;0.59). In the full sample, no measures of the neighbourhood built environment were statistically significantly associated with total PA. Larger distances to specific health care resources (general practice and physiotherapist) and retail resources (supermarket) were associated with more time spent on PA in older people with LLOA than in those without LLOA. In particular, the associations of light and high-light PA with distances to these specific resources were stronger in participants with LLOA compared to their counterparts without LLOA. Conclusions: Specific attributes of the neighbourhood built environment are more strongly associated with PA in older people with LLOA than in those without LLOA. Knowledge on the relationship between objectively measured neighbourhood characteristics and PA in older people with and without LLOA could be used to inform policymakers and city planners about adaptation of neighbourhoods and their infrastructures to appropriately facilitate PA in healthy and functionally impaired older adults.
Timmermans, E.J., Deeg, D.J.H. (2016). The influence of weather conditions on joint pain in older adults with osteoarthritis. Geron, Tijdschrift over ouder worden en samenleving, 18, 70-72. >Full Text.
No abstract available.
Timmermans, E.J., Van der Pas, S., Dennison, E.M., Maggi, S., Peter, R., Castell, M.V., Pedersen, N.L., Denkinger, M., Edwards, M.H., Limongi, F., Herbolsheimer, F., Sanchez-Martinez, M., Siviero, P., Queipo, R., Schaap, L.A., Deeg, D.J.H. (2016). The Influence of Weather Conditions on Outdoor Physical Activity Among Older People With and Without Osteoarthritis in 6 European Countries. Journal of Physical Activity & Health, 13, 12, 1385-1395. >Full Text.
Background: Older adults with osteoarthritis (OA) often report that their disease symptoms are exacerbated by weather conditions. This study examines the association between outdoor physical activity (PA) and weather conditions in older adults from 6 European countries and assesses whether outdoor PA and weather conditions are more strongly associated in older persons with OA than in those without the condition. Methods: The American College of Rheumatology classification criteria were used to diagnose OA. Outdoor PA was assessed using the LASA Physical Activity Questionnaire. Data on weather parameters were obtained from weather stations. Results: Of the 2439 participants (65–85 years), 29.6% had OA in knee, hand and/or hip. Participants with OA spent fewer minutes in PA than participants without OA (Median = 42.9, IQR = 20.0 to 83.1 versus Median = 51.4, IQR = 23.6 to 98.6; P < .01). In the full sample, temperature (B = 1.52; P < .001) and relative humidity (B = –0.77; P < .001) were associated with PA. Temperature was more strongly associated with PA in participants without OA (B = 1.98; P < .001) than in those with the condition (B = 0.48; P = .47). Conclusions: Weather conditions are associated with outdoor PA in older adults in the general population. Outdoor PA and weather conditions were more strongly associated in older adults without OA than in their counterparts with OA.
Van Boheemen, L., Tett, S.E., Sohl, E., Hugtenberg, J.G., Van Schoor , N.M., Peeters, G.M.E.E. (2016). Associations Between Statin Use and Physical Function in Older Adults from The Netherlands and Australia: Longitudinal Aging Study Amsterdam and Australian Longitudinal Study on Women's Health Drugs & Aging, 33, 6, 437-445. >Full Text.
Background: Statin therapy may cause myopathy, but long-term effects on physical function are unclear. Objective: We investigated whether statin use is associated with poorer physical function in two population-based cohorts of older adults. Methods: Data were from 691 men and women (aged 69-102 years in 2005/2006) in the LASA (Longitudinal Aging Study Amsterdam) and 5912 women (aged 79-84 years in 2005) in the ALSWH (Australian Longitudinal Study on Women's Health). Statin use and dose were sourced from containers (LASA) and administrative databases (ALSWH). Physical function was assessed using performance tests, questionnaires on functional limitations and the SF-12 (LASA) and SF-36 (ALSWH) questionnaires. Cross-sectional (both studies) and 3-year prospective associations (ALSWH) were analysed for different statin dosage using linear and logistic regression. Results: In total, 25 % of participants in LASA and 61 % in ALSWH used statins. In the cross-sectional models in LASA, statin users were less likely to have functional limitations (percentage of subjects with at least 1 limitation 63.9 vs. 64.2; odds ratio [OR] 0.6; 95 % confidence interval [CI] 0.3-0.9) and had better SF-12 physical component scores (mean [adjusted] 47.3 vs. 44.5; beta [B] = 2.8; 95 % CI 1.1-4.5); in ALSWH, statin users had better SF-36 physical component scores (mean [adjusted] 37.4 vs. 36.5; B = 0.9; 95 % CI 0.3-1.5) and physical functioning subscale scores (mean [adjusted] 55.1 vs. 52.6; B = 2.4; 95 % CI 1.1-3.8) than non-users. Similar associations were found for low- and high-dose users and in the prospective models. In contrast, no significant associations were found with performance tests. Conclusions: Two databases from longitudinal population studies in older adults gave comparable results, even though different outcome measures were used. In these two large cohorts, statin use was associated with better self-perceived physical function.
Van der Pas, S., Schaap, L.A., Castell, M.V., Cooper, C., Denkinger, M., Edwards, M.H., Herbolsheimer, F., Maggi, S., Sanchez-Martinez, M., Deeg, D.J.H. (2016). Availability and use of neighborhood resources by older people with osteoarthritis: Results from the European Project on OSteoArthritis. Health & Place, 1, 1-7. >Full Text.
This study examines the availability and use of neighborhood resources in relation to clinical lower limb osteoarthritis (LLOA) in older participants from six European countries. Of the 2757 participants (65&#4585 years), 22.7% had LLOA. Participants with LLOA made more use of places to sit (OR=2.50; CI: 1.36&#454.60 in the UK), and less use of parks and walking areas (OR=0.30; CI: 0.12&#450.75 in Sweden), compared to participants without LLOA, particularly in countries with high availability of resources. The results suggest that specific features of the environment impact the use of neighborhood resources by older adults with LLOA.
Van Nispen, R.M.A., Vreeken, H.L., Comijs, H.C., Deeg, D.J.H., Van Rens, G.H.M.B. (2016). Role of vision loss, functional limitations and the supporting network in depression in a general population. Acta Ophthalmologica, 94, 7682. >Full Text.
No abstract available.
Van Schoor , N.M., Zambon, S., Castell, M.V., Cooper, C., Denkinger, M., Dennison, E.M., Edwards, M.H., Herbolsheimer, F., Maggi, S., Sanchez-Martinez, M. (2016). Impact of clinical osteoarthritis of the hip, knee and hand on self-rated health in six European countries: the European Project on OSteoArthritis. Quality of Life Research, 25, 1423-1432. >Full Text.
Purpose: Osteoarthritis (OA) has been shown to be associated with decreased physical function, which may impact upon a person's self-rated health (SRH). Only a few studies have examined the association between OA and SRH in the general population, but to date none have used a clinical definition of OA. The objectives are: (1) To examine the cross-sectional association between clinical OA and fair-to-poor SRH in the general population; (2) To examine whether this association differs between countries; (3) To examine whether physical function is a mediator in the association between clinical OA and SRH. Methods: Baseline data of the European Project on OSteoArthritis (EPOSA) were used, which includes pre-harmonized data from six European cohort studies (n = 2709). Clinical OA was defined according to the American College of Rheumatology criteria. SRH was assessed using one question: How is your health in general? Physical function was assessed using the Western Ontario and McMaster Universities OA Index and Australian/Canadian OA Hand Index. Results: The prevalence of fair-to-poor SRH ranged from 19.8 % in the United Kingdom to 63.5 % in Italy. Although country differences in the strength of the associations were observed, clinical OA of the hip, knee and hand were significantly associated with fair-to-poor SRH in five out of six European countries. In most countries and at most sites, the association between clinical OA and fair-to-poor SRH was partly or fully mediated by physical function. Conclusions: Clinical OA at different sites was related to fair-to-poor SRH in the general population. Most associations were (partly) mediated by physical functioning, indicating that deteriorating physical function in patients with OA should be a point of attention in patient care.
Van Schoor , N.M., Comijs, H.C., Llewellyn, D.J., Lips, P.T.A. (2016). Cross-sectional and longitudinal associations between serum 25-hydroxyvitamin D and cognitive functioning. International Psychogeriatrics, 28, 5, 759-768. >Full Text.
Background: Vitamin D deficiency is common in older persons. The objectives of this study were: To examine the cross-sectional and longitudinal association between serum 25-hydroxyvitamin D (25(OH)D) and cognitive functioning in older persons; and to explore the optimal cut-off for serum 25(OH)D. Methods: Data of the Longitudinal Aging Study Amsterdam (LASA) were used. Serum 25(OH)D was determined using a competitive protein binding assay in 1995/6 (n = 1,320). Cognitive functioning was assessed in 1995/6 and 1998/9 using the Mini-Mental State Examination (MMSE, general cognitive functioning), Raven's Colored Progressive Matrices (RCPM, ability of nonverbal and abstract reasoning), the Coding Task (CT, information processing speed), and the 15 Words Test (15WT, immediate memory and delayed recall). The data were analyzed using linear regression analyses and restricted cubic spline functions. The MMSE was normalized using ln(31-MMSE). Results: Mean serum 25(OH)D was 53.7 nmol/L. After adjustment for confounding, patients with serum 25(OH)D levels below 30 nmol/L had significantly lower general cognitive functioning (beta of ln(31-MMSE) = 0.122; p = 0.046) and slower information processing speed (beta = -2.177, p = 0.001) as compared with patients having serum 25(OH)D levels ≥ 75 nmol/L in the cross-sectional analyses. For both outcomes, the optimal cut-off was about 60 nmol/L. No other significant associations were observed. Conclusions: A lower serum 25(OH)D was significantly associated with lower general cognitive functioning and slower information processing speed, but not with a faster rate of cognitive decline.
Zambon, S., Siviero, P., Denkinger, M., Limongi, F., Castell, M.V., Van der Pas, S., Otero, A., Edwards, M.H., Peter, R., Pedersen, N.L., Sanchez-Martinez, M. (2016). Osteoarthritis,comorbidity and pain: Their role in determining functional limitations in older populations (European project on Osteoarthritis). Arthritis Care & Research, 68, 801-810. >Full Text.
No abstract available.

2015

Castell, M.V., Van der Pas, S., Otero, A., Siviero, P., Dennison, E.M., Denkinger, M., Pedersen, N.L., Sanchez-Martinez, M., Queipo, R., Van Schoor , N.M., Zambon, S., Edwards, M.H., Peter, R., Schaap, L.A., Deeg, D.J.H. (2015). Osteoarthritis and frailty in elderly individuals across six European countries: results from the European Project on OSteoArthritis (EPOSA). BMC Musculoskeletal Disorders, 16, 359. >Full Text.
Background: Osteoarthritis (OA) is the most common cause of disability in the elderly. Clinical frailty is associated with high mortality, but few studies have explored the relationship between OA and frailty. The objective of this study was to consider the association between OA and frailty/pre-frailty in an elderly population comprised of six European cohorts participating in the EPOSA project. Methods: Longitudinal study using baseline data and first follow-up waves, from EPOSA; 2,455 individuals aged 65-85 years were recruited from pre-existing population-based cohorts in Germany, Italy, the Netherlands, Spain, Sweden and the United Kingdom. Data were collected on clinical OA at any site (hand, knee or hip), based on the clinical classification criteria developed by the American College of Rheumatology (ACR). Frailty was defined according to Fried's criteria. The covariates considered were age, gender, educational level, obesity and country. We used multinomial logistic regression to analyse the associations between OA, frailty/pre-frailty and other covariates. Results: The overall prevalence of clinical OA at any site was 30.4 % (95 % CI:28.6-32.2); frailty was present in 10.2 % (95 % CI:9.0-11.4) and pre-frailty in 51.0 % (95 % CI:49.0-53.0). The odds of frailty was 2.96 (95 % CI:2.11-4.16) and pre-frailty 1.54 (95 % CI:1.24-1.91) as high among OA individuals than those without OA. The association remained when Knee OA, hip OA or hand OA were considered separately, and was stronger in those with increasing number of joints. Conclusions: Clinical OA is associated with frailty and pre-frailty in older adults in European countries. This association might be considered when designing appropriate intervention strategies for OA management.
De Vries, O.J. (2015). Fall risk factors and secondary fall prevention in older people. PhD Dissertation, VU University Amsterdam.
No abstract available.
Deeg, D.J.H. (2015). Oud worden is normaal. Gern, Tijdschrift over ouder worden & samenleving, 17 (3), 34-37.
Drie grote uitdagingen die voortvloeien uit de toename van het aantal ouderen in de bevolking krijgen veel minder aandacht dan de houdbaarheid van het pensioen- en zorgstelsel: de toename van het aantal ouderen met complexe gezondheidsproblemen; de informatisering van de samenleving die hoge eisen stelt aan het cognitieve vermogen van oudere werknemers; de toename van de druk op jong-oudere leeftijdsgroepen om verschillende vormen van sociale participatie te combineren.
Den Uyl, D., Van Schoor , N.M., Bravenboer, N., Lips, P.T.A., Lems, W.F. (2015). Low grade inflammation is associated with lower velocity of sound and broadband ultrasound attenuation in older men, but not with bone loss or fracture risk in a longitudinal aging study. Bone, 81, 270-276. >Full Text.
No abstract available.
Dijkstra, S. C., Neter, J.E., Van Stralen, , Knol, D.L., Brouwer, I.A., Huisman, M., Visser, M. (2015). The role of perceived barriers in explaining socio-economic status differences in adherence to the fruit, vegetable and fish guidelines in older adults: a mediation study. Public Health Nutrition, 18(5), 797808. >Full Text.
No abstract available.
Ellwardt, L., Van Tilburg, T.G., Aartsen, M.J. (2015). The mix matters: Complex personal networks relate to higher cognitive functioning in old age. Social Science & Medicine, 125, 107-115. >Full Text.
Stronger engagement of older adults in social activities and greater embeddedness in networks is often argued to buffer cognitive decline and lower risks of dementia. One of the explanations is that interaction with other people trains the brain, thereby enhancing cognitive functioning. However, research on the relationship between personal networks and cognitive functioning is not yet conclusive. While previous studies have focused on the size of personal networks as a proxy of cognitive stimulation, little attention has been paid to the complexity of the personal network. Adults embedded in a broad range of network relationships (i.e., various relationship types) are likely to be exposed to a wider range of stimuli than adults embedded in a homogeneous network including similar relationship types. We expect that higher numbers of personal relationship types rather than a higher number of similar contacts relate to higher levels of cognitive functioning and slower cognitive decline. Data are from the Longitudinal Aging Study Amsterdam (LASA) and include 2959 Dutch participants aged 54 to 85 at baseline in 1992 and six follow-ups covering a time span of twenty years. Cognitive functioning is assessed with the Mini-Mental State Examination (MMSE), and for network complexity we use the Social Network Index.We test our expectations using fixed-effects regression models. The results reveal that a reduction in network complexity is associated with a reduction in cognitive functioning, which is neither explained by size of the network nor by presence of specific relationship types. However, enhanced complexity has only a marginal buffering effect on decline in cognitive functioning. We conclude that network characteristics and cognitive functioning are intertwined and that their association is mostly cross-sectional in nature.
Ellwardt, L., Van Tilburg, T.G., Aartsen, M.J., Wittek, R., Steverink, N. (2015). Personal Networks and Mortality Risk in Older Adults: A Twenty-Year Longitudinal Study. PLoS ONE 10(3), e0116731. >Full Text.
No abstract available.
Emerging Risk Factors Collaboration (2015). Association of Cardiometabolic Multimorbidity With Mortality. JAMA 314 (1), 52-60. >Full Text.
Importance: The prevalence of cardiometabolic multimorbidity is increasing. Objective: To estimate reductions in life expectancy associated with cardiometabolic multimorbidity. Design, Setting, and Participants: Age- and sex-adjusted mortality rates and hazard ratios (HRs) were calculated using individual participant data from the Emerging Risk Factors Collaboration (689&#8239;300 participants; 91 cohorts; years of baseline surveys: 1960-2007; latest mortality follow-up: April 2013; 128&#8239;843 deaths). The HRs from the Emerging Risk Factors Collaboration were compared with those from the UK Biobank (499&#8239;808 participants; years of baseline surveys: 2006-2010; latest mortality follow-up: November 2013; 7995 deaths). Cumulative survival was estimated by applying calculated age-specific HRs for mortality to contemporary US age-specific death rates. Exposures: A history of 2 or more of the following: diabetes mellitus, stroke, myocardial infarction (MI). Main Outcomes and Measures: All-cause mortality and estimated reductions in life expectancy. Results: In participants in the Emerging Risk Factors Collaboration without a history of diabetes, stroke, or MI at baseline (reference group), the all-cause mortality rate adjusted to the age of 60 years was 6.8 per 1000 person-years. Mortality rates per 1000 person-years were 15.6 in participants with a history of diabetes, 16.1 in those with stroke, 16.8 in those with MI, 32.0 in those with both diabetes and MI, 32.5 in those with both diabetes and stroke, 32.8 in those with both stroke and MI, and 59.5 in those with diabetes, stroke, and MI. Compared with the reference group, the HRs for all-cause mortality were 1.9 (95% CI, 1.8-2.0) in participants with a history of diabetes, 2.1 (95% CI, 2.0-2.2) in those with stroke, 2.0 (95% CI, 1.9-2.2) in those with MI, 3.7 (95% CI, 3.3-4.1) in those with both diabetes and MI, 3.8 (95% CI, 3.5-4.2) in those with both diabetes and stroke, 3.5 (95% CI, 3.1-4.0) in those with both stroke and MI, and 6.9 (95% CI, 5.7-8.3) in those with diabetes, stroke, and MI. The HRs from the Emerging Risk Factors Collaboration were similar to those from the more recently recruited UK Biobank. The HRs were little changed after further adjustment for markers of established intermediate pathways (eg, levels of lipids and blood pressure) and lifestyle factors (eg, smoking, diet). At the age of 60 years, a history of any 2 of these conditions was associated with 12 years of reduced life expectancy and a history of all 3 of these conditions was associated with 15 years of reduced life expectancy. Conclusions and Relevance: Mortality associated with a history of diabetes, stroke, or MI was similar for each condition. Because any combination of these conditions was associated with multiplicative mortality risk, life expectancy was substantially lower in people with multimorbidity.
Evans, N.C., Pasman, H.R.W., Deeg, D.J.H., Onwuteaka-Philipsen, B.D. (2015). Letter to the editor: Older Dutch People's Self-Reported Advance Euthanasia Directive Completion Before and After the Enactment of the Euthanasia Law: A Time Trend Study (1998-2011). Journal of the American Geriatrics Society, 63, 10, 2217-2219. >Full Text.
No abstract available.
Geurts, T., Van Tilburg, T.G., Poortman, A., Dijkstra, P.A. (2015). Child care by grandparents: changes between 1992 and 2006. Ageing & Society, 35, 1318-1334 >Full Text.
No abstract available.
Geurts, T., Van Tilburg, T.G., Poortman, A., Dijkstra, P.A. (2015). Child care by grandparents: changes between 1992 and 2006. ERRATUM. Ageing & Society, 35, 1341. >Full Text.
No abstract available.
Hartmans, C., Comijs, H.C., Jonker, C. (2015). The Perception of Sexuality in Older Adults and Its Relationship with Cognitive Functioning. The American Journal of Geriatric Psychiatry, 23, 3, 243-252. >Full Text.
No abstract available.
Hoogendijk, E.O. (2015). The challenge of frailty in older adults. Risk factors, assessment instruments and comprehensive community care. PhD Dissertation, VU University Amsterdam.
No abstract available.
Houtjes, W. (2015). Needs of elderly people with late-life depression. Challenges for care improvement. PhD Dissertation, VU University Amsterdam.
No abstract available.
Huisman, M., Kok, A., Aartsen, M.J., Deeg, D.J.H. (2015). Diversiteit in ouder worden hanteerbaar maken voor beleid en praktijk. Gern, Tijdschrift over ouder worden & samenleving, 17(3), 17-20.
Iedereen wordt anders oud. Om deze diversiteit in ouder worden inzichtelijk te maken, gebruiken we gegevens uit de Longitudinal Aging Study Amsterdam om trajecten van veroudering over een periode van 16 jaar in negen (kern) uitkomsten van ouder worden op het vlak van fysiek, cognitief, emotioneel en sociaal functioneren te beschrijven. Uit deze trajecten stellen we vier profielen samen die in principe al beleidsrelevant moeten zijn.
Limonard, E.J., Van Schoor , N.M., De Jongh, R.T., Lips, P.T.A., Fliers, E., Bisschop, P.H. (2015). Osteocalcin and the pituitary-gonadal axis in older men: a population-based study. Clinical Endocrinology, 82, 5, 753-759. >Full Text.
No abstract available.
Michielsen, M. (2015). ADHD in older adults. Prevalence & psychosocial functioning. PhD Dissertation, VU University Amsterdam.
No abstract available.
Michielsen, M., Comijs, H.C., Aartsen, M.J., Semeijn, E., Beekman, A.T.F., Deeg, D.J.H., Kooij, J.J.S. (2015). The relationships between ADHD and social functioning and participation in older adults in a population-based study. Journal of Attention Disorders, 19, 368-379. >Full Text.
Objective: To examine the associations between ADHD and social functioning and participation among older adults. Method: Data were used from the Longitudinal Aging Study Amsterdam (LASA). In 2008/2009, respondents were asked about social functioning and participation. A diagnostic interview to diagnose ADHD was administered among a subsample (N = 231, age 60-94 years). ADHD diagnosis and level of ADHD symptoms were assessed. Results: ADHD diagnosis was associated with being divorced/never married, having less family members in their network, and emotional loneliness. Level of ADHD symptoms was associated with more emotional support given, emotional and social loneliness, greater recreational social participation, and lower income level. Conclusion: ADHD in old age is related to being divorced/never married and loneliness but not to work participation. Psycho geriatric practices should direct their attention to loneliness when treating ADHD.
Monteagudo, C., Dijkstra, S. C., Visser, M. (2015). Self- Perception of Body Weight Status in Older Dutch Adults. The journal of nutrition, health & aging, 19, 6, 612-618. >Full Text.
Objectives: The prevalence of obesity is highest in older persons and a correct self-perception of body weight status is necessary for optimal weight control. The aim of this study was to determine self-perception of, and satisfaction with, body weight status, and to compare current versus ideal body image in a large, nationally representative sample of older people. Furthermore, determinants of misperception were explored. Design: A cross-sectional study. Setting: The Longitudinal Aging Study Amsterdam (LASA), conducted in a population-based sample in the Netherlands. Participants: 1295 men and women aged 60-96 years. Measurements: Body weight status was assessed using measured weight and height. Self-perceived body weight status, satisfaction with body weight and current and ideal body image were also assessed. Multiple logistic regression analysis was used to investigate the association of age, educational level and objectively measured BMI with underestimation of body weight status. Results: The prevalence of obesity was 19.9% in men and 29.3% in women. The agreement between objective and self-perceived body weight status was low (Kappa < 0.2). Among overweight and obese persons, 42.1% of men and 44.1% of women were (very) dissatisfied with their body weight status and >99% of obese participants desired to be thinner (ideal body image < current image). Only 4.4% of obese men and 12.3% of obese women perceived their body weight status correctly. Higher age (women), lower educational level (men) and higher BMI (all) were associated with greater underestimation of body weight status. Conclusion: Many older persons misperceive their body weight status. Future actions to improve body weight perception in older persons are necessary to increase the impact of public health campaigns focussing on a healthy body weight in old age.
Oosterwerff, M.M. (2015). Vitamin D for the prevention of type 2 diabetes. PhD Dissertation, VU University Amsterdam.
No abstract available.
Parsons, C., Clynes, M., Syddall, H., Jagannath, D., Litwic, A., Van der Pas, S., Cooper, C., Dennison, E.M., Edwards, M.H. (2015). How well do radiographic, clinical and self-reported diagnoses of knee osteoarthritis agree? Findings from the Hertfordshire cohort study. Springerplus, 4, 177. >Full Text.
Objective: Epidemiological studies of knee osteoarthritis (OA) have often used a radiographic definition. However, the clinical syndrome of OA is influenced by a broad range of factors in addition to the structural changes required for radiographic OA. Hence more recently several studies have adopted a clinical or self-reported approach to OA diagnosis rather than a radiographic approach. The aim of this study was to investigate agreement between radiographic OA and the clinical and self-reported diagnoses of OA. Design: Data were available for 199 men and 196 women in the Hertfordshire Cohort Study (HCS), UK. Participants completed a questionnaire detailing self-reported OA. Clinical OA was defined based on American College of Rheumatology (ACR) criteria. Knee radiographs were taken and graded for overall Kellgren and Lawrence (K&L) score. Results: The mean (standard deviation (SD)) age of study participants was 75.2 (2.6) years and almost identical proportions of men and women. The prevalence of knee OA differed depending on the method employed for diagnosis; 21% of the study participants self-reported knee OA, 18% of the participants had clinical knee OA and 42% of the participants had radiographic OA. Of those 72 study participants with a self-reported diagnosis of knee OA 52 (72%) had a radiographic diagnosis of knee OA, while 66% (39 out of 59) of study participants with clinical knee OA had a diagnosis of radiographic knee OA. However 58% of those participants diagnosed with radiographic OA did not have either self-reported knee OA or a diagnosis of clinical OA. Therefore in comparison with the radiographic definition of OA, both the clinical and self-report definitions had high specificity (91.5% & 91.5% respectively) and low sensitivity (24.5% and 32.7% respectively). Conclusion: There is modest agreement between the radiographic, clinical and self-report methods of diagnosis of knee OA.
Post Hospers, G., Smulders, Y., Maier, A.B., Deeg, D.J.H., Muller, M.J. (2015). Relation between blood pressure and mortality risk in an older population: role of chronological and biological age. Journal of Internal Medicine, 277 (4), 488-497. >Full Text.
Background: The relation between high blood pressure (BP) and mortality risk in older individuals (above 65 years of age) is still debated. Some data suggest that this relation is inverted in certain subgroups of (biologically) older individuals. We therefore investigated whether the association between BP and mortality is dependent on chronological age and on physical and cognitive function as indicators of biological age. Methods: The relationship between BP and all-cause mortality was investigated in 1466 older participants (aged 65 years and older; mean age 75.8 years) of the Longitudinal Ageing Study Amsterdam using multiple adjusted Cox proportional hazard models. Analyses were stratified for age, gait speed and mini mental state examination score. Results: A total of 1008 participants died after a median (range) follow-up of 10.6 (0.2; 15.9) years. Low diastolic blood pressure (DBP) was associated with an increased all-cause mortality risk: hazard ratio (HR) of low DBP (&#8804;70 mmHg) compared to normal DBP (71-90 mmHg) was 1.36 [95% confidence interval (CI) 1.15; 1.61]. This relation was particularly strong in the oldest old (individuals aged >80 years) and in those who had lower levels of both physical and cognitive functioning: HRs (95% CIs) of low versus normal DBP were 1.58 (1.26; 1.98) and 1.45 (1.18; 1.77), respectively. Conclusion: In a large population-based cohort of older adults, low DBP was associated with an increased all-cause mortality risk, especially in the oldest old and in biologically old individuals.
Raho, E., van Oostrom, S.H., Visser, M., Huisman, M., Zantinge, E.M., Smit, H.A., Verschuren, W.M.M., Hulsegge, G., Picavet, H.S.J. (2015). Generation shifts in smoking over 20 years in two Dutch population-based cohorts aged 20-100 years. BMC Public Health, 15, 142. >Full Text.
Background: Younger and older generations may differ substantially in their lifetime smoking habits, which may result in generation-specific health challenges. We aimed to quantify generation shifts in smoking over a period of 25 years. Methods: We used the Doetinchem Cohort Study (baseline 1987-1991; 7768 individuals; 20-60 years; follow-up 1993-2012) and the Longitudinal Aging Study Amsterdam (baseline 1992-1993; 3017 individuals; 55-85 years; follow-up 1995-2009). Generation shifts were studied between 10-year generations (age range: 20-100 years). Generation shifts were examined graphically and by using logistic random effect models for men and women. Results: Among men, significant generation shifts in current smoking were found between two non-successive generations: for instance men in their 40s at baseline smoked much more than men in their 40s at follow-up (33.6% vs. 23.1%, p&#8201;<&#8201;0.05). Among women, the most recently born generation showed a favourable significant generation shift in current smoking (-7.3%) and ever smoking (-10.1%). For all other generations, the prevalence of ever smoking among women was significantly higher in every more recently born generation, whereas no other generation shifts were observed for current smoking. The unfavourable generation shifts were mainly found among the lower educated. Conclusions: The future burden of disease due to smoking is expected to be reduced among men, but not yet among women. Educational differences in smoking-related health problems are expected to increase.
Rijs, K.J., Van den Kommer, T.N., Comijs, H.C., Deeg, D.J.H. (2015). Prevalence and Incidence of Memory Complaints in Employed Compared to Non-Employed Aged 55-64 Years and the Role of Employment Characteristics. PLoS ONE 10 (3), e0119192 >Full Text.
Objectives: To examine the association of employment status and characteristics with prevalent and incident memory complaints (MC) in 55–64-year-olds. Methods: Subjects were participants of the Longitudinal Aging Study Amsterdam (LASA). Respondents with baseline data were selected to examine the association of employment status (n = 1525) and employment characteristics (n = 1071) with prevalent MC (i.e., MC at baseline). Respondents without MC at baseline were selected to examine the association of employment (n = 526) and employment characteristics (n = 379; working hours, job prestige, job level, psychological job demands, iso-strain) with incident MC (i.e., no MC at baseline and MC at three-year follow-up). Associations were adjusted for relevant covariates (demographics, memory performance, physical health, mental health, personality traits). Logistic regression was applied. Data were weighed according to gender and age of the Dutch population. Results: At baseline 20.5% reported MC. At three-year follow-up, 15.4% had incident MC. No associations were found between employment status and MC. Adjusted analysis revealed that individuals with high occupational cognitive demands were more likely to have prevalent MC. Conclusions: Middle-aged workers are equally as likely to experience MC as non-working age-peers. Among workers, those with cognitively demanding work were more likely to experience MC, independent of memory performance. Memory decline due to ageing may be noticed sooner in 55–64-year-olds performing cognitively demanding work.
Sanders, J.B., Comijs, H.C., Bremmer, M.A., Deeg, D.J.H., Beekman, A.T.F. (2015). A 13-year prospective cohort study on the effects of aging and frailty on the depression-pain relationship in older adults. International Journal of Geriatric Psychiatry, 30, 751-757. >Full Text.
Objectives: The primary aim of the study is to investigate the effect of age and aging on the association between pain and depression over 13 years. We hypothesized that (1) this association would become stronger with age and frailty and that (2) this association is mainly driven by somatic and psychological factors. Methods: Data were derived from the Longitudinal Aging Study Amsterdam, a prospective populationbased cohort study with four follow-up measurements over 13 years, consisting of 1528 respondents (mean age 67.9-8.1). Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale; pain was measured with an adapted version of the Nottingham Health Profile. Follow-up time and age were used as proxy variables for aging and gait speed as frailty marker. Cognition, mastery and neuroticism were measured using the mini mental state examination, the Pearlin Mastery Scale and the Dutch Personality Questionnaire respectively. Results: Linear mixed models showed that pain and depressive symptoms were associated over the 13-year follow-up: b=0.095, p<0.001. Neither aging nor frailty changed this association. Measured somatic and psychological characteristics explained 40% of the covariance between pain and depressive symptoms over time. Discussion: When dealing with people suffering from pain and depression, interventions should be similar for all aged people, encompassing both somatic and psychological factors, irrespective of age or frailty status.
Sant, N., Huisman, M., Thomése, G.C.F., Van de Schoot, R., Turnhout, S., Minkman, M. (2015). Langer thuis, mythe of nieuwe maatschappelijke modus? Beleid ontmoet wetenschap en praktijk. Tijdschrift voor Gerontologie en Geriatrie, 46,3, 185-187. >Full Text.
No abstract available.
Schoenmakers, E, Van Tilburg, T.G., Fokkema, C.M. (2015). Problem-focused and emotion-focused coping options and loneliness: how are they related? European Journal of Ageing, 12, 2, 153-161. >Full Text.
No abstract available.
Semeijn, E., Comijs, H.C., Kooij, J.J.S., Michielsen, M., Beekman, A.T.F., Deeg, D.J.H. (2015). The role of adverse life events on depression in older adults with ADHD. Journal of Affective Disorders, 174, 574579. >Full Text.
No abstract available.
Semeijn, E., Korten, N.C.M., Comijs, H.C., Michielsen, M., Deeg, D.J.H., Beekman, A.T.F., Kooij, J.J.S. (2015). No lower cognitive functioning in older adults with attention-deficit/hyperactivity disorder. International Psychogeriatrics, 27, 9, 14671476. >Full Text.
No abstract available.
Smetsers, S.E., Velleuer, E., Dietrich, R., Wu, T., Brink, A., Buijze, M., Deeg, D.J.H., Soulier, J., Leemans, C.R., Braakhuis, B.J.M., Brakenhoff, R.H. (2015). Noninvasive molecular screening for oral precancer in Fanconi anemia patients. Cancer Prevention Research, 8, 11, 1102-1111. >Full Text.
LOH at chromosome arms 3p, 9p, 11q, and 17p are well-established oncogenetic aberrations in oral precancerous lesions and promising biomarkers to monitor the development of oral cancer. Noninvasive LOH screening of brushed oral cells is a preferable method for precancer detection in patients at increased risk for head and neck squamous cell carcinoma (HNSCC), such as patients with Fanconi anemia. We determined the prevalence of LOH in brushed samples of the oral epithelium of 141 patients with Fanconi anemia and 144 aged subjects, and studied the association between LOH and HNSCC. LOH was present in 14 (9.9%) nontransplanted patients with Fanconi anemia, whereas LOH was not detected in a low-risk group (n = 50, >58 years, nonsmoking/nonalcohol history) and a group with somewhat increased HNSCC risk (n = 94, >58 years, heavy smoking/excessive alcohol use); Fisher exact test, P = 0.023 and P = 0.001, respectively. Most frequent genetic alteration was LOH at 9p. Age was a significant predictor of LOH (OR, 1.13, P = 0.001). Five patients with Fanconi anemia developed HNSCC during the study at a median age of 39.6 years (range, 24.8-53.7). LOH was significantly associated with HNSCC (Fisher exact test, P = 0.000). Unexpectedly, the LOH assay could not be used for transplanted patients with Fanconi anemia because donor DNA in brushed oral epithelium, most likely from donor leukocytes present in the oral cavity, disturbed the analysis. Noninvasive screening using a LOH assay on brushed samples of the oral epithelium has a promising outlook in patients with Fanconi anemia. However, assays need to be adapted in case of stem cell transplantation, because of contaminating donor DNA.
Sohl, E. (2015). Towards optimal vitamin D status: determinants and consequences of citamin D deficiency in the older population. PhD Dissertation, VU University Amsterdam.
No abstract available.
Sohl, E., De Jongh, R.T., Swart, K.M.A., Enneman, A.W., van Wijngaarden, J.P., Van Dijk, S.C., Ham, A.C., Van der Zwaluw, N.L., Brouwer-Brolsma, E.M., Van der Velde, N., De Groot, L.C.P.G.M., Te Velde, S.J., Lips, P.T.A., Van Schoor , N.M. (2015). The association between vitamin D status and parameters for bone density and quality is modified by body mass index. Calcified Tissue International, 96, 2, 113-122. >Full Text.
The association of vitamin D status with bone mineral density (BMD) and Quantitative Ultrasound measurements (QUS) has been inconsistent in previous studies, probably caused by moderating effects. This study explored (1) the association of vitamin D status with QUS and BMD, and (2) whether these associations were modi-fied by body mass index (BMI), age, gender, or physical activity. Two-independent cohorts of the Longitudinal Aging Study Amsterdam (LASA-I, 1995/1996, aged C65; LASA-II, 2008/2009, aged 61&ndash;71) and baseline measurement of the B-vitamins for the prevention of osteoporotic fractures (B-PROOF) study (2008&ndash;2011, aged 65?) were used. QUS measurements [broadband ultrasound attenuation (BUA) and speed of sound (SOS)] were performed at the calcaneus in all three cohorts (N = 1,235, N = 365, N = 1319); BMD was measured by Dual X-ray absorptiometry (DXA) in B-PROOF (N = 1,162 and 1,192 for specific sites) and LASA-I (N = 492 and 503). The associations of vitamin D status with BUA and BMD were modified by BMI. Only in persons with low-to-normal BMI (<25 kg/m2) and serum 25(OH)D <25 nmol/L was associated with lower BUA as compared to the reference group (>=50 nmol/L) in LASA-I and B-PROOF. Furthermore, in LASA-I, these individuals had lower BMD at the hip and lumbar spine. In LASA-II, no associations with BUA were observed. Vitamin D status was not associated with SOS, and these associations were not modified by the effect modifiers tested. The association between vitamin D status and BUA and BMD was modified by BMI in the olderaged cohorts: there was only an association in individuals with BMI <25 kg/m2.
Sohl, E., De Jongh, R.T., Heymans, M.W., Van Schoor , N.M., Lips, P.T.A. (2015). Thresholds for Serum 25(OH)D Concentrations With Respect to Different Outcomes. The Journal of Clinical Endocrinology & Metabolism, 100, 6, 2480-2488. >Full Text.
Context: Vitamin D is essential for bone health. In addition, vitamin D has recently been proposed to play a role in the pathophysiology of many chronic diseases. Despite the large number of studies published on vitamin D, the threshold for a sufficient serum 25-hydroxyvitamin D [25(OH)D] concentration is still debated and may differ according to outcomes and subgroups. Objective: The objective of the study was to estimate the thresholds for serum 25(OH)D concentration with respect to the different outcomes and for different subgroups. Design, Setting, and Participants: Observational data from the Longitudinal Aging Study Amsterdam, an ongoing population-based Dutch cohort study [n = 1164, mean (SD) age 75.2 (6.5) y], were used. Main Outcome Measures: Falling, fractures, hypertension, cardiovascular disease, blood pressure, PTH, grip strength, physical performance, functional limitations, body mass index (BMI), and mortality were measured. To determine thresholds, spline curves were used. Visual inspection and the statistical best fit of the spline regression models were used together to estimate the best estimate of the thresholds. Results: Thresholds for serum 25(OH)D concentrations in the whole sample ranged from 46 nmol/L (PTH) to 68 nmol/L (hypertension). On average, women, the oldest old (&#8805;75 y), and individuals with a high BMI (>25 kg/m(2)) had lower thresholds compared with men, the youngest old (65-75 y), and individuals with a low to normal BMI (<25 kg/m(2)). Conclusion: The results indicate that thresholds for serum 25(OH)D may vary according to different outcomes and subgroups. This study does not support the high thresholds (>75 nmol/L) as advised by some experts, and the higher requirements in women, older persons, and those with high BMI.
Sohl, E., Van Schoor , N.M. (2015). Implementatie van het vitamine D-advies (verslag van een expertmeeting). Nederlands Tijdschrift voor Geneeskunde, 159, 20, 895-899. > Full Text.
No abstract available.
Swart, K.M.A. (2015). B-vitamins for the prevention of fractures and decline of physical function. PhD Dissertation, VU University Amsterdam.
No abstract available.
Timmermans, E.J., Schaap, L.A., Herbolsheimer, F., Dennison, E.M., Maggi, S., Pedersen, N.L., Castell, M.V., Denkinger, M., Edwards, M.H., Limongi, F., Sanchez-Martinez, M., Van der Pas, S., Deeg, D.J.H. (2015). The Influence of Weather Conditions on Joint Pain in Older People with Osteoarthritis: Results from the European Project on OSteoArthritis. The Journal of Rheumatology, 42, 1885-1892. >Full Text.
Objective: This study examined whether daily weather conditions, 3-day average weather conditions, and changes in weather conditions influence joint pain in older people with osteoarthritis (OA) in 6 European countries. Methods: Data from the population-based European Project on OSteoArthritis were used. The American College of Rheumatology classification criteria were used to diagnose OA in older people (65�85 yrs). After the baseline interview, at 6 months, and after the 12�18 months followup interview, joint pain was assessed using 2-week pain calendars. Daily values for temperature, precipitation, atmospheric pressure, relative humidity, and wind speed were obtained from local weather stations. Multilevel regression modelling was used to examine the pain-weather associations, adjusted for several confounders. Results: The study included 810 participants with OA in the knee, hand, and/or hip. After adjustment, there were significant associations of joint pain with daily average humidity (B = 0.004, p < 0.01) and 3-day average humidity (B = 0.004, p = 0.01). A significant interaction effect was found between daily average humidity and temperature on joint pain. The effect of humidity on pain was stronger in relatively cold weather conditions. Changes in weather variables between 2 consecutive days were not significantly associated with reported joint pain. Conclusion: The associations between pain and daily average weather conditions suggest that a causal relationship exist between joint pain and weather variables, but the associations between day-to-day weather changes and pain do not confirm causation. Knowledge about the relationship between joint pain in OA and weather may help individuals with OA, physicians, and therapists to better understand and manage fluctuations in pain.
Van den Heuvel, E.G.H.M., Van Schoor , N.M., Vermeer, C., Zwijsen, R.M.L., Den Heijer, M., Comijs, H.C. (2015). Vitamin K status is not associated with cognitive decline in middle aged adults. Journal of Nutrition, Health and Aging, 19, (9), 908-912. >Full Text.
Objectives: The aim of this study was to examine the association between dephospho-uncarboxylated matrix Gla protein (dp-ucMGP), an indicator of vitamin K status, and cognitive decline, and the modifying role of 25(OH)D. Design: Longitudinal study with six years follow-up. Setting: Community based. Participants: 599 participants of the Longitudinal Aging Study Amsterdam (aged 55-65 years). Measurements: Information processing speed and a composite Z-score by combining three domains of cognition reflecting general cognitive functioning. Results: Generalized estimating equations (GEE) showed no significant associations between dp-ucMGP and decline in general cognitive functioning. Vitamin D modified the association between dp-ucMGP and speed of information processing (p<0.05). In the group with a 25(OH)D concentration > 50 nmol/l, the highest tertile of dp-ucMGP (>406 pmol/l), which corresponds to lower vitamin K levels, was associated with 1.5 higher score on information processing speed (p=0.023) as compared to the lowest tertile of dp-ucMGP. Conclusion: In contrast to our hypothesis, a suboptimal vitamin K was not associated with cognitive decline in middle-aged adults.
van der Aa, H.P.A., Comijs, H.C., Penninx, B.W.J.H., Van Rens, G.H.M.B., Van Nispen, R.M.A. (2015). Major Depressive and Anxiety Disorders in Visually Impaired Older Adults. Investigative Ophthalmology & Visual Science, 56, 849-854. >Full Text.
Purpose: We assessed the prevalence of subthreshold depression and anxiety, and major depressive, dysthymic, and anxiety disorders (panic disorder, agoraphobia, social phobia, and general anxiety disorder) in visually impaired older adults and compared these estimates with those of normally sighted peers. Methods: Cross-sectional data were analyzed based on telephone interviews with visually impaired older adults aged ‡ 60 years (n ¼ 615) with a visual acuity of ‡ 0.30 logMAR (20/40 Snellen) in the best eye from outpatient low vision rehabilitation centers, and face-to-face interviews with community-dwelling normally sighted peers (n ¼ 1232). To determine prevalence rates, the normally sighted population was weighted on sex and age to fit the visually impaired population. Logistic regression analyses were used to compare the populations and to correct for confounders. Results: The prevalence of major depressive disorder (5.4%) and anxiety disorders (7.5%), as well as the prevalence of subthreshold depression (32.2%) and subthreshold anxiety (15.6%), were significantly higher in visually impaired older adults compared to their normally sighted peers (P < 0.05). Agoraphobia and social phobia were the most prevalent anxiety disorders in visually impaired older adults. Conclusions: This study shows that depression and anxiety are major public health problems in visually impaired older adults. Research on psychotherapeutic and psychopharmacologic interventions to improve depression and anxiety in this population is warranted. (http://www.trialregister.nl number, NTR3296.)
Van der Pas, S., Galenkamp, H. (2015). Gezondheid en sociale participatie van ouderen in Europa. Gern, Tijdschrift over ouder worden & samenleving, 17(4), 32-34.
No abstract available.
Van der Pas, S., Galenkamp, H. (2015). Health and social participation of older people in Europe. Gern, Tijdschrift over ouder worden & samenleving, 17, Supplement 1, 33-36.
Older people play an important role in the social participation in our society. However, are these mainly the healthy and active older people that remain active or also those older people with health problems? To what extent does health affect the social participation of older people in Europe?
Van Tilburg, T.G., Aartsen, M.J., Van der Pas, S. (2015). Loneliness after Divorce: A Cohort Comparison among Dutch Young-Old Adults. European Sociological Review, 31, 243-252. >Full Text.
No abstract available.
Van Varsseveld, N.C., Van Bunderen, C.C., Sohl, E., Comijs, H.C., Penninx, B.W.J.H., Lips, P.T.A., Drent, M.L. (2015). Serum insulin-like growth factor 1 andlate-life depression: A population-basedstudy. Psychoneuroendocrinology, 54, 3140. >Full Text.
Objective: Serum insulin-like growth factor 1 (IGF-1) concentration decreases, while the prevalence of depressive symptoms increases with advancing age. Although basic research indicates a link between low IGF-1 concentration and depression, this has scarcely been investigated in humans. This study investigates whether lower IGF-1 concentrations are associated with prevalent and incident late-life depression over a 3-year period. Methods: The study included 1188 participants, aged &#8805; 65 years, from the Longitudinal Aging Study Amsterdam (LASA), an ongoing, population-based cohort study. Depression was assessed at baseline and after three years using the Center for Epidemiological Studies-Depression Scale (CES-D) and the Diagnostic Interview Schedule (DIS), and categorized into minor depression and major depression (MDD). Serum IGF-1 concentration was determined at baseline. Associations were adjusted for relevant confounders. Results: Serum IGF-1 concentrations were within the normal range (mean 13.9 nmol/l, standard deviation 5.3 nmol/l). At baseline, in men, as compared to high concentrations, mid concentrations decreased the probability of prevalent minor depression (odds ratio [OR] = 0.35, 95% confidence interval [CI] = 0.15-0.82). In women, as compared to high concentrations, low concentrations tended to increase the probability of prevalent MDD (OR = 2.66, 95% CI = 0.89-7.89). At three-year follow-up, in men, no significant prospective associations were detected. In women, as compared to high concentrations, mid concentrations decreased the probability of incident minor depression (OR = 0.43, 95% CI = 0.19-0.95). Conclusions: Several associations, which differed across the genders, were observed between IGF-1 and depression. Cross-sectional findings were not supported by longitudinal findings, which suggest that IGF-1 may not play an important predictive role in the development of depression in older persons over time. However, a more acute role of IGF-1 in current depression, as indicated by the cross-sectional results, may be possible. Further studies are needed to elucidate the complex relation between IGF-1 and late-life depression.
Van Varsseveld, N.C., Sohl, E., Drent, M.L., Lips, P.T.A. (2015). Gender-Specific Associations of Serum Insulin-Like Growth Factor-1 With Bone Health and Fractures in Older Persons. The Journal of Clinical Endocrinology & Metabolism, 100, 11, 4272-4281. >Full Text.
No abstract available.
Wouterse, B., Huisman, M., Meijboom, B.R., Deeg, D.J.H., Polder, J.J. (2015). The effect of trends in health and longevity on health services use by older adults. BMC Health Services Research, 15, 1, 574. >Full Text.
Background: The effect of population aging on future health services use depends on the relationship between longevity gains and health. Whether further gains in life expectancy will be paired by improvements in health is uncertain. We therefore analyze the effect of population ageing on health services use under different health scenarios. We focus on the possibly diverging trends between different dimensions of health and their effect on health services use. Methods: Using longitudinal data on health and health services use, a latent Markov model has been estimated that includes different dimensions of health. We use this model to perform a simulation study and analyze the health dynamics that drive the effect of population aging. We simulate three health scenarios on the relationship between longevity and health (expansion of morbidity, compression of morbidity, and the dynamic equilibrium scenario). We use the scenarios to predict costs of health services use in the Netherlands between 2010 and 2050. Results: Hospital use is predicted to decline after 2040, whereas long-term care will continue to rise up to 2050. Considerable differences in expenditure growth rates between scenarios with the same life expectancy but different trends in health are found. Compression of morbidity generally leads to the lowest growth. The effect of additional life expectancy gains within the same health scenario is relatively small for hospital care, but considerable for long-term care. Conclusions: By comparing different health scenarios resulting in the same life expectancy, we show that health improvements do contain costs when they decrease morbidity but not mortality. This suggests that investing in healthy aging can contribute to containing health expenditure growth.

2014

Boot, C.R.L., Deeg, D.J.H., Abma, T., Rijs, K.J., Van der Pas, S., Van Tilburg, T.G., Van der Beek, A. (2014). Predictors of having paid work in older workers with and without chronic disease: a 3-year prospective cohort study. Journal of Occupational Rehabilitation, 24, 563-572. >Full Text.
Background As the prevalence of chronic disease amongst older workers is high and increasing, it is important to know if the large subgroup of older workers with chronic disease has specific needs when it comes to prolonging participation in paid work. Objectives To investigate differences and similarities in predictors of having paid work in workers aged 55+ with and without chronic disease. Methods Workers aged 55-62 years were selected from the 2002-2003 cohort of the Longitudinal Aging Study Amsterdam (n = 333). Potential predictors were: health, personality, work characteristics, and demographics. Per potential predictor, a logistic regression coefficient for \\\\\\\'having paid work in 2005-2006\\\\\\\' was calculated for workers with and without chronic disease. A pooled estimate was computed and differences between the pooled estimate and the coefficients were tested. Results Follow-up data were available for 95 %, of whom 67 % still had paid work. Predictors of having paid work were similar for workers with and without chronic diseases, except for physical workload (&#967;(2) = 5.37; DF = 1) and psychosocial resources at work (&#967;(2) = 5.94; DF = 1). Having more psychosocial resources (OR = 3.57; 95 %CI 1.33-10.0) was predictive for having paid work in workers with chronic disease and not in workers without chronic disease. Lower age, more weekly working hours, no functional limitations, fewer depressive symptoms, lower neuroticism scores, and more sense of mastery were significantly associated with having paid work in all workers. Conclusions Differences between predictors of having paid work between workers with and without chronic disease should be taken into account when aiming to prevent exit from the workforce. In particular the vulnerable subgroup of older workers with chronic disease and low psychosocial resources at work is more likely to quit working.
Braam, A.W., Schaap-Jonker, J., Van der Horst, M.H.L., Steunenberg, B., Beekman, A.T.F., Van Tilburg, W., Deeg, D.J.H. (2014). Twelve-Year History of Late-Life Depression and Subsequent Feelings to God. The American Journal of Geriatric Psychiatry, 22, 1272-1281. >Full Text.
Objectives: Growing evidence shows several possible relations between religiousness and late-life depression. Emotional aspects of religiousness such as facets of the perceived relationship with God can be crucial in this connection. The aim of the current study was to examine the association between the course of late-life depression and feelings about God and religious coping. Design: Longitudinal survey study; naturalistic; 12-year follow-up. Setting: Longitudinal Aging Study Amsterdam; population-based, in three regions in The Netherlands. Participants: A subsample of 343 respondents (mean age: 77.2 years), including all respondents with high levels of depressive symptoms at any measurement cycle between 1992 and 2003 (assessed by using the Center for Epidemiologic Studies Depression Scale and the Diagnostic Interview Schedule) and a random sample of nondepressed respondents who completed a postal questionnaire in 2005. Measurements: Scales on God Image and Religious Coping. Twelve-year depression course trajectories serve as predicting variables and are specified according to recency and seriousness. Results: Persistent and emergent depression are significantly associated with fear of God, feeling wronged by God, and negative religious coping. In terms of negative religious coping, significant associations were observed after adjustment for concurrent depression with a history of repeated minor depression and previous major depression. Conclusions: Late-life depression seems to maintain a pervasive relationship over time with affective aspects of religiousness. Religious feelings may parallel the symptoms of anhedonia or a dysphoric mood and could represent the experience of an existential void.
Broese van Groenou, M.I., Huisman, M. (2014). De sociaal-maatschappelijke positie van ouderen. In: Joost van Vliet en Jan S. Jukema (Eds.), Perspectieven op ouder worden en de sociaal professionals.(pp. 65-72). Den Haag: Boom Lemma uitgevers. ISBN 9789059319882.
Dit hoofdstuk gaat over sociaaleconomische verschillen tussen ouderen: de manier waarop sociaaleconomische status samenhangt met gezondheid en de gevolgen daarvan door de zorgbehoefte en de zorgvraag. Het gaat ook over verouderingsonderzoek, want daaruit blijkt dat ouderen met een lage sociaaleconomische status (SES) minder gezond zijn en eerder sterven dan ouderen met een hoge SES. Professionals zullen dat overal in hun beroepspraktijk tegenkomen. Zij kunnen de oorzaken van SES-verschillen niet altijd veranderen, maar ze kunnen er rekening mee houden en extra aandacht besteden aan ouderen in relatief slechte sociaaleconomische omstandigheden.
Claassens, C.T.J., Widdershoven, G.A.M., Van Rhijn, S.C., Van Nes, F., Broese van Groenou, M.I., Deeg, D.J.H., Huisman, M. (2014). Perceived control in health care: A conceptual model based on experiences of frail older adults. Journal of Aging Studies, 31, 159-170. >Full Text.
Frail older adults are increasingly encouraged to be in control of their health care, in Western societies. However, little is known about how they themselves perceive control in health care. Therefore, this study aims to investigate the concept of health care-related perceived control from the viewpoint of frail older adults. A qualitative interview study was conducted following a Grounded Theory approach. Thirty-two Dutch frail older adults, aged 65 and over, participated in 20 in-depth interviews (n=20) and three focus group discussions (n=12). Data were analysed according to techniques of coding and constant comparison. From this analysis constituting factors of perceived control emerged, providing elements of a conceptualmodel. Perceived control reflects the feeling or belief that health care is under control, which is constituted by five, either internal or external, factors: (I) self-confidence in organising professional and/or informal care, (II) self-confidence in health management in the home setting, (III) perceived support from people in the social network, (IV) perceived support from health care professionals and organisations, and (V) perceived support from (health care) infrastructure and services. Therefore, the concept does not only consist of people\\\\\\\'s own perceived efforts, but also includes the influence of external sources. Our conceptual model points outwhat external factors should be taken into consideration by health care professionals and policy makers when enhancing older people\\\\\\\'s perceived control. Moreover, it can serve as the basis for the development of a measurement instrument, to enable future quantitative research on health care-related perceived control among older adults.
De Jong Gierveld, J., Broese van Groenou, M.I. (2014). Quality of marriage and social loneliness in later life. In: Michalos AC (Ed.). Encyclopedia of Quality of Life and Well-Being Research. (pp. 5309-5312). Springer, Dordrecht, Netherlands: Springer.
No abstract available.
Deeg, D.J.H. (2014). Nieuwe tijden, nieuwe prioriteiten? Gern, Tijdschrift over ouder worden & samenleving, 16 (3)
No abstract available.
Dijkstra, S. C., Neter, J.E., Brouwer, I.A., Huisman, M., Visser, M. (2014). Adherence to dietary guidelines for fruit, vegetables and fish among older Dutch adults; the role of education, income and job prestige. The Journal of Nutrition, Health & Aging, 18, 2, 115-121. >Full Text.
Objectives: Little is known about socio-economic differences in dietary intake among older adults. In this study we describe self-reported dietary adherence to the fruit, vegetables and fish guidelines among older Dutch adults and investigate the independent associations of three socio-economic status (SES) indicators with adherence to these guidelines. Design: Cross sectional data-analyses. Settings: The Longitudinal Aging Study Amsterdam (LASA), the Netherlands. Subjects: 1057 community dwelling older adults, aged 55-85 years. Measurements: Fruit, vegetable and fish intake was assessed using a short food frequency questionnaire. We measured SES using self-reported levels of education, household income and occupational prestige. Results: 82.5% of the respondents reported to adhere to the fruit guideline, 65.1% to the vegetables guideline, and 31.7% to the fish guideline. After adjustment for confounders and the other two SES indicators, respondents in the lowest education group adhered less often to the vegetables guideline (OR 0.39 (95% CI 0.22-0.70)) compared to those in the highest education group. Respondents in the lowest income group adhered less often to the fruit (0.44 (95 % CI 0.22-0.91) and fish guideline (OR 0.55 (95% CI 0.33-0.91) compared to those in the highest groups. Occupational prestige was not independently associated with adherence any the guidelines. Conclusion: Self-reported adherence to the fruit, vegetables and fish guidelines among older adults can be improved and particularly in those with a low SES. Education and income have independent and unique contributions to dietary adherence. Future research should investigate potential pathways through which these specific SES indicators influence dietary adherence.
Dijkstra, S. C., Neter, J.E., Brouwer, I.A., Huisman, M., Visser, M. (2014). Misperception of self-reported adherence to the fruit, vegetable and fish guidelines in older Dutch adults. Appetite, 82, 166-172. >Full Text.
In this study we investigated (the degree of) misperception of adherence to the fruit, vegetable and fish guidelines in older Dutch adults and examined to what extent misperception is associated with socio-economic position (SEP) and other demographic, lifestyle and nutrition-related characteristics. The sample included 1057 community dwelling adults, aged 55-85 years, who participated in the Longitudinal Aging Study Amsterdam. Respondents completed a lifestyle questionnaire which included a food frequency questionnaire to calculate fruit, vegetable and fish intake. After current dietary guidelines were explained, respondents were asked to indicate whether they believed they adhered to the fruit, vegetable and fish guidelines. Characteristics potentially associated with misperception included level of income and education, lifestyle factors, nutritional knowledge, as well as attitude, social support and self-efficacy toward healthy eating. In the total sample, 69.1% of the older adults reported to adhere to the fruit guideline, 77.5% to the vegetable guideline, and 36.4% to the fish guideline. Based on the calculated intake data, 82.6% adhered to the fruit guideline, 65.5% to the vegetable guideline and 33.8% to the fish guideline. Overestimation of adherence was most common for the vegetable guideline (18.7%). Multivariate analysis, adjusted for level of income as well as for attitude and self-efficacy toward healthy eating, showed that lower educated respondents were more likely to overestimate their adherence to the vegetable guideline (relative index of inequality (RII): 2.97 (95% CI: 1.47-6.01)). Overestimation rates for fish (3.4%) and fruit (2.3%) were lower and not associated with any of the characteristics. This study showed that overestimation in older adults was common for adherence to the vegetable guideline and especially in those with a lower education level, but not for adherence to the fruit and fish guideline.
Dijkstra, S. C., Neter, J.E., Brouwer, I.A., Huisman, M., Visser, M. (2014). Motivations to eat healthily in older Dutch adults--a cross sectional study. International Journal of Behavioral Nutrition and Physical Activity, 11, 141. >Full Text.
No abstract available.
Edwards, M.H., Van der Pas, S., Denkinger, M., Parsons, C., Jameson, K.A., Schaap, L.A., Zambon, S., Castell, M.V., Herbolsheimer, F., Nasell, H., Sanchez-Martinez, M., Otero, A., Nikolaus, T., Van Schoor , N.M. (2014). Relationships between physical performance and knee and hip osteoarthritis: findings from the European Project on Osteoarthritis (EPOSA). Age Ageing, 43 (6), 806-813. >Full Text.
Background: poor physical performance (PP) is known to be associated with disability, lower quality of life and higher mortality rates. Knee and hip osteoarthritis (OA) might be expected to contribute to poor PP, through joint pain and restricted range of movement. Both clinical and self-reported OA are often used for large-scale community and epidemiological studies. Objective: to examine the relationships between hip and knee OA and PP in a large data set comprising cohorts from six European countries. Methods: a total of 2,942 men and women aged 65-85 years from the Germany, Italy, Netherlands, Spain, Sweden and the UK were recruited. Assessment included an interview and clinical assessment for OA. PP was determined from walking speed, chair rises and balance (range 0-12); low PP was defined as a score of &#8804;9. Results: the mean (SD) age was 74.2 (5.1) years. Rates of self-reported OA were much higher than clinical OA. Advanced age, female gender, lower educational attainment, abstinence from alcohol and higher body mass index were independently associated with low PP. Clinical knee OA, hip OA or both were associated with a higher risk of low PP; OR (95% CI) 2.93 (2.36, 3.64), 3.79 (2.49, 5.76) and 7.22 (3.63, 14.38), respectively, with relationships robust to adjustment for the confounders above as well as pain. Conclusion: lower limb OA at the hip and knee is associated with low PP, and for clinical diagnosis relationships are robust to adjustment for pain. Those at highest risk have clinical OA at both sites.
Evans, N.C. (2014). Patient-physician communication at the end of life: a European perspective. PhD Dissertation, VU University Amsterdam.
No abstract available.
Evans, N.C., Pasman, H.R.W., Deeg, D.J.H., Onwuteaka-Philipsen, B.D. (2014). How do general end-of-life treatment goals and values relate to specific treatment preferences? A population-based study Palliative Medicine, 28, 10, 1206-1212. >Full Text.
No abstract available.
Furrer, R., Van Schoor , N.M., De Haan, A., Lips, P.T.A., De Jongh, R.T. (2014). Gender-specific associations between physical functioning, bone quality, and fracture risk in older people. Calcified Tissue International, 94, 522-530. >Full Text.
The aim of this study was to investigate which parameters of physical functioning are associated with bone quality and fracture risk and whether gender-specific differences exist within these associations. We studied 1,486 participants of the Longitudinal Aging Study Amsterdam. As measures of physical functioning, handgrip strength, physical performance, and level of physical activity were assessed. To assess bone quality, broadband ultrasound attenuation (BUA) and speed of sound (SOS) were measured at baseline using quantitative ultrasound and bone mineral density (BMD) at baseline and after 3 years by dual-energy X-ray absorptiometry. In addition, fracture incidence over 6 years was assessed. After adjustment for confounders (age, serum 25[OH]D, smoking, and body weight), in men, physical performance was positively related to BUA, SOS, and BMD cross-sectionally and to BMD longitudinally. Using Cox proportional hazards model, in men higher handgrip strength and physical performance were associated with reduced fracture risk after adjustment for confounders (hazard ratio [HR] 0.96, 95 % confidence interval [CI] 0.92-0.99, and HR 0.89, 95 % CI 0.80-0.98, respectively). In women, a moderate level of physical activity was related to reduced fracture risk (HR 0.57, 95 % CI 0.33-0.99). In conclusion, in men, higher handgrip strength and physical performance are related to higher bone quality and reduced fracture risk, whereas in women, a moderate to high level of physical activity is associated with reduced fracture risk. These measurements may contribute to the identification of individuals at high fracture risk. Both the causality of and explanations for gender-specific differences in these relationships remain subject to further studies.
Galenkamp, H., Huisman, M., Braam, A.W., Schellevis, F.G., Deeg, D.J.H. (2014). Disease prevalence based on older people's self-reports increased, but patient-general practitioner agreement remained stable, 1992-2009. Journal of Clinical Epidemiology, 67, 7, 773-780. >Full Text.
Objectives: Previous studies revealed increases in the prevalence of chronic diseases in older people in most countries. This study investigated if a changed inclination to report diseases underlies these increases, by comparing the agreement between self-reports and general practitioner (GP) records of chronic diseases between 1992-1993 and 2008-2009. Study Design and Settings: Cross-sectional analyses were performed on data from two waves of the Longitudinal Aging Study Amsterdam. Data from older adults aged 60-85 years came from 1992-1993 (N=1,896) and from the same age group in 2008-2009 (N=1,086). We compared respondent (R) and GP records of lung disease, cardiac disease, peripheral arterial disease, stroke, diabetes, arthritis, and cancer. Multilevel regression models were applied to examine (change in) predictors of over-reporting (R+, GP-) and under-reporting (R-, GP+). Results: Over-reporting of chronic diseases became significantly more common over time, whereas under-reporting became less common. Agreement and change in agreement differed across the specific diseases. Under-reporting was associated with male gender; over-reporting with female gender, worse self-rated health, and worse physical functioning. Older adults were less accurate in their self-reports than younger adults. Conclusion: Trends in self-reported chronic diseases may be influenced by changes in reporting behavior, and future studies should take this possibility into account.
Hermans, H., Beekman, A.T.F., Evenhuis, H.M. (2014). Comparison of anxiety as reported by older people with intellectual disabilities and by older people with normal intelligence. The American Journal of Geriatric Psychiatry, 22, 12, 1391-1398. >Full Text.
Objectives: Older people with intellectual disabilities (ID) may experience more and different symptoms of anxiety than older people with normal intelligence. Study Questions: (1) Is the reported severity of anxiety in this group similar to that in the general older population; (2) Are specific anxiety symptoms reported as frequently by both groups? Design: Cross-sectional. Setting: Formal Dutch intellectual disability services and Dutch population-based study. Participants: One hundred fifty-four participants of the Healthy Ageing and Intellectual Disability study with mild or moderate ID (IQ <70), aged 55-85 years, and 2,917 participants of the Longitudinal Aging Study Amsterdam with normal intelligence, aged 55-85 years. Measurements: The general anxiety subscale of the Hospital Anxiety and Depression Scale. Results: Mean (standard deviation) Hospital Anxiety and Depression Scale total score of subjects with ID was significantly higher than that of subjects with normal intelligence (3.53 [3.03]) versus 2.53 [3.30]; p <0.01), whereas the percentage of scores above cutoff in both groups was similar. Four of 7 items were more often reported as present by subjects with ID: \"tense or wound up feelings,\" \"frightened feelings,\" \"worrying thoughts,\" and \"sudden feelings of panic.\" Conclusions: Older people with ID report more symptoms of anxiety than older people with normal intelligence. Tense feelings and worrying especially need more attention, because more than one-half of all older people with ID reported such symptoms.
Holvik, K., Van Schoor , N.M., Eekhoff, E.M.W., Den Heijer, M., Deeg, D.J.H., Lips, P.T.A., De Jongh, R.T. (2014). Plasma osteocalcin levels as a predictor of cardiovascular disease in older men and women: a population-based cohort study. European Journal of Endocrinology, 171, 2, 161-170. >Full Text.
Objective: The role of osteocalcin (OC) in cardiovascular disease (CVD) is unresolved. We aimed to study the association between plasma OC concentrations and the risk of non-fatal and fatal CVDs. We also aimed to investigate whether such an association, if present, would be mediated by established metabolic risk factors. Design: A population-based longitudinal cohort study. Methods: In 1995/1996, OC was determined in blood samples drawn from 1319 subjects aged 65-88 years participating in the Longitudinal Aging Study Amsterdam in 1995/1996. The self-reported CVD events were collected every 3 years until 2005/2006, and CVD deaths until 1st January 2007. Cox proportional hazards regression was performed, considering potential confounders (smoking, physical activity, and BMI) and mediators (blood pressure, plasma triglycerides, total and HDL cholesterol, fructosamine, and aortic calcification). Results: During the median 4.1 years follow-up, 709 subjects (53.8%) suffered a CVD event. There was no overall association between OC and CVD: hazard ratio (HR) was 0.97 (95% CI 0.90-1.04) per nmol/l higher plasma OC, adjusted for age and sex. There was a statistical interaction between plasma OC, age, and sex on CVD (P=0.014). In those subjects aged &#8805;75 years, age-adjusted HRs (95% CI) were 0.86 (0.75-0.99) in men and 1.16 (1.03-1.31) in women per nmol/l higher plasma OC. Adjustment for covariates only slightly attenuated the association in older-old men, but did not affect the association in older-old women. Conclusion: A higher plasma OC concentration was associated with a reduced risk of CVD in older-old men and with an increased risk of CVD in older-old women. We found no evidence that this was mediated by arterial calcification or metabolic risk factors.
Hoogendijk, E.O., Van Hout, H.P.J., Heymans, M.W., Van der Horst, H.E., Frijters, D.H.M., Broese van Groenou, M.I., Deeg, D.J.H., Huisman, M. (2014). Explaining the association between educational level and frailty in older adults: results from a 13-year longitudinal study in the Netherlands. Annals of Epidemiology, 24, 538-544. >Full Text.
Purpose: The aim of this study was to examine the longitudinal association between educational level and frailty prevalence in older adults and to investigate the role of material, biomedical, behavioral, social, and mental factors in explaining this association. Methods: Data over a period of 13 years were used from the Longitudinal Aging Study Amsterdam. The study sample consisted of older adults aged 65 years and above at baseline (n = 1205). Frailty was assessed using Fried\\\\\\\'s frailty criteria. A relative index of inequality was calculated for the level of education. Longitudinal logistic regression analyses based on multilevel modeling were performed. Results: Older adults with a low educational level had higher odds of being frail compared with those with a high educational level (relative index of inequality odds ratio, 2.94; 95% confidence interval, 1.84-4.71). These differences persisted during 13 years of follow-up. Adjustment for all explanatory factors reduced the effect of educational level on frailty by 76%. Income, self-efficacy, cognitive impairment, obesity, and number of chronic diseases had the largest individual contribution in reducing the effect. Social factors had no substantial contribution. Conclusions: Our findings highlight the need for a multidimensional approach in developing interventions aimed at reducing frailty, especially in lower educated groups.
Hoogendijk, E.O., Van Hout, H.P.J., Van der Horst, H.E., Frijters, D.H.M., Dent, E., Deeg, D.J.H., Huisman, M. (2014). Do psychosocial resources modify the effects of frailty on functional decline and mortality? Journal of Psychosomatic Research, 77, 547-551. >Full Text.
Objective: Little is known about factors that may prevent or delay adverse health outcomes in frail older adults. Previous studies have demonstrated beneficial effects of psychosocial resources on health outcomes in older adults. The aim of this study was to investigate whether psychosocial resources modify the effects of frailty on functional decline and mortality. Methods: The study sample consisted of 1665 men and women aged 58 and over from two waves of the Longitudinal Aging Study Amsterdam (LASA), a population based study. Frailty and psychosocial resources were assessed at T1 (2005/2006). Frailty was assessed using the criteria of Fried\\\'s phenotype. Psychosocial resources included sense of mastery, self-efficacy, instrumental support and emotional support. Functional decline and mortality were assessed at T2 (2008/2009). Results: Results of logistic regression analyses demonstrated that frail older adults had higher odds of both functional decline (OR=2.63, 95% CI=1.61-4.27) and 3-year mortality (OR=3.17, 95% CI=1.95-5.15). After adjustment for covariates, higher levels of mastery and self-efficacy were associated with decreased odds of functional decline, but not mortality. No statistically significant interaction effects between frailty and psychosocial resources were found for either functional decline or mortality. Conclusion: This study found no evidence that psychosocial resources buffer against functional decline and mortality in frail older adults.
Houtjes, W., Van Meijel, B., Van de Ven, P., Deeg, D.J.H., Van Tilburg, T.G., Beekman, A.T.F. (2014). The impact of an unfavorable depression course on network size and loneliness in older people: a longitudinal study in the community. International Journal of Geriatric Psychiatry, 29, 1010-1017. >Full Text.
Objective: This work aims to gain insight into the long-term impact of depression course on social network size and perceived loneliness in older people living in the community. Methods: Within a large representative sample of older people in the community (Longitudinal Aging Study Amsterdam (LASA)), participants with clinically relevant levels of depressive symptoms (scores >16 on the Center for Epidemiological Studies Depression Scale) were followed up over a period of 13&#8201;years of the LASA study (five waves). General estimating equations were used to estimate the impact of depression course on network size and loneliness and the interaction with gender and age. Results: An unfavorable course of depression was found to be associated with smaller network sizes and higher levels of loneliness over time, especially in men and older participants. Conclusions: The findings of this study stress the importance of clinical attention to the negative consequences of chronicity in depressed older people. Clinicians should assess possible erosion of the social network over time and be aware of increased feelings of loneliness in this patient group.
Korten, N.C.M., Penninx, B.W.J.H., Pot, A.M., Deeg, D.J.H., Comijs, H.C. (2014). Adverse childhood and recent negative life events: contrasting associations with cognitive decline in older persons. Journal of Geriatric Psychiatry and Neurology, 27, 2, 128-138. >Full Text.
Objective: To examine whether persons who experienced adverse childhood events or recent negative life events have a worse cognitive performance and faster cognitive decline and the role of depression and apolipoprotein E-&#8714;4 in this relationship. Methods: The community-based sample consisted of 10-year follow-up data of 1312 persons participating in the Longitudinal Aging Study Amsterdam (age range 65-85 years). Results: Persons who experienced adverse childhood events showed a faster 10-year decline in processing speed but only when depressive symptoms were experienced. Persons with more recent negative life events showed slower processing speed at baseline but no faster decline. Conclusions: Childhood adversity may cause biological or psychological vulnerability, which is associated with both depressive symptoms and cognitive decline in later life. The accumulation of recent negative life events did not affect cognitive functioning over a longer time period.
Korten, N.C.M. (2014). Stress, depression and cognition across the life span. PhD Dissertation, VU University Amsterdam.
No abstract available.
Maarsingh, O.R., Stam, H., Van de Ven, P., Van Schoor , N.M., Ridd, M.J., Van der Wouden, J.C. (2014). Predictors of dizziness in older persons: a 10-year prospective cohort study in the community. BMC Geriatrics, 14, 133, 1-7 > Full Text.
Background: The current diagnosis-oriented approach of dizziness does not suit older patients. Often, it is difficult to identify a single underlying cause, and when a diagnosis is made, therapeutic options may be limited. Identification of predictors of dizziness may provide new leads for the management of dizziness in older patients. The aim of the present study was to investigate long-term predictors of regular dizziness in older persons. Methods: Population-based cohort study of 1,379 community-dwelling participants, aged &#8805;60 years, from the Longitudinal Aging Study Amsterdam (LASA). Regular dizziness was ascertained during face-to-face medical interviews during 7- and 10-year follow-up. We investigated 26 predictors at baseline from six domains: socio-demographic, medical history, medication, psychological, sensory, and balance/gait. We performed multivariate logistic regression analyses with presence of regular dizziness at 7- and 10-year follow-up as dependent variables. We assessed the performance of the models by calculating calibration and discrimination. Results: Predictors of regular dizziness at 7-year follow-up were living alone, history of dizziness, history of osteo/rheumatoid arthritis, use of nitrates, presence of anxiety or depression, impaired vision, and impaired function of lower extremities. Predictors of regular dizziness at 10-year follow-up were history of dizziness and impaired function of lower extremities. Both models showed good calibration (Hosmer-Lemeshow P value of 0.36 and 0.31, respectively) and acceptable discrimination (adjusted AUC after bootstrapping of 0.77 and 0.71). Conclusions: Dizziness in older age was predicted by multiple factors. A multifactorial approach, targeting potentially modifiable predictors (e.g., physical exercise for impaired function of lower extremities), may add to the current diagnosis-oriented approach.
Marijnissen, R.M., Wouts, L., Schoevers, R.A., Bremmer, M.A., Beekman, A.T.F., Comijs, H.C., Oude Voshaar, R.C. (2014). Depression in context of low neuroticism is a risk factor for stroke A 9-year cohort study. Neurology, 83, 1692-1698 >Full Text.
No abstract available.
Meesters, P.D., Comijs, H.C., Sonnenberg, C.M., Hoogendoorn, A.W., De Haan, L., Eikelenboom, P., Beekman, A.T.F., Stek, M.L. (2014). Prevalence and correlates of depressive symptoms in a catchment-area based cohort of older community-living schizophrenia patients. Schizophrenia Research, 157, 285-291. >Full Text.
Background: Depressive symptoms frequently accompany schizophrenia. Older patients constitute the fastest growing segment of the schizophrenia population. With regard to the risk factors associated with depression, it is uncertain to which extent older schizophrenia patients differ from their age peers in the community. Methods: We assessed self-reported depressive symptoms in an epidemiological sample of older Dutch community-living patients with schizophrenia or schizoaffective disorder (N=99; mean age 67years). Demographic, clinical and social variables were evaluated for their predictive value on the level of depressive symptoms. A comparison group, proportionally matched for age and gender, was recruited from a community study. Results: In the schizophrenia group, 47.5% reported depressive symptoms at a level indicating clinically relevant depression, in contrast to 12.1% in their age peers (odds ratio 6.55; 95% CI, 3.19-13.48; p<0.001). This difference could not be explained by differential exposure to the evaluated general risk factors. In both groups, functional limitations were the strongest predictor of depressive symptoms. In the patient group, chronic physical disorders and lack of a confidant were predictors, while a diagnosis of schizoaffective disorder (vs. schizophrenia) was the only disorder-related risk factor that contributed to depressive symptoms, with marginal significance. Conclusion: The high rate of depressive symptoms in this epidemiological sample of older schizophrenia patients confirms that these symptoms frequently accompany this severe mental illness in late life. With physical and social factors as important predictors of depressive symptoms, risk factors for depression are more comparable between older schizophrenia patients and their age peers than is often assumed.
Michielsen, M., Comijs, H.C., Semeijn, E., Beekman, A.T.F., Deeg, D.J.H., Kooij, J.J.S. (2014). Attention Deficit Hyperactivity Disorder and Personality Characteristics in Older Adults in the General Dutch Population. The American Journal of Geriatric Psychiatry, 22, 1623-1632. >Full Text.
No abstract available.
Moayyeri, A., GEFOS/GENOMOS consortium (2014). Genetic determinants of heel bone properties: genome-wide association meta-analysis and replication in the GEFOS/GENOMOS consortium. Human Molecular Genetics, 23, 11, 3054-3068. >Full Text.
No abstract available.
Oei, H.L.D.W., GEFOS/GENOMOS consortium (2014). Genome-wide association study for radiographic vertebral fractures: a potential role for the 16q24 BMD locus. Bone, 59, 20-27. >Full Text.
No abstract available.
Oei, H.L.D.W., GEFOS/GENOMOS consortium (2014). A genome-wide copy number association study of osteoporotic fractures points to the 6p25.1 locus. Journal of Medical Genetics, 51, 122-131. >Full Text.
No abstract available.
Pronk, M., Deeg, D.J.H., Smits, C., Twisk, J.W.R., Van Tilburg, T.G., Festen, J.M., Kramer, S.E. (2014). Hearing loss in older persons: does the rate of decline affect psychosocial health? Journal of Aging and Health, 26, 5, 703-723. >Full Text.
Objective: This study investigates whether the rate of decline in older persons\\\\\\\' hearing status is associated with the rate of decrease in their psychosocial health and explores moderation by baseline hearing status, health-related factors, and sociodemographic factors. Method: Multilevel analyses were applied to data of 1,178 older participants from the Longitudinal Aging Study Amsterdam (LASA), covering 3 to 7 years of follow-up. Results: Faster decrease in speech-in-noise recognition was significantly associated with more increase in loneliness for persons with a moderate baseline speech-in-noise recognition (emotional and social loneliness) and for persons who recently lost their partner (emotional loneliness). No relationship was found with depression. Discussion: The results indicate that faster hearing decline results in more increase in loneliness in specific subgroups of older persons: in persons with an already impaired hearing and in widow(er)s. Monitoring older persons\\\\\\\' hearing seems important and may be a relevant starting point for targeted loneliness prevention efforts.
Pronk, M. (2014). Wanneer je gehoor je in de steek laat. Kennislink.nl > Full Text.
Horen, we doen het de hele dag door. We zijn voor een groot deel van onze dagelijkse activiteiten afhankelijk van een goed gehoor. Bijna alle ouderen krijgen vroeg of laat te maken met slechthorendheid. En dat is niet alleen lastig, maar het kan ook leiden tot eenzaamheid.
Rafiq, , Swart, K.M.A., Van Schoor , N.M., Deeg, D.J.H., Lips, P.T.A., De Jongh, R.T. (2014). Associations of serum 25-hydroxyvitamin D concentrations with quality of life and self-rated health in an older population. The Journal of Clinical Endocrinology & Metabolism, 99, 9, 3136-3143. >Full Text.
Context: Vitamin D deficiency has been associated with impaired physical functioning, depression, and several chronic diseases and might thereby affect quality of life and self-rated health. Objective: The aim of this study was to assess relationships of serum 25-hydroxyvitamin D [25(OH)D] with quality of life and self-rated health and to examine whether physical performance, depressive symptoms, and number of chronic diseases mediate these relationships. Design: We analyzed data from the Longitudinal Aging Study Amsterdam, an ongoing population-based cohort study of older Dutch individuals. Main Outcome Measures: Serum 25(OH)D was classified into the following categories: less than 25, 25-50, and 50 nmol/L or greater. We assessed quality of life (QOL) using the Short Form-12 Health Survey (SF-12; n = 862) and self-rated health (SRH) with a single question, dichotomized into good vs poor SRH (n = 1248). Results: Individuals with serum 25(OH)D less than 25 nmol/L scored lower on the physical component score of the SF-12 and had a lower odds on good SRH score compared with individuals with serum 25(OH)D greater than 50 nmol/L (&#946; (95% confidence interval) -3.9 (-6.5 to -1.3) for SF-12, and odds ratio [95% confidence interval) 0.50 (0.33-0.76) for SRH]. Physical performance, depressive symptoms, and the number of chronic diseases were associated with vitamin D status, QOL, and SRH. Adding all these potential mediators to regression models attenuated associations of 25(OH)D less than 25 nmol/L with QOL with 78% and SRH with 32%. Conclusion: Lower 25(OH)D status is related to lower scores on QOL and SRH. A large part of the association with QOL can statistically be explained by physical performance, depressive symptoms, and the number of chronic diseases.
Read, S., Braam, A.W., Lyyra, T-M., Deeg, D.J.H. (2014). Do negative life events promote gerotranscendence in the second half of life? Aging & Mental Health, 18, 1, 117-124. >Full Text.
No abstract available.
Rijs, K.J., Van der Pas, S., Geuskens, G.A., Cozijnsen, M.R., Koppes, L.L.J., Van der Beek, A., Deeg, D.J.H. (2014). Development and validation of a physical and psychosocial job-exposure matrix in older and retired workers. Annals of Occupational Hygiene, 58, 2, 152-170. >Full Text.
Objectives: A general population job-exposure matrix (GPJEM) including physical and psychosocial demands as well as psychosocial resources applicable to older and retired workers was developed. Its validity was evaluated by examining associations of physical demands and iso-strain (combination of high psychosocial demands and low resources) with health. Methods: Physical and psychosocial work exposures reported by 55-64 year olds were derived from the Netherlands Working Conditions Survey and linked to the Netherlands Standard Classification of Occupations 1992. A GPJEM with low, moderate, and high probability of exposure to demands and resources was developed. To examine associations with health, two groups of the Longitudinal Aging Study Amsterdam were selected: current (i.e. at the time of the interview, 55-64 years) and former workers (55-84 years). Linear and logistic regression models were applied. Results: Use of force and work in uncomfortable positions were significantly associated with functional limitations and self-perceived health (SPH), but not hip or knee osteoarthritis (OA), in current and former workers. A moderate probability of repetitive movements was associated with functional limitations in former workers. A high probability of repetitive movements was associated with functional limitations in current and former workers as well as with SPH and hip and knee OA in former workers. Respondents formerly exposed to iso-strain had significantly higher diastolic blood pressure and more often hypertension. No such associations were found in current workers. No association was found with cardiovascular disease. Conclusions: The results suggest that our GPJEM accurately classifies jobs according to physical demands and, although less clearly, iso-strain.
Rijs, K.J. (2014). Employment, Retirement, and Health. Potential threats to older workers'workforce participation: work demands, memory functioning, social timing of retirement, and health. PhD Dissertation, VU University Amsterdam.
No abstract available.
Schoenmakers, E, Van Tilburg, T.G., Fokkema, C.M. (2014). Awareness of risk factors for loneliness among third agers. Ageing & Society, 34, 1035-1051. >Full Text.
Awareness of risk factors for loneliness is a prerequisite for preventive action. Many risk factors for loneliness have been identified. This paper focuses on two: poor health and widowhood. Preventive action by developing a satisfying social network requires time and effort and thus seems appropriate for people unexposed to risk factors, i.e. third agers and non-lonely persons. The third age is the period in old age after retirement, before people\\\\\\\'s social relationships deteriorate. This paper addresses three questions: Are older adults aware of poor health and widowhood as risk factors for loneliness? Are there differences in awareness between third and fourth agers? Are there differences in awareness between lonely and non-lonely older adults? After being introduced to four vignette persons, 920 respondents from the Longitudinal Aging Study Amsterdam were asked whether they expected these persons to be lonely. Older adults, especially third agers, expected peers exposed to the risk factors to be lonely more often than peers who were unexposed. The results indicate that awareness of loneliness-provoking factors is high among third agers, which is a first step towards taking actions to avoid loneliness. Compared to lonely older adults, non-lonely ones expected peers to be lonely less often, suggesting the latter\\\\\\\'s lower awareness of the risk factors. The results provide evidence for policy makers and practitioners that combating loneliness might require early action.
Sohl, E., Heymans, M.W., De Jongh, R.T., Den Heijer, M., Visser, M., Merlijn, T., Lips, P.T.A., Van Schoor , N.M. (2014). Prediction of vitamin D deficiency by simple patient characteristics. The American Journal of Clinical Nutrition, 99, 1089-1095. >Full Text.
Background: Vitamin D status is currently diagnosed by measuring serum 25-hydroxyvitamin D [25(OH)D]. Objective: This study aimed to develop a risk profile that can be used to easily identify older individuals at high risk of vitamin D deficiency. Design: This study was performed within the Longitudinal Aging Study Amsterdam, an ongoing cohort study in a representative sample of the Dutch older population (n = 1509 for the development sample and n = 1100 for the validation sample). Prediction models for serum 25(OH)D concentrations <50 and <30 nmol/L were developed by using backward logistic regression. Risk scores were calculated by dividing the individual regression coefficients by the regression coefficient with the lowest &#946; to create simple scores. Results: Serum 25(OH)D concentrations <50 and <30 nmol/L were present in 46.2% and 17.5% of participants, respectively. The model for the prediction of concentrations <50 nmol/L consisted of 13 easily assessable predictors, whereas the model for concentrations <30 nmol/L contained 10 predictors. The resulting areas under the curve (AUCs) were 0.78 and 0.80, respectively. The AUC in the external validation data set was 0.71 for the <50-nmol/L model. At a cutoff of 58 in total risk score (range: 8-97), the model predicted concentrations <50 nmol/L with a sensitivity of 61% and a specificity of 82%, whereas these values were 61% and 84%, respectively, at a cutoff of 110 in the total risk score (range: 6-204) in the model for concentrations <30 nmol/L. Conclusions: Two total risk scores, including 13 or 10 predictors that can easily be assessed, were developed and are able to predict serum 25(OH)D concentrations <50 and <30 nmol/L accurately. These risk scores may be useful in clinical practice to identify persons at risk of vitamin D deficiency.
Thijsen, A., Wiegersma, S.B., Deeg, D.J.H., Janssen, J. (2014). Leeftijd is meer dan een getal: subjectieve leeftijd en subjectieve levensverwachting onder Nederlandse ouderen. Centaal Bureau voor de Statistiek. Bevolkingstrends 2014, 2-14. > Full Text.
No abstract available.
Timmermans, E.J., Van der Pas, S., Schaap, L.A., Sanchez-Martinez, M., Zambon, S., Peter, R., Pedersen, N.L., Dennison, E.M., Denkinger, M., Castell, M.V. (2014). Self-perceived weather sensitivity and joint pain in older people with osteoarthritis in six European countries: results from the European Project on OSteoArthritis (EPOSA). BMC Musculoskeletal Disorders, 15, 66 >Full Text.
Background: People with osteoarthritis (OA) frequently report that their joint pain is influenced by weather conditions. This study aimed to examine whether there are differences in perceived joint pain between older people with OA who reported to be weather-sensitive versus those who did not in six European countries with different climates and to identify characteristics of older persons with OA that are most predictive of perceived weather sensitivity. Methods: Baseline data from the European Project on OSteoArthritis (EPOSA) were used. ACR classification criteria were used to determine OA. Participants with OA were asked about their perception of weather as influencing their pain. Using a two-week follow-up pain calendar, average self-reported joint pain was assessed (range: 0 (no pain)-10 (greatest pain intensity)). Linear regression analyses, logistic regression analyses and an independent t-test were used. Analyses were adjusted for several confounders. Results: The majority of participants with OA (67.2%) perceived the weather as affecting their pain. Weather-sensitive participants reported more pain than non-weather-sensitive participants (M&#8201;=&#8201;4.1, SD&#8201;=&#8201;2.4 versus M&#8201;=&#8201;3.1, SD&#8201;=&#8201;2.4; p&#8201;<&#8201;0.001). After adjusting for several confounding factors, the association between self-perceived weather sensitivity and joint pain remained present (B&#8201;=&#8201;0.37, p&#8201;=&#8201;0.03). Logistic regression analyses revealed that women and more anxious people were more likely to report weather sensitivity. Older people with OA from Southern Europe were more likely to indicate themselves as weather-sensitive persons than those from Northern Europe. Conclusions: Weather (in)stability may have a greater impact on joint structures and pain perception in people from Southern Europe. The results emphasize the importance of considering weather sensitivity in daily life of older people with OA and may help to identify weather-sensitive older people with OA.
Tolkacheva, N., Broese van Groenou, M.I., Van Tilburg, T.G. (2014). Sibling Similarities and Sharing the Care of Older Parents. Journal of Family Issues, 35, 3, 312-330. >Full Text.
This study examines the degree to which the sharing of parental care, as indicated by the amount of children participating in caregiving and by equality in caregiving intensity, is associated with similarities among sibling characteristics. A selected sample of 186 parents with at least two children was asked to report on the assistance provided by all their children. Results reveal that in most families the care was shared between children. However, there was a large variation in caregiving intensity. Multivariate regression analyses show that similarities in employment status among children predicted a higher chance that the care was shared and a higher degree of equality in caregiving intensity among siblings. Similarities in partner status and emotional support exchanges with parents were associated with the equality among siblings in caregiving intensity. Results from this study suggest that siblings with similar characteristics and opportunities are more likely to share care (equally).
Van den Heuvel, E.G.H.M., Van Schoor , N.M., Lips, P.T.A., Magdeleyns, E.J.P., Deeg, D.J.H., Vermeer, C., Den Heijer, M. (2014). Circulating uncarboxylated matrix Gla protein, a marker of vitamin K status, as a risk factor of cardiovascular disease. Maturitas, 77, 137-141. >Full Text.
Objectives: Vitamin K plays a pivotal role in the synthesis of Matrix Gla protein (MGP), a calcification inhibitor in vascular tissue. Vascular calcification has become an important predictor of cardiovascular disease. The aim of the current study was to examine the potential association of circulating desphospho-carboxylated and -uncarboxylated MGP (dp-cMGP and dp-ucMGP), reflecting vitamin K status, with the incidence of cardiovascular events and disease (CVD) in older individuals. Study design: The study was conducted in 577 community-dwelling older men and women of the Longitudinal Aging Study Amsterdam (LASA), aged >55 year, who were free of cardiovascular disease at baseline. Multivariate Cox proportional hazards models were used to analyze the data. Main outcome measures: Incidence of CVD. Results: After a mean follow-up of 5.6�1.2 year, we identified 40 incident cases of CVD. After adjustment for classical confounders and vitamin D status, we observed a more than 2-fold significantly higher risk of CVD for the highest tertile of dp-ucMGP with a HR of 2.69 (95% CI, 1.09-6.62) as compared with the lowest tertile. Plasma dp-cMGP was not associated with the risk of CVD. Conclusions: Vitamin K insufficiency, as assessed by high plasma dp-ucMGP concentrations is associated with an increased risk for cardiovascular disease independent of classical risk factors and vitamin D status. Larger epidemiological studies on dp-ucMGP and CVD incidence are needed followed by clinical trials to test whether vitamin K-rich diets will lead to a decreased risk for cardiovascular events.
Van den Kommer, T.N., Comijs, H.C., Rijs, K.J., Heymans, M.W., Van Boxtel, M.P.J., Deeg, D.J.H. (2014). Classification models for identification of at-risk groups for incident memory complaints. International Psychogeriatrics, 26, 2, 257-271. >Full Text.
Background: Memory complaints in older adults may be a precursor of measurable cognitive decline. Causes for these complaints may vary across age groups. The goal of this study was to develop classification models for the early identification of persons at risk for memory complaints using a broad range of characteristics. Methods: Two age groups were studied, 55-65 years old (N = 1,416.8) and 65-75 years old (N = 471) using data from the Longitudinal Aging Study Amsterdam. Participants reporting memory complaints at baseline were excluded. Data on predictors of memory complaints were collected at baseline and analyzed using logistic regression analyses. Multiple imputation was applied to handle the missing data; missing data due to mortality were not imputed. Results: In persons aged 55-65 years, 14.4% reported memory complaints after three years of follow-up. Persons using medication, who were former smokers and had insufficient/poor hearing, were at the highest risk of developing memory complaints, i.e., a predictive value of 33.3%. In persons 65-75 years old, the incidence of memory complaints was 22.5%. Persons with a low sense of mastery, who reported having pain, were at the highest risk of memory complaints resulting in a final predictive value of 56.9%. In the subsample of persons without a low sense of mastery who (almost) never visited organizations and had a low level of memory performance, 46.8% reported memory complaints at follow-up. Conclusions: The classification models led to the identification of specific target groups at risk for memory complaints. Suggestions for person-tailored interventions may be based on these risk profiles.
Van Exel, E., Eikelenboom, P., Comijs, H.C., Deeg, D.J.H., Stek, M.L., Westendorp, R.G.J. (2014). Insulin-like growth factor-1 and risk of late-onset Alzheimer's disease: findings from a family study. Neurobiology of Aging 35, 725.e7-725.e10. >Full Text.
Insulin-like growth factor-1 (IGF-1), part of an evolutionary conserved signaling pathway in both mammalian and non-mammalian species, is inferred in neurodegenerative disorders including Alzheimer&#39s disease (AD). A murine model for AD shows that reduced IGF-1 signaling prevents AD-like characteristics. However, variation in serum levels of IGF-1 and risk of AD in humans has yet to be determined. We used a proven family design, comparing middle-aged offspring with and without a parental history of AD. The offspring under study carry an increased risk of AD but do not yet experience cognitive impairment. A total of 206 offspring from 92 families with a parental history of AD were compared with 200 offspring from 97 families without a parental history of AD. Apolipoprotein-E (APOE) genotypes and serum IGF-1 levels were compared in subjects with and without a parental history of AD using linear regression, adjusted for APOE genotype and other possible demographic and clinical confounders. Offspring with a parental history of AD were more likely to be an APOE &#949;4 allele carrier (46.5% vs. 21%, p = 0.001) than were offspring without such a parental history. Offspring with a parental history of AD had higher IGF-1 levels than subjects without such a history, in both unadjusted and adjusted analyses (18.3 mmol/L vs. 16.7 mmol/L, p = 0.001). In conclusion, higher serum IGF-1 levels in middle age are associated with risk of AD disease in older age, independent of APOE genotype.
Van Nes, F., Sant, N. (2014). Samen oud(er) worden. Kennislink. > Full Text.
Ouder worden komt vaak met gebreken, maar dat hoeft niet altijd zo erg te zijn. Hoe vang je het op? En vooral: hoe doe je dat met elkaar? Fenna van Nes, ergotherapeut, heeft onderzoek gedaan naar de dagelijkse activiteiten van zelfstandig wonende oudere echtparen met een toenemende achteruitgang van de gezondheid.
Van Schoor , N.M., Knol, D.L., Deeg, D.J.H., Peters, E.P.A.M.N., Heijboer, A.C., Lips, P.T.A. (2014). Longitudinal changes and seasonal variations in serum 25-hydroxyvitamin D levels in different age groups: results of the Longitudinal Aging Study Amsterdam. Osteoporosis International, 25, 1483-1491. >Full Text.
No abstract available.
Van Tilburg, T.G., Aartsen, M.J., Van der Pas, S. (2014). Loneliness after Divorce: A Cohort Comparison among Dutch Young-Old Adults. European Sociological Review, 1-10. >Full Text.
No abstract available.
Visser, M., Brychta, R.J., Chen, K.Y., Koster, A. (2014). Self-Reported Adherence to the Physical Activity Recommendation and Determinants of Misperception in Older Adults. Journal of Aging and Physical Activity, 22, 226-234. >Full Text.
No abstract available.
Wijnhoven, H.A.H., Van Zon, S.K.R., Twisk, J.W.R., Visser, M. (2014). Attribution of Causes of Weight Loss and Weight Gain to 3-Year Mortality in Older Adults: Results From the Longitudinal Aging Study Amsterdam. The Journals of Gerontology, Biological Sciences & Medical Sciences, 69A, 10, 1236-1243. >Full Text.
No abstract available.

2013

Alma, M.A., Van der Mei, S.F., Feitsma, W.N., Groothoff, J.W., Van Tilburg, T.G., Suurmeijer, T.P.B.M. (2013). Loneliness and self-management abilities in the visually impaired elderly. Tijdschrift voor Gerontologie en Geriatrie, 44, 132-142. >Full Text.
Objectives: To describe the degree of loneliness among the visually impaired elderly and to make a comparison with a matched reference group of the normally sighted elderly. In addition, we examined self-management abilities (SMAs) as determinants of loneliness among the visually impaired elderly. Methods: In a cross-sectional study, 173 visually impaired elderly persons completed telephone interviews. Loneliness and SMAs were assessed with the Loneliness Scale of De Jong Gierveld and the SMAS-30, respectively. Results: The prevalence of loneliness among the visually impaired elderly was higher compared to the reference group (50% vs 29%; pG.001). Multivariate hierarchical regression analysis showed that the SMA self-efficacy, partner status, and self-esteem were determinants of loneliness. Severity and duration of visual impairment had no effect on loneliness. Discussion: The relationship between SMAs (i.e., self-efficacy) and loneliness is promising, since SMAs can be learned through training. Consequently, selfmanagement training may reduce feelings of loneliness.
Bloem, B.A., Van Tilburg, T.G., Thomése, G.C.F. (2013). Starting relationships with neighbors after a move later in life: An exploratory study. Journal of Housing for the Elderly, 27, 28-47. >Full Text.
No abstract available.
Bloem, B.A. (2013). Residential relocation and personal networks of older Dutch adults. PhD Dissertation, VU University Amsterdam.
No abstract available.
Broese van Groenou, M.I., Hoogendijk, E.O., Van Tilburg, T.G. (2013). Continued and new personal relationships in later life: differential effects of health. Journal of Aging and Health, 25 (2), 274-295. >Full Text.
Objectives: The aim of this study is to increase our understanding of declining network size with aging by differentiating between processes of loss and gain and studying the associations with various health problems. Methods: Six observations of the Longitudinal Aging Study Amsterdam (LASA) across a time period of 16 years are used to study detailed network changes in a large sample of Dutch older adults aged 55 to 85 at baseline. Results: Results from multilevel regression analyses show that network size declines with aging, in particular for the oldest old. The decline in network size is to a large degree due to a lack of replacement of lost relationships with new relationships. Results show differential effects of health. Discussion: The older old and people in poor health have limited possibilities to compensate for network losses and may have a serious risk of declining network size in later life.
Buiting, H.M., Deeg, D.J.H., Knol, D.L., Ziegelmann, J.P., Pasman, H.R.W., Widdershoven, G.A.M., Onwuteaka-Philipsen, B.D. (2013). Opvattingen van ouderen over levensbeëindiging. Huisarts Wet, 56 (3), 102-105.
No abstract available.
Buizert, P.J., Van Schoor , N.M., Simsek, S., Lips, P.T.A., Heijboer, A.C., Den Heijer, M., Deeg, D.J.H., Eekhoff, E.M.W. (2013). PTH: a new target in arteriosclerosis? Journal of Clinical Endocrinology & Metabolism, 98, E1583-E1590. >Full Text.
Context: Growing evidence demonstrates that hyperparathyroidism is associated with an increased risk of cardiovascular morbidity and mortality. However, little is known about the relation between serum PTH levels within the normal range and cardiovascular diseases (CVD). Objective: In this study the relationship of serum PTH levels within the normal range with CVD and abdominal aortic calcifications was investigated. Design: A cross-sectional, population-based study was performed using data of the Longitudinal Aging Study Amsterdam, including 558 men and 537 women, aged 65-88 years. Models were controlled for sex, age, body mass index, hypertension, diabetes mellitus, high-density lipoprotein cholesterol, total cholesterol, smoking, physical activity, alcohol consumption, glomerular filtration rate, season of blood collection, calcium or diuretic use, and serum 25-hydroxyvitamin D and osteocalcin levels when these variables were found to be relevant confounders. Results: Multivariate models showed that subjects in the highest quintile of serum PTH had a significantly higher risk of CVD as compared with subjects in the lowest quintile (odds ratio 2.22, confidence interval 1.39-3.56). The relationship between PTH and abdominal aortic calcifications was observed only in men, which remained significant after adjusting for confounders (odds ratio 4.03, confidence interval 1.50-10.83). Conclusions: This study demonstrated that in older persons the presence of serum PTH levels within the upper normal range is highly related to CVD. In men, this association may partly be explained by calcifications of the abdominal aorta. Because CVD poses an important health risk, further elucidation of the role of serum PTH in CVD and arteriosclerosis is relevant.
Comijs, H.C. (2013). Somatische en psychische problematiek bij ouderen; samenhang en zorggebruik (LASA-rapport 2012). > Full Text.
No abstract available.
Cozijnsen, M.R. (2013). Retirement in transition. Dutch retirees in a changing social context. PhD Dissertation, VU University Amsterdam.
No abstract available.
De Vries, O.J., Peeters, G.M.E.E., Elders, P.J.M., Sonnenberg, C.M., Muller, M.J., Deeg, D.J.H., Lips, P.T.A. (2013). The elimination half-life of benzodiazepines and fall risk: two prospective observational studies. Age and Ageing, 42, 764-770. >Full Text.
No abstract available.
De Vries, O.J., Peeters, G.M.E.E., Lips, P.T.A., Deeg, D.J.H. (2013). Does frailty predict increased risk of falls and fractures? A prospective population-based study. Osteoporosis International, 24, 2397-2403. >Full Text.
No abstract available.
Deckers, M.M.L., De Jongh, R.T., Lips, P.T.A., Penninx, B.W.J.H., Milaneschi, Y., Smit, J.H., Van Schoor , N.M., Blankenstein, M.A., Heijboer, A.C. (2013). Prevalence of vitamin D deficiency and consequences for PTH reference values. Clinica Chimica Acta, 426, 41-45. >Full Text.
Reference values of PTH depend on vitamin D status of the reference population. This is often not described in package inserts. The aim of the present study was therefore to calculate assay specific PTH reference levels in EDTA plasma for the Architect (Abbott) in relation to 25-hydroxyvitamin D (25OHD) levels. The relation between PTH levels, 25OHD, BMI, age, gender and kidney function was determined in a cohort of older individuals from the Longitudinal Aging Study Amsterdam (LASA, n = 738, age 55-65 years) and in a cohort of healthy individuals from the Netherlands Study of Depression and Anxiety (NESDA, n = 633, 18-65 years). The LASA cohort is a representative sample of the Dutch older population. As expected, PTH reference values were significantly lower in 25OHD sufficient subjects (25OHD>50 nmol/L) than in 25OHD deficient and insufficient subjects. The 97.5th percentile of PTH in 25OHD sufficient subjects was 10 pmol/L (94.3 pg/mL), which was higher than the upper limit stated by the manufacturer (7.2 pmol/L or 68.3 pg/mL). The relation between vitamin D and PTH was independent of age, gender, BMI and kidney function. In conclusion, we have shown that it is important to establish PTH reference values in a local reference population taking 25OHD status into account.
Deeg, D.J.H. (2013). Genderregimes en gezondheidsverschillen in Europa. Tijdschrift voor Genderstudies, 2, 7-26. > Full Text.
No abstract available.
Deeg, D.J.H., Van Vliet, M.J.G., Kardaun, J.W.P.F., Huisman, M. (2013). Understanding the mortality decline at older ages. Improved life course or improved present period? Annual Review of Gerontology and Geriatrics 33, 261-291. >Full Text.
No abstract available.
Deeg, D.J.H., Rijs, K.J. (2013). Toename arbeidsdeelname ondanks slechtere gezondheid. Gern, Tijdschrift over ouder worden & samenleving, 15(3), 15-18.
In het debat over de pensioenleeftijd wordt uitgegaan van cijfers - maar zijn dit de juiste cijfers? Worden alle relevante aspecten rond de pensionering wel in de gangbare cijfers gevat? Veelal wordt alleen de levensverwachting in de discussie betrokken. Het staat te bezien welke pensioenleeftijd optimaal is wanneer ook ontwikkelingen in de gezondheid mee worden gewogen.
Deeg, D.J.H., Huisman, M., Terwee, C.B., Comijs, H.C., Thomése, G.C.F., Visser, M. (2013). Changes in functional ability with ageing and over time. In: C. Phellas (Ed.), Aging in European Societies, International Perspectives on Aging 6. (pp. 117-132). New York: Springer Science+Business Media. >Full Text.
No abstract available.
Deeg, D.J.H. (2013). Where we are now ? Monitoring health and disability in older European populations and what harmonisation efforts (CLESA, EPOSA) could tell. BMC Proceedings 2013, 7(Suppl 4), K1. > Full Text.
From European Workshop on Health and Disability Surveillance in Ageing Populations (EUWAP) Berlin, Germany. 22-23 November 2012.
Ellwardt, L., Aartsen, M.J., Deeg, D.J.H., Steverink, N. (2013). Does loneliness mediate the relation between social support and cognitive functioning in later life? Social Science & Medicine, 98, 116-124. >Full Text.
No abstract available.
Fagerström, J., Aartsen, M.J. (2013). Successful aging and its relationship to contemporary norms. A critical look at the call to "age well". Recherches Sociologiques et Anthropologiques, 44 (1), 51-73.
Objective: Human ageing is inextricably bound to the loss of physical and cognitive functions, loss of social roles, and loss of social contacts. However, these losses not necessarily threatens the level of general well-being of older adults or match the older adults&#39; conviction of being an unsuccessful ager. When asked older adults to rate their health in comparison with the health of others, most of them will respond that their health is better than most of their peers. This paradoxical finding has fuelled the scientific and political arena for many years, and discussions about what is successful aging has not yet subsided. To investigate to what extend changes in various domains of functioning rated by older adults as being important for successful ageing are related to changes in general well being, we estimate long term (1992-2006) trajectories of various domains of functioning and estimate to what extend these changes are related to long term changes in general well-being. Method: Using data from the Longitudinal Aging Study Amsterdam (n= 1257), latent change models for domains of successful ageing were estimated. Each trajectory was regressed on demographic variables to examine if these explained individual differences. Parallel growth models were fitted to determine associations between changes in successful ageing domains and changes in general well-being. Results: On average, general well-being was stable over time, whereas there was a decline in all other domains of successful ageing. Apart from these so-called intra-individual differences, large inter-individual differences in speed of decline were observed in all domains indicating that some people remain at stable levels of functioning until advanced age, whereas others show rapid decline in one or more domains of functioning. Demographic variables explained some of the differences in the level of successful ageing, but rate of change was less well predicted. Changes in successful ageing domains were correlated to change in general well-being. Discussion: The general picture that emerges from our analyses is that ageing is associated with losses in multiple domains, but direct assessment of change shows that the decline in many functions is quite small. General well-being, on the other hand, does not decrease. Most striking was our finding that there is only weak correlation between decline in domains of functioning generally considered by scientists and politicians as crucial for successful ageing - absence of disease and high functional and cognitive capacity-and decline in general well-being. This gives empirical support to much of the critique on the successful ageing paradigm. If we are open to defining successful ageing as something more than achieving a (socially and politically) desirable image of ageing we need to take into account that doing well is not the only path to feeling good.
Galenkamp, H. (2013). Feeling healthy versus being healthy: change and stability in older people`s self-rated health. PhD Dissertation, VU University Amsterdam.
No abstract available.
Galenkamp, H., Braam, A.W., Huisman, M., Deeg, D.J.H. (2013). Seventeen-year time trend in poor self-rated health in older adults: changing contributions of chronic diseases and disability. European Journal of Public Health, 23, 3, 511-517. >Full Text.
No abstract available.
Galenkamp, H., Deeg, D.J.H., Huisman, M., Hervonen, A., Braam, A.W., Jylha, M. (2013). Hoe is uw gezondheidstoestand? Ook de ervaren gezondheid van 90-plussers wordt bepaald door chronische aandoeningen en functionele beperkingen. Nederlands Tijdschrift voor Behavioral Medicine, 24 (1), > Full Text.
Eerder onderzoek heeft aangetoond dat de oudste ouderen hun gezondheid relatief positief beoordelen ten opzichte van hun objectieve gezondheidsproblemen. Dit onderzoek had tot doel bij 90-plussers te onderzoeken hoe bruikbaar hun oordeel over de eigen gezondheid is. Er werd hiervoor gebruik gemaakt van gegevens van de Finse Vitality 90+ Studie.
Galenkamp, H., Deeg, D.J.H., Braam, A.W., Huisman, M. (2013). "How was your health 3 years ago?" Predicting mortality in older adults using a retrospective change measure of self-rated health. Geriatrics & Gerontology International, 13, 678-686. >Full Text.
Aim: Studies have shown better predictive value of self-rated health (SRH) for mortality when prospective change in SRH is considered. However, retrospective change is more feasible and might have better sensitivity to objective health changes. This study compares the predictive value for mortality of retrospectively measured change in SRH (based on a &#34;then-test&#34;) with current SRH and prospectively measured change in SRH. Methods: Data from two waves of the Longitudinal Aging Study Amsterdam (2001-2003 and 2005-2006 [T0], n = 1894) were used. Retrospective change was defined as the difference between SRH at T0 (&#34;current SRH&#34;) and SRH measured with a then-test at T0, asking for a renewed judgement of one&#39;s health at the previous wave. Prospective change was defined as change in SRH between the two waves. We applied Cox proportional hazards analysis to predict 5-year mortality. Results: Having poorer current SRH significantly predicted mortality (HR poor vs very good SRH = 4.42). Declined SRH was associated with higher mortality risk, but only when measured prospectively (one point decline vs no change HR = 1.33; two points decline HR = 1.95). After adjusting for current SRH, neither change measure predicted mortality. Results were similar in subgroups that did and did not experience incident diseases or limitations between the two waves. Conclusions: Neither retrospective, nor prospective changes in SRH improved the prediction of mortality in older adults over current SRH. These results imply that using a standard single indicator for self-rated health in research or clinical practice might suffice to identify those with a high risk of future negative health outcomes.
Galenkamp, H., Deeg, D.J.H., Huisman, M., Hervonen, A., Braam, A.W., Jylha, M. (2013). Is Self-Rated Health Still Sensitive for Changes in Disease and Functioning Among Nonagenarians? Journals of Gerontology. Series B: Psychological Sciences and Social Sciences, 68 (5), 848-858. >Full Text.
Objectives: With age, there is an increasing gap between relatively stable levels of self-rated health (SRH) and actual health status. This study investigates longitudinal changes in SRH and examines its sensitivity to changes in chronic conditions and functioning among people aged 90 and older. Methods: In the Vitality 90+ Study, questionnaires were sent to all people aged 90 years and older living in Tampere, Finland. Included were respondents who provided data on the 2001 measurement and at least one follow-up measurement in 2003, 2007, or 2010 (N = 334). Generalized Estimating Equations analyses examined longitudinal change in SRH and the predictive value of number of chronic conditions and a functioning score based on 5 activities. Results: Within 2 years, most people (56.3%) had unchanged SRH, but declined SRH (22.3%) was associated with worse baseline functioning and declined functioning. Clear declines in SRH after 6 and 9 years were associated with increased chronic conditions (odds ratio [OR] = 1.23) and decreased functioning (OR = 1.28). The impact of chronic conditions and functioning was smaller among institutionalized people (chronic conditions OR = 0.90; functioning OR = 1.18) than among people living independently (chronic conditions OR = 1.30; functioning OR = 1.44). Discussions: SRH among nonagenarians was sensitive to changes in the number of chronic conditions and functioning although more pronounced on the longer than on the shorter term.
Gardner, M.P., Lightman, S., Sayer, A.A., Cooper, C., Cooper, R., Deeg, D.J.H., Ebrahim, S., Gallacher, J. (2013). Dysregulation of the hypothalamic pituitary adrenal (HPA) axis and physical performance at older ages: an individual participant meta-analysis. Psychoneuroendocrinology, 38, 40-49. >Full Text.
The association between functioning of the hypothalamic pituitary adrenal (HPA) axis and physical performance at older ages remains poorly understood. We carried out meta-analyses to test the hypothesis that dysregulation of the HPA axis, as indexed by patterns of diurnal cortisol release, is associated with worse physical performance. Data from six adult cohorts (ages 50-92 years) were included in a two stage meta-analysis of individual participant data. We analysed each study separately using linear and logistic regression models and then used meta-analytic methods to pool the results. Physical performance outcome measures were walking speed, balance time, chair rise time and grip strength. Exposure measures were morning (serum and salivary) and evening (salivary) cortisol. Total sample sizes in meta-analyses ranged from n=2146 for associations between morning Cortisol Awakening Response and balance to n=8448 for associations between morning cortisol and walking speed. A larger diurnal drop was associated with faster walking speed (standardised coefficient per SD increase 0.052, 95% confidence interval (CI) 0.029, 0.076, p<0.001; age and gender adjusted) and a quicker chair rise time (standardised coefficient per SD increase -0.075, 95% CI -0.116, -0.034, p<0.001; age and gender adjusted). There was little evidence of associations with balance or grip strength. Greater diurnal decline of the HPA axis is associated with better physical performance in later life. This may reflect a causal effect of the HPA axis on performance or that other ageing-related factors are associated with both reduced HPA reactivity and performance.
Heima, N.E., Eekhoff, E.M.W., Oosterwerff, M.M., Lips, P.T.A., Van Schoor , N.M., Simsek, S. (2013). Thyroid function and the metabolic syndrome in older persons: a population-based study. European Journal of Endocrinology, 168, 59-65. >Full Text.
No abstract available.
Huisman, M., Deeg, D.J.H. (2013). Regie, een buffer tegen voortschrijdende beperkingen bij ouderen. Gern, Tijdschrift over ouder worden & samenleving, 15(2), 42-44.
Het ervaren van regie en het streven naar regie zijn belangrijke concepten binnen de positieve psychologie. Er is voldoende wetenschappelijk bewijs voor het bestaan van invloeden van controle op gezondheid bij ouderen, bijvoorbeeld gemeten door middel van lichamelijke beperkingen, maar de mechanismen die deze invloed verklaren zijn nog niet helder.
Kaspers, P.J., Onwuteaka-Philipsen, B.D., Deeg, D.J.H., Pasman, H.R.W. (2013). Decision-making capacity and communication about care of older people during their last three months of life. BMC Palliative Care, 12, 1-10. >Full Text.
Background: Limited decision-making capacity (DMC) of older people affects their abilities to communicate about their preferences regarding end-of-life care. In an advance directive (AD) people can write down preferences for (non)treatment or appoint a proxy as a representative in (non)treatment choices in case of limited DMC.The aim is to study limited DMC during the end of life and compare the background, (satisfaction with) care and communication characteristics of people with and without limited DMC. Furthermore, the aim is to describe patient proxies\\\\\\\' opinions about experiences with the use of (appointed proxy) ADs. Methods: Using a questionnaire, data were collected from proxies of participants of a representative sample of the Longitudinal Aging Study Amsterdam (n=168) and a purposive sample of the Advance Directive cohort study (n=184). Differences between groups (with and without limited DMC, and/or with and without AD) were tested with chi-square tests, using a level of significance of p < 0.05. Results: At a month before death 27% of people had limited DMC; this increased to 67% of people having limited DMC in the last week of life. The care received was in accordance with the patient\\\\\\\'s preferences for the majority of older people, although less often for people who had limited DMC for more than a week. The majority of the proxies were satisfied with the communication between physician and the patient and them, regardless of DMC of the patient. Of people with an AD, a small majority of relatives indicated that the AD had been of additional value. Finally, no differences were found in the role of the relative and the satisfaction with this role between people with and without a proxy AD. Conclusions: Although relatives have positive experiences with ADs, our study does not provide strong evidence that (proxy) ADs are very influential in the last phase of life. They can best be seen as a tool for advance care planning.
Kaspers, P.J. (2013). End-of-life care and preferences for (non) treatment decisions in older people during the last three months of life. PhD Dissertation, VU University Amsterdam. > Full Text.
No abstract available.
Kaspers, P.J., Pasman, H.R.W., Onwuteaka-Philipsen, B.D., Deeg, D.J.H. (2013). Changes over a decade in end-of-life care and transfers during the last 3 months of life: A repeated survey among proxies of deceased older people. Palliative Medicine, 27 (6), 544-552. >Full Text.
No abstract available.
Knipscheer, C.P.M., Van Tilburg, T.G. (2013). Generational contact and support among late adult siblings within a verticalized family. In: M. Silverstein & R. Giarrusso (Eds.), Kinship and cohort in an aging society: From generation to generation (pp. 59-76). Baltimore, MD: The Johns Hopkins University Press. ISBN 9781421408934. > Full Text.
No abstract available.
Kooij, J.J.S., Semeijn, E., Michielsen, M., Comijs, H.C. (2013). Heeft opa ADHD? GZ-Psychologie, 2, 10-12.
No abstract available.
Manenschijn, L., Schaap, L.A., Van Schoor , N.M., Van der Pas, S., Peeters, G.M.E.E., Lips, P.T.A., Koper, J.W., Van Rossum, E.F.C. (2013). High long-term cortisol levels, measured in scalp hair, are associated with a history of cardiovascular disease. Journal of Clinical Endocrinology & Metabolism, 98, 5,2078-2083. >Full Text.
Background: Stress is associated with an increased incidence of cardiovascular disease. The impact of chronic stress on cardiovascular risk has been studied by measuring cortisol in serum and saliva, which are measurements of only 1 time point. These studies yielded inconclusive results. The measurement of cortisol in scalp hair is a novel method that provides the opportunity to measure long-term cortisol exposure. Our aim was to study whether long-term cortisol levels, measured in scalp hair, are associated with cardiovascular diseases. Methods: A group of 283 community-dwelling elderly participants were randomly selected from a large population-based cohort study (median age, 75 y; range, 65-85 y). Cortisol was measured in 3-cm hair segments, corresponding roughly with a period of 3 months. Self-reported data concerning coronary heart disease, stroke, peripheral arterial disease, diabetes mellitus, and other chronic noncardiovascular diseases were collected. Results: Hair cortisol levels were significantly lower in women than in men (21.0 vs 26.3 pg/mg hair; P < .001). High hair cortisol levels were associated with an increased cardiovascular risk (odds ratio, 2.7; P = .01) and an increased risk of type 2 diabetes mellitus (odds ratio, 3.2; P = .04). There were no associations between hair cortisol levels and noncardiovascular diseases. Conclusions: Elevated long-term cortisol levels are associated with a history of cardiovascular disease. The increased cardiovascular risk we found is equivalent to the effect of traditional cardiovascular risk factors, suggesting that long-term elevated cortisol may be an important cardiovascular risk factor.
Michielsen, M., Semeijn, E., Comijs, H.C., Beekman, A.T.F., Kooij, J.J.S. (2013). Attention-deficit hyperactivity disorder, across the lifespan. Authors reply to comments. The British Journal of Psychiatry, 202, 2, 156. >Full Text.
No abstract available.
Michielsen, M., Comijs, H.C., Semeijn, E., Beekman, A.T.F., Deeg, D.J.H., Kooij, J.J.S. (2013). The comorbidity of anxiety and depressive symptoms in older adults with attention-deficit/hyperactivity disorder: a longitudinal study. Journal of Affective Disorders, 148, 2-3, 220-227 >Full Text.
Background: Comorbidity between Attention-Deficit/Hyperactivity Disorder (ADHD) and depression and anxiety disorders in children and young to middle-aged adults has been well documented in the literature. Yet, it is still unknown whether this comorbidity persists into later life. The aim of this study is therefore to examine the comorbidity of anxiety and depressive symptoms among older adults with ADHD. This is examined both using cross-sectional and longitudinal data. Methods: Data were used from the Longitudinal Aging Study Amsterdam (LASA). Participants were examined in three measurement cycles, covering six years. They were asked about depressive and anxiety symptoms. To diagnose ADHD, the DIVA 2.0, a diagnostic interview was administered among a subsample (N=231, age 60-94). In addition to the ADHD diagnosis, the association between the sum score of ADHD symptoms and anxiety and depressive symptoms was examined. Data were analyzed by means of linear regression analyses and linear mixed models. Results: Both ADHD diagnosis and more ADHD symptoms were associated with more anxiety and depressive symptoms cross-sectionally as well as longitudinally. The longitudinal analyses showed that respondents with higher scores of ADHD symptoms reported an increase of depressive symptoms over six years whereas respondents with fewer ADHD symptoms remained stable. Limitations: The ADHD diagnosis is based on the DSM-IVcriteria, which were developed for children, and have not yet been validated in (older) adults. Conclusions: It appears that the association between ADHD and anxiety/depression remains in place with aging. This suggests that, in clinical practice, directing attention to both in concert may be fruitful.
Oosterwerff, M.M., Van Schoor , N.M., Lips, P.T.A., Eekhoff, E.M.W. (2013). Osteocalcin as a predictor of the metabolic syndrome in older persons: a population-based study. Clinical Endocrinology, 78, 242-247. >Full Text.
Background: Recent evidence indicates that the osteoblast-derived protein osteocalcin is able to influence adiposity and glucose homeostasis in mice. Little is known about this relationship in humans. OBJECTIVE: To investigate the association of plasma osteocalcin levels with the metabolic syndrome in a community-dwelling cohort of older persons in the Netherlands. Design and Participants: Data were used from the Longitudinal Aging Study Amsterdam (LASA), an ongoing multidisciplinary cohort study in a representative sample of the older Dutch population (&#8805; 65 years old). A total of 1284 subjects (629 men and 655 women) between the ages of 65 and 88 years participated in this study.Measurements: Metabolic syndrome (U.S. National Cholesterol Education Program definition) and its individual components were assessed as well as plasma osteocalcin levels. RESULTS: Among the participants, the prevalence of the metabolic syndrome was 37.1%. The median osteocalcin level was 2.0 nmol/l. Plasma osteocalcin was inversely associated with the metabolic syndrome. The odds ratio (OR) was 3.68 with 95% confidence interval (CI) 2.53-5.34 for the lowest osteocalcin quartile compared to the highest quartile. The association between osteocalcin and the metabolic syndrome was mainly determined by high triglycerides, low HDL, waist circumference and hypertension. Conclusion: Low plasma osteocalcin levels are strongly associated with the metabolic syndrome in an older community-dwelling population.
Pasman, H.R.W., Onwuteaka-Philipsen, B.D., Deeg, D.J.H. (2013). De laatste levensmaanden van ouderen in Nederland (LASA-rapport 2012). > Full Text.
No abstract available.
Pasman, H.R.W., Kaspers, P.J., Deeg, D.J.H., Onwuteaka-Philipsen, B.D. (2013). Preferences and Actual Treatment of Older Adults at the End of Life. A Mortality Follow-Back Study. Journal of the American Geriatrics Society, 61, 1722-1729. >Full Text.
No abstract available.
Piccinin, A.M., Muniz-Terrera, G., Clouston, S., Reynolds, C.A., Thorvaldsson, V., Deary, I.J., Deeg, D.J.H., Johansson, B., Mackinnon, A., Spiro, A., Starr, J.M., Skoog, I., Hofer, S.M. (2013). Coordinated analysis of age, sex, and education effects on change in MMSE scores. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 68, 3, 374-390. >Full Text.
Objectives: We describe and compare the expected performance trajectories of older adults on the Mini-Mental Status Examination (MMSE) across six independent studies from four countries in the context of a collaborative network of longitudinal studies of aging. A coordinated analysis approach is used to compare patterns of change conditional on sample composition differences related to age, sex, and education. Such coordination accelerates evaluation of particular hypotheses. In particular, we focus on the effect of educational attainment on cognitive decline. Method: Regular and Tobit mixed models were fit to MMSE scores from each study separately. The effects of age, sex, and education were examined based on more than one centering point. Results: Findings were relatively consistent across studies. On average, MMSE scores were lower for older individuals and declined over time. Education predicted MMSE score, but, with two exceptions, was not associated with decline in MMSE over time. Conclusion: A straightforward association between educational attainment and rate of cognitive decline was not supported. Thoughtful consideration is needed when synthesizing evidence across studies, as methodologies adopted and sample characteristics, such as educational attainment, invariably differ.
Pronk, M. (2013). When your hearing fails you. Hearing loss determinants, psychosocial consequences, and possible interventions following screening in older adults. PhD Dissertation, VU University Amsterdam. > Full Text.
No abstract available.
Pronk, M., Deeg, D.J.H., Festen, J.M., Twisk, J.W.R., Smits, C., Comijs, H.C., Kramer, S.E. (2013). Decline in older persons ability to recognize speech in noise: The influence of demographic, health-related, environmental, and cognitive factors. Ear and Hearing, 34, 722-732. >Full Text.
No abstract available.
Pronk, M., Deeg, D.J.H., Kramer, S.E. (2013). Hearing status in older persons: A significant determinant of depression and loneliness? Results from the Longitudinal Aging Study Amsterdam. American Journal of Audiology, 22, 316-320. >Full Text.
Purpose: The aims were to 1) determine the longitudinal relationships between baseline hearing status and 4-year follow-up depression and loneliness in an older population, and to 2) investigate possible differences across subgroups in these relationships. Methods: We used data from two waves of the Longitudinal Aging Study Amsterdam (4y follow-up, baseline ages 63-93). Sample sizes were 996 (self-report analyses) and 830 (speech-in-noise test analyses). Multiple linear regression analyses were used to assess the associations between baseline hearing status and 4-year follow-up of depression, social loneliness, and emotional loneliness. Hearing was measured by self-report and by speech-innoise test. Age, gender, hearing aid use, baseline depression or loneliness, and relevant confounders and effect modifiers were incorporated. Results: Both hearing measures showed significant associations with loneliness (p<0.05), but these effects were confined to specific subgroups of older persons. For instance, adverse effects were confined to non-hearing aid users (self-report, social-loneliness model) and men (self-report and speech-in-noise test, emotional-loneliness model). No significant effects appeared for depression.Discussion: We found significant adverse effects of poor hearing on loneliness for specific subgroups of older persons. Future research should further examine the subgroup effects observed. Eventually, this may contribute to the development of tailored prevention programs.
Rijs, K.J., Comijs, H.C., Van den Kommer, T.N., Deeg, D.J.H. (2013). Do employed and not employed 55 to 64-year-olds' memory complaints relate to memory performance? A longitudinal cohort study. European Journal of Public Health, 23, 6, 1013-1020. >Full Text.
Background: Whether middle-aged individuals are capable of employment continuation may be limited by poor memory. Subjective memory complaints may be used to identify those at risk of poor memory. Research questions, therefore, were (i) are prevalent memory complaints associated with relevantly poor memory performance and decline in 55 to 64-year-olds; (ii) are incident memory complaints associated with relevant memory decline; and (iii) do these associations differ between employed and not employed individuals? Methods: Participants of the Longitudinal Aging Study Amsterdam (LASA) were examined. Data were weighted by sex, age and region. To examine the association of prevalent memory complaints with relevantly poor learning ability (n = 903) and delayed recall (n = 897; both assessed with the Auditory Verbal Learning Test), subnormal (&#8804;mean1 SD) and impaired (&#8804;mean1.5 SD) memory performance were defined. To examine the association of prevalent and incident memory complaints with relevant decline after 3 years in learning ability (n = 774 and 611, respectively) and delayed recall (n = 768 and 603, respectively), above normal (&#8804;) mean1 SD) and clinically relevant (&#8804;mean1.5 SD) memory decline were investigated. Logistic regression analyses were applied. Results: Adjusted for gender, education and age, individuals with memory complaints more often had impaired delayed recall and clinically relevant decline in learning ability. Incident memory complaints were borderline significantly associated with clinically relevant decline in learning in continuously employed individuals (paid job &#8805;1 h weekly), but not in continuously not employed individuals. Conclusion: Memory complaints may identify 55 to 64-year-olds at risk of memory impairment and decline. Our results provide hypotheses about the association between memory complaints and decline in employed 55 to 64-year-olds.
Robitaille, A., Piccinin, A.M., Muniz-Terrera, G., Hoffman, L., Johansson, B., Deeg, D.J.H., Aartsen, M.J., Comijs, H.C., Hofer, S.M. (2013). Longitudinal mediation of processing speed on age-related change in memory and fluid intelligence. Psychology and Aging, 28, 4, 887-901. >Full Text.
Age-related decline in processing speed has long been considered a key driver of cognitive aging. While the majority of empirical evidence for the processing speed hypothesis has been obtained from analyses of between-person age differences, longitudinal studies provide a direct test of within-person change. Using recent developments in longitudinal mediation analysis, we examine the speed-mediation hypothesis at both the within-and between-person levels in two longitudinal studies, Longitudinal Aging Study Amsterdam (LASA) and Origins of Variance in the Oldest-Old (OCTO-Twin). We found significant within-person indirect effects of change in age, such that increasing age was related to lower speed, which in turn relates to lower performance across repeated measures on other cognitive outcomes. Although between-person indirect effects were also significant in LASA, they were not in OCTO-Twin which is not unexpected given the age homogeneous nature of the OCTO-Twin data. A more in-depth examination through measures of effect size suggests that, for the LASA study, the within-person indirect effects were small and between-person indirect effects were consistently larger. These differing magnitudes of direct and indirect effects across levels demonstrate the importance of separating between- and within-person effects in evaluating theoretical models of age-related change.
Schilp, J. (2013). Undernutrition in community-dwelling older individuals. Recognition & treatment. PhD Dissertation, VU University Amsterdam.
No abstract available.
Schindhelm, R.K., Ten Boekel, E., Heima, N.E., Van Schoor , N.M., Simsek, S. (2013). Thyroid hormones and erythrocyte indices in a cohort of euthyroid older subjects. European Journal of Internal Medicine, 24 (3), 241-244. >Full Text.
Objectives: Hypothyroidism is associated with normocytic anaemia. Indeed, a limited number of studies have shown significant associations between free thyroxin (T4) and erythrocyte indices. These studies did not include vitamin B12, folic acid, iron and renal function in the analyses. We therefore studied the association between thyroid hormones and erythrocyte indices in a population-based cohort of older euthyroid subjects, with adjustment for major confounding parameters. Design: Data, including thyroid hormones and erythrocyte indices, are from the Longitudinal Aging Study Amsterdam (LASA), an ongoing cohort study on predictors and consequences of changes in health in the ageing population in the Netherlands. Multivariable linear regression analyses were applied to study the cross-sectional associations between free T4, thyroid stimulating hormone (TSH) and erythrocyte indices (haemoglobin content, haematocrit, mean cell volume (MCV) and erythrocyte count) in a euthyroid sub-sample. The final models were adjusted for vitamin B12, folic acid, iron levels and renal function. Results: In 708 euthyroid older subjects, an increase of 5pmol/L free T4 was associated with a mean increase of 0.12mmol/L or 0.19g/dL of haemoglobin, 0.068 10/L erythrocytes and 0.006L/L haematocrit (P=0.007, P=0.005, P=0.001, respectively). Free T4 was not significantly associated with MCV (P>0.05). TSH appeared not to be associated with any of the erythrocyte indices (all P>0.05). Conclusions: In a cohort of older subjects, free T4, but not TSH, was associated with erythrocyte indices, confirming the role of thyroid hormones in the regulation of erythropoiesis.
Schoenmakers, E (2013). Coping with loneliness. PhD Dissertation, VU University Amsterdam.
No abstract available.
Semeijn, E., Michielsen, M., Comijs, H.C., Deeg, D.J.H., Beekman, A.T.F., Kooij, J.J.S. (2013). Criterion validity of an Attention Deficit Hyperactivity Disorder (ADHD) screening list for screening ADHD in older adults aged 60-94 years. The American Journal of Geriatric Psychiatry, 21, 7, 631-635. >Full Text.
No abstract available.
Semeijn, E., Kooij, J.J.S., Comijs, H.C., Michielsen, M., Deeg, D.J.H., Beekman, A.T.F. (2013). Attention-Deficit/Hyperactivity Disorder, Physical Health, and Lifestyle in Older Adults. Journal of the American Geriatrics Society, 61, 882-887. >Full Text.
Objectives: To increase insight into the effect of attention-deficit/hyperactivity disorder (ADHD) on health in general in older adults. Design: Two-phase sampling side-study. Setting: Longitudinal Aging Study Amsterdam (LASA). Participants: Two hundred twenty-three randomly selected LASA respondents. Measurements: Information was collected during home visits on physical health, medication use, and lifestyle characteristics in Phase 1 and on ADHD diagnosis in Phase 2. The associations between independent variables and ADHD were examined with linear and logistic regression analyses. Results: The adjusted regression estimates of the linear regression analysis showed that the number of ADHD symptoms was positively associated with the presence of chronic nonspecific lung diseases (CNSLD) (B = 2.58, P = .02), cardiovascular diseases (B = 2.18, P = .02), and number of chronic diseases (B = 0.69, P = .04) and negatively associated with self-perceived health (B = -2.83, P = .002). Lifestyle is not a mediator of the association between ADHD and physical health. Conclusion: Attention-deficit/hyperactivity disorder in older adults was associated with chronic physical illness and poorer self-perceived health. Contrary to expectations, there were no associations between symptoms of ADHD and lifestyle variables.
Singh, G.M., Emerging Risk Factors Collaboration (2013). The age-specific quantitative effects of metabolic risk factors on cardiovascular diseases and diabetes: a pooled analysis. PLoS One, 30, 8 (7), e65174. >Full Text.
Background: The effects of systolic blood pressure (SBP), serum total cholesterol (TC), fasting plasma glucose (FPG), and body mass index (BMI) on the risk of cardiovascular diseases (CVD) have been established in epidemiological studies, but consistent estimates of effect sizes by age and sex are not available. Methods: We reviewed large cohort pooling projects, evaluating effects of baseline or usual exposure to metabolic risks on ischemic heart disease (IHD), hypertensive heart disease (HHD), stroke, diabetes, and, as relevant selected other CVDs, after adjusting for important confounders. We pooled all data to estimate relative risks (RRs) for each risk factor and examined effect modification by age or other factors, using random effects models. Results: Across all risk factors, an average of 123 cohorts provided data on 1.4 million individuals and 52,000 CVD events. Each metabolic risk factor was robustly related to CVD. At the baseline age of 55-64 years, the RR for 10 mmHg higher SBP was largest for HHD (2.16; 95% CI 2.09-2.24), followed by effects on both stroke subtypes (1.66; 1.39-1.98 for hemorrhagic stroke and 1.63; 1.57-1.69 for ischemic stroke). In the same age group, RRs for 1 mmol/L higher TC were 1.44 (1.29-1.61) for IHD and 1.20 (1.15-1.25) for ischemic stroke. The RRs for 5 kg/m(2) higher BMI for ages 55-64 ranged from 2.32 (2.04-2.63) for diabetes, to 1.44 (1.40-1.48) for IHD. For 1 mmol/L higher FPG, RRs in this age group were 1.18 (1.08-1.29) for IHD and 1.14 (1.01-1.29) for total stroke. For all risk factors, proportional effects declined with age, were generally consistent by sex, and differed by region in only a few age groups for certain risk factor-disease pairs. Conclusion: Our results provide robust, comparable and precise estimates of the effects of major metabolic risk factors on CVD and diabetes by age group.
Sohl, E., De Jongh, R.T., Heijboer, A.C., Swart, K.M.A., Brouwer-Brolsma, E.M., Enneman, A.W., De Groot, L.C.P.G.M., Van der Velde, N., Dhonukshe-Rutten, R.A.M., Lips, P.T.A., Van Schoor , N.M. (2013). Vitamin D status is associated with physical performance: the results of three independent cohorts. Osteoporos International, 24, 187-196. >Full Text.
No abstract available.
Sohl, E., Van Schoor , N.M., De Jongh, R.T., Visser, M., Deeg, D.J.H., Lips, P.T.A. (2013). Vitamin D status is associated with functional limitations and functional decline in older individuals. Journal of Clinical Endocrinology and Metabolism, 98, 9, E1483-E1490. >Full Text.
No abstract available.
Sonnenberg, C.M. (2013). Late life depression: Sex differences in clinical presentation and medication use. PhD Dissertation, VU University Amsterdam. > Full Text.
No abstract available.
Sonnenberg, C.M., Deeg, D.J.H., Van Tilburg, T.G., Vink, D., Stek, M.L., Beekman, A.T.F. (2013). Gender differences in the relation between depression and social support in later life. International Psychogeriatrics, 25 (1), 61-70. >Full Text.
No abstract available.
Suanet, B.A. (2013). Societal dynamics and older adults'social functioning. PhD Dissertation, VU University Amsterdam. > Full Text.
No abstract available.
Suanet, B.A., Van Tilburg, T.G., Broese van Groenou, M.I. (2013). Nonkin in older adults' personal networks: more important among later cohorts? Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 68, 4, 633-643. >Full Text.
Objectives: Research on age-related changes in personal networks has found compelling evidence for socioemotional selectivity theory and exchange theory holding that older adults experience a decline in less emotionally close nonkin relations as they age. However, recent societal developments are likely to have increased the salience of nonkin relations. We hypothesize that age-related decline in the proportion of nonkin in personal networks has been delayed or is slower in late birth cohorts of older adults compared with earlier cohorts. Method: Seven observations by the Longitudinal Aging Study Amsterdam covering a time span of 17 years since 1992 were analyzed using multilevel regression analysis. The sample had 12,949 person-year observations from 3,516 respondents born between 1908 and 1937. Results: Age-related decline in the proportion of nonkin is absent for cohorts born after 1922 and large for cohorts born in 1922 and before. Mediating variables for health and other resources did not explain cohort differences in agerelated change. Discussion: The salience of nonkin relationships is likely to have increased due to societal changes, resulting in absence or delay of decline in later cohorts. The findings raise the need for a reevaluation of old age and the creation of new theoretical perspectives.
Suanet, B.A., Van der Pas, S., Van Tilburg, T.G. (2013). Who is in the Stepfamily? Change in Stepparents' Family Boundaries Between 1992 and 2009. Journal of Marriage and Family, 75, 1070-1083. > Full Text.
Guided by trends of increased prevalence and social acceptance of stepfamilies, the authors argue that stepparents are more likely to include stepchildren in their personal network in recent times. Data are from observations by 2 studies: (a) the Living Arrangements and Social Networks of Older Adults Study and (b) the Longitudinal Aging Study Amsterdam in 1992-2009 of 247 Dutch stepparents age 54-91 years. The results revealed that in 1992, 63% of the stepparents had stepchildren in their personal network, and this percentage increased to 85% in 2009. The network membership of stepchildren was less likely for stepparents from living-apart-together partnerships. Stepmothers less often included stepchildren in their personal network than stepfathers. Both effects may be understood in terms of family commitment. Stepfamily boundaries have become more permeable over time, suggesting that there is an increased potential for support exchange and caregiving within stepfamilies.
Swart, K.M.A., Van Schoor , N.M., Heymans, M.W., Schaap, L.A., Den Heijer, M., Lips, P.T.A. (2013). Elevated homocysteine levels are associated with lod muscle strength and functional limitations in older persons. The Journal of Nutrition, Health & Aging, 17, 6, 578-584. >Full Text.
Objective: the current study aimed to examine homocysteine in relation to different aspects of physical functioning. Design, setting and participants: cross-sectional and longitudinal data (3-years follow-up)from the Longitudinal Aging Study Amsterdam (LASA) were used. the study was performed in persons aged &#8805; 65 years (N= 1301 after imputation). Measurements: different measures of physical functioning, including muscle mass, grip strength, functional limitations, and falling were regarded as outcomes. Gender and serum creatinine level were investigated as effect modifiers. Results: results were stratified by gender. in men, higher homocysteine levels were associated with lower grip strength (Quartile 4: regression coefficient (B)= -3.07 (-4.91; -1.22)), and more functional limitations at baseline (Quartile 4: B= 1.15 (0.16-2.14)). in women, higher homocysteine levels were associated with more functional limitations after 3 years (Quartile 4: B= 1.19 (0.25; 2.13)). higher homocysteine levels were not associated with low muscle mass or falling. Conclusions: these data suggest an inverse association of homocysteine levels with functional limitations in older men and women, and with muscle strength in older men.
Van Bunderen, C.C., Oosterwerff, M.M., Van Schoor , N.M., Deeg, D.J.H., Lips, P.T.A., Drent, M.L. (2013). Serum IGF1, metabolic syndrome, and incident cardiovascular disease in older people: a population-based study. European Journal of Endocrinology, 168, 393-401. >Full Text.
No abstract available.
van Campen, C., Iedema, J., Broese van Groenou, M.I., Deeg, D.J.H. (2013). Met zorg ouder worden. Zorgtrajecten van ouderen in tien jaar. > Full Text.
De komende jaren verandert er veel in de financiering en het aanbod van de langdurige zorg en ondersteuning. Deels door kabinetsbeleid, deels omdat de behoeften en leefsituatie van ouderen veranderen. Het is nog onduidelijk welke gevolgen dit heeft voor hulpbehoevende en kwetsbare ouderen. Zij gaan vaak van verschillende voorzieningen gebruikmaken naarmate ze ouder worden. Welke trajecten doorlopen ze feitelijk in het weidse landschap van medische zorg, informele zorg, mantelzorg, gemeentelijke ondersteuning, thuiszorg en tehuiszorg? Deze studie geeft een beeld van de zorg en ondersteuning die 65-plussers feitelijk ontvangen in een periode van tien jaar en onderscheidt vijf herkenbare patronen en profielen.
Van den Heuvel, E.G.H.M., Van Schoor , N.M., De Jongh, R.T., Visser, M., Lips, P.T.A. (2013). Cross-sectional study on different characteristics of physical activity as determinants of vitamin D status; inadequate in half of the population. European Journal of Clinical Nutrition, 67, 360-365. >Full Text.
BACKGROUND/OBJECTIVES: Physical activity (PA) may have an impact on vitamin D status. The aim of the present study is to assess the contribution of different characteristics of PA (duration, intensity as estimated by energy expenditure, location) to vitamin D status. SUBJECTS/METHODS: The study was conducted in 1255 community-dwelling older men and women of the Longitudinal Aging Study Amsterdam (LASA). Cross-sectional relationships between PA and serum 25-hydroxyvitamin D (25(OH)D) concentrations were examined. RESULTS: Total PA, both indoor and outdoor PA, expressed in kcal/d was positively associated with 25(OH)D in women (P<0.05) but not in men. The total time spent on these activities was not associated. As compared with the lowest tertile, both men and women in the highest tertile of cycling activity (&#8776; 6.4 min/d or 34.7 kcal/d) had a &#8805; 6 nmol/l higher 25(OH)D (P<0.05). For men and women in the highest tertile of gardening (&#8805; 8.6 min/d or 87.6 kcal/d), these levels were 14.2 nmol/l (P<0.001) and 5.8 nmol/l 25(OH)D (P<0.05), respectively. Walking showed no association. CONCLUSIONS: Daily time spent on total PA is often included when studying the association between sum of PA and 25(OH)D, while our study showed that energy expenditure might be a better unit. Individual types of outdoor PA with a high intensity, such as gardening and cycling, were associated with 25(OH)D.
Van den Kommer, T.N., Comijs, H.C., Aartsen, M.J., Huisman, M., Deeg, D.J.H., Beekman, A.T.F. (2013). Depression and Cognition: How Do They Interrelate in Old Age? The American Journal of Geriatric Psychiatry, 21, (4), 398-410. >Full Text.
Objectives: To disentangle the reciprocal effects between depressive symptoms and cognitive functioning over time and to study the association between changes in their trajectories using 13 years of follow-up. Design and Participants: Data were used from five waves of the population-based Longitudinal Aging Study Amsterdam. Subjects were included if data was present on depressive symptoms and cognitive performance on at least two occasions, which resulted in a study sample of N = 2,299. Measurements: Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale. Cognitive functioning was assessed using the Mini-Mental State Examination (general cognitive functioning) and timed coding task (speed of information processing). Results: Cross-domain latent change analyses showed that depression at baseline predicted both decline of general cognitive functioning and information processing speed, independent of relevant covariates. Conversely, information processing speed at baseline, but not general cognitive functioning was related to the course of depressive symptoms. The course of cognitive functioning was not significantly associated with the course of depressive symptoms. Conclusion: Depressive symptoms in older patients flag an increased likelihood of cognitive decline. This effect is considerable and may be due to several underlying mechanisms. The likelihood of the relationship reflecting either a causal effect of depression on cognitive decline, or a common cause, or both, should be estimated. Likewise, older persons with more limitations in information processing speed specifically are more vulnerable to increases in depression.
Van der Eerden, B.C.J., Oei, H.L.D.W., Roschger, P., Fratzl-Zelman, N., Hoenderop, J.G.J., Van Schoor , N.M., Pettersson-Kymmer, U., Schreuders-Koedam, M., Uitterlinden, A.G., Hofman, A., Suzuki, M., Klaushofer, K., Ohlsson, C., Lips, P.T.A., Rivadeneira, F.F., Bindels, R.J.M., Van Leeuwen, J.P.T.M. (2013). TRPV4 deficiency causes sexual dimorphism in bone metabolism and osteoporotic fracture risk. Bone, 57, 2, 443-454. >Full Text.
We explored the role of transient receptor potential vanilloid 4 (TRPV4) in murine bone metabolism and association of TRPV4 gene variants with fractures in humans. Urinary and histomorphometrical analyses demonstrated reduced osteoclast activity and numbers in male Trpv4(-/-) mice, which was confirmed in bone marrow-derived osteoclast cultures. Osteoblasts and bone formation as shown by serum procollagen type 1 amino-terminal propeptide and histomorphometry, including osteoid surface, osteoblast and osteocyte numbers were not affected in vivo. Nevertheless, osteoblast differentiation was enhanced in Trpv4(-/-) bone marrow cultures. Cortical and trabecular bone mass was 20% increased in male Trpv4(-/-) mice, compared to sex-matched wild type (Trpv4(+/+)) mice. However, at the same time intracortical porosity was increased and bone matrix mineralization was reduced. Together, these lead to a maximum load, stiffness and work to failure of the femoral bone, which were not different compared to Trpv4(+/+) mice, while the bone material was less resistant to stress and less elastic. The differential impacts on these determinants of bone strength were likely responsible for the lack of any changes in whole bone strength in the Trpv4(-/-) mice. None of these skeletal parameters were affected in female Trpv4(-/-) mice. The T-allele of rs1861809 SNP in the TRPV4 locus was associated with a 30% increased risk (95% CI: 1.1-1.6; p=0.013) for non-vertebral fracture risk in men, but not in women, in the Rotterdam Study. Meta-analyses with the population-based LASA study confirmed the association with non-vertebral fractures in men. This was lost when the non-population-based studies Mr. OS and UFO were included. In conclusion, TRPV4 is a male-specific regulator of bone metabolism, a determinant of bone strength, and a potential risk predictor for fractures through regulation of bone matrix mineralization and intra-cortical porosity. This identifies TRPV4 as a unique sexually dimorphic therapeutic and/or diagnostic candidate for osteoporosis.
Van der Pas, S., Castell, M.V., Cooper, C., Denkinger, M., Dennison, E.M., Edwards, M.H., Herbolsheimer, F., Limongi, F., Lips, P.T.A., Maggi, S., Nasell, H., Nikolaus, T., Otero, A., Pedersen, N.L., Peter, R., Sanchez-Martinez, M., Schaap, L.A., Zambon, S., Van Schoor , N.M., Deeg, D.J.H. (2013). European project on osteoarthritis: design of a six-cohort study on the personal and societal burden of osteoarthritis in an older European population. BMC Musculoskeletal Disorders, 14, 138. >Full Text.
No abstract available.
Van der Pas, S., Van Tilburg, T.G., Silverstein, M. (2013). Stepfamilies in Later Life. Journal of Marriage and Family, 75, 1065-1069 > Full Text.
No abstract available.
Van der Pas, S., Suanet, B.A. (2013). Families, van traditioneel naar samengesteld. Gern, Tijdschrift over ouder worden & samenleving, 15(3), 34-36.
No abstract available.
Van Gennip, I.E., Pasman, H.R.W., Kaspers, P.J., Oosterveld-Vlug, M.G., Willems, D.L., Deeg, D.J.H., Onwuteaka-Philipsen, B.D. (2013). Death with dignity from the perspective of the surviving family: a survey study among family caregivers of deceased older adults. Palliative Medicine, 27, 616-624. >Full Text.
Background: Death with dignity has been identified as important both to patients and their surviving family. While research results have been published on what patients themselves believe may affect the dignity of their deaths, little is known about what family caregivers consider to be a dignified death. Aim: (1) To assess the prevalence of death with dignity in older adults from the perspective of family caregivers, (2) to determine factors that diminish dignity during the dying phase according to family caregivers, and (3) to identify physical, psychosocial, and care factors associated with death with dignity. Design: A survey study with a self-administered questionnaire. Participants: Family caregivers of 163 deceased older (>55 years of age) adults (\"patients\") who had participated in the Longitudinal Aging Study Amsterdam. Results: Of the family caregivers, 69% reported that their relative had died with dignity. Factors associated with a dignified death in a multivariate regression model were patients feeling peaceful and ready to die, absence of anxiety and depressive mood, presence of fatigue, and a clear explanation by the physician of treatment options during the final months of life. Conclusions: The physical and psychosocial condition of the patient in combination with care factors contributed to death with dignity from the perspective of the family caregiver. The patient\'s state of mind during the last phase of life and clear communication on the part of the physician both seem to be of particular importance.
Van Leeuwen, D.M. (2013). Strength and voluntary activation in relation to functioning in patients with osteoarthritis. PhD Dissertation, VU University Amsterdam.
No abstract available.
Van Leeuwen, D.M., Peeters, G.M.E.E., De Ruiter, C.J., Lips, P.T.A., Twisk, J.W.R., Deeg, D.J.H., De Haan, A. (2013). Effects of self-reported osteoarthritis on physical performance: a longitudinal study with a 10-year follow-up. Aging Clinical and Experimental Research, 25, 561-569. >Full Text.
Background and aims: Osteoarthritis (OA) of the knee or hip is associated with limitations in activities of daily life. There are only a few long-term studies on how knee or hip OA affects the course of physical performance. The aim of this study was to investigate the effects of knee or hip OA on physical performance during a follow-up period of 10 years. Methods: Participants in the Longitudinal Aging Study Amsterdam with self-reported hip or knee OA (N = 155) were prospectively followed for 10 years on 4 occasions from the onset of OA and compared to participants without OA (N = 1004). Physical performance was tested with walk, chair stand and balance tests. Scores for each test were summed to a total performance score (range 0-12), higher scores indicating better performance. Generalized estimating equations were used to analyze differences between participants with and without OA, unadjusted as well as adjusted for confounders. Results: There was a significant interaction between OA and sex (P = 0.068). Both in men and women, total performance was lower for participants with OA, with greater differences in men. Chair stand and walking performance (P < 0.05), but not balance, were lower in participants with OA. After adjustment for confounders, these associations remained significant in men but not in women. Additional analyses correcting for follow-up duration and attrition showed lower performance scores for men and women with OA. Conclusions: OA negatively affected physical performance 3-6 years after it was first reported. Performance in men with OA was more affected than in women.
Van Nes, F., Jonsson, H., Abma, T., Deeg, D.J.H. (2013). Changing everyday activities of couples in late life: Converging and keeping up. Journal of Aging Studies, 27, 82-91. >Full Text.
The influence of mutual spousal interrelations in domains such as health and wellbeing has been demonstrated, but little is known about the domain of everyday activities of couples in late life. In the present explorative study, we considered all of the activities participating couples talked about to be their everyday activities. Its aim was to understand, over time, changes in everyday activities as experienced by late-life community-dwelling couples. In a two-year period, 41 individual and joint interviews were conducted with 8 couples, who were purposefully selected from the Longitudinal Aging Study Amsterdam. Analyses involved the construction of couple narratives and constant comparisons within and across couples. Changing everyday activities in late-life couples was interpreted to be a two-way process of (1) converging, and (2) keeping up, which occurred in three fluid phases. Converging was a slow inward movement with a shift towards diminished everyday activities performed in a smaller world. Keeping up was an outward movement in order to resist the converging process by using everyday activities as a means to keep fit, physically and mentally, and to connect with the wider social world. In the first phase, couples maintained their unique linked activity pattern. In the second phase, spouses resisted converging by keeping up. In the third phase, spouses co-performed everyday activities closely together. The findings support the need to develop couple-oriented interventions that aim to enhance the couples\' functioning in the domain of everyday activities.
Van Nes, F. (2013). Everyday activities of ageing couples: changes in the face of declining health. PhD Dissertation, VU University Amsterdam. > Full Text.
No abstract available.
Van Tilburg, T.G., Broese van Groenou, M.I. (2013). Netwerken en gezondheid. In B. Vlker, H. Flap & G. Mollenhorst (Red.), Sociale netwerken (pp. 139-151). Groningen: Noordhoff. ISBN 978-90-01-80995-9.
No abstract available.
Visser, M., Koster, A. (2013). Development of a questionnaire to assess sedentary time in older persons - a comparative study using accelerometry. BioMed Central Geriatrics, 13, 80. >Full Text.
Background: There is currently no validated questionnaire available to assess total sedentary time in older adults. Most studies only used TV viewing time as an indicator of sedentary time. The first aim of our study was to investigate the self-reported time spent by older persons on a set of sedentary activities, and to compare this with objective sedentary time measured by accelerometry. The second aim was to determine what set of self-reported sedentary activities should be used to validly rank people&#39;s total sedentary time. Finally we tested the reliability of our newly developed questionnaire using the best performing set of sedentary activities. Methods: The study sample included 83 men and women aged 65-92 y, a random sample of Longitudinal Aging Study Amsterdam participants, who completed a questionnaire including ten sedentary activities and wore an Actigraph GT3X accelerometer for 8 days. Spearman correlation coefficients were calculated to examine the association between self-reported time and objective sedentary time. The test-retest reliability was calculated using the intraclass correlation coefficient (ICC). Results: Mean total self-reported sedentary time was 10.4 (SD 3.5) h/d and was not significantly different from mean total objective sedentary time (10.2 (1.2) h/d, p&#8201;=&#8201;0.63). Total self-reported sedentary time on an average day (sum of ten activities) correlated moderately (Spearman&#3;s r&#8201;=&#8201;0.35, p&#8201;<&#8201;0.01) with total objective sedentary time. The correlation improved when using the sum of six activities (r&#8201;=&#8201;0.46, p&#8201;<&#8201;0.01), and was much higher than when using TV watching only (r&#8201;=&#8201;0.22, p&#8201;=&#8201;0.05). The test-retest reliability of the sum of six sedentary activities was 0.71 (95% CI 0.57-0.81). Conclusions: A questionnaire including six sedentary activities was moderately associated with accelerometry-derived sedentary time and can be used to reliably rank sedentary time in older persons.
Vogel, N., Schilling, O.K., Wahl, H-W., Beekman, A.T.F., Penninx, B.W.J.H. (2013). Time-to-death-related change in positive and negative affect among older adults approaching the end of life. Psychology and Aging, 28 (1), 128-141. >Full Text.
No abstract available.
Wirtz, F., Aartsen, M.J., Visser, M., Deeg, D.J.H. (2013). Sport en eenzaamheid. Individuele en groepssport en de relatie met emotionele en sociale eenzaamheid bij ouderen (LASA-rapport 2012). > Full Text.
No abstract available.
Wouterse, B., Huisman, M., Meijboom, B.R., Deeg, D.J.H., Polder, J.J. (2013). Modeling the relationship between health and health care expenditures using a latent Markov model. Journal of Health Economics, 32, 423-439. >Full Text.
We investigate the dynamic relationship between several dimensions of health and health care expenditures for older individuals. Health data from the Longitudinal Aging Survey Amsterdam is combined with data on hospital and long term care use. We estimate a latent variable based jointly on observed health indicators and expenditures. Annual transition probabilities between states of the latent variable are estimated using a Markov model. States associated with good current health and low annual health care expenditures are not associated with lower cumulative health care expenditures over remaining lifetime. We conclude that, although the direct health care cost saving effect is limited, the considerable gain in healthy lifeyears can make investing in the improvement of health of the older population worthwhile.
Wouterse, B. (2013). Economic consequences of healthy aging. PhD Dissertation, Tilburg University.
No abstract available.

2012

Aartsen, M.J., Comijs, H.C. (2012). Alcohol consumption and depressive symptoms among older adults: Results of the Longitudinal Aging Study Amsterdam. Tijdschrift voor Gerontologie en Geriatrie, 43, 127-136. > Full Text.
The aim of this research is to investigate the often assumed relation between alcohol use and depressive symptoms among older men and women. For this study, a subsample of 2,119 participants of the Longitudinal Aging Study Amsterdam, aged 65 to 85 years at baseline, was followed over time and visited in their homes in 1992, 1995, 1998 and 2002. Depressive symptoms are assessed with the Centre for Epidemiologic Studies Depression Scale (CES-D). Alcohol use is measured with questions about the frequency and quantities of alcohol use. A relation between depressive symptoms and alcohol use could not be demonstraded in a population based sample of older drinkers. Only older heavily drinking men with higher levels of depressive symptoms, higher levels of anxiety, and more chronic diseases at baseline significantly reduced the number of glasses consumed per week from 26 to 14 in the ten years of follow-up. Heavily drinking women do not reduce the level of alcohol intake during follow-up. Public prevention strategies are needed to make older heavy drinking women and men who are still in relatively good health aware of the potential risks of excessive alcohol use.
Braam, A.W., Klinkenberg, M., Galenkamp, H., Deeg, D.J.H. (2012). Late-Life Depressive Symptoms, Religiousness, and Mood in the Last Week of Life. Depression Research and Treatment, article ID 754031, 1-10. >Full Text.
Aim of the current study is to examine whether previous depressive symptoms modify possible effects of religiousness on mood in the last week of life. After-death interviews with proxy respondents of deceased sample members of the Longitudinal Aging Study Amsterdam provided information on depressed mood in the last week of life, as well as on the presence of a sense of peace with the approaching end of life. Other characteristics were derived from interviews with the sample members when still alive. Significant interactions were identified between measures of religiousness and previous depressive symptoms (CES-D scores)in their associations with mood in the last week of life. Among those with previous depressive symptoms, church-membership, church-attendance and salience of religion were associated with a greater likelihood of depressed mood in the last week of life. Among those without previous depressive symptoms, church-attendance and salience of religion were associated with a higher likelihood of a sense of peace. For older adults in the last phase of life, supportive effects of religiousness weremore or less expected. Fore those with recent depressive symptoms, however, religiousness might involve a component of existential doubt.
Broese van Groenou, M.I., Van Tilburg, T.G. (2012). Six-year follow-up on volunteering in later life: a cohort comparison in the Netherlands. European Sociological Review, 28, 1, 1-11. >Full Text.
No abstract available.
Buiting, H.M., Deeg, D.J.H., Knol, D.L., Ziegelmann, J.P., Pasman, H.R.W., Widdershoven, G.A.M., Onwuteaka-Philipsen, B.D. (2012). Older peoples' attitudes towards euthanasia and an end-of-life pill in The Netherlands: 2001-2009. Journal of Medical Ethics, 38, 267-273. >Full Text.
Introduction: With an ageing population, end-of-life care is increasing in importance. The present work investigated characteristics and time trends of older peoples&#39;attitudes towards euthanasia and an end-of-life pill. Methods: Three samples aged 64 years or older from the Longitudinal Ageing Study Amsterdam (N&#61;1284 (2001), N&#61;1303 (2005) and N&#61;1245 (2008)) were studied. Respondents were asked whether they could imagine requesting their physician to end their life (euthanasia), or imagine asking for a pill to end their life if they became tired of living in the absence of a severe disease (end-of-life pill). Using logistic multivariable techniques, changes of attitudes over time and their association with demographic and health characteristics were assessed. Results The proportion of respondents with a positive attitude somewhat increased over time, but significantly only among the 64e74 age group. For euthanasia, these percentages were 58% (2001), 64% (2005) and 70% (2008) (OR of most recent versus earliest period (95% CI): 1.30 (1.17 to 1.44)). For an end-of-life pill, these percentages were 31% (2001), 33% (2005) and 45% (2008) (OR (95% CI): 1.37 (1.23 to 1.52)). For the end-of-life pill, interaction between the most recent time period and age group was significant. Conclusions: An increasing proportion of older people reported that they could imagine desiring euthanasia or an end-of-life pill. This may imply an increased interest in deciding about your own life and stresses the importance to take older peoples&#39; wishes seriously.
Comijs, H.C., Aartsen, M.J., Visser, M., Deeg, D.J.H. (2012). Alcohol consumption among persons aged 55+ in the Netherlands. Tijdschrift voor Gerontologie en Geriatrie, 43, 115-126. > Full Text.
In the Netherlands no detailed information about alcohol consumption among older persons (55 years and older) is available. Therefore we investigated the prevalence and determinants of alcohol consumption with data from the Longitudinal Aging Study Amsterdam. The results show that 13.4% of persons of 55 years and older are heavy drinkers (male > 3 glasses per day, female > 2 glasses per day). Most heavy drinkers are younger than 75 years of age, and in this age group more female (22.2%) than male (14.8%) are heavy drinkers. 13% of all participants frequently drinks 6 or more glasses in a short period of time (binge drinking). In the age group of 55-65 years alcohol consumption has considerably increased over a period of ten years. This increase is stronger among females than among males. When people grow older alcohol consumption decreases, which seems associated with a decline in physical or psychological health and/or cognitive decline. Heavy and binge drinking is associated with younger age, higher education and income, and may be strongly related to their social lifes.
De Hollander, E.L., Bemelmans, W.J.E., Boshuizen, H.C., Friedrich, N., Wallaschofski, H., Guallar-Castilln, P., Walter, S., Zillikens, M.C., Rosengren, A., Lissner, L., Bassett, J.K., Giles, G.G., Orsini, N., Heim, N., Visser, M., De Groot, L.C.P.G.M. (2012). The association between waist circumference and risk of mortality considering body mass index in 65- to 74-year-olds: a meta-analysis of 29 cohorts involving more than 58 000 elderly persons. International Journal of Epidemiology, 41, 805-817. >Full Text.
No abstract available.
Deeg, D.J.H. (2012). Veroudering en ouderenzorg. In M. Adriaansen, P. Hermsen, R. van der Sande (ed.), Langdurige zorg themas en perspectieven, pp 133-155. Deventer: Van Tricht uitgeverij.
No abstract available.
Emerging Risk Factors Collaboration (2012). Adult height and the risk of cause-specific death and vascular morbidity in 1 million people: individual participant meta-analysis. International Journal of Epidemiology, 41, 1419-1433. >Full Text.
No abstract available.
Estrada, K., GEFOS/GENOMOS consortium (2012). Genome-wide meta-analysis identifies 56 bone mineral density loci and reveals 14 loci associated with risk of fracture. Nature Genetics, 44, 5, 491-501. >Full Text.
No abstract available.
Galenkamp, H., Huisman, M., Braam, A.W., Deeg, D.J.H. (2012). Estimates of prospective change in self-rated health in older people were biased owing to potential recalibration response shift. Journal of Clinical Epidemiology, 65, 978-988. >Full Text.
No abstract available.
Geurts, T., Poortman, A., Van Tilburg, T.G. (2012). Older parents providing child care for adult children: Does it pay off? Journal of Marriage and Family, 74, 239-250. >Full Text.
No abstract available.
Geurts, T., Van Tilburg, T.G., Poortman, A. (2012). The grandparent-grandchild relationship in childhood and adulthood: A matter of continuation? Personal Relationships, 19, 267-278. >Full Text.
No abstract available.
Geurts, T. (2012). Grandparent-grandchild relationships in the Netherlands: a dynamic and multigenerational perspective. PhD Dissertation, VU University Amsterdam.
No abstract available.
Heima, N.E., Eekhoff, E.M.W., Oosterwerff, M.M., Lips, P.T.A., Van Schoor , N.M., Simsek, S. (2012). Thyroid function and the metabolic syndrome in older persons: a population-based study. European Journal of Endocrinology, 168, 1, 59-65. >Full Text.
Background: Studies suggest an association between a high TSH and (individual components of) the metabolic syndrome. Only a few studies have been performed in the general older population. Objective: This study investigates the association between serum TSH and the metabolic syndrome in a representative sample of older persons in The Netherlands. Design and Patients: Data of the Longitudinal Aging Study Amsterdam were used, which is an ongoing cohort study in a representative sample of Dutch older persons. A total of 1187 subjects (590 men and 597 women) between the ages of 65 and 88 years participated in the study. Measurements: Metabolic syndrome (US National Cholesterol Education Program definition) and its individual components were assessed, as well as serum TSH levels. Results: Among the participants, the prevalence of the metabolic syndrome was 34.2%. The mean serum TSH was 1.9&#8202;mU/l. Subjects in the upper quartile with a serum TSH level above 2.28&#8202;mU/l (odds ratio (OR)=1.68; 95% confidence interval (CI) 1.19-2.37) had a significantly increased prevalence of metabolic syndrome compared with subjects in the lowest quartile with a serum TSH below 1.04&#8202;mU/l. After adjustment for confounders, age, sex, alcohol use, total physical activity, and smoking, the OR was 1.62 (95% CI 1.15-2.32). Conclusions: Subjects with a serum TSH in the upper quartile have a higher prevalence of metabolic syndrome as compared with subjects with a serum TSH in the lowest quartile.
Hilderink, P.H., Burger, H., Deeg, D.J.H., Beekman, A.T.F., Oude Voshaar, R.C. (2012). The temporal relation between pain and depression: results from the longitudinal aging study Amsterdam. Psychosom Med., 74, 9, 945-951. >Full Text.
OBJECTIVE: Pain and depression are both common in old age, but their (long-term) temporal relationship remains unknown. This study is designed to determine whether pain predicts the onset of depression and vice versa. METHODS: This is a prospective, population-based cohort study with 12-year follow-up and 3-year intervals in the Netherlands (Longitudinal Aging Study Amsterdam). At baseline, participants were aged 55 to 85 years (n = 2028). Main measurements outcomes were incident depression defined as crossing the cutoff of 16 and showing a relevant change (&#8805; 5 points) on the Center for Epidemiological Studies-Depression Scale among nondepressed participants and incident pain defined as a score of 2 or higher on the pain scale of the 5-item Nottingham Health Profile in pain-free participants. Multiple imputations were adopted to estimate missing values. RESULTS: In nondepressed participants (n = 1769), a higher level of pain was predictive of incident depression in multiple extended Cox regression analyses (hazard rate [HR] = 1.13 [95% confidence interval {CI}: 1.05-1.22], p = .001), which all remained significant after correction for sociodemographic characteristics, life-style characteristics, functional limitations, and chronic diseases (HR = 1.09 [95% CI = 1.01-1.18], p = .035). In the pain-free participants (n = 1420), depressive symptoms at baseline predicted incident pain (HR = 1.02 [95% CI: 1.01-1.04], p = .006). This depression measure did not independently predicted the onset of pain in the fully adjusted models. CONCLUSIONS: As pain precedes the onset of depression, strategies to prevent depression in chronic pain patients are warranted. In contrast, no effects of depression on the development of subsequent pain were found when adjusting for covariates.
Hoeymans, N., Wong, A., Van Gool, C.H., Deeg, D.J.H., Nusselder, W., De Klerk, M.M.Y., Van Boxtel, M.P.J., Picavet, H.S.J. (2012). The disabling effect of diseases: A study on trends in diseases, activity limitations, and their interrelationships. American Journal of Public Health, 102, 163-170. >Full Text.
Objectives: Data from the Netherlands indicate a recent increase in prevalence of chronic diseases and a stable prevalence of disability, suggesting that diseases have become less disabling. We studied the association between chronic diseases and activity limitations in the Netherlands from 1990 to 2008. Methods: Five surveys among noninstitutionalized persons aged 55 to 84 years (n=54847) obtained self-reported data on chronic diseases (diabetes, heart disease, peripheral arterial disease, stroke, lung disease, joint disease, back problems, and cancer) and activity limitations (Organisation for Economic Cooperation and Development [OECD] long-term disability questionnaire or 36-item Short Form Health Survey [SF-36]). Results: Prevalence rates of chronic diseases increased over time, whereas prevalence rates of activity limitations were stable (OECD) or slightly decreased (SF-36). Associations between chronic diseases and activity limitations were also stable (OECD) or slightly decreased (SF-36). Surveys varied widely with regard to disease and limitation prevalence rates and the associations between them. Conclusions: The hypothesis that diseases became less disabling from 1990 to 2008 was only supported by results based on activity limitation data as assessed with the SF-36. Further research on how diseases and disability are associated over time is needed.
Koeneman, M.A., Chinapaw, M.J.M, Verheijden, M.W., Van Tilburg, T.G., Visser, M., Deeg, D.J.H., Hopman-Rock, M. (2012). Do major life events influence physical activity among older adults: the Longitudinal Aging Study Amsterdam. International of Behavioral Nutrition and Physical Activity, 9, 147 > Full Text.
No abstract available.
Kremers, S.P.J., De Bruijn, G.J., Visscher, T.L.S., Deeg, D.J.H., Thomése, G.C.F., Visser, M., Van Mechelen, W., Brug, J. (2012). Associations between Safety from Crime, Cycling, and Obesity in a Dutch Elderly Population: Results from the Longitudinal Aging Study Amsterdam. Journal of Environmental and Public Health,article ID 127857, 1-6. >Full Text.
No abstract available.
Michielsen, M., Semeijn, E., Comijs, H.C., Beekman, A.T.F., Deeg, D.J.H., Kooij, J.J.S. (2012). Prevalence of attention-deficit hyperactivity disorder in older adults in The Netherlands. The British Journal of Psychiatry, 201, 298-305. >Full Text.
No abstract available.
Pijpers, E., Ferreira, I., De Jongh, R.T., Deeg, D.J.H., Lips, P.T.A., Stehouwer, C.D.A., Nieuwenhuijzen Kruseman, A.C. (2012). Older individuals with diabetes have an increased risk of recurrent falls: analysis of potential mediating factors: the Longitudinal Ageing Study Amsterdam Age and Ageing, 41, 358-365. >Full Text.
No abstract available.
Plaisier, I., Broese van Groenou, M.I., Deeg, D.J.H. (2012). Kwetsbare ouderen: Zorg of geen zorg? (LASA-rapport 2011). > Full Text.
No abstract available.
Prina, A.M., Deeg, D.J.H., Brayne, C., Beekman, A.T.F., Huisman, M. (2012). The association between depressive symptoms and non-psychiatric hospitalisation in older adults. Journal PLoS ONE, 7, 4, e34821. >Full Text.
No abstract available.
Pronk, M., Deeg, D.J.H., Smits, C., Van Tilburg, T.G., Kuik, D.J., Festen, J.M., Kramer, S.E. (2012). Een slechter gehoor leit tot meer eenzaamheid, maar niet bij alle ouderen. Tijdschrift voor Gerontologie en Geriatrie, 43, 103-104. > Full Text.
No abstract available.
Rijs, K.J., Cozijnsen, M.R., Deeg, D.J.H. (2012). The effect of retirement and age at retirement on self-perceived health after three years of follow-up in Dutch 55-64-years-olds. Ageing & Society, 32, 281-306. >Full Text.
No abstract available.
Sanders, J.B., Bremmer, M.A., Deeg, D.J.H., Beekman, A.T.F. (2012). Do depressive symptoms and gait speed impairment predict each other's incidence? a 16-year prospective study in the community. Journal of the American Geriatrics Society, 60, 1673-1680. >Full Text.
Objectives: To investigate whether gait speed predicts incident depressive symptoms and whether depressive symptoms predict incident gait speed impairment; to ascertain the presence of shared risk factors for these associations. Design: The Longitudinal Aging Study Amsterdam, a prospective cohort study with five follow-up cycles over 16 years. Setting: Population based. Participants: One thousand nine hundred twentyeight respondents for incident depressive symptoms (mean age 68.9 &#177 8.5) and 1,855 respondents for incident gait speed impairment (mean age 68.0 &#177 8.2). Measurements: Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale; gait speed was measured, back and forth, during a 3-m walk as quickly as possible, with a 180&#186 turn. Multivariate analyses were performed for both sexes using Cox regression. Results: Incident depressive symptoms occurred in 24% of respondents. In univariate analyses, gait speed at baseline predicted incident depressive symptoms in men and women; after adjustment for covariates, this association persisted in men only. Examining the reverse association, 34% of respondents developed gait speed impairment. Depressive symptoms at baseline were univariately associated with incident gait speed impairment in women but not in men; this association did not persist after adjustment. The bidirectional associations did not share the same explanatory variables. Conclusion: Gait speed predicts depressive symptoms in men. The geriatric giants of depressive symptoms and slowed gait speed in late life appear to result from different pathologies, both of which therefore require their own treatment strategies.
Sant, N., Aartsen, M.J. (2012). Lights Later, twenty years of research into aging. Geron,Tijdschrift over ouder worden & samenleving 2, 59-61.
Vanwege het twintigjarig bestaan van de Longitudinal Aging Study Amsterdam (LASA) vond op 10 november 2011 de LASA-publieksdag \\\"Licht op Later\\\" plaats. Tijdens deze dag deelde LASA-onderzoekers hun kennis met het grote publiek. De dag was allereerst bedoeld voor ouderen die van heinde en ver kwamen aangestroomd, waaronder vertegenwoordigers van ouderenorganisaties en ouderen die participeren in het Nationaal Programma Ouderenzorg (ZonMw), maar professionals, beleidsmedewerkers en andere belangstellenden waren aanwezig. Een dag met interessante inzichten en inspirerende uitwisselingen.
Schilp, J., Kruizenga, H.M., Wijnhoven, H.A.H., Leistra, E., Evers, A.M., Van Binsbergen, J.J., Deeg, D.J.H., Visser, M. (2012). High prevalence of undernutrition in Dutch community-dwelling older individuals. Nutrition, 28 (11-12), 1151-1156. >Full Text.
Objective: To examine the prevalence of undernutrition in community-dwelling older individuals (&#8805;65 y) using data from various settings. Methods: A cross-sectional observational study was performed to examine the prevalence of undernutrition in three samples (all &#8805;65 y): 1) 1267 community-dwelling individuals participating in a large prospective population-based study, the Longitudinal Aging Study Amsterdam (LASA) in 1998/99; 2) 814 patients receiving home care in 2009/10; and 3) 1878 patients from general practices during the annual influenza vaccination in 2009/10. Undernutrition was assessed by the Short Nutritional Assessment Questionnaire 65+. Results: Mean age was 77.3 y (SD 6.7) in the LASA sample, 81.6 y (SD 7.4) in the home care sample, and 75.3 y (SD 6.5) in the general practice sample. The prevalence of undernutrition was highest in the home care sample (35%), followed by the general practice (12%) and LASA (11%) samples. The prevalence of undernutrition increased significantly with age in the general practice and LASA samples. Gender differences were observed in the general practice and home care samples; women were more likely to be undernourished in the general practice sample and men were more likely to be undernourished in the home care sample. Conclusion: The prevalence of undernutrition in Dutch community-dwelling older individuals was relatively high, especially in home care patients.
Schoenmakers, E, Van Tilburg, T.G., Fokkema, C.M. (2012). Coping with loneliness: What do older adults suggest? Aging & Mental Health, 16, 3, 353-360. >Full Text.
No abstract available.
Simón-Sánchez, J., Dopper, E.G.P., Cohn-Hokke, P.E., Hukema, R.K., Nicolaou, N., Seelaar, H., De Graaf, J.R.A., De Koning, I., Van Schoor , N.M., Deeg, D.J.H. (2012). The clinical and pathological phenotype of C9ORF72 hexanucleotide repeat expansions. Brain. A Journal of Neurology, 135, 723-735. >Full Text.
No abstract available.
Sohl, E., Van Schoor , N.M., De Jongh, R.T., De Vries, O.J., Lips, P.T.A. (2012). The impact of medication on vitamin D status in older individuals. European Journal of Endocrinology, 166, 477-485. >Full Text.
Objective: Vitamin D deficiency and polypharmacy are common in the elderly. However, knowledge on the associations between the use of specific medicines and serum 25-hydroxyvitamin D (25(OH)D) is limited. The aim of this study was to (better) define the associations between the use of specific medicines and serum 25(OH)D. Methods: Two different cohorts (1995/1996 and 2002/2003) from the Longitudinal Aging Study Amsterdam (LASA) were used for cross-sectional analyses. LASA is based on an age and sex-stratified random sample of the Dutch older population. Study participants were aged 65-88 years in the first cohort (n = 1301) and 55-65 years in the second cohort (n = 736). Serum 25(OH)D of users of several groups of medicines were compared with levels of non-users using multiple linear regression analysis. Results: Of all participants, 75.4% (first cohort) and 61.1% (second cohort) were using at least one medicine. In both cohorts, the number of medicines was associated with lower serum 25(OH)D. In the first cohort, after adjustment for confounding, users of any kind of medicine, loop diuretics and inhaled corticosteroids (only men) had respectively 4.4 nmol/l (P<0.01), 4.7 nmol/l (P = 0.04) and 7.3 nmol/l (P = 0.02) lower serum 25(OH)D than non-users. In the second cohort, the use of oral antidiabetics, calcium-channel blockers and angiotensin-converting enzyme inhibitors was associated with respectively 7.4 nmol/l (P = 0.04), 7.7 nmol/l (P = 0.01) and 7.6 nmol/l (P<0.01) lower serum 25(OH)D. Conclusions: These data show that users of several medicines have lower serum 25(OH)D than non-users. Vitamin D supplementation may be considered in patients with chronic use of medicines.
Sonnenberg, C.M., Bierman, E.J.M., Deeg, D.J.H., Comijs, H.C., Van Tilburg, W., Beekman, A.T.F. (2012). Ten-year trends in benzodiazepine use in the Dutch population. Social Psychiatry & Psychiatric Epidemiology, 47, 293-301. >Full Text.
No abstract available.
Sourial, N., Bergman, H., Karunananthan, S., Wolfson, C., Guralnik, J.M., Payette, H., Gutierrez-Robledo, L., Deeg, D.J.H., Fletcher, J.D., Puts, M.T.E., Zhu, B., Bland, F. (2012). Contribution of frailty markers in explaining differences among individuals in five samples of older persons. Journal of Gerontology: Medical Sciences, 67 (11), 1197-1204. >Full Text.
Background: There has been little research on the relative importance of frailty markers. The objective was to investigate the association among seven frailty domains (nutrition, physical activity, mobility, strength, energy, cognition, and mood) and their relative contribution in explaining differences among individuals in five samples of older persons. Methods: Data from five studies of aging were analyzed using multiple correspondence analysis. Aggregation of frailty markers was evaluated using graphical output. Decomposition of variability was used to assess the relative contribution of each marker in each sample. Results were combined across the samples to assess the average contribution. Results: Frailty markers were found to consistently aggregate in each sample, suggesting a possible underlying construct. Physical strength had the highest contribution on average in explaining differences among individuals. Mobility and energy also had large contributions. Nutrition and cognition had the smallest contributions. Conclusions: Our results provide further evidence supporting the notion that frailty domains may belong to a common construct. Physical strength may be the most important discriminating characteristic.
Stevens, N.L., Van Tilburg, T.G. (2012). Vriendschap wordt belangrijker. In T. Verlaan & M. de Coole (Red.), Ouder worden in de 21e eeuw (pp. 91-97). Amsterdam: SWP. [Herdruk van: Gern, Tijdschrift over ouder worden en maatschappij, 12 (3), 4-7.] ISBN 9789088502842
Het sociale leven van oudere volwassenen is gedurende de laatste twee decennia behoorlijk veranderd als gevolg van maatschappelijke ontwikkelingen. Onderliggende processen bij deze veranderingen zijn individualisering en het loslaten van tradities. Er is meer persoonlijke vrijheid in de keuze van leefstijl en identiteit, en grotere persoonlijke verantwoordelijkheid voor het ontwikkelen en in stand houden van een persoonlijk netwerk van sociale relaties.
Suanet, B.A., Broese van Groenou, M.I., Van Tilburg, T.G. (2012). Informal and formal home care use among older adults in Europe: Can cross-national differences be explained by societal context and composition? Ageing and Society, 32, 491-515. >Full Text.
Cross-national comparisons used welfare state regimes to explain differences in care use in the European older population, yet these classifications do not cover all care-related societal characteristics and limit our understanding of which specific societal characteristics are most important. This study explores to the familialistic culture, welfare state context, and socio-economic and demographic composition add to our understanding of informal and formal care use of older adults in 11 European countries. Using the Survey of Ageing, Health and Retirement (2006), multilevel logistic regression analyses show that, in addition to individual determinants, societal determinants are salient for understanding informal and formal care use. In countries with a less familialistic culture, a high availability of home based services, a larger proportion of women in part-time work and a smaller proportion of 65 years and older in the population, older adults are more likely to receive formal home care, particularly when they have functional limitations. In countries with more residential care, more spending in pensions, more women in part-time employment and a more aged population, older adults with functional limitations are less likely to receive informal care. We can tentatively conclude that the incorporation of societal determinants rather than commonly used welfare state classifications yields more insight in factors that determine older adults informal and formal care use.
Swart, K.M.A., Van Schoor , N.M., Blom, H.J., Smulders, Y., Lips, P.T.A. (2012). Homocysteine and the risk of nursing home admission and mortality in older persons. European Journal of Clinical Nutrition, 66, 188-195. >Full Text.
No abstract available.
Van den Kommer, T.N., Dik, M.G., Comijs, H.C., Lutjohann, D., Lips, P.T.A., Jonker, C., Deeg, D.J.H. (2012). The role of extracerebral cholesterol homeostasis and ApoE e4 in cognitive decline. Neurobiology of Aging, 33, 622.e17-622.e28. >Full Text.
We examined the associations between extracerebral markers of cholesterol homeostasis and cognitive decline over 6 years of follow-up, and studied the modifying effect of apolipoprotein E (ApoE) e4. Data were collected in the Longitudinal Aging Study Amsterdam (n = 967, with longitudinal data on cognition, ages &#8805; 65 years) and analyzed using linear mixed models. General cognition (Mini-Mental State Examination; MMSE), memory (Auditory Verbal Learning Test), and information processing speed (Coding task) were measured. The results show that ApoE e4 was a significant effect modifier. Significant associations were found only in ApoE e4 noncarriers (n = 718). We found a nonlinear negative association between the ratio of lanosterol to cholesterol (&#8804; 189.96 ng/mg), a marker for cholesterol synthesis, and general cognition. Lower cholesterol absorption, i.e., lower ratios of campesterol and sitosterol to cholesterol, as well as a higher rate of cholesterol synthesis relative to absorption were associated with lower information processing speed. In ApoE e4 carriers, the negative association between the ratio of campesterol to cholesterol and memory reached borderline significance. Future research should focus on the interaction between (disturbed) cholesterol homeostasis and ApoE e4 status with respect to dementia.
Van den Kommer, T.N., Dik, M.G., Comijs, H.C., Jonker, C., Deeg, D.J.H. (2012). The role of lipoproteins and inflammation in cognitive decline: Do they interact? Neurobiology of Aging, 33, 196.e1-196.e12. >Full Text.
The aim of this study was to examine the associations between high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triglycerides, and cognition and focus on the modifying effect of inflammation. Data were collected in the population-based Longitudinal Aging Study Amsterdam and analyzed with mixed linear models. The sample comprised 1003 persons  65 years with cognitive data on at least 2 occasions over 6 years of follow-up. Cognition was measured with the Mini-Mental State Examination (general cognition), Auditory Verbal Learning Test (memory), and Coding Task (information processing speed). We found an independent association between high HDL cholesterol and better memory performance. In addition, low LDL cholesterol was predictive of worse general cognitive performance and faster decline on information processing speed. Furthermore, a significant modifying effect of inflammation (C-reactive protein, -antichymotrypsin) was found. A negative additive effect of low LDL cholesterol and high inflammation was found on general cognition and memory performance. Also, high triglycerides were associated with lower memory performance in those with high inflammation. Thus, a combination of these factors may be used as markers of prolonged lower cognitive functioning.
Van Schoor , N.M., Swart, K.M.A., Pluijm, S.M.F., Visser, M., Simsek, S., Smulders, Y., Lips, P.T.A. (2012). Cross-sectional and longitudinal association between homocysteine, vitamin B12 and physical performance in older persons. European Journal of Clinical Nutrition, 66, 174-181. >Full Text.
No abstract available.
Van Schoor , N.M., De Jongh, R.T., Daniels, J.M., Heymans, M.W., Deeg, D.J.H., Lips, P.T.A. (2012). Peak expiratory flow rate shows a gender-specific association with vitamin d deficiency. Journal Clinical of Endocrinology Metabolism, 97, 6, 2164-2171. > Full Text.
Context: To our knowledge, no previous studies examined the longitudinal relationship between vitamin D status and pulmonary function in a population-based sample of older persons. Objective: Our objective was to examine the cross-sectional as well as the longitudinal relationship between vitamin D status and peak expiratory flow rate (PEFR) in a representative sample of the Dutch older population. Design, Setting, and Participants: Participants included men and women in the Longitudinal Aging Study Amsterdam, an ongoing cohort study in older people. Main Outcome Measure: PEFR was measured using the mini-Wright peak flow meter. Results: Men with serum 25-hydroxyvitamin D (25-OHD) levels below 10 ng/ml (25 nmol/liter) had a significantly lower PEFR in the cross-sectional analyses, and men with serum 25-OHD levels below 20 ng/ml (50 nmol/liter) had a significantly lower PEFR in the longitudinal analyses as compared with men with serum 25-OHD levels above 30 ng/ml (75 nmol/liter) (cross-sectional: &#946; = -47.0, P = 0.01 for serum 25-OHD <10 ng/ml; longitudinal: &#946; = -45.0, P < 0.01 for serum 25-OHD <10 ng/ml; and &#946; = -20.2, P = 0.03 for serum 25-OHD = 10-20 ng/ml in the fully adjusted models). Physical performance (&#946; = -32.5, P = 0.08 for serum 25-OHD <10 ng/ml) and grip strength (&#946; = -40.0, P = 0.03 for serum 25-OHD <10 ng/ml) partly mediated the cross-sectional associations but not the longitudinal associations. In women, statistically significant associations between 25-OHD and PEFR were observed in the cross-sectional analyses after adjustment for age and season of blood collection but not in the fully adjusted models or in the longitudinal analyses. Conclusions: A strong relationship between serum 25-OHD and PEFR was observed in older men, both in the cross-sectional as well as longitudinal analyses, but not in older women. The association in men could partly be explained by physical performance and muscle strength.
Visser, M., Dijkstra, S. C. (2012). Naar verklaringen voor het eetgedrag van ouderen (LASA-rapport 2011). > Full Text.
No abstract available.
Wijnhoven, H.A.H., Snijder, M.B., Van Bokhorst-de van der Schueren, M.A.E., Deeg, D.J.H., Visser, M. (2012). Region-specific fat mass and muscle mass and mortality in community-dwelling older men and women. Gerontology, 58, 32-40. >Full Text.
No abstract available.
Wijnhoven, H.A.H., Schilp, J., Van Bokhorst-de van der Schueren, M.A.E., De Vet, H.C.W., Kruizenga, H.M., Deeg, D.J.H., Ferruci, L., Visser, M. (2012). Development and validation of criteria for determining undernutrition in community-dwelling older men and women: The Short Nutritional Assessment Questionnaire 65+ Clinical Nutrition, 31, 351-358. >Full Text.
No abstract available.

2011

Alma, M.A., Van der Mei, S.F., Feitsma, W.N., Groothoff, J.W., Van Tilburg, T.G., Suurmeijer, T.P.B.M. (2011). Loneliness and self-management abilities in the visually impaired elderly. Journal of Aging and Health, 23 (5), 843-861. >Full Text.
Objectives: To describe the degree of loneliness among the visually impaired elderly and to make a comparison with a matched reference group of the normally sighted elderly. In addition, we examined self-management abilities (SMAs) as determinants of loneliness among the visually impaired elderly. Method: In a cross-sectional study, 173 visually impaired elderly persons completed telephone interviews. Loneliness and SMAs were assessed with the Loneliness Scale of De Jong Gierveld and the SMAS-30, respectively. Results: The prevalence of loneliness among the visually impaired elderly was higher compared with the reference group (50% vs. 29%; p < .001). Multivariate hierarchical regression analysis showed that the SMA self-efficacy, partner status, and self-esteem were determinants of loneliness. Severity and duration of visual impairment had no effect on loneliness. Discussion: The relationship between SMAs (i.e., self-efficacy) and loneliness is promising, as SMAs can be learned through training. Consequently, self-management training may reduce feelings of loneliness.
Alma, M.A., Van der Mei, S.F., Melis-Dankers, B.J.M., Van Tilburg, T.G., Groothoff, J.W., Suurmeijer, T.P.B.M. (2011). Participation of the elderly after vision loss. Disability and Rehabilitation, 33 (1), 63-72. >Full Text.
Purpose: To assess the degree of participation of the visually impaired elderly and to make a comparison with population-based reference data. Method: This cross-sectional study included visually impaired elderly persons (&#8805;55 years; n=173) who were referred to a low-vision rehabilitation centre. Based on the International Classification of Functioning, Disability and Health (ICF) participation in: 1) domestic life, 2) interpersonal interactions and relationships, 3) major life areas, and 4) community, social and civic life was assessed by means of telephone interviews. In addition, we assessed perceived participation restrictions. Results: Comparison with reference data of the elderly showed that visually impaired elderly persons participated less in heavy household activities, recreational activities and sports activities. No differences were found for the interpersonal interactions and relationships domain. Participants experienced restrictions in household activities (84%), socializing (53%), paid or voluntary work (92%), and leisure activities (88%). Conclusions: Visually impaired elderly persons participate in society, but they participate less than their peers. They experience restrictions as a result of vision loss. These findings are relevant, since participation is an indicator for successful aging and has a positive influence on health and subjective well-being.
Boumans, J., Deeg, D.J.H. (2011). Changes in the quality of life of older people living at home: does type of care play a role? Tijdschrift voor Gerontologie en Geriatrie, 42, 170-183. > Full Text.
Purpose: To determine whether a change in physical, psychological and social dimensions of quality of life of older people living at home is associated with receiving formal care, compared to informal care and no care. Method: Data from the observation cycles in 1998 and 2001 of the Longitudinal Aging Study Amsterdam (LASA) were used. Older people receiving formal homecare in 1998 were compared to older people receiving informal care and to older people receiving no care at all in 1998 on subjective scores on 3-year changes in self-perceived health, loneliness, positive affect and satisfaction with life. The data were analysed using linear regression analysis and ANOVA. Results: In all groups there is a change for the worse between 1998 and 2001 in the four aspects of quality of life. Self-perceived health declines significantly more in the group receiving formal care compared to the group without care, but this is explained by a higher score on functional limitations in 1998. Loneliness increases significantly more in the group receiving formal care, even after correction for confounders. In the group receiving formal care the satisfaction with life decreases significantly more compared to the group receiving no care and the group with informal care. An interaction effect with gender was found, showing that after correction for confounders this difference is maintained for the women but not for the men. There is no significant difference between the three care groups regarding changes in positive affect. Conclusion: Older men and women who receive formal home care experience an increase in loneliness, and older women who receive formal care experience less satisfaction with life, compared to women who receive informal care or no care. Future research should confirm these results and investigate the mechanisms underlying these changes.
Braam, A.W., Klinkenberg, M., Deeg, D.J.H. (2011). Religiousness and mood in the last week of life: an explorative approach based on after-death proxy interviews. Journal of Palliative Medicine, 14 (1), 31-37. >Full Text.
No abstract available.
Broese van Groenou, M.I. (2011). Samen zorgen voor ouderen. Tijdschrift voor Gerontologie en Geriatrie, 42, 156-158. > Full Text.
No abstract available.
Comijs, H.C., Van den Kommer, T.N., Minnaar, R.W.M., Penninx, B.W.J.H., Deeg, D.J.H. (2011). Accumulated and differential effects of life events on cognitive decline in older persons: depending on depression, baseline cognition, or ApoE ε4 status? The Journals of Gerontology, Series B: Psychological Sciences and Social Scienses, 66B (S1), i111-i120. >Full Text.
Objectives: The study examined the accumulated as well as the differential influence of negative life events on cognitive decline in older persons, and whether this association was different for persons with normal and poor cognitive functioning, and for ApoE &#949;4 carriers and noncarriers. Methods: We used data from the Longitudinal Aging Study Amsterdam (N = 1,356). Data were analyzed using linear mixed models. Results: We found differential associations for different negative life events with cognitive decline none of which were mediated by depressive symptoms. The death of a child or grandchild, which may be considered a highly stressful event, was associated to a higher rate of cognitive decline, whereas more chronic stressors, such as the illness of a partner or relative, or serious conflicts, were associated with better cognitive function. The associations between life events and cognitive function were stronger in ApoE &#1013;4 carriers compared with noncarriers, suggesting that this gene plays a role in the association between stress and cognitive function. Discussion: Highly stressful events seem to be associated with a higher rate of cognitive decline, whereas mild chronic stressors may have an arousing function that stimulates cognitive performance.
Cooper, R., Huisman, M., Kuh, D., Deeg, D.J.H. (2011). Do positive psychological characteristics modify the associations of physical performance with functional decline and institutionalization? Findings from the Longitudinal Aging Study Amsterdam. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 66 (4), 468-477. >Full Text.
No abstract available.
De Jongh, R.T., Lips, P.T.A., Rijs, K.J., Van Schoor , N.M., Kramer, M.H.H., Vandenbroucke, J.P., Dekkers, O.M. (2011). Associations between vitamin D receptor genotypes and mortality in a cohort of older Dutch individuals. European Journal of Endocrinology, 164, 75-82. >Full Text.
CONTEXT: Vitamin D receptor (VDR) polymorphisms are associated with a variety of diseases, which may translate into an effect on mortality. OBJECTIVE: To investigate the associations between VDR gene variants and mortality among older people. DESIGN: The analyses were conducted in a population-based, prospective cohort of the Longitudinal Aging Study Amsterdam. Adequate DNA analysis was performed in 923 men and women (&#8805;65 years). We aimed to assess the associations between mortality and the VDR polymorphism FokI, three haplotypes of the Cdx2 and GATA polymorphisms, and three haplotypes of the BsmI, ApaI, and TaqI polymorphisms. RESULTS: During the median follow-up of 10.7 years, 480 participants deceased (51%). Homozygosity for the Cdx2-GATA haplotype 1 allele was associated with a 30% higher mortality risk compared to the absence of alleles (hazard ratios (HR) 1.30, 95% confidence intervals (CI) 1.01-1.68). Adjustment for cardiovascular risk factors and 25-hydroxyvitamin D levels did not affect this HR. The number of copies of the Cdx2-GATA haplotype 1 allele was associated, although not significantly, with an increased risk of osteoporotic fractures (0 copies=reference, HR, 95% CI: 1 copy 2.01, 0.99-4.07 and 2 copies 1.81, 0.87-4.18). After adjustment for osteoporotic fractures, homozygosity for the Cdx2-GATA haplotype 1 allele was no longer associated with higher mortality risk (HR 1.08, 95% CI 0.83-1.41). CONCLUSIONS: The Cdx2-GATA haplotype 1 allele was related to increased mortality risk, which may be partly explained by osteoporotic fractures. As the biological mechanism is uncertain and this study size is limited, our results should be interpreted as hypothesis generating.
De Jongh, R.T., Lips, P.T.A., Van Schoor , N.M., Rijs, K.J., Deeg, D.J.H., Comijs, H.C., Kramer, M.H.H., Vandenbroucke, J.P., Dekkers, O.M. (2011). Endogenous subclinical thyroid disorders, physical and cognitive function, depression, and mortality in older individuals. European Journal of Endocrinology, 165, 545-554. >Full Text.
No abstract available.
Galenkamp, H., Braam, A.W., Huisman, M., Deeg, D.J.H. (2011). Somatic multimorbidity and self-rated health in the older population. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 66 (3), 380-386. >Full Text.
No abstract available.
Gerritsen, L., Comijs, H.C., Deeg, D.J.H., Penninx, B.W.J.H., Geerlings, M.I. (2011). Salivary cortisol, APOE-ε4 allele and cognitive decline in a prospective study of older persons. Neurobiology of Aging, 32, 9, 1615-1625. >Full Text.
No abstract available.
Heim, N., Snijder, M.B., Heymans, M.W., Deeg, D.J.H., Seidell, J.C., Visser, M. (2011). Optimal cutoff values for high-risk waist circumference in older adults based on related health outcomes. American Journal of Epidemiology, 174 (4), 479-489. >Full Text.
No abstract available.
Heim, N. (2011). Obesity in old age. Criteria and consequences. PhD Dissertation, VU University Amsterdam.
No abstract available.
Huisman, M., Poppelaars, J.L., Van der Horst, M.H.L., Beekman, A.T.F., Brug, J., Van Tilburg, T.G., Deeg, D.J.H. (2011). Cohort Profile: The Longitudinal Aging Study Amsterdam. International Journal of Epidemiology, 40, 868-876. >Full Text.
No abstract available.
Huisman, M., Visser, M. (2011). Rookgedrag onder ouderen (LASA-rapport 2010). > Full Text.
No abstract available.
Kriebitzsch, C., Verlinden, L., Eelen, G., Van Schoor , N.M., Swart, K.M.A., Lips, P.T.A., Meyer, M.B., Pike, J.W., Boonen, S., Carlberg, C., Vitvitsky, V., Bouillon, R., Banerjee, R., Verstuyf, A. (2011). 1,25-Dihydroxyvitamin D3 influences cellular homocysteine levels in murine preosteoblastic MC3T3-E1 cells by direct regulation of cystathionine b-Synthase. Journal of Bone and Mineral Research, 26, 12, 2991-3000. >Full Text.
High homocysteine (HCY) levels are a risk factor for osteoporotic fracture. Furthermore, bone quality and strength are compromised by elevated HCY owing to its negative impact on collagen maturation. HCY is cleared by cystathionine b-synthase (CBS), the first enzyme in the transsulfuration pathway. CBS converts HCY to cystathionine, thereby committing it to cysteine synthesis. A microarray experiment on MC3T3-E1 murine preosteoblasts treated with 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] revealed a cluster of genes including the cbs gene, of which the transcription was rapidly and strongly induced by 1,25(OH)2D3. Quantitative real-time PCR and Western blot analysis confirmed higher levels of cbs mRNA and protein after 1,25(OH)2D3 treatment in murine and human cells. Moreover, measurement of CBS enzyme activity and quantitative measurements of HCY, cystathionine, and cysteine concentrations were consistent with elevated transsulfuration activity in 1,25(OH)2D3-treated cells. The importance of a functional vitamin D receptor (VDR) for transcriptional regulation of cbs was shown in primary murine VDR knockout osteoblasts, in which upregulation of cbs in response to 1,25(OH)2D3 was abolished. Chromatin immunoprecipitation on chip and transfection studies revealed a functional vitamin D response element in the second intron of cbs. To further explore the potential clinical relevance of our ex vivo findings, human data from the Longitudinal Aging Study Amsterdam suggested a correlation between vitamin D status [25(OH)D3 levels] and HCY levels. In conclusion, this study showed that cbs is a primary 1,25(OH)2D3 target gene which renders HCY metabolism responsive to 1,25(OH)2D3.
Oosterwerff, M.M., Eekhoff, E.M.W., Heymans, M.W., Lips, P.T.A., Van Schoor , N.M. (2011). Serum 25-hydroxyvitamin D levels and the metabolic syndrome in older persons: a population-based study. Clinical Endocrinology, 75, 5, 608-613. >Full Text.
No abstract available.
Op den Velde, W., Deeg, D.J.H., Hovens, J.E., Van Duijn, M.A.J., Aarts, P.G.H. (2011). War stress and late-life mortality in world war II male civilian resistance veterans. Psychological Reports, 108,2, 437-448. >Full Text.
The mental and physical health of 146 Dutch males exposed to severe war stress during their young adulthood were examined in 1986-1987 when they were at ages 61 to 66 years. The veterans\\\'data were compared with a randomly selected population-based sample of same-aged males. In 2005, 70% of the war stress veterans had died, and only 35% of the comparison group. The baseline quality of life was significantly poorer in the war stress veterans than in the comparison group. Baseline variables explained 42% of the increased risk of mortality among war stress veterans. Smoking was the largest single contributor to mortality.
Peeters, G.M.E.E., Elders, P.J.M., Lips, P.T.A., Deeg, D.J.H. (2011). Quick estimation of the risk of recurrent falls in the elderly. Huisarts en Wetenschap, 54 (4), 186-191. > Full Text.
Background: Thirty percent of people aged 65 years or older fall at least once a year, and about a quarter seek medical attention. Existing falls risk profiles are too complex for daily use. We describe a falls decision tree consisting of three simple questions that provides a quick indication of the risk of recurrent falls in older people who have recently fallen down Methods: We investigated simple, easy to measure predictors of repeated falls in 408 community-dwelling older people (65+ years) who had consulted a GP or gone to an accident and emergency (A&E) department after falling down. These predictors were then used to develop a falls decision tree, to indicate when a new fall can be expected. The decision tree was validated in a second sample of patients. Results: Three predictors, namely, falls history, fear of falling, and use of a walking aid, in combination provided an adequate indication of the risk of a new fall. The risk of a new fall was 9% if none of the predictors was present and 42% if all three predictors were present. If high falls risk was defined as a higher than 30% risk of new falls, then 80% of the participants in the development sample and 70% of the participants in the validation sample were correctly classified as having a high falls risk. Conclusion: The falls decision tree is a simple tool for use in GP surgeries or in A&E departments to assess the risk of a new fall in older individuals who have recently fallen down.
Plaisier, I., Van Tilburg, T.G., Deeg, D.J.H. (2011). Mogelijkheden voor preventie van AWBZ-gebruik: netwerken van zelfstandig wonende ouderen (LASA-rapport 2010). > Full Text.
No abstract available.
Portrait, F.R.M., Teeuwiszen, E., Deeg, D.J.H. (2011). Early life undernutrition and chronic diseases at older ages: The effects of the Dutch famine on cardiovascular diseases and diabetes. Social Science & Medicine, 73, 711-718. >Full Text.
No abstract available.
Pronk, M., Deeg, D.J.H., Smits, C., Van Tilburg, T.G., Kuik, D.J., Festen, J.M., Kramer, S.E. (2011). Prospective effects of hearing status on loneliness and depression in older persons: Identification of subgroups. International Journal of Audiology, 50, 887-896. >Full Text.
No abstract available.
Rabelink, N.M., Peeters, G.M.E.E., Van Schoor , N.M., Drent, M.L., Lips, P.T.A. (2011). Self-reported loss of consciousness after head trauma does not predispose to hypopituitarism in an older population. Journal of Head Trauma Rehabilitation, 26, 1, 90-97. >Full Text.
Objective: This population study examines the prevalence of hypopituitarism and low bone mineral density (BMD) in older persons reporting loss of consciousness after head trauma (HT). Methods: Data from the Longitudinal Aging Study Amsterdam were used pertaining to 630 women (53 HT) and 533 men (63 HT). Subjects were asked whether they had ever had an HT with loss of consciousness. Linear regression analysis (adjusted for age, body mass index, chronic diseases, smoking, alcohol use, and gender) was performed to examine the association between HT and serum anteriory pituitary hormone levels, BMD, and quantative ultrasound measurements. Results: Serum follicle stimulating hormone was significantly higher in males in the HT group (P = .05) than in the non-HT group. This difference was not found in women (P = .25). No other differences were observed in serum hormone levels between subjects with and without HT (P > .30). Also, no significant differences between the HT and non-HT group were found in BMD and quantitative ultrasound measurements. Conclusion: A self-reported history of HT with loss of consciousness does not seem to increase the risk of hypopituitarism and lower BMD in an aging population.
Rurup, M.L., Pasman, H.R.W., Kerkhof, A.J.F.M., Deeg, D.J.H., Onwuteaka-Philipsen, B.D. (2011). Older people who are 'weary of life' their expectations for the future and perceived hopelessness Tijdschrift voor Gerontologie en Geriatrie, 42, 159-169. > Full Text.
There has been a debate for over a decade in the Netherlands about whether physicians should be allowed to provide assistance with suicide to older people who are &#39;weary of life&#39;. Actual knowledge about these older people is missing in this debate. The purpose of this article is to explore and discuss the expectations older people who are &#39;weary of life&#39; have of their future, and to what extent they perceive their suffering as hopeless. In this qualitative study, 31 older people who were &#39;weary of life&#39; were interviewed The results of this study show that most respondents who were &#39;weary of life&#39; did not plan to end their life within a short time frame. The burden to their loved ones played a large role in their decision in addition to the awareness of still having reasons to live. Most respondents tried not to think too much about the future, and hoped death would come soon. Most respondents could not name a condition that would diminish their wish to die, that they also found desirable and feasible. The results of this study suggest that people who develop thoughts about death do so when they give up finding solutions to improve their situation.
Rurup, M.L., Deeg, D.J.H., Poppelaars, J.L., Kerkhof, A.J.F.M., Onwuteaka-Philipsen, B.D. (2011). Wishes to Die in Older People. A Quantitative Study of Prevalence and Associated Factors. Crisis, 32(4), 194-203. >Full Text.
No abstract available.
Rurup, M.L., Pasman, H.R.W., Goedhart, J., Deeg, D.J.H., Kerkhof, A.J.F.M., Onwuteaka-Philipsen, B.D. (2011). Understanding Why Older People Develop a Wish to Die. A Qualitative Interview Study. Crisis, 32(4), 204-216. >Full Text.
No abstract available.
Sanders, J.B., Bremmer, M.A., Comijs, H.C., Deeg, D.J.H., Lampe, I.K., Beekman, A.T.F. (2011). Cognitive functioning and the natural course of depressive symptoms in late life. American Journal of Geriatric Psychiatry, 19, 664-672. >Full Text.
No abstract available.
Schaap, L.A., Peeters, G.M.E.E., Dennison, E.M., Zambon, S., Nikolaus, T., Sanchez-Martinez, M., Musacchio, E., Van Schoor , N.M., Deeg, D.J.H. (2011). European Project on OSteoArthritis (EPOSA): methodological challenges in harmonization of existing data from five European population-based cohorts on aging. BMC Musculoskelet Disorders, 12, 272 >Full Text.
No abstract available.
Schilp, J., Wijnhoven, H.A.H., Deeg, D.J.H., Visser, M. (2011). Early determinants for the development of undernutrition in an older general population: Longitudinal Aging Study Amsterdam. British Journal of Nutrition, 106, 708-717. >Full Text.
No abstract available.
Stevens, N.L., Van Tilburg, T.G. (2011). Cohort differences in having and retaining friends in personal networks in later life. Journal of Social and Personal Relationships, 28 (1), 24-43. >Full Text.
No abstract available.
Tolkacheva, N. (2011). Sharing the care of older parents. PhD Dissertation, VU University Amsterdam.
No abstract available.
Van den Kommer, T.N. (2011). Cognitive decline in late-life: biological markers and early identification of persons at risk for dementia. PhD Dissertation, VU University Amsterdam.
No abstract available.
Van Gool, C.H., Picavet, H.S.J., Deeg, D.J.H., De Klerk, M.M.Y., Nusselder, W., Van Boxtel, M.P.J., Wong, A., Hoeymans, N. (2011). Trends in activity limitations: the Dutch older population between 1990 and 2007. International Journal of Epidemiology, 40, 1056-1067. >Full Text.
No abstract available.
Van Nimwegen, M., Speelman, A.D., Hofman-van Rossum, E.J.M., Overeem, S., Deeg, D.J.H., Borm, G.F., Van der Horst, M.H.L., Bloem, B.R., Munneke, M. (2011). Physical inactivity in Parkinson's disease. Journal of Neurology, 258, 2214-2221. >Full Text.
Patients with Parkinson&#39;s disease (PD) are likely to become physically inactive, because of their motor, mental, and emotional symptoms. However, specific studies on physical activity in PD are scarce, and results are conflicting. Here, we quantified daily physical activities in a large cohort of PD patients and another large cohort of matched controls. Moreover, we investigated the influence of disease-related factors on daily physical activities in PD patients. Daily physical activity data of PD patients (n = 699) were collected in the ParkinsonNet trial and of controls (n = 1,959) in the Longitudinal Aging Study Amsterdam (LASA); data were determined using the LAPAQ, a validated physical activity questionnaire. In addition, variables that may affect daily physical activities in PD were recorded, including motor symptoms, depression, disability in daily life, and comorbidity. Patients were physically less active; a reduction of 29% compared to controls (95% CI, 10-44%). Multivariate regression analyses demonstrated that greater disease severity, gait impairment, and greater disability in daily living were associated with less daily physical activity in PD (R2 = 24%). In this large study, we show that PD patients are about one-third less active compared to controls. While disease severity, gait, and disability in daily living predicted part of the inactivity, a portion of the variance remained unexplained, suggesting that additional determinants may also affect daily physical activities in PD. Because physical inactivity has many adverse consequences, work is needed to develop safe and enjoyable exercise programs for patients with PD.
Visser, M., Schaap, L.A. (2011). Consequences of sarcopenia. Clinics in Geriatric Medicine, 27 (3), 387-399. >Full Text.
No abstract available.
Visser, M., Dijkstra, S. C. (2011). Eetgedrag onder ouderen (LASA-rapport 2010). > Full Text.
No abstract available.
Zhang, B., Fokkema, M., Cuijpers, P., Li, J., Smits, N., Beekman, A.T.F. (2011). Measurement invariance of the center for epidemiological studies depression scale (CES-D) among chinese and dutch elderly. BMC Medical Research Methodology, 11, 74. > Full Text.
Background: Although previous studies using non- elderly groups have assessed the factorial invariance of the Center for Epidemiological Studies Depression Scale (CES-D) across different groups with the same social-cultural backgrounds, few studies have tested the factorial invariance of the CES-D across two elderly groups from countries with different social cultures. The purposes of this study were to examine the factorial structure of the CES-D, and test its measurement invariance across two different national elderly populations. Methods: A total of 6806 elderly adults from China (n = 4903) and the Netherlands (n = 1903) were included in the final sample. The CES-D was assessed in both samples. Three strategies were used in the data analysis procedure. First, a confirmatory factor analysis (CFA) was carried out to determine the factor structures of the CES-D that best fitted the two samples. Second, the best fitting model was incorporated into a multi-group CFA model to test measurement invariance of the CES-D across the two population groups. Third, latent mean differences between the two groups were tested. Results: The results of confirmatory factor analysis (CFA) showed: 1) in both samples, Radloff\'s four-factor model resulted in a significantly better fit and the four dimensions (somatic complaints, depressed affect, positive affect, and interpersonal problems) of the CES-D seem to be the most informative in assessing depressive symptoms compared to the single-, three-, and the second-order factor models; and 2) the factorial structure was invariant across the populations under study. However, only partial scalar and uniqueness invariance of the CES-D items was supported. Latent means in the partial invariant model were lower for the Dutch sample, compared to the Chinese sample. Conclusions: Our findings provide evidence of a valid factorial structure of the CES-D that could be applied to elderly populations from both China and the Netherlands, producing a meaningful comparison of total scores between the two elderly groups. However, for some specific factors and items, caution is required when comparing the depressive symptoms between Chinese and Dutch elderly groups.

2010

Bath, P.A., Deeg, D.J.H., Poppelaars, J.L. (2010). The harmonisation of longitudinal data: a case study using data from cohort studies in The Netherlands and the United Kingdom. Ageing & Society, 30, 1419-1437. >Full Text.
No abstract available.
Braam, A.W., Noort, A., Schaap-Jonker, J., Deeg, D.J.H. (2010). Godsbeeld en depressie bij ouderen in Sassenheim: een detailverkenning naar schuldgevoelens. Psyche & Geloof, 21, 4, 263-274.
No abstract available.
Braam, A.W., Beekman, A.T.F., Dewey, M.E., Delespaul, P., Fichter, M., Lobo, A., Magnsson, H., Prs, K., Reischies, F.M., Roelands, M., Saz, P., Schoevers, R.A., Skoog, I., Copeland, J.R.M. (2010). Depression and parkinsonism in older Europeans: results from the EURODEP concerted action. International Journal of Geriatric Psychiatry, 25, 679-687. >Full Text.
No abstract available.
Broese van Groenou, M.I., Deeg, D.J.H. (2010). Formal and informal social participation of the 'young-old' in The Netherlands in 1992 and 2002. Ageing & Society, 30, 445-465. >Full Text.
The study compares the formal and informal social participation of 60-69 year olds in The Netherlands in 1992 and 2002, and examines which attributes of the two cohorts favour social participation. Using data from the Longitudinal Aging Study Amsterdam, it was found that cohort differences in formal participation (as members of organisations, in volunteer work and in religious organisations) and in informal participation (having a large social network, and in cultural and recreational activities) associated with cohort differences in individual characteristics (level of education, health, employment status and marital status). Descriptive analyses showed an increase between 1992 and 2002 in all forms of participation except religious involvement. The 2002 cohort members were more educated and more engaged in employment, but in worse health and had a higher prevalence of divorce than the 1992 cohort members. Logistic regression analyses showed that the positive effect on social participation of the recent cohort&#39;s higher educational level was suppressed by the negative effect of their worse health. Being divorced had mixed effects on formal and informal participation, but the difference in the number of divorcees did not explain cohort differences in social participation. Interaction effects showed that the influence of sex and health on volunteer work and religious involvement changed over time. The paper concludes with a discussion of the prospects for higher levels of formal and informal social participation among future cohorts of young-older people.
Comijs, H.C., Gerritsen, L., Penninx, B.W.J.H., Bremmer, M.A., Deeg, D.J.H., Geerlings, M.I. (2010). The association between serum cortisol and cognitive decline in older persons. American Journal of Geriatric Psychiatry, 18, 42-50. >Full Text.
No abstract available.
Comijs, H.C. (2010). Alcoholgebruik onder ouderen (LASA-rapport 2009). > Full Text.
No abstract available.
Cozijnsen, M.R., Stevens, N.L., Van Tilburg, T.G. (2010). Maintaining work-related personal ties following retirement. Personal Relationships, 17, 345-356. >Full Text.
No abstract available.
Deeg, D.J.H. (2010). De opkomst van de kwetsbare oudere-over ambivalente gezondheidstrends en mogelijke verklaringen. In J.P. Mackenbach (ed.), Trends in volksgezondheid en gezondheidszorg. Liber amicorum voor prof. dr. Paul van der Maas (pp. 45-63). Amsterdam: Elsevier gezondheidszorg. ISBN 978.90.352.31016.
No abstract available.
Deeg, D.J.H., Huisman, M. (2010). Cohort differences in 3-year adaptation to health problems among Dutch middle-aged, 1992-1995 and 2002-2005. European Journal of Ageing, 7, 157-165. >Full Text.
No abstract available.
Deeg, D.J.H. (2010). Empowerment (LASA-rapport 2009). > Full Text.
No abstract available.
Gerritsen, L., Geerlings, M.I., Beekman, A.T.F., Deeg, D.J.H., Penninx, B.W.J.H., Comijs, H.C. (2010). Early and late life events and salivary cortisol in older persons. Psychological Medicine, 40 (9), 1569-1578. >Full Text.
No abstract available.
Gerritsen, L. (2010). Stress, the brain and cognition. PhD Dissertation, Utrecht University.
No abstract available.
Guiaux, M. (2010). Social adjustment to widowhood changes in personal relationships and loneliness before and after partner loss. PhD Dissertation, VU University Amsterdam.
No abstract available.
Heim, N., Snijder, M.B., Heymans, M.W., Deeg, D.J.H., Seidell, J.C., Visser, M. (2010). Exploring cut-off values for large waist circumference in older adults: a new methodological approach. The Journal of Nutrition, Health & Aging, 14, no. 4, 272-277. >Full Text.
Background: There is an ongoing debate about the applicability of current criteria for large waist circumference (WC) in older adults. Objectives: Our aim was to explore cut-off values for large WC in adults aged 70 years and older, using previously used and new methods. Design: Prospective cohort study. Participants: Data of 1049 participants of the Longitudinal Aging Study Amsterdam (LASA) (1995-1996), aged 70-88y, were used. Measurements: Measured BMI and WC, and self-reported mobility limitations. Results Linear regression analyses showed that the values of WC corresponding to BMI of 25kg/m2 and 30kg/m2 were higher than the current cut-offs. Cut-offs found in men were 97 and 110cm, whereas 88 and 98cm represented the cut-offs in women. Areas under the Receiver Operating Characteristic (ROC) curves showed that the accuracy to predict mobility limitations improved when the higher cut-offs were applied. Spline regression curves showed that the relationship of WC with mobility limitations was U-shaped in men, while in women, the risk for mobility limitations increased gradually with increasing WC. However, at the level of current cut-off values for WC the odds for mobility limitations were not increased. Conclusion: Based on results of extensive analyses, this study suggests that the cut-offs for large WC should be higher when applied to older adults. The association of WC with other negative health outcomes needs to be investigated to establish the final cut-points.
Jakobsdottir, S., Van Nieuwpoort, I.C., Schaap, L.A., Van Schoor , N.M., Lips, P.T.A., Drent, M.L. (2010). Serum insulin-like growth factor-I and body composition in community dwelling older people. Clinical Endocrinology, 73, 173-180. >Full Text.
No abstract available.
Jonker, A.G.C. (2010). Health decline and well-being in old age: the need of coping. PhD Dissertation, VU University Amsterdam.
No abstract available.
Joshi, D., Van Schoor , N.M., De Ronde, W., Schaap, L.A., Comijs, H.C., Beekman, A.T.F., Lips, P.T.A. (2010). Low free testosterone levels are associated with prevalence and incidence of depressive symptoms in older men. Clinical Endocrinology, 72, 232-240. >Full Text.
No abstract available.
Kappelle, H.M., Deeg, D.J.H. (2010). Ouderdom komt echt met gebreken. Zijn we wel fit genoeg om langer door te werken. Pensioen & Praktijk, 7, 6-10 > Full Text.
No abstract available.
Kaptijn, R.W.J., Thomése, G.C.F., Van Tilburg, T.G., Liefbroer, A.C., Deeg, D.J.H. (2010). Low fertility in contemporary humans and the mate value of their children: sex-specific effects on social status indicators. Evolution and Human Behavior, 31, 59-68. >Full Text.
No abstract available.
Koek, W.N.H., Van Meurs, J.B.J., Van der Eerden, B.C.J., Rivadeneira, F.F., Zillikens, M.C., Hofman, A., Obermayer-Pietsch, B., Lips, P.T.A., Pols, H.A.P., Uitterlinden, A.G., Van Leeuwen, J.P.T.M. (2010). The T-13910C polymorphism in the lactase phlorizin hydrolase gene is associated with differences in serum. Calcium Levels and Calcium Intake Journal of Bone and Mineral Research, 25, 9, 1980-1987. >Full Text.
No abstract available.
Kuchuk, N.O. (2010). Osteoporosis: risk factors and diagnostic approach. PhD Dissertation, VU University Amsterdam.
No abstract available.
Peeters, G.M.E.E., Van Schoor , N.M., Pluijm, S.M.F., Deeg, D.J.H., Lips, P.T.A. (2010). Is there a U-shaped association between physical activity and falling in older persons? Osteoporosis International, 21, 1189-1195. >Full Text.
This study tests whether the relationship between physical activity and (recurrent) falling is U-shaped. Among 1,337 community-dwelling older persons, no evidence for a nonlinear association was found. If all older persons increase their physical activity level with 100 units, 4% may be prevented to become recurrent fallers. INTRODUCTION: Previous studies suggest a U-shaped relationship between physical activity and falling. This study tests this hypothesis and examines whether this relationship is modified by level of physical functioning. METHODS: Community-dwelling persons (65+) from the Longitudinal Aging Study Amsterdam (LASA) were prospectively followed on falls for 3 years after baseline assessment in 1995/1996 (n = 1,337). Outcome measures were time to first fall and time to recurrent falling. The LASA Physical Activity Questionnaire was used to calculate physical activity in minutes per day weighted for intensity (range 0-2000). Physical functioning was measured with physical performance tests and self reported functional limitations. Confounders were age, sex, body mass index, chronic diseases, psychotropic medication, cognitive functioning, depressive symptoms, and fear of falling. RESULTS: No evidence for a nonlinear association was found (p for physical activity(2) > 0.20). No significant association was found between physical activity and time to first fall. An increase in physical activity of 100 units led to a 4% decrease in risk of recurrent falling (adjusted hazard ratio 0.96, 95% confidence interval 0.92, 0.99). No interactions with physical performance or functional limitations were found (p > 0.50). CONCLUSIONS: The hypothesized U-shaped relationship between physical activity and falling could not be confirmed. At higher levels of physical activity, the risk of recurrent falling decreased, while no association was found with fall risk.
Peeters, G.M.E.E., Verweij, L.M., Van Schoor , N.M., Pijnappels, M., Pluijm, S.M.F., Visser, M., Lips, P.T.A. (2010). Which types of activities are associated with risk of recurrent falling in older persons? Journal of Gerontology, Medical Sciences, 65 (7), 743-750. >Full Text.
Background: This study explored the associations between various types of activities, their underlying physical components, and recurrent falling in community-dwelling older persons. Methods: This study included 1,329 community-dwelling persons (>/=65 years) of the Longitudinal Aging Study Amsterdam (LASA). The time spent in walking, cycling, light and heavy household activities, and two sports was measured using the LASA Physical Activity Questionnaire (LAPAQ). Physical activity components included strength, intensity, mechanical strain, and turning. Time to second fall in a 6-month period was measured during 3 years with fall calendars. Cox proportional hazards models were adjusted for confounders and stratified for physical performance and sex in case of significant (p < .10) interaction. RESULTS: During 3 years, 325 (24.5%) persons became recurrent fallers. In women, doing light (hazard ratios [HRs] = 0.40, 95% confidence intervals [CIs] = 0.20-0.79) or heavy household activities (HR = 0.63, CI = 0.44-0.79) was associated with a decreased risk of recurrent falling. In persons with good physical performance, doing sports (HR = 1.56, CI = 1.07-2.28), high intensity (HR > 1.75, CI = 1.09-3.16), and high mechanical strain (HR = 1.70, CI = 1.01-2.83) activities was associated with an increased risk of recurrent falling. CONCLUSIONS: The results suggest that the relationship between physical activity and recurrent falling differs per type of activity and is modified by physical performance. Doing household activities was associated with a decreased risk of recurrent falling in women. In physically fit older persons, doing sports or activities with high intensity or mechanical strain demands was associated with an increased risk of recurrent falling.
Peeters, G.M.E.E., Pluijm, S.M.F., Van Schoor , N.M., Elders, P.J.M., Bouter, L.M., Lips, P.T.A. (2010). Validation of the LASA fall risk profile for recurrent falling in older recent fallers. Journal of Clinical Epidemiology 63, 1242-1248. >Full Text.
Objectives: The fall risk profile developed in the Longitudinal Aging Study Amsterdam (LASA) identifies community-dwelling elderly at high risk for recurrent falling. This study assessed the predictive validity of this profile in older persons seeking care after a fall. Study Design and Setting: The LASA fall risk profile was completed for 408 persons of 65 years and older who consulted the emergency department or general practitioner after a fall. Falls were prospectively reported with a calendar during 1 year. Recurrent falling was defined as >2 falls within a period of 6 months. Results: During 1 year of followup, 76 (18.6%) participants became recurrent fallers. The area under the receiver operating characteristic curve was 0.65 (95% confidence interval [95% CI]: 0.58e0.72). At a cutoff value of 8, the sensitivity was 56.6% (CI: 51.8e61.4), the specificity was 71.4% (CI: 67.0e75.8), the positive predictive value was 34.1% (CI: 29.5e38.7), and the negative predictive value was 85.6% (CI: 82.2e89.0). Conclusion: The discriminative ability of the LASA fall risk profile was moderate. The predictive validity of the LASA fall risk profile to identify recurrent fallers is limited among older persons who consulted the emergency department or general practitioner after a fall.
Portrait, F.R.M., Alessie, R., Deeg, D.J.H. (2010). Do early life and contemporaneous macroconditions explain health at older ages? An application to functional limitations of Dutch older individuals. Journal of Population Economics, 23, 617-642. >Full Text.
This paper presents an approach that assesses the role of early life and contemporaneous macroconditions in explaining health at older ages. In particular, we investigate the role of exposure to diseases and economic conditions during infancy and childhood, as well as the effect of current health care facilities. Specific attention is paid to the impact of unobserved heterogeneity, selective attrition, and omitted relevant macrovariables. We apply our approach to self-reports on functional limitations of Dutch older individuals. The prevalence of functional limitations is found to increase in the 1990s, in part due to restricted access to hospital care.
Sant, N. (2010). Overgewicht van ouderen een steeds groter probleem. Kenninslink
No abstract available.
Schaap, L.A. (2010). Muscles growing older inflammatory markers and sex hormones as determinants of sarcopenia and decline in physical functioning. PhD Dissertation, VU University Amsterdam.
No abstract available.
Schoenmakers, E, Sant, N. (2010). De eenzame Nederlander > Full Text.
Ongeveer 30% van de Nederlanders voelt zich wel eens eenzaam. Maar wat is eenzaamheid eigenlijk en in hoeverre is het een probleem? En kunnen we ook iets doen aan eenzaamheid?
Steunenberg, B., Beekman, A.T.F., Deeg, D.J.H., Kerkhof, A.J.F.M. (2010). Personality predicts recurrence of late-life depression. Journal of Affective Disorders, 123, 164-172. >Full Text.
Objective: To examine the association of personality with recurrence of depression in later life. Method: A subsample of 91 subjects from the Longitudinal Aging Study Amsterdam (LASA; baseline sample size n=3107; aged >/=55 years) depressed at baseline, who had recovered in the course of three years (first follow-up cycle) was identified. 41 (45%) respondents experienced a recurrence during the subsequent six years. The influences of personality and late life stress (demographic factors, health and social factors) on recurrence were investigated prospectively. Results: Recurrence of depression was associated with a high level of neuroticism and low level of mastery, residual depressive symptoms at time of recovery, female gender, pain complaints and feelings of loneliness. In multivariable analysis entering all predictors significant in single variable analysis, residual depressive symptoms and lack of mastery remained significantly associated with recurrence. Conclusion: In predicting the recurrence of depression in later life, the direct effects of personality remain important and comparable in strength with other late life stressors related to recurrence.
Tolkacheva, N., Broese van Groenou, M.I., Van Tilburg, T.G. (2010). Sibling Influence on Care Given by Children to Older Parents. Research on Aging, 32, 6, 739-759. >Full Text.
No abstract available.
Van Bunderen, C.C., Van Nieuwpoort, I.C., Van Schoor , N.M., Deeg, D.J.H., Lips, P.T.A., Drent, M.L. (2010). The association of serum insulin-like growth factor-I with mortality, cardiovascular disease, and cancer in the elderly: a population-based study. The Journal of Clinical Endocrinology & Metabolism, 95, 4616-4624. >Full Text.
No abstract available.
Van den Berg, G.J., Deeg, D.J.H., Lindeboom, M., Portrait, F.R.M. (2010). The role of early-life conditions in the cognitive decline due to adverse events later in life. The Economic Journal, 120, F411F428. >Full Text.
Serious life events, such as the loss of a relative or the onset of a chronic condition may influence cognitive functioning. We examine whether the cognitive impact of such events is stronger if conditions very early in life were adverse, using Dutch longitudinal data of older persons. We exploit exogenous variation in early-life conditions as generated by the business cycle.
Van den Kommer, T.N., Dik, M.G., Comijs, H.C., Jonker, C. (2010). Homocysteine and inflammation: Predictors of cognitive decline in older persons? Neurobiology of Aging, 31, 1700-1709. >Full Text.
The aim of the current study was to examine the association between homocysteine and 6-year cognitive decline, and the modifying role of the inflammatory markers Interleukin-6 (IL-6), C-reactive protein (CRP) and alpha-1-antichymotrypsin (ACT). Data were collected within the Longitudinal Aging Study Amsterdam (ages &#8805;65 years) and analyzed using multiple longitudinal regression models (N = 1257 of whom N = 1076 had longitudinal data). Cognition was measured with the Mini-Mental State Examination (general cognition), Auditory Verbal Learning Test (memory), Coding Task (information processing speed) and Raven Coloured Progressive Matrices (fluid intelligence). Higher homocysteine at baseline was negatively associated with prolonged lower cognitive functioning and a faster rate of decline in information processing speed and fluid intelligence. The negative association between higher homocysteine and immediate recall was strongest in persons with a high level of IL-6. Only in the highest tertile of CRP, higher homocysteine was negatively associated with retention. In the middle tertile of ACT, higher homocysteine was associated with lower information processing speed and faster decline. Both in the lower and middle tertile of CRP, higher homocysteine was associated with a faster rate of decline in information processing speed. The results implicate that a combination of both risk factors may be used as a marker for cognitive impairment.
Van der Pas, S., Van Tilburg, T.G. (2010). The influence of family structure on the contact between older parents and their adult biological children and stepchildren in the Netherlands. Journal of Gerontology; Social Sciences, 65B, 2, 236-245. >Full Text.
No abstract available.
Van der Zouwen, J., Smit, J.H., Draisma, S. (2010). The effect of the question topic on interviewer behavior; an interaction analysis of control activities of interviewers. Qual Quant, 44, 71-85. >Full Text.
No abstract available.
Van Nes, F., Abma, T., Jonsson, H., Deeg, D.J.H. (2010). Language differences in qualitative research: is meaning lost in translation? European Journal of Ageing, 7, 313-316. >Full Text.
This article discusses challenges of language differences in qualitative research, when participants and the main researcher have the same non-English native language and the non-English data lead to an English publication. Challenges of translation are discussed from the perspective that interpretation of meaning is the core of qualitative research. As translation is also an interpretive act, meaning may get lost in the translation process. Recommendations are suggested, aiming to contribute to the best possible representation and understanding of the interpreted experiences of the participants and thereby to the validity of qualitative research.
Van Nispen, R.M.A., Knol, D.L., Mokkink, L.B., Comijs, H.C., Deeg, D.J.H., Van Rens, G.H.M.B. (2010). Vision-related quality of life Core Measure (VCM1) showed low-impact differential item functioning between groups with different administration modes. Journal of Clinical Epidemiology, 63, 1232-1241. >Full Text.
No abstract available.
Van Tilburg, T.G. (2010). Gevoelens van sociale onveiligheid onder ouderen (LASA-rapport 2009). > Full Text.
No abstract available.
Van Vliet, M.J.G., Broese van Groenou, M.I., Deeg, D.J.H. (2010). Extramurale zorgpakketten. Verleende zorg aan thuiswonende ouderen in onderscheidende pakketten (LASA-rapport 2010). > Full Text.
No abstract available.
Verweij, L.M., Van Schoor , N.M., Dekker, J., Visser, M. (2010). Distinguishing four components underlying physical activity: a new approach to using physical activity questionnaire data in old age. BMC Geriatrics, 10-20. >Full Text.
Background: It is evident that physical activity has many benefits, but it often remains unclear which types of activity are optimal for health and functioning in old age. The aim of this methodological study was to propose a method for distinguishing four components underlying self reported physical activity of older adults: intensity, muscle strength, turning actions and mechanical strain. Methods: Physical activity was assessed by the validated LAPAQ questionnaire among 1699 older adults of the Longitudinal Aging Study Amsterdam. Based on expert consultation and literature review, the four component scores for several individual daily and sports activities were developed. Factor analysis was performed to confirm whether the developed components indeed measured different constructs of physical activity. Results: Based on the factor analyses, three components were distinguished: 1. intensity and muscle strength loaded on the same factor, 2. mechanical strain and 3. turning actions. Analyses in gender, age and activity level subgroups consistently distinguished three factors. Conclusion: Future research using these components may contribute to our understanding of how specific daily and sports activities may have a different influence on health and physical functioning in old age.
Waterlander, W.E., De Haas, W.E., Van Amstel, I., Schuit, A.J., Twisk, J.W.R., Visser, M., Seidell, J.C., Steenhuis, I.H.M. (2010). Energy density, energy costs and income - how are they related? Public Health Nutrition, 13 (10), 1599-1608. >Full Text.
Objective: To examine the association between energy density and energy costs in single food items and composed diets, and to explore differences in energy density and energy cost between income levels. Design: A cross-sectional study using data from two Dutch cohort studies and recent national food prices. Food prices were retrieved from two market leader supermarkets. Data on dietary intake were measured using a computerized faceto-face interview (cohort 1) and 24 h recalls (cohort 2). Setting: The Netherlands. Subjects: A sample of 373 young adults from the Amsterdam Growth and Health Longitudinal Study (AGHLS, measured in 2000) and a sample of 200 communitydwelling elderly from the Longitudinal Ageing Study Amsterdam (LASA, measured in 2007). Results: We found significant inverse associations between energy density and energy costs in single food items (r520?436, P,0?01) and composed diets (AGHLS men r520?505, women r520?413, P,0?001; LASA men r520?559, women r520?562, P,0?001). Furthermore, we found that people stratified into higher energy density quartiles consumed significantly more energy per day, less fruits and vegetables, and had significantly lower diet costs. Explorative analyses on income did not reveal significant differences regarding energy density, costs, or fruit and vegetable intake. Conclusions: In the Netherlands also, energy density was inversely related with energy costs, implying that healthier diets cost more. However, we could not find differences in energy density or costs between income levels. Future research, using precise food expenditures, is of main importance in studying the economics of obesity and in the aim of making the healthier choice easier.
Wijnhoven, H.A.H., Van Bokhorst-de van der Schueren, M.A.E., Heymans, M.W., De Vet, H.C.W., Kruizenga, H.M., Twisk, J.W.R., Visser, M. (2010). Low mid-upper arm circumference, calf circumference, and Body Mass Index and mortality in older persons. Journal of Gerontology: Medical Sciences 65A (10), 1107-1114. >Full Text.
No abstract available.

2009

Bet, P.M., Bochdanovits, Z., Penninx, B.W.J.H., Uitterlinden, A.G., Beekman, A.T.F., Van Schoor , N.M., Deeg, D.J.H., Hoogendijk, W.J.G. (2009). Glucocorticoid receptor gene polymorphisms and childhood adversity are associated with depression: new evidence for a gene-environment interaction. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 150 B, 660-669. >Full Text.
No abstract available.
Buizert, P.J., Van Schoor , N.M., Lips, P.T.A., Deeg, D.J.H., Eekhoff, E.M.W. (2009). Lipid Levels: A Link Between Cardiovascular Disease and Osteoporosis? Journal of Bone and Mineral Research, 24, 1103-1109. >Full Text.
No abstract available.
Comijs, H.C., Kriegsman, D.M.W., Dik, M.G., Deeg, D.J.H., Jonker, C., Stalman, W.A.B. (2009). Somatic chronic diseases and 6-year change in cognitive functioning among older persons. Archives of Gerontology and Geriatrics, 48, 191-196. >Full Text.
No abstract available.
De Jong Gierveld, J., Broese van Groenou, M.I., Hoogendoorn, A.W., Smit, J.H. (2009). Quality of marriages in later life and emotional and social loneliness. The Journal of Gerontology: Psychological Sciences and Social Sciences, 64B, 4, 497-506. >Full Text.
No abstract available.
Deeg, D.J.H. (2009). Kwetsbare ouderen: over de epidemiologie van ziekten en beperkingen. In C. Smit, K. Brinkman, K. Rmke, A. de Knecht-van Eekelen (eds.), Oud worden met hiv. Gezondheid en ziekte van oudere hiv-patienten: een inventarisatie (pp. 33-38). Amsterdam: Aids Fonds.
In deze bijdrage wordt uiteengezet hoe de prevalentie van ziekten,beperkingen en kwetsbaarheid stijgt met de leeftijd in de algemene oudere bevolking. Tevens wordt aandacht besteed aan de rol van inflammatie bij deze aspecten van de gezondheid. Hierbij wordt gebruik gemaakt van de voor Nederlandse ouderen representatieve gegevens van de Longitudinal Aging Study Amsterdam.
Deeg, D.J.H., Comijs, H.C., Thomése, G.C.F., Visser, M. (2009). The Longitudinal Ageing Study Amsterdam: a survey of 17 years of research into changes in daily functioning. Tijdschrift voor Gerontologie en Geriatrie, 40, 217-227.
In this article, a report is provided of results from the Longitudinal Aging Study Amsterdam (LASA). LASA is a study on determinants and consequences of changes in daily functioning. In this article, the focus is on changes in physical functioning. From longitudinal data, it is observed that many older people experience function loss, especially at higher ages. A host of factors are associated with function loss, such as chronic diseases, cognitive decline, depressive complaints, socio-economic status, and life style. A few of these factors are causal, others are characteristics of groups with raised chances of function loss. From trend analyses, it is apparent that the prevalence of functional limitations is not fixed, but varies over time. The LASA study shows that this prevalence is increasing. In view of the absolute and relative rise of the number of older people in the population, it is of great importance to realise a lower prevalence of function loss and a delay of function loss to older ages. Based on the findings presented, some suggestions for this are given. Also, some directions for future research are described.
Deeg, D.J.H. (2009). Van oude naar nieuwe mythen over ouder worden. Geron, Tijdschrift over ouder worden & samenleving, 11, no. 4.
No abstract available.
Gerritsen, L., Geerlings, M.I., Bremmer, M.A., Beekman, A.T.F., Deeg, D.J.H., Penninx, B.W.J.H., Comijs, H.C. (2009). Personality characteristics and hypothalamic-pituitary-adrenal axis regulation in older persons. American Journal of Geriatric Psychiatry, 17, 1077-1084. >Full Text.
No abstract available.
Hoeymans, N. (2009). Maatschappelijke participatie bij ouderen. TPEdigitaal 3, 2, 53-66. > Full Text.
No abstract available.
Jonker, A.G.C., Comijs, H.C., Knipscheer, C.P.M., Deeg, D.J.H. (2009). The role of coping resources on change in well-being during persistent health decline. Journal of Aging and Health, 21,8, 1063-1082. >Full Text.
Objectives: Research in older persons with deteriorative health shows a decrease in well-being. The aim of this study was to examine the role of psychological coping resources in the association between health decline and well-being, in a longitudinal design. Method: Data were used from the Longitudinal Aging Study Amsterdam (LASA). Health decline was defined as persistent deterioration of functioning (PDF), persistent decline in cognitive functioning and/or physical functioning, and/or increase of chronic diseases. Measurements of well-being included life satisfaction and positive affect. Measurements of coping resources included self-esteem, mastery, and self-efficacy. Results: Multivariate linear regression analyses showed that self-efficacy, mastery, and self-esteem mediated the association between PDF and change in well-being. Mastery also was a moderator of the association between PDF and life satisfaction. In older persons with a decreasing mastery, PDF was associated with a significant decrease on life satisfaction; this effect was not observed in older persons with stable or increasing mastery. Discussion: This study suggests that coping resources are of importance in explaining associations between persistent health decline and decreasing well-being. Stable or improving mastery even proves to protect older persons with PDF from decreasing well-being.Therefore, it may be of importance to develop interventions for older persons aimed at maintaining or improving psychological coping resources when health declines.
Kuchuk, N.O., Pluijm, S.M.F., Van Schoor , N.M., Looman, C.W., Smit, J.H., Lips, P.T.A. (2009). Relationships of serum 25-hydroxyvitamin D to bone mineral density and serum parathyroid hormone and markers of bone turnover in older persons. Journal of Clinical Endocrinology and Metabolism, 94, 4, 1244-1250. >Full Text.
Context: Serum 25-hydroxyvitamin D [25(OH)D] may influence serum PTH and other parameters of bone health up to a threshold concentration, which may be between 25 and 80 nmol/liter. OBJECTIVE: The aim of the study was to assess the threshold serum 25(OH)D with regard to PTH, bone turnover markers, and bone mineral density (BMD). Design and setting: This was part of the Longitudinal Aging Study Amsterdam, an ongoing cohort study. Participants: A total of 1319 subjects (643 men and 676 women) between the ages of 65 and 88 yr participated in the study. Main Outcome Measures: Serum 25(OH)D, PTH, osteocalcin, urinary deoxypyridinoline/creatinine, quantitative ultrasound of the heel, BMD of lumbar spine and hip, total body bone mineral content, and physical performance. The relationship between the variables was explored by analysis of covariance and the locally weighted regression (LOESS) plots. Results: Serum 25(OH)D was below 25 nmol/liter in 11.5%, below 50 nmol/liter in 48.4%, below 75 nmol/liter in 82.4%, and above 75 nmol/liter in 17.6% of the respondents. Mean serum PTH decreased gradually from 5.1 pmol/liter when serum 25(OH)D was below 25 nmol/liter to 3.1 pmol/liter when serum 25(OH)D was above 75 nmol/liter (P < 0.001) without reaching a plateau. All BMD values were higher in the higher serum 25(OH)D groups, although only significantly for total hip (P = 0.01), trochanter (P = 0.001), and total body bone mineral content (P = 0.005). A threshold of about 40 nmol/liter existed for osteocalcin and deoxypyridinoline/creatinine, 50 nmol/liter for BMD, and 60 nmol/liter for physical performance. Conclusions: Low serum 25(OH)D concentrations are common in the elderly. Bone health and physical performance in older persons are likely to improve when serum 25(OH)D is raised above 50-60 nmol/liter.
Naarding, P., Veereschild, M., Bremmer, M.A., Deeg, D.J.H., Beekman, A.T.F. (2009). The symptom profile of vascular depression. International Journal of Geriatric Psychiatry, 24, 965-969. >Full Text.
No abstract available.
Peeters, G.M.E.E. (2009). Prevention of falling in older persons with a high risk of recurrent falling. PhD Dissertation, VU University Amsterdam.
No abstract available.
Pluijm, S.M.F., Steyerberg, E.W., Kuchuk, N.O., Rivadeneira, F.F., Looman, C.W., Van Schoor , N.M., Koes, B., Mackenbach, J.P., Lips, P.T.A., Pols, H.A.P. (2009). Practical operationalizations of risk factors for fracture in older women: results from two Longitudinal Studies. Journal of Bone and Mineral Research, 24, 3, 534-542. >Full Text.
No abstract available.
Pluijm, S.M.F., Koes, B., De Laet, C., Van Schoor , N.M., Kuchuk, N.O., Rivadeneira, F.F., Mackenbach, J.P., Lips, P.T.A., Pols, H.A.P., Steyerberg, E.W. (2009). A simple risk score for the assessment of absolute fracture risk in general practice based on two Longitudinal Studies. Journal of Bone and Mineral esearch, 24, 5, 768-774. >Full Text.
No abstract available.
Pot, A.M., Portrait, F.R.M., Visser, G., Puts, M.T.E., Broese van Groenou, M.I., Deeg, D.J.H. (2009). Utilization of acute and long-term care in the last year of life: comparison with survivors in a population-based study. BMC Health Services Research, 9, 139- >Full Text.
No abstract available.
Proper, K.I., Deeg, D.J.H., Van der Beek, A. (2009). Challenges at work and financial rewards to stimulate longer workforce participation. Human Resources for Health , 7, 70, 1-13. >Full Text.
Background: Because of the demographic changes, appropriate measures are needed to prevent early exit from work and to encourage workers to prolong their working life. To date, few studies have been performed on the factors motivating continuing to work after the official age of retirement. In addition, most of those studies were based on quantitative data. The aims of this study were to examine, using both quantitative and qualitative data: (1) the reasons for voluntary early retirement; (2) the reasons for continuing working life after the official retirement age; and (3) the predictive value of the reasons mentioned. Methods: Quantitative data analyses were performed with a prospective cohort among persons aged 55 years and older. Moreover, qualitative data were derived from interviews with workers together with discussions from a workshop among occupational physicians and employers. Results: Results showed that the presence of challenging work was among the most important reasons for not taking early retirement. In addition, this motive appeared to positively predict working status after three years. The financial advantages of working and the maintenance of social contacts were the reasons reported most frequently for not taking full retirement, with the financial aspect being a reasonably good predictor for working status after three years. From the interviews and the workshop, five themes were identified as important motives to prolong working life: challenges at work, social contacts, reward and appreciation, health, and competencies and skills. Further, it was brought forward that each stakeholder can and should contribute to the maintenance of a healthy and motivated ageing workforce. Conclusion: Based on the findings, it was concluded that measures that promote challenges at work, together with financial stimuli, seem to be promising in order to prolong workforce participation.
Puts, M.T.E., Shekary, N., Widdershoven, G.A.M., Heldens, J., Deeg, D.J.H. (2009). The meaning of frailty according to Dutch older frail and non-frail persons. Journal of Aging Studies, 23, 258-266. >Full Text.
Frailty is a term often used by researchers and clinicians to describe a state in which older persons are at risk for adverse outcomes such as falls, disability, institutionalization and mortality. However, no study so far examined what frailty means to older persons. Therefore the aim of this study was to describe the meaning that older community-dwelling persons attach to frailty. Twenty-five semi-structured interviews were conducted. The interviews were analyzed using the grounded theory method. Frailty was described as being in poor health, having walking difficulties, feeling down, being anxious, having few social contacts and not being able to do the things one likes to do. Men described in more detail the physical dimension whereas women elaborated in more depth on the psychological and social component. Existing definitions of frailty should be adjusted to better reflect the meaning of frailty for older persons.
Schaap, L.A., Pluijm, S.M.F., Deeg, D.J.H., Harris, T.B., Kritchevsky, S.B., Newman, A.B., Colbert, L.H., Pahor, M. (2009). Higher inflammatory marker levels in older persons: associations with 5-year change in muscle mass and muscle strength. Journal of Gerontology: Medical Sciences, 64A, 11, 1183-1189. >Full Text.
Background: There is growing evidence that higher levels of inflammatory markers are associated with physical decline in older persons, possibly through the catabolic effects of inflammatory markers on muscle. The aim of this study was to investigate the association between serum levels of inflammatory markers and loss of muscle mass and strength in older persons. Methods: Using data on 2,177 men and women in the Health, Aging, and Body Composition Study, we examined 5-year change in thigh muscle area estimated by computed tomography and grip and knee extensor strength in relation to serum levels of interleukin-6 (IL-6), C-reactive protein, tumor necrosis factor-alpha (TNF-), and soluble receptors (measured in a subsample) at baseline. Results: Higher levels of inflammatory markers were generally associated with greater 5-year decline in thigh muscle area. Most associations, with the exception of soluble receptors, were attenuated by adjustment for 5-year change in weight. Higher TNF- and interleukin-6 soluble receptor levels remained associated with greater decline in grip strength in men. Analyses in a subgroup of weight-stable persons showed that higher levels of TNF- and its soluble receptors were associated with 5-year decline in thigh muscle area and that higher levels of TNF- were associated with decline in grip strength. Conclusions: TNF- and its soluble receptors showed the most consistent associations with decline in muscle mass and strength. The results suggest a weight-associated pathway for inflammation in sarcopenia.
Schoorlemmer, R.M., Peeters, G.M.E.E., Van Schoor , N.M., Lips, P.T.A. (2009). Relationships between cortisol level, mortality and chronic diseases in older persons. Clinical Endocrinology, 71, 779-786. >Full Text.
Context: High cortisol level is known to be associated with osteoporosis, hypertension, diabetes mellitus, susceptibility to infections and depression and may protect against chronic obstructive pulmonary disease (COPD). Objective: This study assesses the association between cortisol level, 6-7.5 year mortality risk and prevalence of chronic diseases. Design/setting/participants: Subjects were selected from the Longitudinal Aging Study Amsterdam (LASA), an ongoing multidisciplinary cohort study in a general population of older persons (>/=65 years). Serum cortisol was measured in 1181 men and women in 1995/96 (second cycle) and salivary cortisol in 998 men and women in 2001/02 (fourth cycle). Main outcome measures: Six to seven and a half year mortality and prevalence of chronic diseases. Results: Men with high salivary morning cortisol had a higher mortality risk than men with low levels (HR=1.63, p=0.04 for the third versus the lowest tertile). Women with high salivary evening cortisol had a higher mortality risk than women with low levels (HR=1.82, p=0.04 for the third versus the lowest tertile). In men, high serum cortisol was independently associated with chronic non-specific lung disease (CNSLD): OR=0.72, p<0.01; hypertension: OR=1.38, p<0.01; diabetes mellitus: OR=1.38, p=0.02. In women, high salivary evening cortisol was independently associated with diabetes mellitus: OR=1.33, p=0.01 and CNSLD: OR=0.58, p=0.02. No independent association between cortisol and number of chronic diseases was found. Conclusion: High salivary cortisol levels are associated with increased mortality risk in a general older population. High cortisol levels are associated with higher risks of hypertension and diabetes mellitus and lower risk of CNSLD.
Simón-Sánchez, J., Seelaar, H., Bochdanovits, Z., Deeg, D.J.H., Van Swieten, J.C., Heutink, P. (2009). Variation at GRN 3'-UTR rs5848 is not associated with a risk of frontotemporal lobar degeneration in Dutch population. PLoS ONE, 4, 10, e7494. >Full Text.
Background: A single nucleotide polymorphism (rs5848) located in the 3&#39;- untranslated region of GRN has recently been associated with a risk of frontotemporal lobar degeneration (FTLD) in North American population particularly in pathologically confirmed cases with neural inclusions immunoreactive for ubiquitin and TAR DNA-binding protein 43 (TDP-43), but negative for tau and alpha-synuclein (FTLD-TDP). Methodology/Principal Findings: In an effort to replicate these results in a different population, rs5848 was genotyped in 256 FTLD cases and 1695 controls from the Netherlands. Single SNP gender-adjusted logistic regression analysis revealed no significant association between variation at rs5848 and FTLD. Fisher&#39;s exact test, failed to find any significant association between rs5848 and a subset of 23 pathology confirmed FTLD-TDP cases. Conclusions/Significance: The evidence presented here suggests that variation at rs5848 does not contribute to the etiology of FTLD in the Dutch population.
Steunenberg, B., Braam, A.W., Beekman, A.T.F., Deeg, D.J.H., Kerkhof, A.J.F.M. (2009). Evidence for an association of the big five personality factors with recurrence of depressive symptoms in later life. International Journal of Geriatric Psychiatry, 24, 1470-1477. >Full Text.
No abstract available.
Suanet, B.A., Broese van Groenou, M.I., Braam, A.W. (2009). Changes in volunteering among young old in the Netherlands between 1992 and 2002: the impact of religion, age-norms, and intergenerational transmission. European Journal of Ageing, 6, 157-165. >Full Text.
No abstract available.
Van den Kommer, T.N., Dik, M.G., Comijs, H.C., Fassbender, K., Jonker, C. (2009). Total cholesterol and oxysterols: Early markers for cognitive decline in elderly? Neurobiology of Aging, 30, 534-545. >Full Text.
In this prospective study we examined whether total cholesterol and the oxysterols 24S- and 27-hydroxycholesterol were related to cognitive performance and rate of cognitive decline in elderly, and whether these associations were modified by ApoE _4. Data were collected during 6 years of follow-up as part of the Longitudinal Aging Study Amsterdam (N= 1181, age ?65 years), and analyzed using generalized estimating equations. Cognitive performance was measured with the mini-mental state examination (general cognition), the auditory verbal learning test (memory) and the coding task (information processing speed). Lower cholesterol at baseline was negatively associated with both general cognition (p = .012) and information processing speed (p = .045). ApoE modified the association between cholesterol and cognitive decline, and the association between the ratio of 27-hydroxycholesterol to cholesterol and cognitive functioning. In ApoE _4 carriers, lower cholesterol was related to a higher rate of decline on information processing speed (p = .006), and a higher ratio of 27-hydroxycholesterol to cholesterol was related to a lower level of general performance (p = .002) and memory functioning (p = .045). The results implicate that lower total cholesterol may be considered as a frailty marker, predictive of lower cognitive functioning in elderly.
Van Exel, E., Eikelenboom, P., Comijs, H.C., Frohlich, M., Smit, J.H., Stek, M.L., Scheltens, P., Eefsting, J.E., Westendorp, R.G.J. (2009). Vascular Factors and Markers of Inflammation in Offspring With a Parental History of Late-Onset Alzheimer Disease. Archives of General Psychiatry, 66 (11), 1263-1270. >Full Text.
Context: Alzheimer disease (AD) is a complex disorder with a strong heritable component. Amyloid pathology, vascular factors, and inflammation are postulated to be involved in its pathogenesis, but causality has not been established unequivocally. Objective: To identify heritable traits in middle age that contribute to AD. Design: We used a proven family design, comparing middle-aged offspring with and without a parental history of AD. In such a design, the offspring under study are enriched for risk factors of AD but do not yet have the disease. Setting: The Netherlands. Participants: Two hundred six offspring of 92 families with a parental history of late-onset AD and 200 offspring of 97 families without a parental history of AD. Main Outcome Measures: The APOE &#949;4 genotype, vascular factors, production capacity of pro- and anti-inflammatory cytokines upon stimulation with lipopolysaccharide, and circulating markers of inflammation. All outcome measures were assessed in the offspring only and not in the parental generation. Results: More offspring with a parental history of AD carried APOE &#949;4 than those without a parental history of the disease (47% vs 21%, P < .001). Those with a parental history of AD also had higher systolic blood pressures (P = .006), higher diastolic blood pressures (P < .001), and lower ankle brachial indices (P = .005) when compared with offspring without a family history of dementia. Production capacity of pro-inflammatory cytokines in offspring with a parental history of AD was also different, with higher levels of IL-1&#946; (interleukin 1&#946;) (P < .001), IL-1&#946; to IL-1ra ratio (P < .001), tumor necrosis factor &#945; (P = .008), IL-6 (P = .04), and interferon &#947; (P = .01). All of these positive associations were independent of APOE &#949;4 genotype. Conclusions: Hypertension and the expression of an innate pro-inflammatory cytokine profile in middle age are early risk factors of AD in old age. For the offspring of affected families, it provides clues for screening and preventive strategies, of which blood pressure control can be implemented directly.
Van Tilburg, T.G. (2009). Retirement, effects on relationships. In H.T. Reis & S. Sprecher (Eds.), Encyclopedia of human relationships (vol. 3, pp. 1376-1378). Thousand Oaks, CA: Sage. ISBN 978-1-41295-846-2.
No abstract available.
Verweij, L.M., Van Schoor , N.M., Deeg, D.J.H., Dekker, J., Visser, M. (2009). Physical activity and incident clinical knee osteoarthritis in older adults. Arthritis & Rheumatism (Arthritis Care & Research), 61, 2, 152-157. >Full Text.
Objective: To study the relationship between 4 components of physical activity and the 12-year incidence of clinical knee osteoarthritis (OA) among older adults. Methods: Longitudinal data from 1,678 men and women, ages 55-85 years, were collected in the Longitudinal Aging Study Amsterdam. Incident clinical knee OA was defined by an algorithm using self-report and general practitioner data. Physical activity was assessed by a validated questionnaire from which 4 physical activity component scores were created: muscle strength, intensity, mechanical strain, and turning actions. Cox proportional hazards models were conducted to examine the relationship between these scores and incident knee OA and reported as hazard ratios (HRs) with 95% confidence intervals (95% CIs). Results: During 12 years of followup, 463 respondents (28%) developed clinical knee OA. A high mechanical strain score (HR 1.43, 95% CI 1.15-1.77) and a low muscle strength score (HR 1.30, 95% CI 1.01-1.68) were associated with an increased risk of knee OA after adjustment for age, sex, region of living, education, lifetime physical work demands, lifetime general physical activity, body mass index, current total physical activity level, and depression. No association was observed in the intensity and turning actions components. The results were similar for men and women, and for obese and nonobese respondents. Conclusion: Older adults who perform low muscle strength activities or activities causing high mechanical strain had an increased risk of clinical knee OA. These results suggest that specific components of physical activity may influence the development of knee OA.
Vink, D., Aartsen, M.J., Comijs, H.C., Heymans, M.W., Penninx, B.W.J.H., Stek, M.L., Deeg, D.J.H., Beekman, A.T.F. (2009). Onset of anxiety and depression in the aging population: comparison of risk factors in a 9-year prospective study. American Journal of Geriatric Psychiatry, 17, 8, 642-652. > Full Text.
No abstract available.
Vogelzangs, N., Beekman, A.T.F., Dik, M.G., Bremmer, M.A., Comijs, H.C., Hoogendijk, W.J.G., Deeg, D.J.H., Penninx, B.W.J.H. (2009). Late-life depression, cortisol and the metabolic syndrome (Brief report). American Journal of Geriatric Psychiatry, 17, 8, 716-721. > Full Text.
Objectives: High-cortisol levels in depressed persons could possibly give rise to the metabolic syndrome. This study investigated cross-sectionally whether depression and high-cortisol levels increased the odds of metabolic syndrome in an older community-based sample. Methods: In 1,212 participants, aged > or =65 years, enrolled in the Longitudinal Aging Study Amsterdam, depression (major [1-month diagnosis] or subthreshold [no 1-month diagnosis, but symptoms]), metabolic syndrome (modified Adult Treatment Panel III criteria), and free cortisol index (total serum cortisol/cortisol binding globulin) were assessed. Results: Major depression was not associated with the metabolic syndrome (odds ratio [OR] = 1.16, 95% confidence interval [CI] = 0.54-2.49), but subthreshold depression was associated with a decreased odds (OR = 0.55, 95% CI = 0.37-0.82). Persons with higher levels of free cortisol index showed a higher odds of metabolic syndrome (OR per standard deviation increase = 1.21, 95% CI = 1.06-1.39). Conclusions: As persons with high-cortisol levels more often had metabolic syndrome, hypercortisolemia within depressed persons may increase the risk of metabolic syndrome.

2008

Bierman, E.J.M. (2008). Anxiety, depression and cognition in later life. PhD Dissertation, VU University Amsterdam.
No abstract available.
Bierman, E.J.M., Comijs, H.C., Rijmen, F., Jonker, C., Beekman, A.T.F. (2008). Anxiety symptoms and cognitive performance in later life: results from the Longitudinal Aging Study Amsterdam. Aging & Mental Health, 12, 4, 517-523. >Full Text.
No abstract available.
Bloem, B.A., Van Tilburg, T.G., Thomése, G.C.F. (2008). Changes in older Dutch adults'role networks after moving. Personal Relationships, 15, 465-478. > Full Text.
Using the convoy model (R. L. Kahn & T. C. Antonucci, 1980), this study examined the differential impact of relocation, depending on the distance moved, on the size of 3 types of role networks. A total of 890 Dutch nonmovers and 445 movers (aged 55-86 years) were selected from the Longitudinal Aging Study Amsterdam. Results of analyses of variance showed that the neighbor networks changed most after relocation. Long-distance movers discontinued the largest number of relationships with fellow club members. As expected, moving did not affect coworker networks. The findings show that, consistent with the convoy model, role networks proved to be unstable. Older adults, however, restored their partial networks at the second observation by starting new relationships.
Bloem, B.A., Van Tilburg, T.G., Thomése, G.C.F. (2008). Residential mobility in older Dutch adults: Influence of later life events. International Journal of Ageing and Later Life, 1, 3, 21-44.
In this study, we examined life course events of older Dutch adults in relation to three types of moves and the moving distance. Using the frameworks developed by Litwak and Longino (1987) and Mulder and Hooimeijer (1999), we stipulated life events or triggers and conditions in various life domains. We selected a total of 1160 men and 1321 women (aged 54 to 91) from the Longitudinal Aging Study Amsterdam. We conducted multinomial logistic regression analyses to predict moves to a residential care facility, adapted housing or regular housing and to predict the moving distance. Retirement, an empty nest, widowhood and a decline in health each triggered specific moves. In additional analyses, the effects of triggers, especially health changes, were moderated by conditions. There is no indication of a specific trajectory of moves associated with consecutive life events, as suggested by Litwak and Longino. By combining triggers and conditions, however, the framework developed by Mulder and Hooimeijer allows for a more valid analysis.
Braam, A.W., Mooi, B., Schaap-Jonker, J., Van Tilburg, W., Deeg, D.J.H. (2008). God image and Five-Factor Model personality characteristics in later life: A study among inhabitants of Sassenheim in The Netherlands. Mental Health, Religion & Culture, 11, 6, 547-559. >Full Text.
Affective or emotional aspects of religiousness are considered to be crucial in the association between religiousness and well-being, especially in later life. Such affective aspects can be understood as pertaining to the God-object relationship, corresponding to feelings of trust towards God or to religious discontent. Personality characteristics, such as those defined by the Five-Factor Model of Personality, are expected to correspond with God image. A small sample of older mainline church members in Sassenheim, The Netherlands (n = 53), aged 68-93, filled out a questionnaire, including 120 items of the NEO-PI-R, the Questionnaire God Image, frequency of prayer, church attendance, and depressive symptoms. Neuroticism was associated with feelings of anxiety towards God as well as discontent towards God. Agreeableness was associated with perceiving God as supportive and with prayer. These findings persisted after adjustment for depressive symptoms. For the other three personality factors, no clear patterns emerged. Results were compared with those from studies of God image and the Five-Factor Model of personality among younger people.
Braam, A.W., Klinkenberg, M., Deeg, D.J.H. (2008). Religiousness and mood in the last week of life. Research Institute for Spirituality and Health, 3, 2, 3-4.
No abstract available.
Braam, A.W., Schaap-Jonker, J., Mooi, B., De Ritter, D., Beekman, A.T.F., Deeg, D.J.H. (2008). God image and mood in old age: Results from a community-based pilot study in the Netherlands. Mental Health, Religion & Culture, 11, 2, 221-237. >Full Text.
Religious involvement is frequently found to be associated with less depression in later life. The emotional aspects of religiousness, such as pertaining to the God-object relationship, have not received substantial attention in empirical research among older adults, and especially not in European samples. As part of a pilot study of the Longitudinal Aging Study Amsterdam, a small sample of older church-members (n = 60), aged 68-93, filled out a questionnaire, including the Questionnaire God Image on feelings to God and perceptions of God, two of the God Image Scales designed by Lawrence on perceptions of God, the brief positive and negative religious coping scale designed by Pargament, and items on hopelessness, depressive symptoms, and feelings of guilt. Feelings of discontent towards God correlated positively with hopelessness, depressive symptoms, feelings of guilt, and also with depressive symptoms assessed 13 years earlier; these findings pertained to Protestant participants in particular. Most facets of God image, positive, critical, and about punishment reappraisals, were associated with more feelings of guilt. A possible explanation for the most pervasive finding, that feelings of discontent towards God are related to depressive symptoms, is that both, throughout life, remain rooted in insecure attachment styles.
Bremmer, M.A., Beekman, A.T.F., Deeg, D.J.H., Penninx, B.W.J.H., Dik, M.G., Hack, C.E., Hoogendijk, W.J.G. (2008). Inflammatory markers in late-life depression: Results from a population-based study. Journal of Affective Disorders, 106, 249-255. >Full Text.
No abstract available.
Bremmer, M.A. (2008). Late-life depression and cardiac diseases: biological underpinnings in a population-based sample. PhD Dissertation, VU University Amsterdam.
No abstract available.
De Jong Gierveld, J., Van Tilburg, T.G. (2008). De ingekorte schaal voor algemene, emotionele en sociale eenzaamheid [A shortened scale for overall, emotional and social loneliness]. Tijdschrift voor Gerontologie en Geriatrie, 39, 4-15.
Loneliness is an indicator of social well-being and pertains to the feeling of missing an intimate relationship (emotional loneliness) or missing a wider social network (social loneliness). The 11-item De Jong Gierveld scale has proved to be a valid and reliable measuring instrument for overall, emotional and social loneliness, although its length has sometimes rendered it difficult to use the scale in large surveys. In this study, we empirically tested a shortened version of the scale on data from tow surveys (N = 9448). Confirmatory factor analyses confirmed the specification of two latent factors. Congruent validity and the relationship with determinants (partner status, health) proved to be optimal. The 6-item De Jong Gierveld scale is a reliable and valid measuring instrument for overall, emotional and social loneliness, which is suitable for large surveys.
Deeg, D.J.H., Puts, M.T.E. (2008). Kwetsbaarheid bij ouderen: predictoren en gevolgen [Frailty in the older persons. Predictors and outcomes]. Verpleegkunde, 23, 1, 12-23
No abstract available.
Heim, N., Snijder, M.B., Deeg, D.J.H., Seidell, J.C., Visser, M. (2008). Obesity in older adults is associated with an increased prevalence and incidence of pain. Obesity, 16, 2510-2517. >Full Text.
No abstract available.
Hoogendijk, E.O., Broese van Groenou, M.I., Van Tilburg, T.G., Deeg, D.J.H. (2008). Educational differences in functional limitations: comparisons of 55-65-year-olds in the Netherlands in 1992 and 2002. International Journal of Public Health, 53, 281-289. >Full Text.
No abstract available.
Hoogendijk, W.J.G., Lips, P.T.A., Dik, M.G., Deeg, D.J.H., Beekman, A.T.F., Penninx, B.W.J.H. (2008). Depression is associated with decreased 25-Hydroxyvitamin D and increased Parathyoid Hormone levels in older adults. Archives of General Psychiatry, 65, 5, 508-512. > Full Text.
No abstract available.
Jonker, A.G.C., Comijs, H.C., Knipscheer, C.P.M., Deeg, D.J.H. (2008). Persistent deterioration of functioning (PDF) and change in well-being in older persons. Aging Clinical and Experimental Research, 20, 5, 461-468.
Background and aims: It is often assumed that aging is accompanied by diverse and constant functional and cognitive decline, and it is therefore surprising that the well-being of older persons does not appear to decline in the same way. This study investigates longitudinally whether well-being in older persons changes due to Persistent Deterioration of Functioning (PDF). Methods: Data were collected in the context of the Longitudinal Aging Study Amsterdam (LASA). Conditions of PDF are persistent decline in cognitive functioning, physical functioning and increase in chronic diseases. Measurements of well-being included life satisfaction, positive affect, and valuation of life. T-tests were used to analyse mean difference scores for well-being, and univariate and multivariate regression analyses were performed to examine changes in three well-being outcomes in relation to PDF. Results: Crosssectional analyses showed significant differences and associations between the two PDF subgroups and non-PDF for well-being at T3. In longitudinal analyses, we found significant decreases in and associations with wellbeing over time in respondents fulfilling one PDF condition (mild PDF). For respondents fulfilling two or more PDF conditions (severe PDF), longitudinally no significan associations were found. Conclusions: Cognitive aspects of well-being (life satisfaction and valuation of life) and the affective element (positive affect) of well-being appear to be influenced negatively by mild PDF, whereas well-being does not seem to be diminished in persons with more severe PDF. This may be due to the ability to accept finally the inevitable situation of severe PDF.
Knipscheer, C.P.M., Van Schoor , N.M., Penninx, B.W.J.H., Smit, J.H. (2008). Levenswaardering bij ouderen (LWO): de validering van een meetinstrument [Adaptation and validation of the Dutch translation of the "Valuation of Life"scale]. Tijdschrift voor Gerontologie en Geriatrie, 39, 133-145.
No abstract available.
Koedam, E.L.G.E., Pijnenburg, Y.A.L., Deeg, D.J.H., Baak, M.M.E., Van der Vlies, A.E., Scheltens, P., Van der Flier, W.M. (2008). Early-Onset Dementia Is Associated with Higher Mortality. Dementia and Geriatric Cognitive Disorders, 26, 147-152. >Full Text.
No abstract available.
Korporaal, M., Broese van Groenou, M.I., Van Tilburg, T.G. (2008). Effects of own and spousal disability on loneliness among older adults. Journal of Aging and Health, vol. 20, 3, 306-325. >Full Text.
No abstract available.
Peeters, G.M.E.E., Van Schoor , N.M., Van Rossum, E.F.C., Visser, M., Lips, P.T.A. (2008). The relationship between cortisol, muscle mass and muscle strength in older persons and the role of genetic variations in the glucocorticoid receptor. Clinical Endocrinology, 69 (4), 673-682. >Full Text.
No abstract available.
Peeters, G.M.E.E., Van Schoor , N.M., Lips, P.T.A., Deeg, D.J.H. (2008). Validering van screeningsinstrumenten voor de identificatie van vallers (LASA-rapport 2008). > Full Text.
No abstract available.
Schaap, L.A., Pluijm, S.M.F., Deeg, D.J.H., Penninx, B.W.J.H., Nicklas, B.J., Lips, P.T.A., Harris, T.B., Newman, A.B., Kritchevsky, S.B., Cauley, J.A., Goodpaster, B.H., Tylavsky, F.A., Yaffe, K., Visser, M. (2008). Low testosterone levels and decline in physical performance and muscle strength in older men: findings from two prospective cohort studies. Clinical Endocrinology, 68, 42-50. >Full Text.
No abstract available.
Schram, M.T., Frijters, D.H.M., Van de Lisdonk, E.H., Ploemacher, J., De Craen, A.J.M., De Waal, M.W.M., Van Rooij, F.J., Heeringa, J., Hofman, A., Deeg, D.J.H., Schellevis, F.G. (2008). Setting and registry characteristics affect the prevalence and nature of multimorbidity in the elderly. Journal of Clinical Epidemiology, 61, 1104-1112. >Full Text.
No abstract available.
Schram, M.T., De Waal, M.W.M., De Craen, A.J.M., Deeg, D.J.H., Schellevis, F.G. (2008). Multimorbiditeit: de nieuwe epidemie. Tijdschrift voor Sociale Geneeskunde 86, 23-25.
No abstract available.
Sonnenberg, C.M., Deeg, D.J.H., Comijs, H.C., Van Tilburg, W., Beekman, A.T.F. (2008). Trends in antidepressant use in the older population: Results from the LASA-study over a period of 10 years. Journal of Affective Disorders, 111, 299-305. >Full Text.
No abstract available.
Stenholm, S., Harris, T.B., Rantanen, T., Visser, M., Kritchevsky, S.B., Ferruci, L. (2008). Sarcopenic obesity - definition, etiology and consequences. Current Opinion in Clinical Nutrition & Metabolic Care, 11, 6, 693-700. >Full Text.
No abstract available.
Van de Kamp, K., Braam, A.W., Deeg, D.J.H. (2008). Verschuiving van de ervaren gezondheid van 55-64-jarigen tussen 1992/1993 en 2002/2003. Verklarende factoren. [Shift in the self-perceived health of 55-64-year olds between 1992 and 2002]. Tijdschrift voor Gerontologie en Geriatrie, 39, 182-192.
No abstract available.
Van den Kommer, T.N., Comijs, H.C., Dik, M.G., Jonker, C., Deeg, D.J.H. (2008). Development of classification models for early identification of persons at risk for persistent cognitive decline. Journal of Neurology, 255, 10, 1486-1494. >Full Text.
No abstract available.
Van Meurs, J.B.J. (2008). Large-scale analysis of association between LRP5 and LRP6 variants and osteoporosis. JAMA, 299 (11), 1277-1290. >Full Text.
Context: Mutations in the low-density lipoprotein receptor-related protein 5 (LRP5) gene cause rare syndromes characterized by altered bone mineral density (BMD). More common LRP5 variants may affect osteoporosis risk in the general population. Objective: To generate large-scale evidence on whether 2 common variants of LRP5 (Val667Met, Ala1330Val) and 1 variant of LRP6 (Ile1062Val) are associated with BMD and fracture risk. Design and Setting: Prospective, multicenter, collaborative study of individual-level data on 37,534 individuals from 18 participating teams in Europe and North America. Data were collected between September 2004 and January 2007; analysis of the collected data was performed between February and May 2007. Bone mineral density was assessed by dual-energy x-ray absorptiometry. Fractures were identified via questionnaire, medical records, or radiographic documentation; incident fracture data were available for some cohorts, ascertained via routine surveillance methods, including radiographic examination for vertebral fractures. Main Outcome Measures: Bone mineral density of the lumbar spine and femoral neck; prevalence of all fractures and vertebral fractures. Results: The Met667 allele of LRP5 was associated with reduced lumbar spine BMD (n = 25,052 [number of participants with available data]; 20-mg/cm2 lower BMD per Met667 allele copy; P = 3.3 x 10(-8)), as was the Val1330 allele (n = 24,812; 14-mg/cm2 lower BMD per Val1330 copy; P = 2.6 x 10(-9)). Similar effects were observed for femoral neck BMD, with a decrease of 11 mg/cm2 (P = 3.8 x 10(-5)) and 8 mg/cm2 (P = 5.0 x 10(-6)) for the Met667 and Val1330 alleles, respectively (n = 25 193). Findings were consistent across studies for both LRP5 alleles. Both alleles were associated with vertebral fractures (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.08-1.47 for Met667 [2001 fractures among 20 488 individuals] and OR, 1.12; 95% CI, 1.01-1.24 for Val1330 [1988 fractures among 20,096 individuals]). Risk of all fractures was also increased with Met667 (OR, 1.14; 95% CI, 1.05-1.24 per allele [7876 fractures among 31,435 individuals)]) and Val1330 (OR, 1.06; 95% CI, 1.01-1.12 per allele [7802 fractures among 31 199 individuals]). Effects were similar when adjustments were made for age, weight, height, menopausal status, and use of hormone therapy. Fracture risks were partly attenuated by adjustment for BMD. Haplotype analysis indicated that Met667 and Val1330 variants both independently affected BMD. The LRP6 Ile1062Val polymorphism was not associated with any osteoporosis phenotype. All aforementioned associations except that between Val1330 and all fractures and vertebral fractures remained significant after multiple-comparison adjustments. Conclusions: Common LRP5 variants are consistently associated with BMD and fracture risk across different white populations. The magnitude of the effect is modest. LRP5 may be the first gene to reach a genome-wide significance level (a conservative level of significance [herein, unadjusted P < 10(-7)] that accounts for the many possible comparisons in the human genome) for a phenotype related to osteoporosis.
Van Schoor , N.M., Visser, M., Pluijm, S.M.F., Kuchuk, N.O., Smit, J.H., Lips, P.T.A. (2008). Vitamin D deficiency as a risk factor for osteoporotic fractures. Bone, 42, 260-266. >Full Text.
No abstract available.
Van Tilburg, T.G., Van der Pas, S. (2008). The intergenerational care potential of Dutch older adults in 1992 and 2002. In C. Saraceno (Ed.). Families, ageing and social policy: Generational solidarity in European welfare states (pp. 217-235). Cheltenham, UK: Edward Elgar. ISBN 978-1-84720-648-0; ISBN 978-1-84844-514-7.
No abstract available.
Van Tilburg, T.G. (2008). Social integration/isolation, later life. In D. Carr, R. Crosnoe, M.E. Hughes & A. Pienta (Eds.), Encyclopedia of the life course and human development (vol. 3: Later life, pp. 378-381). Detroit: Macmillan Reference USA. ISBN 978-002866165-0.
No abstract available.
Visser, M. (2008). Ondervoeding bij ouderen (LASA-rapport 2008). > Full Text.
No abstract available.
Wouts, L., Oude Voshaar, R.C., Bremmer, M.A., Buitelaar, J.K., Penninx, B.W.J.H., Beekman, A.T.F. (2008). Cardiac disease, depressive symptoms, and incident stroke in an elderly population. Archives of General Psychiatry, 65, 5, 596-602. > Full Text.
No abstract available.

2007

Bierman, E.J.M., Comijs, H.C., Jonker, C., Beekman, A.T.F. (2007). Symptoms of anxiety and depression in the course of cognitive decline. Dementia and Geriatric Cognitive Disorders, 24, 213-219. >Full Text.
Background/Aims: Anxiety and depression are common inpatients with cognitive decline and Alzheimer\'s disease (AD), and recognition and treatment of these symptoms can improve their quality of life. The present study investigates anxiety and depression in different phases of cognitive decline. Methods: The sample consisted of five groups of elderly people in different phases of cognitive decline; four from a community-based sample (Longitudinal Aging Study Amsterdam), and one group of elderly people diagnosed with AD. ANOVAs were performed to investigate group differences in the severity and prevalence of anxiety and depression, and comorbid anxiety and depressive symptoms. Results: The prevalence rates of anxiety, comorbid anxiety and depressive symptoms and depressive symptoms follow a pattern of an increasing prevalence as cognitive performance declines and a decrease in the prevalence when cognitive functioning is severely impaired. AD patients report fewest anxiety symptoms. Conclusion: We found that the prevalence of anxiety symptoms, depressive symptoms and comorbid anxiety and depressive symptoms seems to increase in the early phase of cognitive decline, and decreases as cognitive functioning further declines. Elderly diagnosed with AD report less anxiety as expected, probably due to lack of insight caused by AD.
Bierman, E.J.M., Comijs, H.C., Gundy, C.M., Sonnenberg, C.M., Jonker, C., Beekman, A.T.F. (2007). The effect of chronic benzodiazepine use on cognitive functioning in older persons: good, bad or indifferent? International Journal of Geriatric Psychiatry, 22, 1194-1200. > Full Text.
No abstract available.
Braam, A.W., Deeg, D.J.H., Poppelaars, J.L., Beekman, A.T.F., Van Tilburg, W. (2007). Prayer and Depressive Symptoms in a Period of Secularization: Patterns Among Older Adults in The Netherlands. American Journal of Geriatric Psychiatry, 15, 273-281. > Full Text.
Objective: Prayer is generally recognized as an important aspect of religiousness. Relatively few empiric studies examined the relation between prayer and depressive symptoms in later life, and findings so far are mixed. Method: Respondents, aged 60-91 years, participated in the third (N = 1,702) and fourth (N = 1,346) assessment cycles, with three-year intervals, of the Longitudinal Aging Study Amsterdam. Data were collected on frequency of prayer, perceived meaningfulness of prayer, religious affiliation, church attendance, salience of religion, demographics, and health variables. Depressive symptoms were assessed with the Center for Epidemiologic Studies-Depression Scale. Results: In the total sample, there was no significant association between frequency of prayer and depressive symptoms. Among those who were not religiously affiliated, prayer was associated with higher levels of depressive symptoms. The results were particularly pronounced among nonaffiliated widowed respondents; odds ratio for praying daily associated with having Center for Epidemiologic Studies-Depression Scale scores of 16 and higher amounted to 3.59 (99% confidence interval: 1.01-11.79). At three-year follow up, prayer did not predict change of depressive symptoms. Conclusions: As secularization in Western Europe progresses, the current results suggest that clinical exploration of private religiousness among older patients remains relevant, also among people who seem to be less religious.
Bras, H., Van Tilburg, T.G. (2007). Kinship and social networks: A regional analysis of sibling relations in twentieth-century Netherlands. Journal of Family History, 32, 3, 296-322. >Full Text.
No abstract available.
Broese van Groenou, M.I., Van Tilburg, T.G. (2007). Network analysis. In J.E. Birren (Ed.), Encyclopedia of gerontology (Second edition): Age, aging, and the aged (Vol. 2, pp. 242-250). San Diego, CA: Elsevier. ISBN 0-12-370530-4; 978-0-1237-0530-3
The personal networks of older people reflect their social opportunities and personal choices to maintain a specific set of relationships with relatives, neighbors, friends, acquaintances and so on. Network analysis is the method used to identify and examine the structural and functional features of the network of the older adult. The conceptualization and operationalization of the personal network depend on the subject of research. Five approaches to define personal network membership are presented and discussed. The five approaches differ regarding the part of the personal network that is mapped, and result in networks of different sizes and compositions. Regardless of the type of network delineation, a distinction can be drawn between the star network (data available on relationships with the focal person) and the full network (data available on all the network relationships). Features of the structure and content of both types of personal networks are presented. Finally, network analysis methods are presented and discussed, including ways to analyze hierarchical databases.
Broese van Groenou, M.I., Van Tilburg, T.G. (2007). Ouder worden in sociaal-relationeel perspectief. In A. Pot, Y. Kuin & M. Vink (Eds.), Handboek ouderenpsychologie (pp. 51-63). Utrecht: De Tijdstroom. ISBN 90-5898-110-X
No abstract available.
Broese van Groenou, M.I., Van Tilburg, T.G. (2007). Het zorgpotentieel in de netwerken van ouderen. In A. de Boer (Ed.), Toekomstverkenning informele zorg (pp. 45-64). Den Haag: Sociaal en Cultureel Planbureau. ISBN 978-90-377-0319-1
No abstract available.
Broese van Groenou, M.I., Deeg, D.J.H. (2007). Gebruik van thuiszorg en welzijnsvoorzieningen door 55-plussers tussen 1992-2006 (LASA-rapport 2007). > Full Text.
No abstract available.
Comijs, H.C., Beekman, A.T.F., Smit, H.F.E., Bremmer, M.A., Van Tilburg, T.G., Deeg, D.J.H. (2007). Childhood adversity, recent life events and depression in late life. Journal of Affective Disorders, 103, 243-246. >Full Text.
No abstract available.
Deeg, D.J.H., Broese van Groenou, M.I. (2007). Zorggebruik door ouderen na opname in het ziekenhuis: Ontwikkelingen in 1992-2002. [The use of care by older adults after hospital discharge: Developments between 1992-2002]. Tijdschrift voor Gezondheidswetenschappen, 85, 3, 174-182.
Changes between 1992 and 2002 in the use of care by older adults after hospital discharge are examined. Data were used from four waves of the population-based Longitudinal Aging Study Amsterdam, including persons aged 64-85 years at each wave. Admission to hospital in the past six months, use of care and dissatisfaction with care were assessed at each wave. The proportion of persons recently admitted to a hospital remained about 10%. Characteristics of those recently admitted to a hospital remained the same: they had more often serious functional limitations, multiple chronic diseases and a low level of education than those not admitted. The total amount of care used after hospital discharge remained the same, but there was an increase in the use of spousal care and a decrease in the use of professional care. Over time a larger proportion of persons was dissatisfied with the care received, in particular after a recent discharge from the hospital. It is concluded that during the implementation of improvements, specific attention should be given to the transition from hospital to home care of older people.
Deeg, D.J.H., Puts, M.T.E. (2007). Het kwetsbare succes van ouder worden. Over kwetsbaarheid, multimorbiditeit en beperkingen. Tijdschrift voor verpleeghuisgeneeskunde, 32, 5, 147-151. > Full Text.
No abstract available.
Deeg, D.J.H. (2007). Epidemiologie vanuit levensloopperspectief. In T. v.d. Lippe, P.A. Dykstra, G. Kraaykamp, J. Schippers (Ed.), De maakbaarheid van de levensloop (pp. 75-85). Assen: Koninklijke van Gorcum.
No abstract available.
Deeg, D.J.H. (2007). Europe. In K.S. Markides, D.G. Blazer, L.G. Branch, S. Studenski (Ed.), Encyclopedia of Health and Aging (pp. 208-212). California /U.S.A: Sage Publication.
No abstract available.
Deeg, D.J.H. (2007). Health and quality of life. In H. Mollenkopf, A. Walker (Ed.), Quality of Life in Old Age (pp. 195-213). Springer.
No abstract available.
Deeg, D.J.H., Visser, M. (2007). Het beweeggedrag van ouderen. In V.H. Hildebrandt, W.T.M. Ooijendijk, M. Hopman-Rock (Ed.), Trendrapport Bewegen en Gezondheid 2004/2005 (pp. 179-190). Leiden: De Bink.
No abstract available.
Deeg, D.J.H. (2007). De psychiater als epidemioloog. In M. Nijsen, A. Beekman, W. Hoogendijk, P. Eikelenboom, T. van Balkom (Eds.), The playing captain. Liber amicorum voor Willem van Tilburg (pp. 61-68). Utrecht: De Tijdstroom. ISBN 978.90.5898.115.8.
No abstract available.
Dik, M.G., Jonker, C., Comijs, H.C., Deeg, D.J.H., Kok, A., Yaffe, K., Penninx, B.W.J.H. (2007). Contribution of metabolic syndrome components to cognition in older individuals. Diabetes Care, 30, 10, 2655-2660. > Full Text.
No abstract available.
Dik, M.G., Deeg, D.J.H., Visser, M., Jonker, C. (2007). Association between early life physical activity and late-life cognition: Evidence for cognitive reserve. In Y. Stern (Ed.), Cognitive reserve. Theory and Applications (pp. 143-157). New York, USA: Taylor & Francis.
No abstract available.
Fang, Y., Van Meurs, J.B.J., Rivadeneira, F.F., Van Schoor , N.M., Van Leeuwen, J.P.T.M., Lips, P.T.A., Pols, H.A.P., Uitterlinden, A.G. (2007). Vitamin D receptor gene haplotype is associated with body height and bone size. The Journal of Clinical Endocrinology & Metabolism, 92, 1491-1501. >Full Text.
No abstract available.
Fokkema, C.M., Van Tilburg, T.G. (2007). Zin en onzin van eenzaamheidsinterventies bij ouderen. Tijdschrift voor Gerontologie en Geriatrie, 38, 185-203. ISSN: 0167-9228
This article focuses on the most important findings of a unique evaluation study of loneliness interventions among older adults. Eighteen interventions have recently been carried out and closely monitored in various parts of the Netherlands. In ten of these interventions the number of participants was sufficiently large to quantitatively determine the effect of the intervention on loneliness. It does not appear to be easy to overcome loneliness: no more than two of the ten interventions resulted in a reduction in loneliness among participants that may be attributed to the intervention. Two other interventions may have had a preventive effect: whereas loneliness increased among members of the control group, it remained more or less constant over time among participants. The effect measurements were followed by process evaluations in an effort to gain insight into the possible reasons why feelings of loneliness were not alleviated among participants in the case of most of the interventions. This resulted in a number of lessons for the future, which may be used as a checklist when designing new interventions projects.
Guiaux, M., Van Tilburg, T.G., Broese van Groenou, M.I. (2007). Changes in contact and support exchange in personal networks after widowhood. Personal Relationships, 14, 457-473 >Full Text.
No abstract available.
Jonker, C., Comijs, H.C. (2007). Lichte cognitieve stoornissen (MCI): Prodromen van dementie? [Mild cognitive impairment: a prodromal phase of dementia?] Tijdschrift voor Gerontologie en Geriatrie, 38, 115-121.
Cognitive decline without dementia is common among older persons. A variety of clinical concepts have been introduced in the past 30 years, in order to describe these cognitive deficits arising in older persons. The most frequently used concept is Mild Cognitive Impairment (MCI). MCI is generally seen as a prodromal phase of Alzheimer disease (AD). Several concepts are described, with the neuropsychiatric features and predictors of conversion to dementia c.q. AD. Finally, consequences of preclinically diagnoses for health care are clarified.
Kevenaar, M.E., Themmen, A.P.N., Rivadeneira, F.F., Uitterlinden, A.G., Laven, J.S.E., Van Schoor , N.M., Pols, H.A.P., Visser, J.A. (2007). A polymorphism in the AMH type II receptor gene is associated with age at menopause in interaction with parity. Human Reproduction, 22, 9, 2382-2388. >Full Text.
Anti-Mullerian hormone (AMH) inhibits primordial follicle recruitment in the mouse ovary. We hypothesize that in women AMH signaling also regulates the usage of the primordial follicle pool and hence influences the onset of menopause. Since age at menopause has a strong genetic component, we investigated the role of AMH signaling using a candidate gene approach. Methods: In two large population-based cohorts of Dutch postmenopausal women (n52381 and n5248), we examined the association between two polymorphisms, one in the AMH gene and one in the AMH type II receptor (AMHR2) gene, and natural age at menopause. Results: The AMH Ile49Ser polymorphism (rs10407022) was not associated with age at menopause in either cohort. In the Rotterdam cohort, the AMHR2 2482 A>G polymorphism (rs2002555) was associated with age at menopause in interaction with the number of offspring (P50.001). Nulliparous women homozygous for the G-allele entered menopause 2.6 years earlier compared with nulliparous women homozygous for the A-allele (P50.005). In the LASA cohort, women with the G/G genotype tended to enter menopause 2.8 years earlier compared with the A/A genotype (P50.063). Conclusions: The observed association of the AMHR2 2482 A>G polymorphism with natural age at menopause suggests a role for AMH signaling in the usage of the primordial follicle pool in women.
Kuchuk, N.O., Van Schoor , N.M., Pluijm, S.M.F., Smit, J.H., De Ronde, W., Lips, P.T.A. (2007). The association of sex hormone levels with quantitative ultrasound, bone mineral density, bone turnover and osteoporotic fractures in older men and women. Clinical Endocrinology, 67, 295-303. >Full Text.
No abstract available.
Peeters, G.M.E.E., Van Schoor , N.M., Visser, M., Knol, D.L., Eekhoff, E.M.W., De Ronde, W., Lips, P.T.A. (2007). Relationship between cortisol and physical performance in older persons. Clinical Endocrinology, 67, 398-406. >Full Text.
No abstract available.
Pluijm, S.M.F., Visser, M., Puts, M.T.E., Dik, M.G., Schalk, B.W.M., Van Schoor , N.M., Schaap, L.A., Bosscher, R.J., Deeg, D.J.H. (2007). Unhealthy lifestyles during the life course: association with physical decline in late life. Aging Clinical and Experimental Research, 19, 1, 75-83.
Background and aims: This study aimed at examining the association between unhealthy lifestyle in young age, midlife and/or old age and physical decline in old age, and between chronic exposure to an unhealthy lifestyle throughout life and physical decline in old age. Methods: The study sample included 1297 respondents of the Longitudinal Aging Study Amsterdam (LASA). Lifestyle in old age (55-85 y) was assessed at baseline, whereas lifestyle in young age (around 25 y) and midlife (around 40 y) were assessed retrospectively. Lifestyle factors included physical activity, body mass index (BMI), number of alcohol drinks per week and smoking. Physical decline was calculated as a change in physical performance score between baseline and six-year follow-up. Results: Of the lifestyle factors present in old age, a BMI of 25-29 vs BMI <25 kg/m2 (OR=1.6; 95% CI: 1.1-2.2) and a BMI of ?30 vs BMI <25 kg/m2 (OR=1.8; 95% CI: 1.2-2.7) were associated with physical decline in old age. Being physically inactive in old age was not significantly associated with an increased risk of physical decline, although, being physically inactive in both midlife and old age increased the odds of physical decline in old age to 1.6 (95% CI: 1.1-2.4), compared with respondents who were physically inactive in midlife and physically active in old age. Being overweight in both age periods was associated with an OR of 1.5 (95% CI: 1.1-2.2). Conclusions: These data suggest that overweight in old age, and chronic exposure to physical inactivity or overweight throughout life, increases the risk of physical decline in old age. Therefore, physical activity and prevention of excessive weight at all ages should be stimulated, to prevent physical decline in old age.
Puts, M.T.E., Shekary, N., Widdershoven, G.A.M., Heldens, J., Lips, P.T.A., Deeg, D.J.H. (2007). What does quality of life mean to older frail and non-frail community-dwelling adults in the Netherlands? Quality of Life Research, 16, 263-277. >Full Text.
Quality of life is a commonly used but seldom defined concept and there is no consensus on how to define it. The aim of this study was to explore the meaning of quality of life to older frail and non-frail persons living in the community. Qualitative interviews were conducted with 25 older men and women. The audio-taped interviews were transcribed and coded for content and analyzed using the grounded-theory approach. Five themes emerged: (physical) health, psychological well-being, social contacts, activities, and home and neighborhood. Factors that influenced quality of life were having good medical care, finances and a car. Respondents compared themselves mostly to others whose situation was worse than their own, which resulted in a satisfactory perceived quality of life. However, the priorities of the domains of quality of life were observed to change. Moreover, the health of the frail limited the amount and scope of activities that they performed. This led to a lower quality of life perceived by the frail compared to the non-frail.
Smit, H.F.E., Comijs, H.C., Schoevers, R.A., Cuijpers, P., Deeg, D.J.H., Beekman, A.T.F. (2007). Target groups for the prevention of late-life anxiety. British Jounal of Psychiatry, 190, 428-434. >Full Text.
Background: Anxiety disorders in older people are highly prevalent, yet there is little evidence to guide targeted prevention strategies. Aims: To identify subgroups at increased risk of developing anxiety in later life. Method: Anxiety was measured with the Hospital Anxiety and Depression anxiety sub-scale in1931people aged 55-85 years followed over 3 years. Risk factors were identified that had a high combined attributable fraction, indicative of substantial health gains when the adverse effect of the risk factors can be contained. Results: Factors significantly associated with increased risk of developing anxiety included sub-threshold anxiety, depression, two or more chronic illnesses, poor sense of mastery, poor self-rated health and low educational level. Conclusions: The identified risk groups are small, thus providing prevention with a narrow focus, and health gains are likely to be more substantial than in groups not exposed to these risk factors. Nevertheless, more research is needed to produce evidence on target groups where prevention has optimal impacts. Declaration of interest: None.
Smit, H.F.E. (2007). Prevention of Depression. PhD Dissertation, VU University Amsterdam.
No abstract available.
Snijder, M.B., Lips, P.T.A., Seidell, J.C., Visser, M., Deeg, D.J.H., Dekker, J.M., Van Dam, R.M. (2007). Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population-based study in older men and women. Journal of International Medicine, 261, 6, 558-565.
Background: Evidence is accumulating that the vitamin D endocrine system has physiological functions beyond bone health including a role in the regulation of blood pressure. Effects of poor vitamin D status on blood pressure may be mediated by elevated parathyroid hormone (PTH) levels. Aim: To evaluate whether serum 25-hydroxyvitamin D [25(OH)D] and PTH levels are independently associated with blood pressure in a population-based study of older men and women. Methods: Subjects were participants of the Longitudinal Aging Study Amsterdam, aged 65 years and older. In 1205 participants, serum 25(OH)D and PTH levels were determined and diastolic and systolic blood pressure were measured. Linear and logistic regression analyses were performed with adjustments for age, sex, region, season, lifestyle factors (physical activity, smoking, alcohol intake), and waist circumference. Results: Serum 25(OH)D was not significantly associated with diastolic (beta 0.00, P = 0.98) or systolic (beta 0.06, P = 0.11) blood pressure. In contrast, higher ln-PTH levels were significantly associated with higher diastolic (beta 1.93, P = 0.03) and systolic (beta 4.67, P = 0.01) blood pressure. Higher PTH levels were associated with a substantially higher prevalence of hypertension (OR 2.00, 95% CI 1.31-3.06 for the highest versus the lowest quartile), whereas 25(OH)D showed no significant association (OR 0.89, 95% CI 0.47-1.69 for the lowest versus the highest 25(OH)D category). Conclusion: These results indicate that PTH is a potentially modifiable determinant of blood pressure in the general elderly population. Serum 25(OH)D, however, was not associated with blood pressure, possibly due to the relatively high levels in our population.
Snijder, M.B., Lips, P.T.A., Seidell, J.C., Visser, M., Deeg, D.J.H., Dekker, J.M., Van Dam, R.M. (2007). Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population-based study in older men and women. Journal of Internal Medicine, 261, 558-565. >Full Text.
No abstract available.
Steunenberg, B., Beekman, A.T.F., Deeg, D.J.H., Bremmer, M.A., Kerkhof, A.J.F.M. (2007). Mastery and neuroticism predict recovery of depression in later life. American Journal of Geriatric Psychiatry, 15, 3, 234-242.
No abstract available.
Vaal, J., Gussekloo, J., De Klerk, M.M.Y., Frijters, D.H.M., Evenhuis, H.M., Van Beek, A.P.A., Van Nispen, R.M.A., Smits, C.H.M., Deeg, D.J.H. (2007). Gecombineerde visus- en gehoorbeperking: naar schatting bij 30.000-35.000 55-plussers in Nederland. Nederlandse Tijdschrift voor Geneeskunde, 151, 26, 1459-1463.
No abstract available.
Van der Pas, S., Van Tilburg, T.G., Knipscheer, C.P.M. (2007). Changes in contact and support within intergenerational relationships in the Netherlands: A cohort and time-sequential perspective. In T. Owens & J.J. Suitor (Eds.), Advances in life course research: Interpersonal relations across the life course (Vol. 12; pp. 243-274). London: Elsevier Science. ISSN 1040-2608; ISBN-13: 978-0-7623-1292-4; ISBN-10: 0-7623-1292-0 > Full Text.
This study investigates whether the frequency of contact and support exchanged in relationships between parents and adult children declines over successive cohorts and over individual time in the Netherlands. Respondents included a birth cohort from 1928 - 1937 with data collected in 1992 (N = 941) and in 2002 (N = 574) and a birth cohort from 1938 - 1947 with data collected in 2002 (N = 884). We assessed cohort and time-sequential changes. Parents of the later cohort had more contact and support exchanges with their children than the earlier cohort, revealing that families have not declined in importance. Furthermore, longitudinally, contact and supportive exchanges with adult children decreased, suggesting that parents and children devote less time to intergenerational relationships during this \'empty nest\' phase.
Van Gool, C.H., Kempen, G.I.J.M., Penninx, B.W.J.H., Deeg, D.J.H., Van Eijk, J.Th.M. (2007). Chronic Disease and Lifestyle Transitions. Results from the Longidutinal Aging Study Amsterdam. Journal of Aging and Health, 19, 3, 416-438. >Full Text.
No abstract available.
Van Schoor , N.M., Dennison, E.M., Lips, P.T.A., Uitterlinden, A.G., Cooper, C. (2007). Serum fasting cortisol in relation to bone, and the role of genetic variations in the glucocorticoid receptor. Clinical Endocrinology, 67, 6, 871-878. >Full Text.
No abstract available.
Van Zelst, W.H. (2007). Posttraumatic stress disorder in late life. PhD Dissertation, VU University Amsterdam.
No abstract available.
Visser, M., Deeg, D.J.H. (2007). The effect of age-related height loss on the BMI classification of older men and women. International Journal of Body Composition Research, 5, 1, 35-40.
No abstract available.
Wicherts, I.S., Van Schoor , N.M., Boeke, A.J.P., Visser, M., Deeg, D.J.H., Smit, J.H., Knol, D.L., Lips, P.T.A. (2007). Vitamin D status predicts physical performance and its decline in older persons. The Journal of Clinical Endocrinology & Metabolism, 92, 6, 2058-2065. >Full Text.
No abstract available.
Zunzunegui, M.V., Minicuci, N., Blumstein, T., Noale, M., Deeg, D.J.H., Jylha, M., Pedersen, N.L. (2007). Gender differences in depressive symptoms among older adults: a cross-national comparison: the CLESA project. Social Psychiatry & Psychiatric Epidemiology, 42, 198-207. >Full Text.
No abstract available.

2006

Bemelmans, W.J.E., Van Lenthe, F., Hoogenveen, R., Kunst, A., Deeg, D.J.H., Van den Brandt, P.A., Goldbohm, R.A., Verschuren, W.M.M. (2006). Modeling predicted that tobacco control policies targeted at lower educated will reduce the differences in life expectancy. Journal of Clinical Epidemiology, 59, 1002-1008. >Full Text.
No abstract available.
Bierman, E.J.M., Comijs, H.C., Depla, M., Ten Have, M., Pot, A.M. (2006). Deelstudie 2: Psychische problemen en GGZ-gebruik bij ouderen met lichamelijke aandoeningen. In Monitor Geestelijke Gezondheidszorg Ouderen. Rapportage 2006 (pp. 11-14).
No abstract available.
Bloem, B.A., Van Tilburg, T.G. (2006). Less lonely after moving? In: Rooilijn (Tijdschrift voor Wetenschap en Beleid in de Ruimtelijke Ordening. Wonen en Zorg (no. 5, pp. 221-226). Assen: Van Gorcum.
No abstract available.
Braam, A.W., Bramsen, I., Van Tilburg, T.G., Van der Ploeg, H.M., Deeg, D.J.H. (2006). Cosmic transcendence and framework of meaning in life: Patterns among older adults in The Netherlands. Journal of Gerontology: Social Sciences, 61B, 3, S121-S128. > Full Text.
Objectives. Gerotranscendence has been conceptualized as a potential development accompanying normal aging. Gerotranscendence is defined as a shift in metaperspective from a materialistic and pragmatic world view to a more cosmic and transcendent one. In the past decade, population-based studies have tested Tornstam\'s Gerotranscendence Scale. Its Cosmic Transcendence subscale, in particular, emerged as consistent. The aim of the present study was to examine (a) how cosmic transcendence relates to having a framework of meaning in life and (b) whether religiousness and demographic characteristics influence possible relationships. Methods. Participants were 928 older Dutch adults who responded to a questionnaire that included the Cosmic Transcendence scale, aspects of religiousness, and the Framework of Meaning in Life subscale of the Life Regard Index. Results. A substantial, positive association between cosmic transcendence and framework of meaning in life was observed. This association was much more pronounced among participants who were less involved in religion, who were women, who were age 75 or older, or who were widowed. Discussion. The current study indicates that the personal relevance of cosmic transcendence depends on cultural factors such as secularization. Furthermore, cosmic transcendence seems to unfold as an important domain in the life view of women, the older old, and the widowed.
Braam, A.W. (2006). Gerotranscendentie: wijsheid of sprookje? Geron, 8, 3, 22-25.
No abstract available.
Braam, A.W., Klinkenberg, M., Deeg, D.J.H. (2006). Religiousness and mood in the last week of life: an explorative approach based on after-death proxy interviews. Tijdschrift voor Gerontologie en Geriatrie, 37, 6, 254-262.
No abstract available.
Bremmer, M.A., Hoogendijk, W.J.G., Deeg, D.J.H., Schoevers, R.A., Schalk, B.W.M., Beekman, A.T.F. (2006). Depression in older age is a risk factor for first ischemic cardiac events. The American Journal of Geriatric Psychiatry, 14, 523-530. > Full Text.
No abstract available.
Broese van Groenou, M.I., Deeg, D.J.H., De Boer, A. (2006). Veranderingen in de levensloop. In A. de Boer (Ed.), Rapportage Ouderen 2006: Veranderingen in de leefsituatie en de levensloop (pp. 167-193). Den Haag: SCP.
No abstract available.
Broese van Groenou, M.I., Deeg, D.J.H. (2006). Veranderingen in sociale participatie. In A. de Boer (Ed.), Rapportage Ouderen 2006: Veranderingen in de leefsituatie en de levensloop (pp. 215-238). Den Haag: SCP.
No abstract available.
Broese van Groenou, M.I., Glaser, K., Tomassini, C., Jacobs, T. (2006). Socio-economic status differences in older people\'s use of informal and formal help: a comparison of four European countries. Ageing & Society, 26, 745-766. >Full Text.
No abstract available.
Broese van Groenou, M.I. (2006). Social participation of the 55-64 year olds: is the new generation more socially active than its predecessor? Tijdschrift vor Gerontologie en Geriatrie, 37, 6, 218-225.
Nowadays people speak of the \\\'new\\\' generation of young old who would be healthier and more socially active compared to the earlier generation. Using data from the Longitudinal Aging Study Amsterdam it was examined to what degree this is a realistic image. The study compared the social participation level of 55-64 year olds in 1992 and the same age group in 2002, and aimed to explain the differences from cohort differences in four determinants of participation: level of education, labour participation, health and partner status. Descriptive analyses showed that the younger cohort was more actively involved in voluntary organisations and participated more often in cultural and leisure activities compared to the older cohort. In addition, the younger cohort was more highly educated, yet reported more functional disabilities, and more often hold paid jobs compared to the older cohort. No cohort differences were found with respect to the proportion of married persons. Logistic regression analyses showed that the higher level of social participation of the younger cohort was mainly due to the higher level of education, but that this effect was reduced by the larger disability of the younger cohort. Job and partner status did not explain the cohort differences in social participation. It is concluded that the current young old are more socially active and higher educated than their predecessors. Their (somewhat) worse health status, however, asks for a more nuanced image of the \\\'new\\\' young old.
Comijs, H.C., Deeg, D.J.H. (2006). Vroege predictoren van dementie (LASA-rapport 2006). > Full Text.
No abstract available.
Comijs, H.C., Dik, M.G., Rijmen, F., Jonker, C., Van den Kommer, T.N., Deeg, D.J.H. (2006). Predictors of dementia, the construction of classification trees. Tijdschrift voor Gerontologie en Geriatrie, 37, 6, 237-242.
In order to identify persons who are at risk for dementia in an early phase, two classification trees were developed. Data were used from the Longitudinal Aging Study Amsterdam (LASA). The prevalence of dementia in the whole sample was 4.0%. In the first tree age seemed to be the strongest predictor, with an increased risk for persons older than 75. In this group the positive predictive value reached a maximum of 33.3% when the persons had memory complaints and a score on the Mini Mental State Examination (MMSE) <24. In a second classification tree, age was excluded as a predictor because of high association with the other potential predictors. In this tree functional limitations seemed the strongest predictor. In the group of persons with at least one functional limitations, the positive predictive value reached a maximum of 28.8% when the persons had memory complaints and a score <24 on the MMSE. In persons without memory complaints, persons with cardiovascular diseases or diabetes were at increased risk of dementia. Further research is necessary before these classification trees can be implemented in general health care.
Cuijpers, P., Beekman, A.T.F., Smit, H.F.E., Deeg, D.J.H. (2006). Predicting the onset of major depressive disorder and dysthymia in older adults with subthreshold depression: a community based study. International Journal of Geriatric Psychiatry, 21, 811-818. >Full Text.
Background: It is well-established that the incidence of major depressive disorder is increased in subjects with subthreshold depression. A new research area focuses on the possibilities of preventing the onset of major depressive disorders in subjects with subthreshold depression. An important research question for this research area is which subjects with subthreshold depression will develop a full-blown depressive disorder and which will not. Methods: We selected 154 older subjects with subthreshold depression (CES-D>16) but no DSM mood disorder from a longitudinal study among a large population based cohort aged between 55 and 85 years in The Netherlands. Of these subjects, 31 (20.1%) developed a mood disorder (major depression and/or dysthymia) at three-year or six-year follow-up. We examined risk factors and individual symptoms of mood disorder as predictors of onset of mood disorder. Results: Two variables were found to be significant predictors in both bivariate and multivariate analyses: eating problems and sleep problems. The incidence of mood disorders differed strongly for different subpopulations, varying from 9% (for those not having any of the two risk factors) to 57% (for those having both risk factors). Conclusions: It appears to be possible to predict to a certain degree whether a subject with subthreshold depression will develop a mood disorder during the following years.
De Jong Gierveld, J., Van Tilburg, T.G., Dykstra, P.A. (2006). Loneliness and social isolation. In D. Perlman & A. Vangelisti (Eds.), The Cambridge handbook of personal relationships (pp. 485-500). Cambridge, UK: Cambridge University Press. ISBN-13 978-0-521-82617-4, ISBN-10 0-521-82617-9 hardback; ISBN-13 978-0-521-53359-1, ISBN-10 0-521-53359-7 paperback. > Full Text.
No abstract available.
De Jong Gierveld, J., Van Tilburg, T.G. (2006). A 6-item scale for overall, emotional, and social loneliness: Confirmatory tests on survey data. Research on Aging, 28, 5, 582-598. >Full Text.
Loneliness is an indicator of social well-being and pertains to the feeling of missing an intimate relationship (emotional loneliness) or missing a wider social network (social loneliness). The 11-item De Jong Gierveld Loneliness Scale has proved to be a valid and reliable measurement instrument for overall, emotional, and social loneliness, although its length has sometimes rendered it difficult to use in large surveys. In this study, the authors empirically tested a shortened version of the scale on data from two surveys (N = 9,448). Confirmatory factor analyses confirmed the specification of two latent factors. Congruent validity and the relationship with determinants (partner status, health) proved to be optimal. The 6-item De Jong Gierveld Loneliness Scale is a reliable and valid measurement instrument for overall, emotional, and social loneliness that is suitable for large surveys.
Deeg, D.J.H. (2006). Ouderen. In A.A. Kaptein, R. Beunderman, J. Dekker, A.J.J.M. Vingerhoets (Ed.), Psychologie en Geneeskunde (Behavioural Medicine) (pp. 395-413). Houten: Bohn Stafleu van Loghum. ISBN: 90-313-4725-6.
No abstract available.
Deeg, D.J.H. (2006). Genuanceerd denken over gezonde levensverwachting. Tijdschrift voor Gezondheidswetenschappen, 84, 4, 195-196.
No abstract available.
Deeg, D.J.H. (2006). 15 jaar Longitudinal Aging Study Amsterdam Introductie op het themanummer. Tijdschrift voor Gerontologie en Geriatrie, 37, 216-217.
Voor u ligt een themanummer met een vijftal artikelen die gebruik maken van gegevens van de Longitudinal Aging Study Amsterdam (LASA). Dit nummer wordt uitgebracht ter gelegenheid van het feit dat LASA 15 jaar bestaat.
Janssen, J., Beekman, A.T.F., Comijs, H.C., Deeg, D.J.H., Heeren, T.J. (2006). Late-life depression: the differences between early - and late-onset illness in a community-based sample. International Journal of Geriatric Psychiatry, 21, 86-93. >Full Text.
Background: Several studies have described etiological and clinical differences between elderly depressed patients with early onset of their illness compared to late onset. While most studies have been carried out in clinical samples it is unclear whether the findings can be generalized to the elderly population as a whole. The aim of this study was to compare early-onset (EOD) and late-onset (LOD) depressive illness in a community-based sample. Methods: Large (n = 3107) representative sample of older persons (55-85 years) in the Netherlands. Two-stage screen procedure to identify elderly with MDD. The Center for Epidemiologic Studies Depression scale (CES-D) was used as a screen and the Diagnostic Interview Schedule (DIS) to diagnose MDD. Data on 90 older persons with early-onset depression and 39 with late-onset depression were available. Results: Those with LOD were older, and more often widowed. Family psychiatric history, vascular pathology, and stressful early and late life events did not differ between groups. EOD subjects had more often double depression and more anxiety. Conclusions: In a community-based sample we did not detect clear differences in etiology and phenomenology between EOD and LOD. This discrepancy with reports from clinical samples could be due to selection bias in clinical studies. Consequently, all patients with late-life depression deserve a diagnostic work-up of both psychosocial and somatic risk factors and treatment interventions should be focused accordingly.
Jonker, C., Droes, R.M. (2006). Dementie. In A.A. Kaptein, R. Beunderman, J. Dekker, A.J.J.M. Vingerhoets (EDS.), Psychologie en Geneeskunde (Behavioural Medicine)(pp. 415-437). Houten: Bohn Stafleu van Loghum. ISBN 90.313.4725.6.
No abstract available.
Koster, A., Bosma, H., Broese van Groenou, M.I., Kempen, G.I.J.M., Penninx, B.W.J.H., Van Eijk, J.Th.M., Deeg, D.J.H. (2006). Explanations of socioeconomic differences in changes in physical function in older adults: Results from the Longitudinal Aging Study Amsterdam. BMC Public Health, 6, 244, 1-12. >Full Text.
No abstract available.
Koster, A., Bosma, H., Kempen, G.I.J.M., Penninx, B.W.J.H., Beekman, A.T.F., Deeg, D.J.H., Van Eijk, J.Th.M. (2006). Socioeconomic differences in incident depression in older adults: The role of psychosocial factors, physical health status, and behavioral factors. Journal of Psychosomatic Research, 61, 619-627. >Full Text.
No abstract available.
Pluijm, S.M.F., Smit, J.H., Tromp, E.A.M., Stel, V.S., Deeg, D.J.H., Bouter, L.M., Lips, P.T.A. (2006). A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: results of a 3-year prospective study. Osteoporosis International, 17, 417-425. >Full Text.
Introduction: The aim of the prospective study reported here was to develop a risk profile that can be used to identify community-dwelling elderly at a high risk of recurrent falling. Materials and Methods: The study was designed as a 3-year prospective cohort study. A total of 1365 community-dwelling persons, aged 65 years and older, of the population-based Longitudinal Aging Study Amsterdam participated in the study. During an interview in 1995/1996, physical, cognitive, emotional and social aspects of functioning were assessed. A follow-up on the number of falls and fractures was conducted during a 3-year period using fall calendars that participants filled out weekly. Recurrent fallers were identified as those who fell at least twice within a 6-month period during the 3-year follow-up. Results: The incidence of recurrent falls at the 3-year follow-up point was 24.9% in women and 24.4% in men. Of the respondents, 5.5% reported a total of 87 fractures that resulted from a fall, including 20 hip fractures, 21 wrist fractures and seven humerus fractures. Recurrent fallers were more prone to have a fall-related fracture than those who were not defined as recurrent fallers (11.9% vs. 3.4%; OR: 3.8; 95% CI: 2.3-6.1). Backward logistic regression analysis identified the following predictors in the risk profile for recurrent falling: two or more previous falls, dizziness, functional limitations, weak grip strength, low body weight, fear of falling, the presence of dogs/cats in the household, a high educational level, drinking 18 or more alcoholic consumptions per week and two interaction terms (high education x 18 or more alcohol consumptions per week and two or more previous falls x fear of falling) (AUC=0.71). Discussion: At a cut-off point of 5 on the total risk score (range 0-30), the model predicted recurrent falling with a sensitivity of 59% and a specificity of 71%. At a cut-off point of 10, the sensitivity and specificity were 31% and 92%, respectively. A risk profile including nine predictors that can easily be assessed seems to be a useful tool for the identification of community-dwelling elderly with a high risk of recurrent falling.
Pluijm, S.M.F., Visser, M., Puts, M.T.E., Dik, M.G., Schalk, B.W.M., Van Schoor , N.M., Schaap, L.A., Bosscher, R.J., Deeg, D.J.H. (2006). Unhealthy lifestyles during the life course: association with physical decline in late life. Tijdschrift voor Gerontologie en Geriatrie, 37, 6, 226-236.
This study aimed to examine the association between unhealthy lifestyle in young age, midlife and/or old age and physical decline in old age, and to examine the association between chronic exposure to an unhealthy lifestyle throughout life and physical decline in old age. The study sample included 1297 respondents of the Longitudinal Aging Study Amsterdam (LASA). Lifestyle in old age (55-85 y) was assessed at baseline, while lifestyle in young age (around 25 y) and midlife (around 40 y) were assessed retrospectively. Lifestyle factors included physical activity, body mass index (BMI), number of alcohol drinks per week and smoking. Physical decline was calculated as change in physical performance score between baseline and six-year follow-up. Of the lifestyle factors present in old age, a BMI of 25-29 vs. BMI <25 kg/m2 (odds ratio (OR) 1.6; 95% confidence interval (CI) 1.1-2.2) and a BMI of > or =30 vs. BMI <25 kg/m2 (OR 1.8; 95% CI 1.2-2.7) were associated with physical decline in old age. Being physically inactive in old age was not significantly associated with an increased risk of physical decline, however, being physically inactive both in midlife and in old age increased the odds of physical decline in old age to 1.6 (95% CI 1.1-2.4) as compared to respondents who were physically inactive in midlife and physically active in old age. Being overweight in both age periods was associated with an OR of 1.5 (95% CI 1.1-2.2). These data suggest that overweight in old age, and chronic exposure to physical inactivity or overweight throughout life increases the risk of physical decline in old age. Therefore, physical activity and prevention of overweight at all ages should be stimulated to prevent physical decline in old age.
Puts, M.T.E. (2006). Frailty: Biological risk factors, negative consequences and quality of life. PhD Dissertation, VU University Amsterdam.
No abstract available.
Ralston, S.H., Uitterlinden, A.G., Brandi, M.L., Balcells, S., Langdahl, B.L., Lips, P.T.A., Lorenc, R., Obermayer-Pietsch, B., Scollen, S., Bustamante, M., Husted, L.B., Carey, A.H., Diez-Perez, A., Dunning, A.M., Falchetti, A., Karczmarewicz, E. (2006). Large-scale evidence for the effect of the COLIA1 Sp1 polymorphism, on osteoporosis outcomes: The GENOMOS study. PloS Medicine, 3, 4, e90, 0515-0523. >Full Text.
No abstract available.
Rurup, M.L., Onwuteaka-Philipsen, B.D., Van der Heide, A., Van der Wal, G., Deeg, D.J.H. (2006). Frequency and determinants of advance directives concerning end-of-life care in The Netherlands. Social Science & Medicine, 62, 1552-1563. >Full Text.
No abstract available.
Sadler, E.A., Braam, A.W., Broese van Groenou, M.I., Deeg, D.J.H., Van der Geest, S. (2006). Cosmic transcendence, loneliness, and exchange of emotional support with adult children: a study among older parents in The Netherlands. European Journal of Ageing, 3, 146-154. >Full Text.
No abstract available.
Schaap, L.A., Pluijm, S.M.F., Deeg, D.J.H., Visser, M. (2006). Inflammatory markers and loss of muscle mass (sarcopenia) and strength. The Americal Journal of Medicine, 119, 526.e9-526.e17. >Full Text.
Purpose: The objective of this study was to investigate whether high levels of serum interleukin (IL)-6, C-reactive protein (CRP), and ?1-antichymotrypsin (ACT) were associated with the loss of muscle strength or muscle mass (sarcopenia) in older persons. Subjects: The study included 986 men and women of the Longitudinal Aging Study Amsterdam, with a mean age of 74.6 years (standard deviation 6.2). Methods: Grip strength (n = 986) and appendicular muscle mass (n = 328, using dual-energy x-ray absorptiometry) were obtained in 1995 and 1996 and repeated after a 3-year follow-up. Loss of muscle strength was defined as a loss of grip strength greater than 40%, and sarcopenia was defined as a loss of muscle mass greater than 3%, approximating the lowest 15% of the study sample. Results: Multiple linear and logistic regression analyses revealed that higher levels of IL-6 were associated with greater decline in muscle strength, which decreased by ?3.21 kg (standard error 0.81) per standard deviation increase in log-transformed IL-6. After adjustment for confounders, including sociodemographic, health, and lifestyle factors, high IL-6 (>5 pg/mL) and high CRP (>6.1 >?g/mL) were associated with a 2 to 3-fold greater risk of losing greater than 40% of muscle strength. Persons with high levels of ACT (>181% of the normal human pooled plasma) were 40% less likely to experience loss of muscle strength and tended (P = .07) to have a smaller decline in muscle mass compared with those in the lowest quartile of ACT. No consistent associations of IL-6 and CRP with sarcopenia were found. Conclusion: The findings of this prospective, population-based study suggest that higher levels of IL-6 and CRP increase the risk of muscle strength loss, whereas higher levels of ACT decrease the risk of muscle strength loss in older men and women.
Schalk, B.W.M., Visser, M., Bremmer, M.A., Penninx, B.W.J.H., Bouter, L.M., Deeg, D.J.H. (2006). Change of serum albumin and risk of cardiovascular disease and all-cause mortality. American Journal of Epidemiology, 164, 969-977. >Full Text.
No abstract available.
Schuijt-Lucassen, N.Y., Broese van Groenou, M.I. (2006). Verschillen in zorggebruik door ouderen naar inkomen: De rol van gezondheid, sociale context, voorkeur en persoonlijkheid [Income inequality in the use of professional home care by older adults: The impact of health, social context, care preference and personality]. Tijdschrift voor Sociale Geneeskunde, 84, 4-11.
No abstract available.
Schuijt-Lucassen, N.Y., Deeg, D.J.H. (2006). Predicting loss of mastery in older adults. Tijdschrift voor Gerontologie en Geriatrie, 37, 6, 243-253.
No abstract available.
Smit, H.F.E., Ederveen, A., Cuijpers, P., Deeg, D.J.H., Beekman, A.T.F. (2006). Opportunities for cost-effective prevention of late-life depression. An epidemiological approach. Archives of General Psychiatry, 63, 290-296. > Full Text.
Context: Clinically relevant late-life depression has aprevalence of 16% and is associated with substantial societalcosts through its disease burden and unfavorable prognosis.From the public health perspective, depression prevention maybe an attractive, if not imperative, means to generate healthgains and reduce future costs.Objective: To target high-risk groups for depression preventionsuch that maximum health gains are generated against the lowestcost.Design: Population-based cohort study over 3 years.Setting: General population in the Netherlands.Participants: Twenty-two hundred community residents aged55 to 85 years. Of these, 1925 were not depressed at baseline.Main Outcome Measure The onset of clinically relevantdepression was measured with the Center for EpidemiologicalStudies Depression Scale. For each of the risk factors (andtheir combinations), we calculated indices of potential healthgain and the effort (costs) required to generate those healthgains.Results: One in every 5 cases of clinically relevant late-lifedepression is a new case. Consequently, depression preventionhas to play a key role in reducing the influx of new cases.This is best done by directing prevention efforts toward elderlypeople who have depressive symptoms, experience functional impairment,and have a small social network, in particular women, as wellas people who have attained only a low educational level orwho suffer from chronic diseases.Conclusions: Directing prevention efforts toward selectedhigh-risk groups could help reduce the incidence of depressionand is likely to be more cost-effective than alternative approaches.This article further shows that we have the methodology at ourdisposal to conduct ante hoc cost-benefit analysis in preventivepsychiatry. This helps set a rational research and developmentagenda before testing the cost-effectiveness of interventionsin time-consuming and expensive trials.
Snijder, M.B., Van Dam, R.M., Visser, M., Deeg, D.J.H., Seidell, J.C., Lips, P.T.A. (2006). Vitamin D and diabetes. Letter-Comment to: C. mathieu, C. Gysemans, A. Giulietti, R. Bouillon (2005). Diabetologia 48, 1247-1257. Diabetologia, 49, 217-218. >Full Text.
No abstract available.
Snijder, M.B., Van Schoor , N.M., Pluijm, S.M.F., Van Dam, R.M., Visser, M., Lips, P.T.A. (2006). Vitamin D status in relation to one-year risk of recurrent falling in older men and women. The Journal of Clinical Endocrinology & Metabolism, 91, 8, 2980-2985. >Full Text.
No abstract available.
Steunenberg, B. (2006). Personality and depression in later life. A longitudinal study into the assocation between personality and depression in later life. PhD Dissertation, VU University Amsterdam.
No abstract available.
Steunenberg, B., Beekman, A.T.F., Deeg, D.J.H., Kerkhof, A.J.F.M. (2006). Personality and the onset of depression in late life. Journal of Affective Disorders, 92, 243-251. >Full Text.
No abstract available.
Thomése, G.C.F., Broese van Groenou, M.I. (2006). Adaptive strategies after health decline in later life: increasing the person-environment fit by adjusting the social and physical environment. European Journal of Ageing, 3, 169-177. >Full Text.
Abstract: Abstract Following the press-competence model (PCM) of Lawton and associates, we tested two expectations as to the adaptations older adults make to their socio-physical environment following health decline: (1) depending on the change in their functional limitations, older adults use adaptive strategies ranging from mobilizing informal care to moving into a residential setting; (2) the more people succeed in realizing suitable adaptations, the higher their wellbeing, measured as depressive symptoms, after a health decline. Data come from two waves of a longitudinal study among Dutch people aged 60�85 and living independently at baseline (Longitudinal Aging Study Amsterdam, LASA). The 819 respondents with a decline in self-reported functional disability within 3 years time were selected for analysis. Results of multivariate logistic and regression analyses show that (1) all adaptive strategies under study occur in response to health decline; (2) mobilization of informal care and moving to a care setting alleviates the negative effect of health decline on depressive symptoms. Furthermore, mobilization of professional home care was associated with more depressive symptoms independent of health decline, whereas adjustment of the home had no effect on depressive symptoms. We argue that some support was found for Lawton\'s PCM, but that evidence can be improved by studying more closely which adaptive strategies alleviate the environmental stress induced by specific physical disabilities.
Uitterlinden, A.G., Ralston, S.H., Brandi, M.L., Carey, A.H., Grinberg, D., Langdahl, B.L., Lips, P.T.A., Lorenc, R., Obermayer-Pietsch, B., Reeve, J., Reid, D.M., Amedei, A. (2006). The association between common vitamin D receptor gene variations and osteoporosis: a participant-level meta-analysis. Annals of Internal Medicine, 145, 255-264. > Full Text.
Background: Polymorphisms of the vitamin D receptor (VDR) gene have been implicated in the genetic regulation of bone mineral density (BMD). However, the clinical impact of these variants remains unclear. Objective: To evaluate the relation between VDR polymorphisms, BMD, and fractures. Design: Prospective multicenter large-scale association study. Setting: The Genetic Markers for Osteoporosis consortium, involving 9 European research teams. Participants: 26 242 participants (18 405 women). Measurements: Cdx2 promoter, FokI, BsmI, ApaI, and TaqI polymorphisms; BMD at the femoral neck and the lumbar spine by dual x-ray absorptiometry; and fractures. Results: Comparisons of BMD at the lumbar spine and femoral neck showed nonsignificant differences less than 0.011 g/cm2 for any genotype with or without adjustments. A total of 6067 participants reported a history of fracture, and 2088 had vertebral fractures. For all VDR alleles, odds ratios for fractures were very close to 1.00 (range, 0.98 to 1.02) and collectively the 95% CIs ranged from 0.94 (lowest) to 1.07 (highest). For vertebral fractures, we observed a 9% (95% CI, 0% to 18%; P _ 0.039) risk reduction for the Cdx2 A-allele (13% risk reduction in a dominant model). Limitations: The authors analyzed only selected VDR polymorphisms. Heterogeneity was detected in some analyses and may reflect some differences in collection of fracture data across cohorts. Not all fractures were related to osteoporosis. Conclusions: The FokI, BsmI, ApaI, and TaqI VDR polymorphisms are not associated with BMD or with fractures, but the Cdx2 polymorphism may be associated with risk for vertebral fractures.
Van der Pas, S. (2006). Intergenerational relationships of older adults. Family structure, contact and norms. PhD Dissertation, VU University Amsterdam.
No abstract available.
Van der Zouwen, J., Smit, J.H., Van der Horst, M.H.L. (2006). Reporting the frequency and duration of household tasks by elderly respondents: The effect of different interview strategies on data quality. Proceedings of the 60th AAPOR Annual Conference, May 12-15, 2005, Miami Beach, Fl, 4007-4014. Alexandria: American Statistical Association. On CD-Rom.
No abstract available.
Van Zelst, W.H., De Beurs, E., Beekman, A.T.F., Van Dyck, R., Deeg, D.J.H. (2006). Well-being, physical functioning, and use of health services in the elderly with PTSD and subthreshold PTSD. International Journal of Geriatric Psychiatry, 21, 180-188. >Full Text.
Objective: To measure the impact of PTSD and subthreshold PTSD on daily life functioning, well-being and health care use in a community based-sample of the elderly population in the Netherlands. Methods: Consequences of PTSD were investigated in an elderly community-based population (LASA study) by comparing three groups: subjects with PTSD, with subthreshold PTSD, and a reference group. Indicators of well-being (loneliness, self-perceived health and satisfaction with life), disability (days spent in bed and disability days) and use of health care (general practitioners, medical specialists, psychiatrists, mental health care, social workers and professional home care) were investigated. Results: In comparison to the reference group, subjects with PTSD or subthreshold PTSD spent more days in bed due to illness and had more disability days, even when corrected for concurring other diseases or functional limitations. They were less satisfied with life in general, used health care for predominantly somatic care and evaluated the care they received to be inadequate. Psychotropic drugs, if prescribed, were predominantly benzodiazepines and seldom antidepressants. Conclusions: The findings strongly suggest that elderly with either PTSD or subthreshold PTSD suffer grave impairments in daily life, are less satisfied with life and do not receive optimum treatment. Especially elderly with PTSD frequently visit medical specialists but are rarely treated by psychiatrists or other mental health professionals, nor do they receive antidepressant treatment from their GP. Lack of adequate treatment may be the cause of dissatisfaction with the care they receive.
Visser, M., Deeg, D.J.H., Puts, M.T.E., Seidell, J.C., Lips, P.T.A. (2006). Low serum concentrations of 25-hydroxyvitamin D in older persons and the risk of nursing home admission. The American Journal of Clinical Nutrition, 84, 616-622.
No abstract available.

2005

Aartsen, M.J., Van Tilburg, T.G., Smits, C.H.M., Comijs, H.C., Knipscheer, C.P.M. (2005). Does widowhood affect memory performance of older persons? Psychological Medicine, 35, 217-226. >Full Text.
No abstract available.
Arwert, L.I., Veltman, D.J., Deijen, J.B., Lammertsma, A.A., Jonker, C., Drent, M.L. (2005). Memory performance and the growth hormone/insulin-like growth factor axis in elderly: A Positron Emission Tomography Study. Neuroendocrinology, 81, 31-40.
No abstract available.
Bierman, E.J.M., Comijs, H.C., Jonker, C., Beekman, A.T.F. (2005). Effects of anxiety versus depression on cognition in later life. American Journal of Geriatric Psychiatry, 13, 686-693. > Full Text.
Objective: The authors investigated the relationship between anxiety and cognition in older persons, taking account of comorbid depression. Methods: Data were used from the Longitudinal Aging Study Amsterdam (LASA), a large epidemiological study of 3,107 elderly citizens in The Netherlands. Anxiety and depression were measured with the Hospital Anxiety and Depression Scale-Anxiety subscale and the Center for Epidemiologic Studies-Depression Scale. In measuring cognitive performance, general cognitive functioning was measured by means of Mini-Mental State Ecam, episodic memory was measured with the Auditory Verbal Learning Test (AVLT), fluid intelligence by using the RAVEN, and information-processing speed by the coading task. Analysis of variance examined the association between anxiety symptoms and cognition in persons with and without depression. Results: Main effects of anxiety symptoms were found for learning and delayed recall of the AVLT. Depression symptoms showed significant main effects on almost all cognitive performance tests. Mild anxiety symptoms were associated with better cognitive performance, whereas severe anxiety symptoms were negatively associated with cognitive functioning. In contrast, depressive symptoms showed a linear association with cognition; more depression was associated with worse cognition. Conclusion: This study suggests that anxiety has a curvilinear relationship with cognition. Depressive symptoms, however, were always negatively associated with cognitive performance.
Braam, A.W., Prince, M.J., Beekman, A.T.F., Delespaul, P., Dewey, M.E., Geerlings, S.W., Kivelä, S.-L., Lawlor, B.A., Magnsson, H., Meller, I. (2005). Physical health and depressive symptoms in older Europeans. Results from EURODEP. British Journal of Psychiatry, 187, 35-42. > Full Text.
Background: Associations between physical health and depression are consistent across cultures aong adults up to 65 years of age. In later life, the impact of physical health on depression is much more substantial and may depend on sociocultural factors. Aims: To examine cross-national differences in the association between physical health and depressive symptoms in elderly people across western Europe. Method: Fourteen community-based studies on depression in later life in nine western European countries contributed to a total study sample of 22 570 respondents aged 65 years and older. Measures were harmonised for depressive symptoms (EURO-D scale), functional limitations and chronic physical conditions. Results: In the majority of the participating samples, the association of depressive symptoms with functional disability was stronger than with chronic physical conditions. Associations were slightly more pronounced in the UK and Ireland. Conclusion: The association between physical health and depressive symptoms in later life is consistent across western Europe. Declaration of interest: None. Funding detailed in Acknowledgements.
Broese van Groenou, M.I. (2005). Delen in de zorg: de rol van broers en zussen in de zorg van kinderen voor hun ouders. In A. de Boer (Ed.), Kijk op Informele Zorg (pp. 61-74). Den Haag: SCP.
No abstract available.
Comijs, H.C., Dik, M.G., Aartsen, M.J., Deeg, D.J.H., Jonker, C. (2005). The impact of change in cognitive functioning and cognitive decline on disability, well-being, and the use of healthcare services in older persons: results of the Longitudinal Aging Study Amsterdam. Dementia and Geriatric Cognitive Disorders, 19, 316-323.
No abstract available.
De Beurs, E., Comijs, H.C., Twisk, J.W.R., Sonnenberg, C.M., Beekman, A.T.F., Deeg, D.J.H. (2005). Stability and change of emotional functioning in late life: modelling of vulnerability profiles. Journal of Affective Disorders, 84, 53-62.
No abstract available.
De Boer, M.R., Pluijm, S.M.F., Lips, P.T.A., Moll, A.C., Völker-Dieben, H.J., Deeg, D.J.H., Van Rens, G.H.M.B. (2005). Better lighting to reduce falls and fracture? Journal of Bone and Mineral Research, 20, 11, 2063. >Full Text.
No abstract available.
Deeg, D.J.H. (2005). The development of physical and mental health from late midlife to early old age. In S.L. Willis, M. Martin (Ed.), Middle Adulthood. A Lifespan perspective (pp. 209-241). California: Sage Publications Inc. Thousand Oaks. ISBN: 0-7619-8853-X.
No abstract available.
Deeg, D.J.H. (2005). Longitudinal characterization of course types of functional limitations. Disability and Rehabilitation, 27, 5, 253-261.
No abstract available.
Deeg, D.J.H., Huizink, A.C., Comijs, H.C., Smid, T. (2005). Disaster and associated changes in physical and mental health in older residents. European Journal of Public Health, 15, 2, 170-174.
Background: Long-term health consequences of disasters have not been studied extensively, one reason amongst others is that no pre-disaster observation is available. This study focuseson an aeroplane crash on an Amsterdam suburb. The ongoing LongitudinalAging Study Amsterdam has one pre-disaster and several post-disasterobservations, making it possible to study changes in health,taking pre-disaster health characteristics into account. Methods:Three exposure groups are distinguished: those living withina radius of 1 km from the disaster (initial n=39), those livingbetween a radius of 1 and 2 km from the disaster (initial n=56),and those living in the rest of the city of Amsterdam (initial n=508). Health measures include general health, health in comparisonwith age peers, functional limitations, disability and cognitivefunctioning. These measures are based on self-ratings, interviewerobservations, or both. Results: Older persons living closestto the disaster area are likely to experience health declinein the wake of a disaster, over and above the health declinethat would occur normally with aging. The disaster-associatedhealth decline is small, and most obvious in the ability toperform actions (such as mobility), but is not observed in eitherdisability in daily functioning, nor in self-perceptions ofhealth. Cognitive functioning even shows a short-term improvement.Conclusion: These findings suggest substantial resilience inolder adults, despite their common health problems.
Deeg, D.J.H., Thomése, G.C.F. (2005). Discrepancies between personal income and neighbourhood status: Effects on physical and mental health. European Journal of Ageing, 2, 98-108.
No abstract available.
Dhonukshe-Rutten, R.A.M., Pluijm, S.M.F., De Groot, L.C.P.G.M., Lips, P.T.A., Smit, J.H., Van Staveren, W.A. (2005). Homocysteine and Vitamin B12 status relate to bone turnover markers, broadband ultrasound attenuation, and fractures in healthy elderly people. Journal of Bone and Mineral Research, 20, 6, 921-929. >Full Text.
No abstract available.
Dik, M.G., Jonker, C., Hack, C.E., Smit, J.H., Comijs, H.C., Eikelenboom, P. (2005). Serum inflammatory proteins and cognitive decline in older persons. Neurology, 64, 1371-1377.
No abstract available.
Dykstra, P.A., Van Tilburg, T.G., De Jong Gierveld, J. (2005). Changes in older adult loneliness: Results from a seven-year longitudinal study. Research on Aging, 27, no. 6, 725-747.
No abstract available.
Geerlings, S.W., Pot, A.M., Twisk, J.W.R., Deeg, D.J.H. (2005). Predicting transitions in the use of informal and professional care by older adults. Ageing & Society, 25, 111-130. >Full Text.
No abstract available.
Key Measurements: Care
Huisman, M., Kunst, A., Deeg, D.J.H., Grigoletto, F., Nusselder, W., Mackenbach, J.P. (2005). Educational inequalitites in the prevalence and incidence of disability in Italy and the Netherlands were observed. Journal of Clinical Epidemiology, 58, 1058-1065.
Background and Objectives: Information on socioeconomic inequalities in incidence of and recovery from disability is still scarce, as is information on socioeconomic inequalities in performance-based disability as compared to self-reported disability. This study aimed to estimate educational inequalities in the prevalence, incidence, and recovery of self-reported and performance-based disability in two European populations. Study Design and Setting: We analyzed data from two longitudinal studies on aging. At each wave, participants were asked to what degree they experienced difficulty with several functional tasks, and interviewers rated their performance on several tasks. Educational inequalities in both outcomes were expressed in terms of prevalence, incidence, and recovery ratios. Results: Educational inequalities in both prevalence and incidence of disability were observed. No large educational inequalities in recovery from disability could be demonstrated. Compared to inequalities in self-reports of disability, inequalities in performance-based disability were equally large in the Dutch study, but smaller in the Italian study. Conclusions: Inequalities in performance-based measures of disability stress the importance of the association of socioeconomic position with disability among older populations. Our results suggest that higher education serves to postpone or avoid disability, but provides less benefit when disability is already present.
Klinkenberg, M., Visser, G., Broese van Groenou, M.I., Van der Wal, G., Deeg, D.J.H., Willems, D.L. (2005). The last 3 months of life: care, transitions and the place of death of older people. Health and Social Care in the Community, 13, 420-430.
Many older people die in hospitals, whereas research indicates that they would prefer to die at home. Little is known about the factors associated with place of death. The aim of this study was to investigate the care received by older people in the last three months of their life, the transitions in care and the predictors of place of death. In this population-based study interviews were held with 270 proxy respondents to obtain data on 342 deceased participants (79% response rate) in the Longitudinal Aging Study Amsterdam (LASA). In the last three months of life the utilization of formal care increased. Half of the community- dwelling older people and their families were confronted with transitions to institutional care. For people who only received informal care the odds of dying in a hospital was 3.68 times the odds for those who received a combination of formal and informal home care. The chance of dying in a hospital was also related to the geographical region. The authors argue that future research is needed into the association found in the present study, i.e. that decedents who received both formal and informal care were more likely to die at home. In view of the differences found in geographical region in relation to place of death, further investigation of regional differences in the availability and accessibility of care is indicated.
Klinkenberg, M., Willems, D.L. (2005). De laatste levensfase van ouderen: aandachtspunten voor de huisarts. Huisarts & Wetenschap, 48 (2), 59-63.
No abstract available.
Koster, A. (2005). Socioeconomic health differences in old age: unraveling the role of biomedical, behavioral, and psychosocial factors. PhD Dissertation, Universiteit Maastricht.
No abstract available.
Melzer, D., Dik, M.G., Van Kamp, G.J., Jonker, C., Deeg, D.J.H. (2005). The apolipoprotein E e4 polymorphism is strongly associated with poor mobility performance test results but not self-reported limitation in older people. Journal of Gerontology, 60A, 10, 1319-1323. > Full Text.
No abstract available.
Noale, M., Minicuci, N., Bardage, C., Gindin, J., Nikula, S., Pluijm, S.M.F., Rodrguez-Laso, A., Maggi, S. (2005). Predictors of mortality: an international comparison of socio-demographic and health characteristics from six longitudinal studies on aging: the CLESA project. Experimental Gerontology, 40, 89-99. >Full Text.
No abstract available.
Penninx, B.W.J.H., Pluijm, S.M.F., Lips, P.T.A., Woodman, R., Miedema, K., Guralnik, J.M., Deeg, D.J.H. (2005). Late-Life Anemia Is Associated with Increased Risk of Recurrent Falls. Journal of the American Geriatrics Society, 53, 2106-2111. >Full Text.
No abstract available.
Pluijm, S.M.F., Bardage, C., Nikula, S., Blumstein, T., Jylha, M., Minicuci, N., Zunzunegui, M.V., Pedersen, N.L., Deeg, D.J.H. (2005). A harmonized measure of activities of daily living was a reliable and valid instrument for comparing disability in older people across countries. Journal of Clinical Epidemiology, 58, 1015-1023. >Full Text.
Background and Objectives: Our aim was to construct a harmonized measure of activities of daily living (ADL) across six countries, and to evaluate the reliability and validity of this measure. Methods: A population of 9,297 persons, aged 65�89 years, was drawn from the Comparison of Longitudinal European Studies on Aging (CLESA) study, which includes data from five European countries and Israel. Because the number, type, and response format of the ADL items differed across the six studies, a four-item scale was constructed to harmonize the data, using items common to most countries. A procedure was devised to substitute or construct items that were not available in two of the countries. Results: Cronbach\\\\\\\'s &#945; for the four-item ADL measure varied from 0.81 in Spain to 0.92 in Finland, and was similar to the &#945; of scales including five or six items. Kappa scores between substituted or constructed items and the actual items varied from 0.50 to 0.78. In all countries, the percentage of persons with ADL disability differed significantly across age and was associated with chronic diseases, poor self-rated health, global disability, and home help utilization. Conclusion: The harmonized four-item ADL measure seems a reliable and valid instrument for comparing ADL disability in older people across countries.
Poortman, A., Van Tilburg, T.G. (2005). Past experiences and older adults' attitudes: A lifecourse perspective. Ageing and Society, 25, 19-39. >Full Text.
In this study we apply a lifecourse perspective to an examination of older adults � attitudes about gender roles and moral issues. The study goes beyond previous research in that it examines the relationships between older adults �attitudes and: (a) experiences in the parental home, (b) people �s own marital and work experiences through the entire lifecourse, and (c) the marital and work experiences of their children. The sample consists of respondents aged 55 or more years from the �Living Arrangements and Social Networks of Older Adults in The Netherlands � survey of 1992 and the �Longitudinal Ageing Study Amsterdam �. It is shown that a large majority of older adults subscribe to the view that people have the freedom to make their own choices about the issues of voluntary childlessness, abortion and euthanasia. Similarly, most older adults favour equality between men and women. Multivariate analyses show that people �s attitudes are generally consistent with their lifecourse experiences. It is found that unconventional lifecourse experiences, particularly with respect to childbearing, associate with more progressive attitudes in late life. The behaviour and lifecourse experiences of their children are also related to older adults �attitudes. Particularly, if their children co-habited, older adults tend to be more progressive. These findings suggest that an important mechanism by which societal change may have affected older adults is through their children �s experiences.
Pot, A.M., Deeg, D.J.H., Twisk, J.W.R., Beekman, A.T.F., Zarit, S.H. (2005). The longitudinal relationship between the use of long-term care and depressive symptoms in older adults. The Gerontologist, 45, 3, 359-369. > Full Text.
No abstract available.
Puts, M.T.E., Lips, P.T.A., Ribbe, M.W., Deeg, D.J.H. (2005). The effect of frailty on residential/nursing home admission in the Netherlands independent of chronic diseases and functional limitations. European Journal of Ageing, 2, 264-274. >Full Text.
No abstract available.
Puts, M.T.E., Lips, P.T.A., Deeg, D.J.H. (2005). Static and dynamic measures of frailty predicted decline in performance-based and self-reported physical functioning. Journal of Clinical Epidemiology, 58, 1188-1198. >Full Text.
No abstract available.
Puts, M.T.E., Visser, M., Twisk, J.W.R., Deeg, D.J.H., Lips, P.T.A. (2005). Endocrine and inflammatory markers as predictors of frailty. Clinical Endocrinology, 63, 403-411. >Full Text.
Objective: To examine the association of serum concentrations of 25-hydroxyvitamin D (25(OH)D), interleukin-6 (IL-6), C-reactive protein (CRP), and insulin-like growth factor-1 (IGF-1) with prevalent and incident frailty. Design: The Longitudinal Aging Study Amsterdam, a prospective cohort study with three-yearly measurement cycles. Setting: General population-based sample. Participants: The respondents were men and women aged 65 and over, who participated at T1 (1995/1996, N=1,720) and T2 (1998/1999, N=1,509). Blood samples were obtained at T1 (N=1,271). Measurements: The presence of frailty at T1 and 3-year incidence of frailty. Frailty is defined as the presence of three out of nine frailty indicators. Results: At T1, 242 (19.0%) of all respondents were frail. Those who were frail at T1 had higher CRP and lower 25(OH)D levels. Serum 25(OH)D remained associated with frailty after adjustment for potential confounders with odds ratios of 2.60 (95%CI 1.60-4.21) for 25(OH)D< 25nmol/l and 1.72 (95%CI 1.19-2.47) for 25(OH)D 25-50 nmol/l versus high levels of 25 (OH)D. Of the non-frail at T1, 125 respondents (14.1%) became frail at T2. After adjustment, moderately elevated CRP levels (3-10 ug/ml) (OR 1.69, 95%CI 1.09-2.63) and low 25(OH)D (OR 2.04, 95%CI 1.01-4.13) were associated with incident frailty. No consistent associations were observed for IL-6 and IGF-1. Conclusion: Low 25(OH)D levels were strongly associated with prevalent and incident frailty; moderately elevated levels of CRP were associated with incident frailty.
Puts, M.T.E., Lips, P.T.A., Deeg, D.J.H. (2005). Sex differences in the risk of frailty for mortality independent of disability and chronic diseases. Journal of the American Geriatrics Society, 53, 40-47. >Full Text.
Objectives: To determine the effect of static and dynamic frailty on mortality in older men and women. Design: A prospective cohort study with three 3-year measurement cycles. Setting: Population based. Participants: The sample was derived from the Longitudinal Aging Study Amsterdam and consisted of respondents who participated in two cycles (T1: 1992/1993 and T2: 1995/1996) and for whom there was complete data on disability and chronic diseases (N=2,257). Measurements: Nine frailty markers were assessed at T1 and T2. The frailty markers were defined in two ways: low functioning at T2 (static frailty) and change in functioning between T1 and T2 (dynamic frailty). Survival time, calculated in days from T2 to January 1, 2000, was used as the outcome variable. Predictive ability was examined using Cox proportional hazards analyses separately for men and women. Results: Women were frailer than men. Static frailty was significantly associated with mortality in men (relative risk (RR)=2.4) and in women (RR=2.6). Dynamic frailty was also associated with mortality in women (RR=2.6), but it was not significantly associated with mortality in men (RR=1.3). When disability and chronic diseases were included in the model as possible mediators, these RRs dropped to 1.6, 2.0, 2.1, and 1.2, respectively, of which the first three were still significant. Conclusion: Frailty was associated with mortality to a greater extent in women than in men, and this effect was independent of disability and chronic disease. In men, the static definition of frailty was more predictive of mortality than the dynamic definition.
Schaap, L.A., Pluijm, S.M.F., Smit, J.H., Van Schoor , N.M., Visser, M., Gooren, L.J.G., Lips, P.T.A. (2005). The association of sex hormone levels with poor mobility, low muscle strength and incidence of falls among older men and women Clinical Endocrinology, 63, 152-160. >Full Text.
Objective:The objective of this study was to examine whether low levels of oestradiol and testosterone are associated with impaired mobility, low muscle strength and the incidence of falls in a population-based sample of older men and women. Design: cross-sectional population-based study, based on data of the Longitudinal Aging Study Amsterdam (LASA), including 623 men and 663 women, aged 65-88 years. Measurements: Serum levels of oestradiol, testosterone, albumin and sex hormone binding globulin (SHBG) were measured. Physical performance, functional limitations and muscle strength were assessed, and a follow-up on falls was performed prospectively during three years. Results: After adjustment for age, level of education, alcohol use, physical activity, chronic disease and body mass index (BMI), men in the highest quartile of the oestradiol/SHBG ratio had significantly higher physical performance scores than men in the lowest quartile (?=0.103). Serum levels of total testosterone were positively associated with muscle strength (?=0.085). Calculated bioavailable testosterone levels were positively associated with physical performance and muscle strength (?=0.128 and 0.109 respectively). No associations of oestradiol levels with mobility were seen in women. Levels of oestradiol and testosterone were not associated with falls. Conclusions: It can be concluded that low levels of sex hormones were associated with impaired mobility and low muscle strength in men, but not in women. Levels of sex hormones were not associated with the incidence of falls neither in men, nor in women.
Schalk, B.W.M., Visser, M., Penninx, B.W.J.H., Baadenhuijsen, H., Bouter, L.M., Deeg, D.J.H. (2005). Change in serum albumin and subsequent decline in functional status in older persons. Aging Clinical and Experimental Research, 17, 4, 297-305.
Background and aims: This study examines whether a three-year change in serum albumin concentration is associated with subsequent decline in functional status in older persons. Methods: A total of 588 participants from the Longitudinal Aging Study Amsterdam aged 65-85 years were followed for six years. The three-year change in serum albumin was classified in four groups: chronic low (< or =43 g/L at both time points), decrease (decrease of 2.4% or more) from normal to low, decrease but still normal, and stable normal albumin (reference group). During the subsequent three years, absolute change and a decline of one standard deviation or more (termed substantial decline) in functional status was assessed. Functional status was measured in two ways: using performance tests and self-reported functional ability. Results: Substantial decline in functional performance and functional ability was observed in 243 persons (41.3%) and 133 persons (22.6%), respectively. After adjustment for baseline functional status and potential confounders, chronic low albumin and a decrease from normal to low albumin were associated with a greater absolute decline in functional performance and in self-reported functional ability. Using the outcome substantial decline in functional status, only decrease to low serum albumin was associated with decline in functional ability [odds ratio (OR)=1.97; one-sided 95% Confidence Limit (CL)=1.09]. Conclusions: This study indicates that chronic low serum albumin is a determinant of decline in functional status. However, a decrease in serum albumin from normal to low levels but within the normal range was a stronger determinant of future decline in functional status. Change in serum albumin level within the normal range measured between two points in time may be used as a general marker of future functional decline.
Schalk, B.W.M., Deeg, D.J.H., Penninx, B.W.J.H., Bouter, L.M., Visser, M. (2005). Serum albumin and muscle strength: a longitudinal study in older men and women. Journal of the American Geriatrics Society, 53, 1331-1338. >Full Text.
To examine whether low serum albumin is associated with low muscle strength and future decline in muscle strength in community-dwelling older men and women. Design: Population-based cohort study. Setting: The Longitudinal Aging Study Amsterdam. Participants: Six hundred seventy-six women and 644 men aged 65 to 88. Measurements: Serum albumin was determined at baseline. Muscle strength was assessed using grip strength at baseline, after 3 (n51,009), and 6 (n5741) years. The outcomes were continuous baseline muscle strength, 3- and 6-year change in muscle strength, and a dichotomous indicator for substantial decline (a decrease if _1 standard deviations for women511 kg, for men512 kg) in muscle strength. Results: Mean serum albumin concentration _ standard deviation was 45.0 _ 3.3 g/L for women and 45.2 _ 3.2 g/L for men. At baseline, adjusting for age, lifestyle factors, and chronic conditions, lower serum albumin was cross-sectionally associated with weaker muscle strength (Po.001) in women and men. After 3 years of follow-up, mean decline in muscle strength was _5.6 _ 10.9 kg in women and _9.6 _ 11.9 kg in men. After adjustment for potential confounders, lower serum albumin was associated with muscle strength decline over 3 years (Po.01) in women and men (b50.57, standard error (SE)5 0.18; b50.37, SE50.16, respectively). Lower serum albumin was also associated with substantial decline in muscle strength in women (per unit albumin (g/L) adjusted odds ratio (OR)51.14, one-sided 95% confidence limit (CL)51.07) and men (per unit albumin (g/L) adjusted OR51.14, 95% CL51.08). Similar but slightly weaker associations were found between serum albumin and 6-year change in muscle strength (Po.05). Conclusion: These results suggest that low serum albumin, even within the normal range, is independently associated with weaker muscle strength and future decline in muscle strength in older women and men.
Schalk, B.W.M. (2005). Albumin and physical health decline in old age. PhD Dissertation, VU University Amsterdam.
No abstract available.
Schuurmans, J., Comijs, H.C., Beekman, A.T.F., De Beurs, E., Deeg, D.J.H., Emmelkamp, P.M.G., Van Dyck, R. (2005). The outcome of anxiety disorders in older people at 6-year follow-up: results from the Longitudinal Aging Study Amsterdam. Acta Psychiatrica Scandinavica, 111, 420-428. >Full Text.
Objective: To examine long-term outcome of late-life anxiety disorders and utilization of mental health care services.Method: A cohort of subjects (aged ?55years) with an anxiety disorder (n=112) was identified in the Longitudinal Aging Study Amsterdam (n=3107). At 6year follow-up, the rate of persistence and prognostic factors for persistence of anxiety were established. Results: Six years after baseline 23% of our sample met the criteria for an anxiety disorder. Another 47% suffered from subclinical anxiety symptoms. Persistence of anxiety was associated with a high score on neuroticism at baseline. Use of benzodiazepines was high (43%), while use of mental health care facilities (14%) and anti-depressants (7%) remained low in those with persistent anxiety. Conclusion: Results indicate that those high in neuroticism are at greater risk for persistence of anxiety. Efforts to enhance appropriate referral of anxious older adults do not seem to have had the desired effect.
Snijder, M.B., Van Dam, R.M., Visser, M., Deeg, D.J.H., Dekker, J.M., Bouter, L.M., Seidell, J.C., Lips, P.T.A. (2005). Adiposity in Relation to Vitamin D Status and Parathyroid Hormone Levels: A Population-Based Study in Older Men and Women. The Journal of Clinical Endocrinology & Metabolism, 90, 7, 4119-4123. >Full Text.
Objective: In small case-control studies, obesity was associated with worse vitamin D status. Our aim was to assess the association of adiposity (anthropometric measures as well as dual energy x-ray absorptiometry) with serum 25-hydroxyvitamin D (25-OH-D) and serum PTH levels in a large population-based study including older men and women. Methods: Subjects were participants of the Longitudinal Aging Study Amsterdam and were aged 65 yr and older. In 453 participants, serum 25-OH-D and PTH were determined, and body mass index, waist circumference, waist to hip ratio, sum of skin folds, and total body fat percentage by dual energy x-ray absorptiometry were measured. Results: After adjustment for potential confounders, higher body mass index, waist circumference, and sum of skin folds were statistically significantly associated with lower 25-OH-D (standardized _ values were _0.136, _0.137, and _0.140, respectively; all P _ 0.05) and with higher PTH (0.166, 0.113, and 0.114, respectively; all P _ 0.05). Total body fat percentage was more strongly associated with 25-OH-D and PTH (_0.261 and 0.287, respectively; both P _ 0.001) compared with anthropometric measures. Total body fat percentage remained associated with 25-OH-D after adjustment for PTH, and with PTH after adjustment for 25-OH-D. Conclusion: Precisely measured total body fat is inversely associated with 25-OH-D levels and is positively associated withPTHlevels. The associations were weaker if anthropometric measures were used, indicating a specific role of adipose tissue. Regardless of the possible underlying mechanisms, it may be relevant to take adiposity into account when assessing vitamin D requirements.
Steunenberg, B., Twisk, J.W.R., Beekman, A.T.F., Deeg, D.J.H., Kerkhof, A.J.F.M. (2005). Stability and Change of Neuroticism in Aging. Journal of Gerontology: Psychological Sciences, vol. 60B, 1, P27-P33. > Full Text.
No abstract available.
Thomése, G.C.F., Van Tilburg, T.G., Broese van Groenou, M.I., Knipscheer, C.P.M. (2005). Network dynamics in later life. In M.L. Johnson (Ed.). In association with: V.L. Bengtson, P.G. Coleman, T.B.L. Krikwood (Eds.), The Cambridge handbook of age and ageing (pp. 463-468). Cambridge, UK: Cambridge University Press. ISBN-10: 0521533708, ISBN-13: 9780521533706. > Full Text.
No abstract available.
Van der Pas, S., Van Tilburg, T.G., Knipscheer, C.P.M. (2005). Measuring older adults' filial responsibility expectations: Exploring the application of a vignette technique and an item scale. Educational and Psychological Measurement, 65, 6, 1026-1045. >Full Text.
This study focused on two conceptually distinct measures of the filial responsibility expectations of older adults: a vignette technique and an attitude item scale. Data were based on 1,553 respondents aged 61 to 92 years who participated in the Longitudinal Aging Study Amsterdam in 1998to 1999.The results showed that the item scale had multiple dimensions of filial expectations. Older adults distinguished between emotional-, instrumental-, contact-, and information-oriented expectations. The vignette technique resulted in a unidimensional measurement of expectations. The intercorrelation between the scores of the item scale and vignette technique was modest, indicating a certain amount of overlap. Child characteristics incorporated into the vignettes added to the specificity of measurements of the filial expectations. The authors observed that older adults were more likely to have expectations for care from an adult child who is not employed and does not have children. Minor differences between sons and daughters were observed.
Van der Zouwen, J., Smit, J.H. (2005). Control processes in survey interviews: a cybernetic approach. Kybernetes, 34, 5, 602-616. >Full Text.
No abstract available.
Van Gool, C.H., Kempen, G.I.J.M., Penninx, B.W.J.H., Deeg, D.J.H., Beekman, A.T.F., Van Eijk, J.Th.M. (2005). Impact of depression on disablement in late middle aged and older persons: results from the Longitudinal Aging Study Amsterdam. Social Science & Medicine, 60, 25-36.
The main pathway of the disablement process consists of four consecutive phases: Pathology (presence of disease/injury), Impairments (dysfunctions/structural abnormalities), Functional Limitations (restrictions in basic physical/mental actions), and Disability (difficulty doing activities of daily life, ADL). This study determines the presence of the main pathway of disablement in a cohort aged 55 years and older and examines whether progression of the main pathway of disablement is accelerated in the presence of depression. Based on baseline (T1) and two three-year followup interviews (T2 and T3) from the Longitudinal Aging Study Amsterdam (LASA) in a population-based cohort of 1110 Dutch persons, we first analysed the intermediate effect of the different consecutive phases of the disablement process by means of multiple regression, adjusted for covariates. Then, depression was used as interaction term in multiple regression analyses linking the consecutive phases of the disablement process. We found that Impairments mediated the association between Pathology and Functional Limitations, and that Functional Limitations mediated the association between Impairments and Disability. Depression significantly modified the associations between Pathology and subsequent Impairments, and between Functional Limitations and subsequent Disability. In sum, the main pathway of the disablement process was identified in our sample. In addition, we found an accelerating effect of depression, particularly in the early and late stages of the model. Reduction of depression may help slow down the process of disablement for persons who find themselves in those stages of the model.
Van Gool, C.H. (2005). The course of chronic disease, depression, and health behavior in longitudinal perspective. Findings concerning the epidemiology of aging. PhD Dissertation, Universiteit Maastricht.
No abstract available.
Van Schoor , N.M., Smit, J.H., Twisk, J.W.R., Lips, P.T.A. (2005). Impact of vertebral deformities, osteoarthritis, and other chronic diseases on quality of life: a population-based study. Osteoporosis International, 16, 7, 749-756. >Full Text.
Vertebral deformities and spinal osteoarthritis are common disorders in elderly persons and are associated with back pain, impaired physical functioning, and loss of quality of life. The objectives of this study were to assess the impact of vertebral deformities and osteoarthritis on quality of life in a population-based sample, and to compare this with the impact of six other important chronic diseases on quality of life. The study was performed as a substudy of the Longitudinal Aging Study Amsterdam. Vertebral deformities and osteoarthritis were assessed by spinal radiographs; chronic diseases were assessed by self-report; quality of life was estimated by the SF-12, EQ-5D (EuroQol) and Qualeffo-41 (n=336). In univariate analyses, severe osteoporosis of the vertebrae significantly worsened the physical component summary scale of the SF-12 and the total score of Qualeffo-41, while osteoarthritis of the spine did not significantly reduce quality of life. The other chronic diseases reduced quality of life, although not all changes reached statistical significance. In multivariate analyses, severe osteoporosis of the vertebrae, cardiac disease, peripheral arterial disease, and diabetes mellitus significantly reduced quality of life. In conclusion, most persons in an elderly population suffer from one or more chronic diseases, and therefore experience loss of quality of life. After adjustment for age, sex, and other chronic diseases, severe osteoporosis of the vertebrae, cardiac disease, peripheral arterial disease, and diabetes mellitus significantly reduced quality of life in the general population.
Visser, M., Pluijm, S.M.F., Van der Horst, M.H.L., Poppelaars, J.L., Deeg, D.J.H. (2005). Leefstijl van 55-64-jarige Nederlanders in 2002/'03 minder gezond dan in 1992/'93 [Lifestyle of Dutch people aged 55-64 years less healthy in 2002/'03 than in 1992/'93]. Nederlands Tijdschrift voor Geneeskunde, 149, 52, 2973-2978.
Objective: To describe the lifestyle of men and women aged 55-64 years in the Netherlands in 2002/&#39;03 and compare it with the lifestyle of people of the same age in 1992/&#39;93. Design: Descriptive. Method: Data were used from the Longitudinal Aging Study Amsterdam. The study comprised two randomly selected samples from local municipal registers in 1992/&#39;93 (n = 966) and 2002/&#39;03 (n = 1002), stratified according to sex, age and expected 5-year survival. Participants were from 11 municipalities in the west, northeast and south of the Netherlands. Data were collected from interviews, measurements and a written questionnaire. The response was 62% in 1992/ &#39;93 and 57% in 2002/&#39;03. Results: In 1992/&#39;93, 9.5% of the men and 20.5% of the women were obese. Ten years later these percentages were 18.4 and 27.5. The percentage of current smokers was stable over time and included one-third of men and one-quarter of women. More people used alcohol in 2002/&#39;03; excessive alcohol use was found in 15.7% of the men (11.7% in 1992/&#39;93) and 19.5% of the women (11.1% in 1992/&#39;93). The energy expended through walking, bicycling, household activities and sports was one-fifth less in 2002/&#39;03. Conclusion: The lifestyle of people aged 55-64 years in the Netherlands was less healthy in 2002/&#39;03 than in 1992/&#39;93. Because positive changes in lifestyle can reduce the risk of chronic diseases, functional limitations and early death, more attention to healthy living is necessary in this age group.
Zunzunegui, M.V., Rodrguez-Laso, A., Otero, A., Pluijm, S.M.F., Nikula, S., Blumstein, T., Jylha, M., Minicuci, N., Deeg, D.J.H. (2005). Disability and social ties: comparative findings of the CLESA study. European Journal of Ageing, 2, 40-47. >Full Text.
Abstract The associations between prevalence, incidence and recovery from activities of daily living (ADL) disability and social ties among community-dwelling persons over 65 in Finland, The Netherlands and Spain are examined. Data were harmonized in the CLESA study. The baseline sample was composed of 3,648 subjects between 65 and 85 years old, living in Finland, The Netherlands and Spain. Disability in four activities of daily living was determined at baseline and at follow-up. Social participation, number of family ties and presence of friends were added to obtain a social ties index. Logistic regressions were fitted to the prevalence, incidence and recovery data to estimate the associations between disability and social ties, adjusting for education, comorbidity and self-rated health. The modifying effects of country, age and sex were tested in all models. For every country, the social ties index, having friends and social participation were negatively associated with ADL disability prevalence. ADL incidence was negatively related to the number of family ties, with a stronger relationship in Spain than in The Netherlands or Finland. ADL recovery was associated with the social ties index. No age or gender differences in these associations were found. Social ties appear to generate a beneficial effect on the maintenance and restoration of ADL function. While social ties play an important role in maintaining and restoring function in all three countries, family ties appear to generate a stronger effect on protection from disability incidence than does social participation, and the strength of this effect varies by culture.

2004

Aartsen, M.J., Martin, M., Zimprich, D. (2004). Gender differences in level and change in cognitive functioning: Results from the longitudinal aging study Amsterdam. Gerontology, 50, 35-38. >Full Text.
Background: Gender differences in level of cognitive functioning are frequently observed, but little is known about gender differences in rate of decline of cognitive functioning. Objective: The present study aims to describe variability between and within men and women specified for four different cognitive abilities at baseline, and variability in change in these abilities among men and women over 6 years. Methods: We started with a study sample of 1,132 men and 1,175 women, with a measurement interval of 3 years. At wave 3 of the study, 1,552 of the respondents from wave 1 were still present. Differences in level and rate of change were estimated with latent change models. Results: Women have higher levels of memory functioning then men, but no gender differences were observed for speed or non- verbal reasoning changes. Conclusion: In spite of evidence for a stronger age- related atrophy of the brain structure of men, no gender differences in decline of cognitive functions could be observed.
Aartsen, M.J., Smits, C.H.M., Knipscheer, C.P.M. (2004). A longitudinal study of the impact of physical and cognitive decline on the personal network in old age. Journal of Social and Personal Relationships, 21,2, 249-266. >Full Text.
The effects of cognitive and physical decline on changes in the size and composition of four types of personal networks over a period of six years were investigated in a Dutch sample of 1552 older adults, aged 55�85 years. The effects of age and a decline in cognitive and physical functioning on the probability of changes in all possible network types were investigated. Transitions related to age and to cognitive and physical decline were observed for about one-third of the study sample. Greater age was associated with an increase in the number of family members in the network. Physical decline was associated with a replacement of friends and neighbors by family members only if the network was large. In small networks, no such association occurred. Cognitive decline was associated with a loss of relationships, most likely friends and neighbors, who were not found to be replaced by family members. Physical decline appears to be associated with an increase in the potential number of supporters in the network, whereas cognitive decline is associated with a decrease in the number of potential supporters.
Beekman, A.T.F., Geerlings, S.W., Deeg, D.J.H., Smit, J.H., Schoevers, R.A., De Beurs, E., Braam, A.W., Penninx, B.W.J.H., Van Tilburg, W. (2004). Het beloop van depressie bij ouderen: resultaten van 6 jaar intensive follow-up. Tijdschrift voor Psychiatrie, 46, 2, 73-84.
No abstract available.
Beekman, A.T.F., Deeg, D.J.H., Smit, J.H., Comijs, H.C., Braam, A.W., De Beurs, E., Van Tilburg, W. (2004). Dysthymia in later life: a study in the community. Journal of Affective Disorders, 81, 191-199. >Full Text.
Background: Dysthymia (DD) may be thought of as depression associated with personality disorder, a phase in the pleomorphic natural history of unipolar depression or a result of exposure to chronic physical illness. Prevalence, clinical features, risk factors and prognosis may change with age. Method: Large (n = 3056) representative sample of elderly (55�85) in the Netherlands. Two-stage screen procedure to identify elderly with DD. The Center for Epidemiologic Studies Depression scale (CES-D) was used as a screen and the Diagnostic Interview Schedule (DIS) to diagnose DD. Data on 277 depressed elderly were available to assess the 6-year prognosis of DD. Results: The prevalence of DD (4.61%) was higher in women and declined with age. The symptom profiles of DD and MDD were very similar. Those with DD were very likely to have had MDD earlier in life (44% in pure DD and 80% in those with double depression). The average age at onset (31 years) was earlier than in MDD (53 years). Environmental and personal vulnerability dominated the risk-factors. The prognosis was unfavourable in most cases. Limitations: Considerable attrition and retrospective data on age at onset and previous histories of depression. Conclusion: Although the prevalence declines with age, DD remains common in later life. Many cases arise later than is often thought and clinical features intertwine with those of MDD in the course of life. Given the unfavourable prognosis, provision of effective treatment is warranted.
Bisschop, M.I. (2004). Psychosocial resources and the consequences of specific chronic diseases in older age. The Longitudinal Aging Study Amsterdam. PhD Dissertation, VU University Amsterdam.
No abstract available.
Bisschop, M.I., Kriegsman, D.M.W., Beekman, A.T.F., Deeg, D.J.H. (2004). Chronic diseases and depression: the modifying role of psychosocial resources. Social Science & Medicine, 59, 721-733. >Full Text.
Psychosocial coping resources have been found to protect against depressive symptoms in people with and without chronic diseases. It has not been established, however, whether these resources have the same effects across patients with different diseases. Therefore, the aim of the study was to estimate the direct and buffer effects of psychosocial resources on depression, and to examine whether these effects are different for various chronic diseases. Data were obtained from the Longitudinal Aging Study Amsterdam. In all, 2288 community-dwelling respondents (age 55�85) were included and followed for a maximum of 6 years. Depressive symptoms (using the Center for Epidemiologic Studies-Depression scale), the presence of seven frequently occurring chronic diseases, social support and personal coping resources, physical functioning and sociodemographic variables were assessed by structured interviews .Generalized estimating equation models were estimated for each disease, social support and personal coping resources. All resources, except social network size, showed a direct effect on depressive symptoms regardless of the presence of chronic diseases. Having a partner, high self-esteem, mastery, self-efficacy and feeling less lonely additionally buffered the negative effect of some, but not all, specific chronic diseases. Unexpectedly, in patients with cardiac disease, none of the psychosocial resources exerted a buffer effect on depressive symptoms. For instrumental and emotional support only direct (unfavorable) effects and no buffer effects could be observed. In conclusion, our study provides evidence that buffer effects of psychosocial resources are different across various chronic diseases. This suggests that interventions to enhance specific resources may ameliorate depressive symptoms in specific chronic patients groups.
Bisschop, M.I., Kriegsman, D.M.W., Deeg, D.J.H., Beekman, A.T.F., Van Tilburg, W. (2004). The longitudinal relation between chronic diseases and depression in older persons in the community: the Longitudinal Aging Study Amsterdam. Journal of Clinical Epidemiology, 57, 187-194. >Full Text.
Objective: The purposes of this study were to examine the differences in influence of various chronic diseases on depressive symptomatology over time and to determine whether there were differences in such influence depending on physical limitations and time of onset of disease. Study Design and Setting: Data for this study were obtained from the Longitudinal Aging Study Amsterdam. Two thousand two hundred eighty-eight respondents (age 55�85) were included and followed for a maximum of 6 years. Depressive symptoms (using the CES-D scale), the presence of seven frequently occurring chronic diseases, physical limitations, and sociodemographic variables were assessed by structured interviews. Generalized estimating equation models were estimated for each disease and compared with each other. Results: Lung disease, arthritis, cardiac disease, and cancer were all positively associated with increased depressive symptoms over time. Stroke was associated with depressive symptoms, but these associations were not found when adjusted for physical limitations. For atherosclerosis and diabetes mellitus only weak or no associations with depressive symptoms were found. Recent onset of disease resulted in less strong associations for in cancer, lung disease, and arthritis. Conclusion: The results demonstrate that the level of depressive symptoms varies across type of chronic disease. In cardiac disease, arthritis, cancer, and lung disease increased depressive symptoms could not be attributed to physical limitations, but in stroke the association found with depressive symptoms was to a large extent attributable to physical limitations.
Braam, A.W., Hein, E., Deeg, D.J.H., Twisk, J.W.R., Beekman, A.T.F., Van Tilburg, W. (2004). Religious involvement and 6-year course of depressive symptoms in older Dutch citizens. Results from the Longitudinal Aging Study Amsterdam. Journal of Aging and Health, 16, 4, 467-489. > Full Text.
Objectives: Expanding on cross-sectional studies, associations are examined between religious involvement and the 6-year course of depressive symptoms in older adults. Methods: Subjects are1,840 community-dwelling older adults (aged 55 to 85) participatingin three measurement cycles of the Longitudinal Aging Study,Amsterdam. Assessments include aspects of religious involvement,depressive symptoms, physical health, self-perceptions, socialintegration, urbanization, and alcohol use. Results: Churchattendance is negatively associated with the course of depressivesymptoms, also after adjustment for explanatory variables. Amongrespondents with functional limitations, lower depression scoresare found for those who attend church on a regular basis. Forrespondents who are bereaved or nonmarried, however, slightlyhigher depression scores are found for those with high levelsof orthodox beliefs. Discussion: There is a consistent negativeassociation over time between church attendance and depressivesymptoms in older Dutch citizens. Both stress-buffering as wellas depression-evoking effects of religious involvement are found.
Braam, A.W., Delespaul, P., Beekman, A.T.F., Deeg, D.J.H., Prs, K., Dewey, M.E., Kivelä, S.-L., Lawlor, B.A., Magnsson, H., Meller, I., Prince, M.J., Reischies, F.M., Roelands, M., Saz, P., Schoevers, R.A., Skoog, I., Turrina, C., Versporten, A., Copeland, J.R.M. (2004). National context of healthcare, economy and religion, and the association between disability and depressive symptoms in older Europeans: results from the EURODEP concerted action. European Journal of Ageing, 1, 26-36. >Full Text.
Associations between disability and depression have been shown to be consistent across cultures among middle-aged adults. In later life the association between disability and depression is much more substantial and may be amenable to influences by health care facilities as well as economic and sociocultural factors. Fourteen community-based studies on depression in later life in 11 western European countries contribute to a total study sample of 22,570 respondents aged 65years or older. Measures are harmonised for depressive symptoms (EURO-D scale) and disability. Using multilevel modelling to control for the stratified data structure we examined whether the association between disability and depressive symptoms is modified by national health care and mental health care availability, national economic circumstances, demographic characteristics and religious tradition. The association between depressive symptoms and disability is attenuated by health care expenditure and availability of mental health care and also by gross domestic product; it was more pronounced in countries with high levels of orthodox religious beliefs. Higher levels of depressive symptoms are found in countries with a larger gross domestic product (per capita) and higher health care expenses but are interpreted with care because of measurement differences between the centres. The findings from this contextual perspective indicate that general and mental health care should be geared to one another wherever possible.
Broese van Groenou, M.I. (2004). Sociaal-economische verschillen in de hulpverlening van kinderen aan hun oude ouders. Sociale Wetenschappen, 47, 4, 49-64.
This study describes and explains the social-economic inequality in the care older parents receive from their children. Income is the indicator of social-economic status. The explanation of inequality is based on expected differences in the need, predisposition and opportunities to receive care. 259 parents report whether their children assist with personal and/or domestic care activities. Logistic regression analyses show that low-income parents are 3,6 times more likely to receive help from their children compared to high-income parents. The difference is explained by the fact that low-income parents are more often female, older and single, less often use privately paid help, prefer family care to professional care, and have more children living within proximity. It is concluded that the predisposition to use care (e.g. preferences) and, in particular, the opportunities to use care (e.g. no alternative sources of care) explain the differences in the use of informal care by older parents.
Comijs, H.C., Dik, M.G., Deeg, D.J.H., Jonker, C. (2004). The course of cognitive decline in older persons: Results from the Longitudinal Aging Study Amsterdam. Dementia and Geriatric Cognitive Disorders, 17, 136-142. >Full Text.
The course of cognitive functioning in older persons is studied over a period of six years. The first aim was to distinguish cognitive decline as a temporary state from progressive cognitive decline. The second aim was to identify predictors which may be useful in discriminating persons with temporary cognitive decline from persons with progressive cognitive decline at an early stage. Data were derived from the Longitudinal Aging Study Amsterdam (LASA), a population-based study in the Netherlands. The results show that 18.2% of the sample of older persons showed cognitive decline over a period of three years. Of this group, 44% recovered from cognitive decline or stayed stable in the next three years. Especially older age, memory complaints and an increase of cardiovascular diseases at follow-up predict further deterioration.
Comijs, H.C., Van Tilburg, T.G., Geerlings, S.W., Jonker, C., Deeg, D.J.H., Van Tilburg, W., Beekman, A.T.F. (2004). Do severity and duration of depressive symptoms predict cognitive decline in older persons? Results of the Longitudinal Aging Study Amsterdam. Aging, Clinical and Experimental Research, 16, 226-232.
Background and Aims: Some prospective studies show that depression is a risk factor for cognitive decline. Thus far, the explanation for the background of this association remained unclear. In the present study it is investigated (1) whether depression is etiologically linked to cognitive decline; (2) whether depression and cognitive decline may be the consequence of the same underlying subcortical pathology, or (3) whether depression is a reaction to global cognitive deterioration. Methods: A cohort of 133 depressed and 144 non-depressed older persons, was followed at eight successive observations during three years. All subjects were participants of the Longitudinal Aging Study Amsterdam (LASA). Depression symptoms were measured by means of the CES-D at eight successive waves. Cognitive function (memory function, information processing speed and global cognitive functioning) was assessed at baseline and at the last CES-D measurement. Results: Our results show that the severity and duration of depressive symptoms were not associated with subsequent decline in memory functioning or global cognitive decline. There was an association between both chronic mild depression and chronic depression, and decline in speed of information processing. Conclusions: These results support the hypothesis that in older persons chronic depression as well as cognitive decline may be the consequence of the same underlying subcortical pathology.
De Boer, M.R., Pluijm, S.M.F., Lips, P.T.A., Moll, A.C., Völker-Dieben, H.J., Deeg, D.J.H., Van Rens, G.H.M.B. (2004). Different aspects of visual impairment as risk factors for falls and fractures in older men and women. Journal of Bone and Mineral Research, 19, 9, 1539-1547. >Full Text.
Visual impairment has been implicated as a risk factor for falling and fractures, but results of previous studies have been inconsistent. The relationship between several aspects of vision and falling/fractures were examined in a prospective cohort study in 1509 older men and women. The analyses showed that impaired vision is an independent risk factor for both recurrent falling and fractures. Introduction: falls and fractures are a major health problem among the elderly. Visual impairment has been implicated as a risk factor for both falls and fractures. However, results from studies are inconsistent. The inconsistency between findings can primarily be attributed to differences in the designs of these studies. Most studies have been cross-sectional or case-control studies, and many have not correctly adjusted for potential confounders. Furthermore, until now, the potential mediating effects of functional limitation, physical performance, and physical activity have not been examined. Materials and Methods: A total of 1509 people was examined in 1995-1996. Contrast sensitivity was assessed with the VCTS_6000-1 chart for near vision. In addition, self-reported visual impairment was assessed by questions on recognizing faces from a distance of 4 m, reading the small print in the newspaper, and problems with glare. Furthermore, many potential confounders and mediators were assessed. Falls and fractures were assessed prospectively during a 3-year follow-up period. The associations between the vision variables and falls and fractures were examined using Cox proportional hazards analyses. Results: After adjustment for potential confounders, contrast sensitivity was shown to be associated with recurrent falling (hazard ratio [HR] = 1.5), and the question on recognizing faces was shown to be associated with fractures (HR = 3.1). Furthermore, functional limitations and physical performance were shown to be mediators in the relationship between vision variables and recurrent falling/fractures. Conclusions: The results indicate that impaired vision is an independent risk factor for falling and fractures, but different aspects of visual functioning may have different relationships to falling and fractures.
De Klerk, M.M.Y., Schoenmakers-Salkinoja, I., Geerlings, S.W. (2004). Kwetsbare ouderen. In M.M.Y. de Klerk (Ed.), Zorg en wonen voor kwetsbare ouderen. Rapportage ouderen 2004 (pp. 13-34). Den Haag: Sociaal en Cultureel Planbureau. ISBN 90-377-0156-6.
No abstract available.
Deeg, D.J.H. (2004). Epidemiologie vanuit levensloopperspectief. Tijdschrift voor Gerontologie en Geriatrie, 35, 143-145.
No abstract available.
Dhonukshe-Rutten, R.A.M. (2004). Vitamin B12: a novel indicator of bone health in vulnerable groups. PhD Dissertation, Wageningen Universiteit.
No abstract available.
Dykstra, P.A., De Jong Gierveld, J. (2004). Gender and marital-history differences in emotional and social loneliness among Dutch older adults. Canadian Journal on Aging, 23, 2, 141-155. >Full Text.
No abstract available.
Geerlings, S.W., Broese van Groenou, M.I., Deeg, D.J.H. (2004). Determinanten van veranderingen in zorggebruik. In M.M.Y. de Klerk (Ed.), Zorg en wonen voor kwetsbare ouderen. Rapportage Ouderen 2004 (pp. 81-111). Den Haag: SCP. ISBN 90-377-0156-6.
No abstract available.
Geerlings, S.W., Deeg, D.J.H. (2004). Determinanten van transities in informeel en professioneel zorggebruik door ouderen. In P.P. Groenewegen, G.A.M. van den bos, P.J. van Megchelen (Eds.), Zorg, opvang en begeleiding van chronisch zieken. Van onderzoeksresultaten naar verbetering van zorg (pp. 171-181). Assen: Van Gorcum. ISBN 90-232-3956-3.
No abstract available.
Geerlings, S.W., Deeg, D.J.H. (2004). Veranderingen in het gebruik van zorg. In M.M.Y. de Klerk (Ed.), Zorg en wonen voor kwetsbare ouderen. Rapportage ouderen 2004 (pp. 65-79). Den Haag: Sociaal en Cultureel Planbureau. ISBN 90-377-0156-6.
No abstract available.
Horn, L.M., Deeg, D.J.H. (2004). Chronische ziekten bij ouderen. In Drs. F.M. Alsem, M. de Coole, prof. Dr. P.P.J. Houben, drs. Mw. H.W. Voermans, mw. A. Berkhout (Eds.), Handboek lokaal ouderenwerk (pp. C2-5-1-C2-5-24). Elsevier Gezondheidszorg. ISBN 90-352-1464-1.
No abstract available.
Klinkenberg, M. (2004). The last phase of life of older people: Health, preferences and care, a proxy report study PhD Dissertation, VU University Amsterdam.
No abstract available.
Klinkenberg, M., Willems, D.L., Onwuteaka-Philipsen, B.D., Deeg, D.J.H., Van der Wal, G. (2004). Preferences in end-of-life care of older persons: after-death interviews with proxy respondents. Social Science & Medicine 59, 2467-2477. >Full Text.
No abstract available.
Klinkenberg, M., Willems, D.L., Van der Wal, G., Deeg, D.J.H. (2004). Symptom burden in the last week of life. Journal of Pain and Symptom Management, 27, 1, 5-13. >Full Text.
In order to investigate symptom burden in the last week of life, we conducted after-death interviews with close relatives of deceased older persons from a population-based sample of older people in The Netherlands (n = 270). Results show that fatigue, pain, and shortness of breath were common (83%, 48% and 50%, respectively). Other symptoms were confusion (36%), anxiety (31%), depression (28%), and nausea and/or vomiting (25%). Cancer patients and patients with chronic obstructive pulmonary disease were clearly at a disadvantage with respect to pain and shortness of breath, respectively. Furthermore, cognitive decline turned out to be predictive of specific symptom burden. Persons with cognitive decline in the last three months had a higher symptom burden and different symptoms compared to patients with no cognitive decline. It is suggested that older persons with cognitive decline require specific attention.
Knipscheer, C.P.M., Broese van Groenou, M.I. (2004). Determinanten van zorgbelasting bij partners en kinderen van hulpbehoevende ouderen met fysieke gezondheidsproblemen. Tijdschrift voor Gerontologie en Geriatrie, 35, 96-106.
No abstract available.
Kriegsman, D.M.W., Deeg, D.J.H., Stalman, W.A.B. (2004). Comorbidity of somatic chronic diseases and decline in physical functioning: the Longitudinal Aging Study Amsterdam. Journal of Clinical Epidemiology, 57, 55-65. >Full Text.
Objective: To assess the association of decline in physical functioning with number of chronic diseases and with specific comorbidity in different index diseases.Methods: A longitudinal design was employed using data from 2,497 older adults participating in the Longitudinal Aging Study Amsterdam. Logistic regression analyses were used to determine influence of chronic diseases on change in physical functioning, operationalized using the Edwards-Nunnally index.Results: Decline in physical functioning was associated with number of chronic diseases (adjusted ORs from 1.58 for 1, to 4.05 for greater than or equal to3 diseases). Comorbidity of chronic nonspecific lung disease and malignancies had the strongest exacerbating influence on decline. An exacerbating effect was also found for arthritis in subjects with diabetes or malignancies and for stroke in subjects with chronic nonspecific lung disease or malignancies. A weaker effect than expected was observed for diabetes in subjects with stroke, malignancies, cardiac disease, or peripheral atherosclerosis.Conclusion: Comorbidities involving chronic diseases that share etiologic factors or pathophysiologic mechanisms appear to have a weaker negative influence on decline in physical functioning than expected. Results indicate that combinations of diseases that both influence physical functioning, but through different mechanisms (locomotor symptoms vs. decreased endurance capacity) may be more detrimental than other combinations.
Licht-Strunk, E., Bremmer, M.A., Van Marwijk, H.W.J., Deeg, D.J.H., Hoogendijk, W.J.G., De Haan, M., Van Tilburg, W., Beekman, A.T.F. (2004). Depression in older persons with versus without vascular disease in the open population: Similar depressive symptom patterns, more disability. Journal of Affective Disorders, 83, 155-160. >Full Text.
Background: Clinical studies suggest that vascular depression presents with typical symptom patterns. The aim of the present study is to examine whether depressed older persons in the open population with and without vascular disease show different symptom patterns. Methods: In the Longitudinal Aging Study Amsterdam (LASA), a depressed cohort with (n=114) and without (n=292) vascular disease was identified. Depression was measured using self-reports (CES-D). Vascular disease was confirmed or ruled out using a combination of self-reported data, medication use and reports from general practitioners. Results: No significant differences were found in depressive symptom patterns, in symptom clusters nor individual items of the CES-D. Depressed subjects with vascular disease showed much more disability than those without vascular disease. Age of onset of depression did not show statistically significant difference. Conclusions: From our study in the open population, there is no evidence to support the hypothesis that depressed older persons with vascular disease have a distinct depressive symptom profile, but they do show more disability.
Melzer, D., Lan, T.Y., Tom, B.D.M., Deeg, D.J.H., Guralnik, J.M. (2004). Variation in thresholds for reporting mobility disability between national population subgroups and studies. Journal of Gerontology: Medical Sciences, 59A, 12, 1295-1303. > Full Text.
Background: Disability questions require older people to report difficulties with everyday activities, using broad categorical responses. Relatively little is known about population group differences in the thresholds for reporting difficulty or inability with medium-distance mobility against tested mobility-related performance. We aimed to estimate the thresholds on tested performance at which self-reports change from one category to another, across a range of sociodemographic subgroups. We also aimed to compare reported and tested performance across two national population studies. Methods: The samples were from the third U.S. National Health and Nutrition Examination Study (NHANES III) and the Longitudinal Aging Study Amsterdam (LASA). Measures of gait speed, chair stands, and peak expiratory flow rate in both studies yielded the validated index of mobility-related physical limitations (MOBLI). Latent probit models were used to estimate cutpoints (thresholds) on the index for reporting difficulty or inability to walk a medium distance. Results: Thresholds for reporting difficulty or inability were studied by age, sex, race, educational level, and income in NHANES III. In models adjusting for the other factors, performance thresholds for reporting disability categories varied by age and income. The younger elderly persons in NHANES III on average reported difficulties or inabilities only when they reached a more severe level of tested limitation compared with older old persons. A similar pattern exists for those on higher incomes. For race, differences in threshold were present only for reporting inability, but not difficulty. Significant differences in thresholds were not present between groups defined by sex or for years of education. Comparisons between the NHANES and LASA studies show that lower reported mobility difficulty or inability prevalence in the Dutch sample is attributable both to reporting at higher levels of limitation and to better functioning. Conclusions: There is evidence of differences in thresholds for reporting mobility disability, especially across age and income groups in older Americans. Further work is needed to understand the perceptual, attitudinal, or environmental factors that cause these reporting differences.
Minicuci, N., Noale, M., Pluijm, S.M.F., Zunzunegui, M.V., Blumstein, T., Deeg, D.J.H., Bardage, C., Jylha, M. (2004). Disability-free life expectancy: a cross-national comparison of six longitudinal studies on aging. he CLESA project. European Journal of Ageing, 1, 37-44. >Full Text.
No abstract available.
Penninx, B.W.J.H. (2004). Depressie, hartziekte en sterfte bij ouderen. Centraal Bureau voor de Statistiek. Bevolkingstrends 52. (pp. 33-35).
No abstract available.
Pluijm, S.M.F., Van Essen, H.W., Bravenboer, N., Uitterlinden, A.G., Smit, J.H., Pols, H.A.P., Lips, P.T.A. (2004). Collagen type I alpha1 Sp1 polymorphism, osteoporosis and intervertebral disc degeneration in older men and women. Annals of the Rheumatic Diseases, 63, 71-77. >Full Text.
No abstract available.
Schalk, B.W.M., Visser, M., Deeg, D.J.H., Bouter, L.M. (2004). Lower levels of serum albumin and total cholesterol and future decline in functional performance in older persons: the Longitudinal Aging Study Amsterdam. Age and Ageing, 33, 3, 266-272. >Full Text.
Background: Both serum albumin and total cholesterol are potential markers of frailty. A decline in functional status is one of the key components of frailty. Objective: The aim of this study was to investigate the association of serum albumin and total cholesterol, separately and combined, with future decline in functional performance. Design: The Longitudinal Aging Study Amsterdam, an ongoing population-based longitudinal study, started in 1992/1993 with a follow-up every 3 years. Participants: 1,064 men and women aged 55-85 years with complete data on serum albumin and total cholesterol at baseline, and functional performance at baseline and 3-year follow-up. Measurements: At baseline, serum albumin and total cholesterol were measured. At baseline and 3 years later, decline in functional status was measured with three performance tests (chair stand, 3-metre walk, putting on and taking off a cardigan). Associations were adjusted for age, life-style and health-related factors. Results: Albumin concentration was not associated with decline in functional performance in men and women. Women with lower serum total cholesterol concentration (</=5.2 mmol/l) were more likely to decline in functional status compared to women with higher serum total cholesterol concentration (reference; OR = 2.50; 95% CI 1.07-5.84). Men with lower serum albumin (</=43 g/l) and lower serum total cholesterol concentration were three times more likely to decline in functional performance compared to men with higher levels (OR = 3.00; 95% CI 1.00-8.97). In women, a similar trend was found (OR = 1.73; 95% CI 0.34-8.94), although not statistically significant. Conclusions: A combination of low albumin and low cholesterol levels may increase the risk of future functional decline.
Stel, V.S., Pluijm, S.M.F., Deeg, D.J.H., Smit, J.H., Bouter, L.M., Lips, P.T.A. (2004). Functional limitations and poor physical performance as independent risk factors for self-reported fractures in older persons. Osteoporos International, 15, 742-750. >Full Text.
Objective: This study examined whether three aspects of functioning (i.e., functional limitations, physical performance, and physical activity) were associated with fractures in older men and women. Design: A 3-year prospective cohort study. Participants and setting: A total of 715 men and 762 women, aged 65 years and older, of the population-based Longitudinal Aging Study Amsterdam. Measurements: During an interview at home, three aspects of functioning were assessed: functional limitations (what people say they can do), physical performance, i.e., three performance tests and handgrip strength (what people are able to do), and physical activity (what people actually do). Afterward, a follow-up on fractures was conducted for 3 years. Results: 77 patients (5.2%) suffered a fracture during 3-year follow-up. Most patients suffered a hip fracture (1.6%) or a wrist fracture (1.4%). The fracture rate per 1,000 person-years was 20.1. During 3-year follow-up, a fracture was reported by 12%, 10%, 12%, and 6% of the respondents with functional limitations, low performance test score, poor handgrip strength, and low physical activity, respectively. Using Cox proportional hazard analysis, functional limitations (RR=3.5; 95%CI, 2.1 to 6.0), low performance test score (RR=1.9; 95% CI, 1.1 to 3.3), low handgrip strength (RR=2.5; 95% CI, 1.5 to 4.1), and low physical activity (RR=1.9; 95% CI, 1.1 to 3.5) were significantly associated with fractures after adjustment for age and sex. Functional limitations (RR=3.2; 95% CI, 1.8 to 5.5), low performance test score (RR=1.8; 95% CI, 1.0 to 3.3) and low handgrip strength (RR=2.0; 95% CI, 1.1 to 3.6) remained significantly associated with fractures after additional adjustment for body composition, chronic diseases, psychosocial factors, life style factors, and the other levels of functioning. No significant interaction terms were found. Conclusions: Functional limitations and poor physical performance were independent risk factors for fractures.
Stel, V.S., Smit, J.H., Pluijm, S.M.F., Lips, P.T.A. (2004). Consequences of falling in older men and women and risk factors for health service use and functional decline. Age and Ageing, 33, 58-65. >Full Text.
Objectives. 1) to examine consequences of falls in older men and women; 2) to examine risk factors for health service use and functional decline among older fallers. Methods. The study was performed within the Longitudinal Aging Study Amsterdam (LASA). In 1998/1999, potential risk factors were assessed during the third data collection. In 1999/2000, 204 community-dwelling persons (?65 years) who reported at least one fall in the year before the interview were asked about consequences of their last fall, including physical injury, health service use, treatment, and functional decline (i.e. decline in functional status, social and physical activities). Results. As a consequence of falling, respondents reported physical injury (68.1%), major injury (5.9%), health service use (23.5%), treatment (17.2%), and decline in functional status (35.3%), and social (16.7%) and physical activities (15.2%). Using multivariate logistic regression, specific risk factors for health service use after falling could not be identified. Female gender (OR=2.8;95%CI:1.5-5.1), higher medication use (OR=1.5;95%CI:1.0-2.2), and depressive symptoms (OR=1.9;95%CI:1.3-2.8) were independently associated with functional decline after falling. Depressive symptoms (OR=2.0;95%CI:1.2-3.3) and falls inside (OR=2.6;95%CI:1.1-6.5) were risk factors for decline in social activities, while female gender (OR=2.7;95%CI:1.1-7.0) and depressive symptoms (OR=1.9;95%CI:1.2-3.0) were risk factors for decline in physical activities after falling. Conclusions. Almost seventy percent of the respondents suffered physical injury, almost a quarter used health services and more than one-third suffered functional decline after falling. No risk factors were found for health service use needed after falling. Female gender, higher medication use, depressive symptoms and falls inside were risk factors for functional decline after falling.
Stel, V.S., Smit, J.H., Pluijm, S.M.F., Visser, M., Deeg, D.J.H., Lips, P.T.A. (2004). Comparison of the LASA Physical Activity Questionnaire with a 7-day diary and pedometer. Journal of Clinical Epidemiology, 57, 252-258. >Full Text.
Purpose. First, to validate the LASA Physical Activity Questionnaire (LAPAQ) by a 7-day diary and a pedometer in older persons. Second, to assess the repeatability of the LAPAQ. Third, to compare the feasibility of these methods. Methods The study was performed in a subsample (n=439, aged 69-92 years) of the Longitudinal Aging Study Amsterdam (LASA). The LAPAQ was completed twice (1998/1999, 1999/2000). Respondents completed a 7-day activity diary and wore a pedometer for seven days (1999/2000). Results. The LAPAQ was highly correlated with the 7-day diary (r = 0.70, p < 0.001), and moderately with the pedometer (r = 0.53, p < 0.001). The repeatability of the LAPAQ was reasonably good (weighted kappa: 0.65-0.75; Pearson: 0.55-0.63). The LAPAQ was completed in 5.7?2.7 minutes and 0.5% of the respondents had missing values. Conclusion. The LAPAQ appears to be a valid and reliable instrument for classifying physical activity in older people. The LAPAQ was easier to use than the 7-day diary and pedometer.
Tomassini, C., Kalogirou, S., Grundy, E., Fokkema, C.M., Martikainen, P., Broese van Groenou, M.I., Karisto, A. (2004). Contacts between elderly parents and their children in four European countries: current patterns and future prospects. European Journal of Ageing, 1, 54-63. >Full Text.
Frequency of contacts with the family represents an indicator of the strength of intergenerational exchange and potential support for older people. Although the availability of children clearly represents a constraint on potential family support, the extent of interaction with and support received from children, depends on factors other than demographic availability alone. In this paper we examine the effects of socio-economic and demographic variables on weekly contacts with children in Great Britain, Italy, Finland and the Netherlands using representative survey data which included information on availability of children, as well as extent of contact. Our results confirm the higher level of parent adult-child contact in Italy, in comparison with Northern European countries, but levels of contact in all the countries considered were high. Multivariate analysis showed that in most countries characteristics such as divorce were associated with a reduced probability of contact between fathers and children; in Finland this also influenced contact between mothers and children. Analyses of possible future scenarios of contact with children, that combine the observed effects of the explanatory variables with hypothetical changes in population distribution, are also included.
Tomassini, C., Glaser, K., Wolf, D.A., Broese van Groenou, M.I., Grundy, E. (2004). Living arrangements among older people: An overview of trends in Europe and the USA. Population Trends, 115, 24-34.
This article compares the trends in living arrangements of older people in several European countries and in the United States. Trends and cross-country variability in several factors that could account for these cross-national differences, including marital status, fertility, labour force participation and attitudes are also examined. In most countries the proportion of older people living alone increased substantially between 1970 and 1990. However, the increase in living alone stabilised or even declined between 1990 and 2000 in most of the countries analysed indicating a possible reversal in the trend. Increases in proportions of older women who are married and reductions in the proportions childless may partially explain this. Considerable variability in both trends and levels of older people�s living arrangements was seen especially between north-western and southern European countries. These variations mirrored contrasts in attitudes towards residential care and parent-child co-residence between the countries.
Van Hout, H.P.J., Beekman, A.T.F., De Beurs, E., Comijs, H.C., Van Marwijk, H.W.J., De Haan, M., Van Tilburg, W., Deeg, D.J.H. (2004). Anxiety and the risk of death in older men and women. British Journal of Psychiatry, 185, 399-404.
No abstract available.
Van Meurs, J.B.J., Dhonukshe-Rutten, R.A.M., Pluijm, S.M.F., Van der Klift, M., De Jonge, R., Lindemans, J., De Groot, L.C.P.G.M., Hofman, A., Witteman, J.C.M. (2004). Homocysteine levels and the risk of osteoporotic fracture. The New England Journal of Medicine, vol. 350, 20, 2033-2041. > Full Text.
No abstract available.
Van Tilburg, T.G., Havens, B., De Jong Gierveld, J. (2004). Loneliness among older adults in the Netherlands, Italy and Canada: A multifaceted comparison. Canadian Journal on Aging, 23, 2, 169-180. > Full Text.
Loneliness is experienced in many cultures. To properly assess cross-cultural differences, attention should be paid to the level, determinants and measurement of loneliness. However, cross-cultural studies have rarely taken into account more than one of these. Differences in the level of loneliness were hypothesized on the basis of national differences in partnership, kinship and friendship, which were assumed to be related to cultural standards within a society. Differences were examined among married and widowed older adults aged 70 to 89 years living independently in the Netherlands (N = 1847), Tuscany, Italy (N = 562) and Manitoba, Canada (N = 1134). Loneliness was measured with an 11-item scale. The Manitobans were high on emotional loneliness and the Tuscans were high on social loneliness. Partner status excepted, the determinants were nearly the same across the three locations. Differential item functioning (DIF) related to the three locations was observed for most items. Interactions with gender and the availability of a partner relationship were observed.
Van Zelst, W.H., De Beurs, E. (2004). Het effect van twee recente gebeurtenissen op symptomen van de posttraumatische stressstoornis in de oudere bevolking. Tijdschrift voor Psychiatrie, 46, 2, 85-91.
No abstract available.
Visser, G., Klinkenberg, M., Broese van Groenou, M.I., Willems, D.L., Knipscheer, C.P.M., Deeg, D.J.H. (2004). The end of life: informal care for dying older people and its relationship to place of death. Palliative Medicine, 18, 468-477. >Full Text.
Objective: This study examined the features of informal end-of-life care of older people living in the community and the association between informal care characteristics and dying at home. Methods: Retrospective data were obtained from interviews and self-administered questionnaires of 56 persons who had been primary caregivers of older relatives in the last three months of their lives. Results: Results showed that informal caregivers of terminally ill older people living in the community provided a considerable amount of personal, household, and management care. Secondary informal caregivers and formal caregivers assisted resident primary caregivers less often than nonresident primary caregivers. Primary caregivers who felt less burdened, who gave personal care more intensively, and/or who were assisted by secondary caregivers, were more likely to provide informal end-of-life care at home until the time of death. Conclusions: Our study showed that informal care at the end of life of older people living in the community is complex, since the care required is considerable and highly varied, and involves assistance from secondary informal caregivers, formal home caregivers as well as institutional care. Burden of informal care is one of the most important factors associated with home death. More attention is needed to help ease the burden on informal caregivers, specifically with regard to resident caregivers and spouses. Since these resident caregivers were disadvantaged in several respects (i.e., health, income, assistance from other carers) compared to nonresident caregivers, interventions by formal caregivers should also be directed towards these persons, enabling them to bear the burden of end-of-life care
Zimprich, D., Hofer, S.M., Aartsen, M.J. (2004). Short-term versus long-term longitudinal changes in processing speed. Gerontology, 50, 17-21. >Full Text.
Background: Previous longitudinal studies of cognitive aging have focused on long-term performance changes. A recent surge of research has demonstrated that there are reliable interindividual differences in short-term cognitive performance changes. Objective: The present study links these two pathways of cognitive aging research by examining the association between short-term (learning, practice) versus long-term (development) changes in processing speed. Methods: Data from 963 elderly participants come from the Longitudinal Aging Study Amsterdam (LASA). Results: Nested latent growth curve analyses show that the amount of learning or practice in processing speed at first measurement occasion is positively related (r = 0.72) to individual differences in development of processing speed across six years. Conclusions: Short-term learning or practice gains in processing speed are positively associated with long-term developmental changes in processing speed in the elderly.

2003

Aartsen, M.J. (2003). The mutual relations between cognitive performance and everyday activities in old age. Research and Practice in Alzheimer\\\'s Disease, 7, 23-29.
The article gives a summary of the study \\\'Activity in older adults: Cause or consequence of cognitive functioning? A longitudinal study on everyday activities and cognitive performance in older adults\\\' (Aartsen et al., 2002). In that study the impact of everyday activities on cognitive functioning over a period of six years was studied in a large 55-85 year old population-based sample (n=2,076). A cross-lagged regression model was applied. None of the activities were found to enhance cognitive functioning six years later when controlling for age, gender, level of education, and health, as well as for unknown confounding variables. Conversely, one cognitive function (i.e. information processing speed) appeared to affect developmental activity. It is suggested that although everyday activities do not contribute to maintenance of cognitive functioning, an active life may help to maintain the level of physical or mental health.
Aartsen, M.J. (2003). On the interrelationship between cognitive and social functioning in older age. PhD Dissertation, VU University Amsterdam
No abstract available.
Bisschop, M.I., Kriegsman, D.M.W., Van Tilburg, T.G., Penninx, B.W.J.H., Van Eijk, J.Th.M., Deeg, D.J.H. (2003). The influence of different social ties on decline in physical functioning among older people with and without chronic diseases: The Longitudinal Aging Study Amsterdam. Aging, Clinical and Experimental Research, 15, 164-173.
Objectives. Global social support measures have been shown to be related to several health outcomes, but little is known about the effects of different social ties and their support on the risk for decline in physical functioning among older people without as compared to those with chronic diseases. This study examines whether different types of social ties and support differentially mitigate the negative effects of chronic diseases on decline in physical functioning. Methods. Using data from two cycles of the Longitudinal Aging Study Amsterdam (N = 2357), logistic regression analyses adjusted for baseline functioning, age, gender, and incidence of chronic diseases were conducted to assess the effect of different social ties for subgroups with different numbers of chronic diseases. Information about presence of different social ties included partner status and numbers of daughters, sons, other family members and non-kin relationships. Social support included instrumental and emotional support and the experience of loneliness. Decline in physical functioning was determined by substantial change after three years on a 6-item self-report scale. Results. Having a partner had a protective effect on decline in physical functioning in people without chronic diseases at baseline, but this was not found for those with chronic diseases. Total network size had an adverse effect in older people without chronic diseases, but a positive effect when chronic diseases were present. This was mainly due to a positive effect for the number of daughters and non-kin relationships. Discussion. Our results provide evidence that different types of social relationships and the support they provide differentially influence the risk for decline in physical functioning in older people with or without a chronic disease.
Broese van Groenou, M.I. (2003). Ongelijke kansen op een goede oude dag: Sociaal-economische gezondheidsverschillen bij ouderen vanuit een levensloopperspectief. Tijdschrift voor Gerontologie en Geriatrie, 34, 196-207.
No abstract available.
Broese van Groenou, M.I., Deeg, D.J.H., Penninx, B.W.J.H. (2003). Income differentials in functional disability in old age: Relative risks of onset, recovery, decline, attrition and mortality. Aging, Clinical and Experimental Research, 15, 174-183.
Background and aims: Socioeconomic status (SES) differences in health decline in late life may be underestimated, because the relatively higher risks of attrition of lower-SES persons are seldom taken into account. This longitudinal study aimed at comparing income differences in the course of disability, non-mortality attrition and mortality in older adults. Methods: A sample population of 3107 older adults who participated in the 1992/1993 baseline of the Longitudinal Aging Study Amsterdam was examined regarding changes in functional disability in 1998/1999. SES was indicated by household income. Results: Multinomial regression analyses revealed that, for men without disability at baseline, the relative rate for attrition was four times higher and the mortality rate was twice as high for low-income vs high-income persons. For non-disabled women, the relative risk for the onset of disability was nearly twice as high for low-income vs high-income persons. For both men and women, these risks decreased only slightly when behavioral and psychosocial risk factors were taken into account. Among persons with disability at baseline, the relative risks for attrition (for women) and mortality (for men) were twice as high for low-income persons, but no income differences were found with respect to recovery and decline. Adjustment for risk factors decreased the relative risks for attrition and mortality to a non-significant level. Conclusions: Income inequality in health in late life is to a large degree explained by the higher incidence of disability among lower-status women and by the higher attrition and mortality risks among lowerstatus men.
Deeg, D.J.H. (2003). Het dogma van \'succesvol ouder worden\' en het ouderenzorgbeleid. Gern, 5, 1, 44-47.
In welke mate leidt de veroudering van de bevolking uiteindelijk tot toename van de vraag naar professionele zorg? Deze zorgbehoefte kan niet los gezien worden van twee voorafgaande vragen: ten eerste, zal de manier waarop ouderen in de toekomst omgaan met gezondheidsproblemen veranderen? Ten tweede, hoe hangen (on)gezondheid en zorg met elkaar samen als het om ouderen gaat?
Deeg, D.J.H., Kriegsman, D.M.W. (2003). Concepts of self-rated health: Specifying the gender difference in mortality risk. Gerontologist, 43, 3, 376-386. > Full Text.
Abstract: Purpose: This study addresses the question of how the relation between self-rated health (SRH) and mortality differs between genders. In addition to the general question, four specific concepts of SRH are distinguished: SRH in comparison with age peers, SRH in comparison with one\'s own health 10 years ago, and current and future health perceptions. For these concepts, the gender-specific risks of mortality were evaluated for a short and a longer follow-up period. Design and Methods: Baseline and mortality data from the Longitudinal Aging Study Amsterdam (N = 1917, initial ages 55-85 years) were used. Mortality risks were evaluated in Cox regression models at 3 and 7.5 years of follow-up, both adjusted for age and for sociodemographic characteristics, indicators of functional and mental health, lifestyle, and social involvement. All SRH measures were scaled from 1 (positive) to 5 (negative). Results: Baseline correlations between SRH concepts were similar for men and women. After 3 years, 12% of the men and 7% of the women had died; after 7.5 years, these percentages were 27 and 15, respectively. In fully adjusted models, current health perceptions predicted 3-year mortality in men (risk ratio of 1.33). At 7.5 years, mortality in men was predicted by current health perceptions and by SRH compared with age peers (risk ratios of 1.25 and 1.23, respectively). In women, no SRH concept predicted either 3-year or 7.5-year mortality. Implications: SRH was a predictor of mortality only in men, not in women. The gender difference showed most clearly at longer follow-up, in the SRH concept \"comparison with age peers.\"
Deeg, D.J.H., Verbrugge, L.M., Jagger, C. (2003). Disability measurement. In J.M. Robine, C. Jagger, C.D. Mathers, E.M. Crimmings, R.M. Suzman (Eds.), Determining Health Expectancies (pp. 203-219). John Wiley & Sons, Ltd.
No abstract available.
Deeg, D.J.H., Visser, M. (2003). LASA project. Aging Clinical and Experimental Research, 15, 2, 162-163.
No abstract available.
Dhondt, T.D.F. (2003). Iatrogenic origins of depression in the elderly PhD Dissertation, VU University Amsterdam.
No abstract available.
Dik, M.G., Deeg, D.J.H., Visser, M., Jonker, C. (2003). Early life physical activity and cognition at old age. Journal of Clinical and Experimental Neuropsychology, 25, 643-653.
Physical activity has shown to be inversely associated with cognitive decline in older people. Whether this association is already present in early life has not been investigated previously. The association between early life physical activity and cognition was studied in 1,241 subjects aged 62-85 years, in a prospective population-based study. Physical activity between ages 15-25 years was asked retrospectively. The findings suggest a positive association between regular physical activity early in life and level of information processing speed at older age in men, not in women. The association could not be explained by current physical activity or other lifestyle factors. This finding supports the cognitive reserve hypothesis, and might suggest that early life physical activity may delay late-life cognitive deficits.
Dik, M.G., Pluijm, S.M.F., Jonker, C., Deeg, D.J.H., Lomecky, M.Z., Lips, P.T.A. (2003). Insulin-like growth factor I (IGF-I) and cognitive decline in older persons. Neurobiology of Aging, 24, 573-581.
No abstract available.
Horn, L.M. (2003). Sociaal-economische verschillen en de gevolgen voor gezondheid. In T. van der Kruk, C. Solentijn, M. Schuurmans (Eds.), Verpleegkundige zorgverlening aan ouderen (pp. 141-151). Utrecht: Uitgeverij Lemma B.V.
No abstract available.
Jonker, C., Comijs, H.C., Korf, E. (2003). Mild cognitive impairment: Een bruikbaar concept? In A.H. Schene, F. Boer, T.J. Heeren, H.W.J. Henselmans, B. Sabbe, J. van Weeghel (Eds.), Jaarboek voor Psychiatrie en Psychotherapie 2003-2004. Houten / Mechelen: Bohn, Stafleu, van Loghum.
No abstract available.
Jonker, C., Comijs, H.C., Smit, J.H. (2003). Does aspirin or other NSAIDs reduce the risk of cognitive decline in elderly persons? Results from a population-based study. Neurobiology of Aging, 24, 583-588.
No abstract available.
Klinkenberg, M., Smit, J.H., Deeg, D.J.H., Willems, D.L., Onwuteaka-Philipsen, B.D., Van der Wal, G. (2003). Proxy reporting in after-death interviews: The use of proxy respondents in retrospective assessment of chronic diseases and symptom burden in the terminal phase of life. Palliative Medicine, 17, 191-201. >Full Text.
This study evaluates the quality of data obtained from after-death interviews with significant others of deceased older persons regarding the prevalence of chronic diseases and symptoms in the terminal phase of life. These data are compared with reports from physicians and earlier self-reports from the deceased person. There were significant increases in nonresponse and nonavailability of significant others for decedents who had been divorced or had never been married, thus introducing some selection bias. At the level of the total sample, significant others seem to give accurate information about the prevalence of chronic diseases when compared with self-reports and reports from physicians. At the level of the individual sample member, after-death interviews with significant others provide valid information for the assessment of the prevalence of malignant neoplasms, diabetes mellitus, chronic obstructive pulmonary disease and cerebrovascular disease, but not for osteo- and rheumatoid arthritis and artherosclerotic disease. At the level of the total sample, the prevalence of symptoms assessed by significant others did not differ greatly from the assessment made by physicians. However, at the level of the individual sample member, the validity of symptom assessment by significant others could not be supported by data obtained from the physicians. With regard to the type of significant others interviewed, children reported more symptoms than partners. The use of significant others in after-death interviews can be a valid method with regard to the assessment of chronic diseases and symptoms on a group level. On an individual level this can be concluded only for chronic diseases with clearly observable consequences.
Lan, T.Y., Deeg, D.J.H., Guralnik, J.M., Melzer, D. (2003). Responsiveness of the index of mobility limitation: Comparison with gait speed alone in the longitudinal aging study Amsterdam. Journal of Gerontology, 58A, 721-727. > Full Text.
Background. Interpreting self-reported disability differences between diverse older populations is complicated by differences in attitudes and environment. We have previously reported on the index of mobility-related limitation tests (MOBLI), and shown that it predicts mortality over 4 years. In this article, we examine whether the index is responsive to changes in self- reported mobility disability. Methods. Data on gait speed, time to complete 5 chair stands, and peak expiratory flow rate, with self-reported difficulty walking for 5 minutes, were available from the baseline and two 3-year follow-ups in the Longitudinal Aging Study Amsterdam. Analysis used data on changes in the index (or walking speed alone) and corresponding change over 3 years in self-reported difficulty or inability with a medium- distance walk. Results. During all follow-ups, groups reporting deterioration in functioning had relatively larger changes in gait speed and MOBLI score than did the \"no deterioration\" groups. In comparative analyses of responsiveness, the MOBLI score had a larger responsiveness index, higher odds ratios, and larger receiving operating characteristic area than gait speed alone. Conclusions. The MOBLI index of mobility-related physical limitation tests is responsive to changes in self- reported mobility disability over two 3-year periods, and performs better than gait speed alone. This property is strongly supportive of its validity for epidemiological comparison of older populations across countries or over longer periods of time.
Minicuci, N., Noale, M., Bardage, C., Blumstein, T., Deeg, D.J.H., Gindin, J., Jylha, M., Nikula, S., Otero, A., Pedersen, N.L., Pluijm, S.M.F., Zunzunegui, M.V., Maggi, S. (2003). Cross-national determinants of quality of life from six longitudinal studies on aging: The CLESA Project. Aging Clinical and Experimental Research, 15, 187-202.
Background and aims: The Comparison of Longitudinal European Studies on Aging (CLESA) Project, here presented for the first time, is a collaborative study involving five European and one Israeli longitudinal study on aging. The aim of this paper is to describe the methodology developed for the harmonization of data and the creation of a Common Data Base (CDB), and to investigate the distribution of some selected common variables among the six countries. The design of each study is briefly introduced and the methodology leading to the harmonization of the common variables is described. Methods: The study base includes data from five European countries (Finland, Italy, the Netherlands, Spain, Sweden) and Israel, for older people aged 65-89 living both in the community and in institutions (total, 11557 subjects). For two age classes (65-74 and 75-84), the prevalence ratios or the mean values of the following selected variables are provided: a) sociodemographic variables; b) health habits: c) health status; d) physical functioning; e) social networks and support; and f) health and social services utilization. Results: Statistically significant differences were found between most of the investigated characteristics across the CLESA countries, with very few exceptions. While some of the differences found may be due to cultural variations, others require further investigation and should be encompassed in the main framework of the Project, which is to identify predictors of hospitalization, mortality, institutionalization and functional decline. Conclusions: A common data base is available for the study of the aging process in five European and one Israeli population. These data provide a unique opportunity to identify common risk factors for mortality and functional decline and increase our understanding of country-specific exposures and vulnerability.
Nikula, S., Jylha, M., Bardage, C., Deeg, D.J.H., Gindin, J., Minicuci, N., Pluijm, S.M.F., Rodrguez-Laso, A. (2003). Are IADLs comparable across countries? Sociodemographic associates of harmonized IADL measures. Aging Clinical and Experimental Research, 15, 6, 451-459.
Background and aims: Independence in Instrumental Activities of Daily Living (IADLs) is determined not only by physical ability but also by the environmental and cultural surroundings of the individual. The present study describes the harmonization of data on IADL functioning of the Comparison of Longitudinal European Studies on Aging (CLESA) Project. The focus of this report is to examine the comparability of IADLs across countries and to study the association of IADLs with age, gender and socioeconomic status, and the scalability of the measure. Methods: The study base includes data from five European countries (Finland, Italy, the Netherlands, Spain, Sweden) and Israel, for older people aged 65-89 living both in the community and in institutions, for a total of 11557 subjects. In this report, only community-dwelling respondents were included (N=8420). The common IADL items in all six countries were: preparing meals, shopping, and doing housework. The analyses include how these items are distributed by age group and gender, and the associations between independence in these items and socioeconomic status (SES) with logistic regression modeling. The scale properties of these three items are also examined. Results: Independence in IADLs decreases steadily with age in all countries. Associations with gender and SES follow largely similar patterns across countries. The reliability of the 3-item scale is satisfactory in most countries, and Cronbach\'s cc-coefficient for the complete CLESA sample was 0.75. Conclusions: The associations between sociodemographic variables and independence in preparing meals, shopping, and doing housework are similar across countries. Results suggest that the predictors of IADLs in different countries are comparable.
Pouwer, F., Beekman, A.T.F., Nijpels, G., Dekker, J.M., Snoek, F.J., Kostense, P.J., Heine, R.J., Deeg, D.J.H. (2003). Rates and risks for co-morbid depression in patients with Type 2 diabetes mellitus: Results from a community-based study. Diabetologia, 46, 892-898. >Full Text.
Aims/hypothesis. There is accumulating evidence that depression is common in people with Type 2 diabetes. However, most prevalence-studies are uncontrolled and could also be inaccurate from selection-bias, as they are conducted in specialized treatment settings. We studied the prevalence and risk factors of co-morbid depression in a community-based sample of older adults, comparing Type 2 diabetic patients with healthy control subjects. Methods. A large (n=3107) community- based study in Dutch adults (55-85 years of age) was conducted. Pervasive depression was defined as a CES-D score greater than 15. Diagnosis of Type 2 diabetes was obtained from self-reports and data from general practitioners. Results. A number of 216 patients (7%) were identified as having Type 2 diabetes. The prevalence of pervasive depression was increased in people with Type 2 diabetes and co-morbid chronic disease (20%) but not in patients with Type 2 diabetes only (8%), compared with the healthy control subjects (9%). Regression analyses in diabetic patients yielded that being single, being female, having functional limitations, receiving instrumental support and having an external locus of control were associated with higher levels of depression. Conclusions/interpretation. The Results suggest that the prevalence of pervasive depression is increased in patients with Type 2 diabetes and co-morbid disease(s), but not in patients with Type 2 diabetes only. Functional limitations that often accompany co-morbid chronic disease could play an essential role in the development of depression in Type 2 diabetes. These findings can enable clinicians and researchers to identify high-risk groups and set up prevention and treatment programs.
Sonnenberg, C.M., Jonker, C. (2003). Medicamenteuze behandeling van agitatie bij dementie. Modern Medicine, 5, 364-368.
No abstract available.
Sonnenberg, C.M., Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, W. (2003). Drug treatment in depressed elderly in the Dutch community. International Journal of Geriatric Psychiatry, 18, 99-104. >Full Text.
Objectives. In older people, a diagnosis of depression is frequently missed, and proper treatment is subsequently hampered. We investigated antidepressant and benzodiazepine use in an older community sample, and assessed possible risk factors associated with non-treatment in depressed elderly. Methods. Data were used from the baseline measurements of the Longitudinal Aging Study Amsterdam (LASA). In a random, age and sex stratified community sample of 3107 older Dutch people (55 to 85 years), respondents were screened on depression with the Center for Epidemiologic Studies Depression Scale (CES-D). In the depressed subsample depressive disorder according to DSM- III was assessed using the Diagnostic Interview Schedule (DIS). The use of antidepressants and anxiolytics (benzodiazepines) in the depressed subsample was measured, and associations with age, sex, cognitive impairment, physical health and anxiety symptoms were investigated. Results. Only 16% of the respondents with a major depressive disorder used antidepressants. More than half of them used non-therapeutic dosages. Lower antidepressant use was associated with cognitive impairment. Benzodiazepine use was more likely than antidepressant. use, which was especially evident in females in the major depressive disorder group. Conclusions. Depressed older people were undertreated, particularly when they were cognitively impaired. A high rate of benzodiazepine use was found, particularly in females.
Stel, V.S., Pluijm, S.M.F., Deeg, D.J.H., Smit, J.H., Bouter, L.M., Lips, P.T.A. (2003). A classification tree for predicting recurrent falling in community-dwelling older persons. Journal of the American Geriatrics Society, 51, 1356-1364. > Full Text.
No abstract available.
Stel, V.S., Smit, J.H., Pluijm, S.M.F., Lips, P.T.A. (2003). Balance and mobility performance as treatable risk factors for recurrent falling in older persons. Journal of Clinical Epidemiology, 56, 7, 659-668. >Full Text.
No abstract available.
Stel, V.S. (2003). Prevention of fall accidents in older persons. From risk profile to intervention strategy. PhD Dissertation, VU University Amsterdam.
No abstract available.
Steunenberg, B., Beekman, A.T.F., Deeg, D.J.H., Kerkhof, A.J.F.M. (2003). Neuroticisme bij ouderen: De bruikbaarheid van de verkorte inadequatie- en sociale- inadequatieschalen van de NPV [[Neuroticism in the elderly. The utility of the shortened DPQ-scales]. Tijdschrift voor Gerontologie en Geriatrie, 34, 120-128.
This article reports on the relation between aging and personal adjustment. Current personality scales are not developed for older persons. Scales contain items which are not valid for an aging population and contain too many items for administration in older populations. As part of the Longitudinal Aging Study Amsterdam (LASA) Neuroticism in older persons was measured with a shortened version of the Inadequacy (IN) and Social Inadequacy (SI) scales of the Dutch Personality Questionnaire (DPQ). The utility of these shortened scales was assessed based on internal consistency, inter-item correlations, test-retest reliability and factor analysis. The consistency of the personality dimension Neuroticism was assessed based on cohort-differences and a 6-year longitudinal comparison. The research-population contained 2118 respondents at baseline, aged between 55 and 85 years, 49% were male and they were not living in an institution. The shortened scales appeared to be reliable and valid instruments to measure Neuroticism in the elderly. The gaining of time due to the administration of the shortened scales enlarges the feasibility of the scales for measuring Neuroticism in older persons. Results showed no significant age-difference on the IN-scale, but revealed a significant difference on the SI-scale (p < .01). The 65+ elderly (65-74 and 75-85) have higher scores on Social Inadequacy than the youngest elderly (55-64). Longitudinal analyses showed an interaction between age at baseline and the stability and change of the level of Neuroticism. On both scales the youngest age-group showed a significant decline in mean level of Neuroticism (p < .01). The mean level of Social Inadequacy in the oldest age-group showed an increase during the 6-year follow-up period (p < .05). However, the differences were very small. Future research is needed to assess the effect of related variables on Neuroticism in older persons.
Thomése, G.C.F., Van Tilburg, T.G., Knipscheer, C.P.M. (2003). Continuation of exchange with neighbors in later life: The importance of the neighborhood context. Personal Relationships, 10, 535-550. >Full Text.
Relationships with neighbors are considered exchange relationships, in which the continuation of exchanges depends on balance in previous exchanges. Our study tested whether this is the case. An exchange relationship implies that neighbor relationships are isolated units. We expected, however, that neighborhood integration also affects the continuation of exchange among neighbors. Data were from a longitudinal study among 1,692 independently living Dutch adults of ages 55 to 85 years at baseline and their 7,415 relationships with proximate network members. At a four-year follow-up, both perceived balance and neighborhood integration at baseline increased the chance of instrumental support exchange occurring. We concluded that it is too limited to view relationships between neighbors as exchange relationships, as these relationships are embedded in larger communities, where such communities exist.
Timmer, E.M.G., Aartsen, M.J. (2003). Mastery beliefs and productive leisure activities in the third age. Social Behavior and Personality, 31, 7, 643-656.
The paper examines associations between beliefs of mastery and two important kinds of productive activities in the third age, participation in education and volunteering. Within the broad concept of mastery beliefs, differential aspects of self-regulatory cognitions were studied, that is self-esteem, control beliefs, effort to complete behavior, persistence in the face of adversity, and willingness to initiate behavior. Effects of these aspects on carrying out activities were investigated and controlled for the impact of some situational and demographic factors. Findings suggest that a general sense of mastery, as reflected in self-esteem and control beliefs, is not a precondition for study and volunteering work in the third age. However, special components of self-efficacy turned out to play a part. Willingness to initiate behavior emerged to be a strong predictor for taking on educational activities, persistence in the face of adversity for being active as a volunteer. In the discussion possibilities were looked at of how better to match productive activities in later life to personal dispositions.
Van der Scheer, E., Boersma, F., Deeg, D.J.H. (2003). Gezondheidstoestand en zorggebruik van bewoners van service-ouderenwoningen. Een vergelijking met zelfstandig wonenden. Tijdschrift voor Gerontologie en Geriatrie, 34, 162-167.
No abstract available.
Van Gool, C.H., Kempen, G.I.J.M., Penninx, B.W.J.H., Deeg, D.J.H., Beekman, A.T.F., Van Eijk, J.Th.M. (2003). Relationship between changes in depressive symptoms and unhealthy lifestyles in late middle aged and older persons: Results from the Longitudinal Aging Study Amsterdam. Age and Ageing, 32, 81-87.
Background: depressed mood is common in late life, more prevalent among the chronically diseased than in the general population, and has various health-related consequences. So far, the association between depression and unhealthy lifestyles among chronically diseased has not been examined longitudinally in older persons. Primary objective: to determine if depressed mood is associated with unhealthy lifestyles in late middle aged and older people, with or without chronic somatic diseases. Methods: in a sample of 1,280 community-dwelling people from the Netherlands, the associations between depressive symptoms and lifestyle domains were analysed cross-sectionally and longitudinally - using logistic regression analyses and multivariate analyses of variance. Results: after controlling for confounders, depressed people (n=176 at baseline) were more likely to be smokers (odds ratio 1.71; 95% confidence interval 1.17-2.52). A persistent depression was associated with an increase in cigarette consumption (P=0.036). Having an emerging depression (n=155) was most likely to co-occur with a person\'s change from being physically active to being sedentary (relative risk-ratio 1.62; 95% confidence interval 1.05-2.52), and was associated with the largest decrease in minutes of physical activity (P=0.038). This effect was not modified or confounded by chronic somatic disease. A persistent depression tended to be associated with incident excessive alcohol use (relative risk-ratio 4.04; 95% confidence interval 0.97-16.09; P=0.056). Conclusions: depression is associated with smoking behaviour, and with an increase in cigarette consumption. An emerging depression is associated with becoming sedentary, irrespective of a person\'s disease status at baseline, and is associated with decrease in minutes of physical activity.
Van Schoor , N.M., Smit, J.H., Twisk, J.W.R., Bouter, L.M., Lips, P.T.A. (2003). Prevention of hip fractures by external hip protectors: A randomized controlled trial. Journal of the American Medical Association, 289, 15, 1957-1962. >Full Text.
Context: Several randomized controlled trials have been performed to examine the effectiveness of external hip protectors in reducing the incidence of hip fractures, but the results are controversial. Objective: To examine the effectiveness of hip protectors in reducing the incidence of hip fractures in an elderly high-risk population. Design, Setting, and Participants: Randomized controlled trial of elderly persons aged 70 years or older, who have low bone density, and are at high risk for falls. Participants lived in apartment houses for the elderly, homes for the elderly, and nursing homes in Amsterdam and surrounding areas in the Netherlands. They were enrolled in the study between March 1999 and March 2001; the mean follow-up was 69.6 weeks. Of the 830 persons who were screened, 561 persons were enrolled. Intervention: External hip protector. Both groups received written information on bone health and risk factors for falls. Main Outcome Measure: Time to first hip fracture. Survival analysis was used to include all participants for the time they participated. Results: In the intervention group, 18 hip fractures occurred versus 20 in the control group. Four hip fractures in the intervention group occurred while an individual was wearing a hip protector. At least 4 hip fractures in the intervention group occurred late at night or early in the morning. Both in univariate analysis (log-rank P=.86) and in multivariate analysis (hazard ratio [HR], 1.05; 95% confidence interval [CI], 0.55-2.03), no statistically significant difference between the intervention group and control group. was found with regard to time to first hip fracture. In addition, the per protocol analysis in compliant participants did not show a statistically significant difference between the groups (HR, 0.77; 95% Cl, 0.25-2.38). Conclusion: The hip protector studied was not effective in preventing hip fractures.
Van Schoor , N.M. (2003). Prevention of hip fractures by external hip protectors. PhD Dissertation, VU University Amsterdam.
No abstract available.
Van Tilburg, T.G. (2003). Consequences of men\'s retirement for the continuation of work-related personal relationships. Ageing International, 28, 4, 345-358. > Full Text.
Retirement is an important life cycle marker and has a major impact on an individual\'s functioning. Based upon the social convoy model, it is hypothesized that retirement decreases the likelihood of continuation of coworker relationships. Socio-emotional selectivity theory predicts a decline in the number of peripheral relationships with aging and thereby in network size and number of coworker relationships among working and retired people. Data comes from the Longitudinal Aging Study Amsterdam with five observations between 1992 and 2002. At baseline 226 men aged 54-81 years were employed; 166 men retired in the course of the study. The results of multilevel regression analyses showed a stable network size both for working and retired men. Among all men the number of work-related network members declined, but more strongly among retirees. It is concluded that the convoy model fits better with the data than socio-emotional selectivity theory.
Van Zelst, W.H., De Beurs, E., Smit, J.H. (2003). Effects of the September 11th attacks on symptoms of PTSD on community-dwelling older persons in the Netherlands. Letters to the editor. International Journal of Geriatric Psychiatry, 18, 190. >Full Text.
No abstract available.
Van Zelst, W.H., De Beurs, E., Beekman, A.T.F., Deeg, D.J.H., Bramsen, I., Van Dyck, R. (2003). Criterion validity of the self-rating inventory for posttraumatic stress disorder (SRIP) in the community of older adults. Journal of Affective Disorders, 76, 229-235. >Full Text.
Background: A validated screening instrument for PTSD in community dwelling older people is lacking. This study evaluates a newly developed measure, the self-rating inventory for posttraumatic stress disorder (SRIP) on its usefulness in survey research. The predictive value of the SRIP in a community setting is investigated. Methods: In a two-phase epidemiologic design the criterion validity of the SRIP was tested against diagnosis made with the comprehensive international diagnostic interview (CIDI) in 1721 older (55-90 years) inhabitants of the Netherlands. Optimal sensitivity and specificity was determined using a weighted receiver operator characteristic (ROC)-curve. Results: Optimal sensitivity (74.2%) and specificity (81.4%) was reached with a cut-off of 39 points. Limitations: According to a strictly applied CIDI algorithm the number of \'true\' cases was limited. Conclusion: Overall findings indicate that posttraumatic stress disorder can be identified adequately in a community-based population of older adults using the SRIP. Use of the SRIP may improve recognition and diagnosis of posttraumatic stress disorder in the community.
Van Zelst, W.H., De Beurs, E., Beekman, A.T.F., Deeg, D.J.H., Van Dyck, R. (2003). Prevalence and risk factors of posttraumatic stress disorder in older adults. Psychotherapy and Psychosomatics, 72, 333-342. >Full Text.
Background: Posttraumatic stress disorder (PTSD) has scarcely been researched in the elderly. There is no population-based information on prevalence and risk factors in older persons. Patients with PTSD are often not recognized or incorrectly diagnosed. As the disorder has great implications for the quality of life, a correct diagnosis and treatment are crucial. Increased knowledge on vulnerability factors for PTSD can facilitate diagnostic procedures and health management in the elderly. Methods: PTSD cases were found following a two-phase sampling procedure: a random selection of 1,721 subjects were screened and in 422 subjects a psychiatric diagnostic interview was administered. Prevalence of PTSD and subthreshold PTSD were calculated. Vulnerability factors regarding demographics, physical health, personality, social factors, recent distress and adverse events in early childhood were assessed. Results: 6-month prevalence of PTSD and of subthreshold PTSD was 0.9 and 13.1%, respectively. The strongest vulnerability factors for both PTSD and subthreshold PTSD were neuroticism and adverse events in early childhood. Conclusions: This is the first population-based study on PTSD in older persons. With a 6-month prevalence of almost 1% the disease is not rare. Comparisons with younger populations suggest some accumulation of cases among older people reflecting the chronic risk factors, which are found in this study: neuroticism and adverse events in early childhood.
Visser, M., Deeg, D.J.H., Lips, P.T.A. (2003). Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (Sarcopenia): The Longitudinal Aging Study Amsterdam. The Journal of Clinical Endocrinology and Metabolism, 88, 12, 5766-5772. >Full Text.
The age-related change in hormone concentrations has been hypothesized to play a role in the loss of muscle mass and muscle strength with aging, also called sarcopenia. The aim of this prospective study was to investigate whether low serum 25-hydroxyvitamin D (25-OHD) and high serum PTH concentration were associated with sarcopenia. In men and women aged 65 yr and older, participants of the Longitudinal Aging Study Amsterdam, grip strength (n = 1008) and appendicular skeletal muscle mass (n = 331, using dual-energy x-ray absorptiometry) were measured in 1995-1996 and after a 3-yr follow-up. Sarcopenia was defined as the lowest sex-specific 15th percentile of the cohort, translating into a loss of grip strength greater than 40% or a loss of muscle mass greater than 3%. After adjustment for physical activity level, season of data collection, serum creatinine concentration, chronic disease, smoking, and body mass index, persons with low (<25 nmol/liter) baseline 25-OHD levels were 2.57 (95% confidence interval 1.40-4.70, based on grip strength) and 2.14 (0.73-6.33, based on muscle mass) times more likely to experience sarcopenia, compared with those with high (>50 nmol/liter) levels. High PTH levels (greater than or equal to4.0 pmol/liter) were associated with an increased risk of sarcopenia, compared with low PTH (<3.0 pmol/liter): odds ratio = 1.71 (1.07-2.73) based on grip strength, odds ratio = 2.35 (1.05-5.28) based on muscle mass. The associations were similar in men and women. The results of this prospective, population-based study show that lower 25-OHD and higher PTH levels increase the risk of sarcopenia in older men and women

2002

Aartsen, M.J., Smits, C.H.M., Van Tilburg, T.G., Knipscheer, C.P.M., Deeg, D.J.H. (2002). Activity in older adults: Cause or consequence of cognitive functioning? A longitudinal study on everyday activities and cognitive performance in older adults. Journal of Gerontology, 57B,no.2, P153-P162. > Full Text.
The impact of three types of everyday activities (i.e., social, experiential, and developmental) on four cognitive functions (i.e., immediate recall, learning, fluid intelligence, and information-processing speed) and one global indicator of cognitive functioning (Mini-Mental State Exam score) over a period of 6 years was studied in a large 55-85 year-old population-based sample (N = 2,076). A cross-lagged regression model with latent variables was applied to each combination of 1 cognitive function and 1 type of activity, resulting in 15 (3 x 5) different models. None of the activities were found to enhance cognitive functioning 6 years later when controlling for age, gender, level of education, and health, as well as for unknown confounding variables. Conversely, one cognitive function (i.e., information-processing speed) appeared to affect developmental activity. It is suggested that no specific activity, but rather socioeconomic status to which activities are closely connected, contributes to maintenance of cognitive functions.
Beekman, A.T.F., Geerlings, S.W., Deeg, D.J.H., Smit, J.H., Schoevers, R.A., De Beurs, E., Braam, A.W., Penninx, B.W.J.H., Van Tilburg, W. (2002). The natural history of late-life depression: A 6-year prospective study in the community. Archives of General Psychiatry, 59, 605-611. > Full Text.
Background: Accurate assessment of the natural history of late- life depression requires frequent observation over time. In later life, depressive disorders fulfilling rigorous diagnostic criteria are relatively rare, while subthreshold disorders are common. The primary aim was to study the natural history of late-life depression, systematically comparing those who did with those who did not fulfill rigorous diagnostic criteria. Methods: Within the Longitudinal Aging Study Amsterdam, a large cohort of depressed elderly persons (n = 277) was identified and followed up for 6 years, using 14 observations. Depression was measured using self-reports (the Center for Epidemiological Studies Depression Scale) and diagnostic interviews (the Diagnostic Interview Schedule). The natural history, was assessed for symptom severity (Center for Epidemiological Studies Depression Scale score), symptom duration, clinical course type, and stability of diagnoses. Results: The average symptom severity remained above the 85th percentile of the population average for 6 years. Symptoms were short-lived in only 14%. There were remissions in 23%, an unfavorable but fluctuating course in 44%, and a severe chronic course in 32% (percentages do not total 100 because of rounding). Comparing the outcome, there was a clear gradient in which those with subthreshold disorders had the best outcome, followed by those with major depressive disorder, dysthymic disorder, and double depression. However, the prognosis of subthreshold disorders was unfavorable in most cases, while this group was at high risk of developing DSM affective disorders. Conclusions: The natural history of late-life depression in the community is poor. DSM affective disorders are relatively rare among elderly persons, but do identify those with the worst prognosis, However, subthreshold depression is serious and chronic in many cases.
Beekman, A.T.F., Penninx, B.W.J.H., Deeg, D.J.H., De Beurs, E., Geerlings, S.W., Van Tilburg, W. (2002). The impact of depression on the well-being, disability and use of services in older adults: A longitudinal perspective. Acta Psychiatrica Scandinavica, 105, 20-27. >Full Text.
Objective: To study the impact of depression on the wellbeing, disability and use of health services of older adults. Method: Prospective community-based study, using a large (n = 2200) sample of the elderly (55-85) in the Netherlands. Using a 3- year follow-up, the effect of depressive symptoms (CES-D) on disability, wellbeing and service utilization was assessed, controlling for competing need for-care (chronic physical illness, functional limitation and cognitive decline), enabling (partner status, size of the social network, social support and locus of control), and predisposing factors (age, sex and level of education). Results: Depressive symptoms have considerable impact on the wellbeing and disability of older people and clear economic consequences caused by inappropriate service utilization. Compared with other need-for-care variables the impact of depression is weaker (service utilization), similar (disability) or stronger (wellbeing). Conclusion: The steeply rising prevalence of competing health risks in later life does not influence the significance of depression.
Broese van Groenou, M.I. (2002). Het persoonlijk netwerk van ouderen. In Handboek Lokaal Ouderenwerk (pp. C 1-3-1 - C 1-3-22). Maarssen: Elsevier Bedrijfsinformatie.
No abstract available.
Comijs, H.C., Deeg, D.J.H., Dik, M.G., Twisk, J.W.R., Jonker, C. (2002). Memory complaints: The association with psycho-affective and health problems and the role of personality characteristics: A six year follow-up study. Journal of Affective Disorders, 72, 157-165. > Full Text.
Background: The objective is to investigate whether memory complaints in older persons without manifest cognitive decline are associated with depressive symptoms, anxiety symptoms, physical health and personality characteristics. Furthermore, it is investigated whether personality characteristics have a modifying effect on the association of memory complaints with depressive and anxiety symptoms and physical health. Methods: The study was carried out using the Longitudinal Aging Study Amsterdam (LASA). Participants were examined during three observation cycles covering a period of 6 years. They were asked about memory complaints, and were examined on cognitive functioning, physical health, depressive and anxiety symptoms, and the personality characteristics: mastery, perceived self- efficacy and neuroticism. The data were analysed by means of Generalised Estimating Equations (GEE). Results: Memory complaints were associated with physical health problems, depressive and anxiety symptoms, low feelings of mastery, low perceived self-efficacy and high neuroticism. The associations between memory complaints and physical health problems, depressive and anxiety symptoms were significantly stronger in people with high mastery, high perceived self-efficacy and low neuroticism. Limitations: We used a conservative criterion for cognitive decline and therefore we might have included some people with cognitive decline during our follow-up. In order to minimise selection bias we included actual cognitive performance in our regression models. Conclusions: Our findings suggest that when older persons complain about their memory and do not show actual cognitive decline, one should be aware that these complaints might reflect psycho-affective or health problems.
De Jong Gierveld, J. (2002). The dilemma of repartnering: Considerations of older men and women entering new intimate relationships in later life. Ageing International, 27 (4), 61-78. > Full Text.
A significant percentage of men and women aged fifty and over attain new partner relationships after divorce or widowhood. Partner relationships investigated in this article include remarriage, unmarried cohabitation, and Living Apart Together (LAT). Drawing on the Dutch NESTOR-LSN survey data (n = 4494) as well as in-depth reinterviewing of repartnered older adults (n = 46), this article examines elderly people\'s main considerations in the decision making process leading to remarriage, a consensual union, or a LAT relationship.
De Jong Gierveld, J., Peeters, A. (2002). Partnerpaden na het vijftigste levensjaar [Partner pathways after the age of fifty]. Mens & Maatschappij, 77, 116-136. > Full Text.
A considerable percentage of men and women aged fifty or over become involved in new partner relationships after divorce or widowhood. Partner relationships investigated in this article include remarriage, consensual unions and Living-Apart-Together (LAT). Drawing on NESTOR-LSN survey data (n = 4494) as well as in-depth interviewing of repartnered older adults (n = 46) this article explicates the motivational, socioeconomic and demographic determinants of starting a new partner relationship. Results from multinomial logistic regression analysis and the motives provided in the in-depth interviews reveal that a traditional versus a more individualistic value orientation, socioeconomic status, and financial motives in particular, contribute to the understanding of older adults\' decisions to either remarry, start a consensual union or a LAT-relationship.
Deeg, D.J.H. (2002). Attrition in longitudinal population studies: Does it affect the generalizability of the findings? An introduction to the series. Journal of Clinical Epidemiology, 55, 213-215.
No abstract available.
Deeg, D.J.H. (2002). Ouder worden, een kwetsbaar succes. Inaugurale rede van prof. dr. D.J.H. Deeg. Oratie, Vrije Universiteit.
No abstract available.
Deeg, D.J.H. (2002). Volksgezondheid en epidemiologie [Public health and epidemiology]. In J.J.F. Schroots (Ed.), Handboek psychologie van de volwassen ontwikkeling en veroudering [Handbook psychology of adult development and aging] (pp. 433-454). Assen: Van Gorcum.
No abstract available.
Deeg, D.J.H., Portrait, F.R.M., Lindeboom, M. (2002). Health profiles and profile-specific health expectancies of older women and men: The Netherlands Journal of Women & Aging, 14, 1/2, 27-46. >Full Text.
This study focuses on gender differences in health profiles, and examines which health profiles drive gender differences in remaining life expectancy in women and men aged 65 and over in the Netherlands. Data from the first two cycles of the Longitudinal Aging Study Amsterdam (n = 2141 and 1659, respectively) were used to calculate health profiles for individuals of 65-85 years. For both women and men, six profiles were found: I. cancer; II. \\\\\\\'other\\\\\\\' chronic diseases; III. cognitive impairment; IV. frailty or multimorbidity; V. cardiovascular diseases; and VI. good health. The further characterization of these types showed some gender differences. Remaining life expectancy for women was greater than for men in each health profile. A decomposition into health expectancies showed that both women and men could expect to live about 5 years in good health from age 66. The greatest gender differences in years spent with health problems were found for profile IV and for profile III. Their greater number of years spent in these health states have direct consequences for the type and cost of care women need.
Deeg, D.J.H., Van Tilburg, T.G., Smit, J.H., De Leeuw, E.D. (2002). Attrition in the Longitudinal Aging Study Amsterdam: The effect of differential inclusion in side studies. Journal of Clinical Epidemiology, 55, 319-328. > Full Text.
This study addresses the relation between attrition and characteristics of the study protocol, specifically contact frequency, and respondent burden. The study is based on data from a longitudinal study with side studies on various topics, so that respondents have differential exposure to these study characteristics. Attrition outcomes are refusal and ineligibility through frailty. The effect of side study contact frequency and respondent burden on these outcomes is examined in two analytical samples: (1) baseline participants surviving to the first follow-up after 10 months (sample I), and (2) first follow-up participants surviving to the second follow-up after 3 years (sample II). Attrition during the first study interval was higher than during the second study interval, 15.5 and 5.4%, respectively. In sample I, the request to participate in a side study on social network implied an increased risk of refusal to participate at first follow-up if subjects refused the request (RR 8.34). However, if subjects participated in the network study, their risk of refusal was decreased (RR 0.42). In sample II, requests to participate in one to four side study cycles increased the risk of refusal to participate at second follow-up if subjects participated in fewer cycles than requested (RR 9.21). If subjects participated in all side study cycles that they were approached for, even if the number of cycles was five or more, this had an opposite effect: it decreased the risk of refusal (RR 0.18). Ineligibility was not significantly associated with contact frequency or respondent burden. Furthermore, neither contact frequency nor respondent burden related refusal was selective with respect to socio-demographic characteristics and physical and mental health indicators. It is concluded that contact frequency is nonlinearly associated with attrition. The findings further suggest that designing a series of side studies within the \"longitudinal paradigm\" does not severely damage the study\'s validity in terms of selective attrition.
Deeg, D.J.H., Portrait, F.R.M., Lindeboom, M. (2002). Gezondheidsprofielen en profiel-specifieke levensverwachting van oudere vrouwen en mannen. Tijdschrift voor Gezondheidswetenschappen, 80, 254-261.
No abstract available.
Dhondt, T.D.F., Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, W. (2002). Iatrogenic depression in the elderly: Results from a community-based study in the Netherlands. Social Psychiatry and Psychiatric Epidemiology, 37, 393-398. >Full Text.
Background. The aim of this study was to investigate the association between the use of medication and depression in the elderly. Method. A cross-sectional population-based study was conducted. Associations between the use of medication and depression are corrected for eight other etiological correlates of depression. The sample consisted of 2646 elderly people living in 11 municipalities in the Netherlands. Subjects were taken from the Longitudinal Aging Study Amsterdam, a 10-year longitudinal study on predictors and consequences of changes in well-being and autonomy in the older population. Associations are expressed in odds ratios (95% Confidence Intervals) between the use of (groups of) medication and depression. Results are adjusted for age, sex, urbanity, socioeconomic status, physical health, social and interpersonal support, comorbidity with other psychiatric disease and personality. The Population Attributable Risk percentage was calculated for selected groups of medication. Results. After correction for competing risk factors of depression, 22 individual medications and nine groups of medications had unique associations with depression. Conclusions. The use of depressogenic medication is an independent etiological factor in the pathogenesis of depression.
Dik, M.G. (2002). Cognitive decline in older persons. Contribution of genetics, health, and lifestyle. PhD Dissertation, VU University Amsterdam.
No abstract available.
Geerlings, S.W. (2002). The age of depression: A follow-up study on depression and physical health in older adults in the community. PhD Dissertation, VU University Amsterdam.
No abstract available.
Geerlings, S.W., Beekman, A.T.F., Deeg, D.J.H., Twisk, J.W.R., Van Tilburg, W. (2002). Duration and severity of depression predict mortality in older adults in the community. Psychological Medicine, 32, 609-618.
Background. The association between depression and mortality has become a topic of interest. Little is known about the association between the course of depression and mortality. Methods. In an initially non-depressed cohort (N = 325) and a depressed cohort (N = 327), depression was measured using the Center for Epidemiologic Studies Depression scale (CES-D) at eight successive waves over a period of 3 years. Both cohorts were then followed with respect to mortality status for up to 3-5 additional years. Clinical course types as well as theoretical course type parameters (basic symptom levels, increases in symptoms and instability over time) were distinguished to study the effect of the course of depression on mortality. Results. Contrary to transient states of depression, both chronic depression and chronic intermittent depression predicted mortality at follow-up. Additionally, evidence was found that the effect on mortality is related to severity of depression; high basic symptom levels and increases in symptoms over time were predictive of mortality. A high degree of instability over time was not associated with mortality. Conclusions. Since the mortality effect of depression is a function of both exposure time and symptom severity, more attention should be paid to the treatment of depression in order to prevent severe longstanding depression.
Geerlings, S.W., Twisk, J.W.R., Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, W. (2002). Longitudinal relationship between pain and depression in older adults: sex, age and physical disability. Social Psychiatry and Psychiatric Epidemiology, 37, 23-30. > Full Text.
Objective. Better understanding of the relationship between pain and depression in older adults in the community is of particular importance considering the high prevalence of both conditions in these adults. In the present study, the longitudinal relationship between pain and depression in older adults was examined, thereby taking into account the role of physical disability and the possibly modifying effect of sex and age. Methods. The study is based on a sample which at the outset consisted of 325 non-depressed and 327 depressed persons (55-85) drawn from a larger random community-based sample in the Netherlands. Depression (CES-D) and pain (subscale of the Nottingham Health Profile) were measured at eight successive waves over 3 years. Results. Pain was very persistent over time as was to a lesser extent depression. The prognosis of comorbid pain and depression was poor. In longitudinal analyses (Generalized Estimating Equations), pain and depression were strongly associated. At the symptom level, the pain-depression relationship was found to be stronger in men than in women. There was no effect of age on the pain-depression relationship. No support was found for the hypothesis that the pain- depression relationship is mediated by disability. Conclusion. The persistent nature of pain and to a lesser extent depression and the intimate and probably reciprocal association between them stress the need for adequate treatment strategies.
Horn, L.M. (2002). Tijd voor eenzaamheid. Geron, 4, 62-66.
No abstract available.
Klinkenberg, M. (2002). Ouderenzorg in de laatste levensfase. COPZ (Centrum voor de Ontwikkeling van Palliatieve Zorg), Amsterdam.
No abstract available.
Knipscheer, C.P.M. (2002). Van een patri/matrilineair naar een 'ad hoc' familieverband: Consequenties voor de ouder-kind relatie op latere leeftijd. In Ouderen en relaties (pp. 79-94). Hoger Instituut voor Gezinswetenschappen, Brussel.
No abstract available.
Kramer, S.E., Kapteyn, T.S., Kuik, D.J., Deeg, D.J.H. (2002). The association of hearing impairment and chronic diseases with psychosocial health status in older age. Journal of Aging and Health, 14,no. 1, 122-137. >Full Text.
Objectives: This study examines the association of hearing impairment and chronic diseases (diabetes mellitus, lung disease, cardiac disease, stroke, cancer, peripheral artery disease, osteoarthritis, rheumatoid arthritis) with psychosocial status (depression, self-efficacy, mastery, loneliness, social network size) in older persons. Methods: The sample consists of 3,107 persons (55 to 85 years) participating in the Longitudinal Aging Study Amsterdam. MANOVA, adjusted for covariates, was used to test the effect of hearing impairment on the combined outcomes. The association of hearing impairment and chronic diseases with psychosocial status was studied using multivariate regression analyses. Results: Hearing impaired elderly report significantly more depressive symptoms, lower self-efficacy and mastery, more feelings of loneliness, and a smaller social network than normally hearing peers. Whereas chronic diseases show significant associations with some outcomes, hearing impairment is significantly associated with all psychosocial variables. Discussion: The findings emphasize the negative effect of hearing impairment on quality of life.
Pluijm, S.M.F., Dik, M.G., Jonker, C., Deeg, D.J.H., Van Kamp, G.J., Lips, P.T.A. (2002). Effects of gender and age on the association of apolipoprotein E epsilon 4 with bone mineral density, bone turnover and the risk of fractures in older people. Osteoporosis International, 13, 701-709. > Full Text.
The aim of this study was to examine whether the presence of apolipoprotein E epsilon4 (ApoE epsilon4) is associated with a lower bone mineral density (BMD), lower quantitative ultrasound (QUS) measurements, higher bone turnover and fracture risk, and whether these relations are modified by gender and age. A total of 1406 elderly men and women (greater than or equal to 65 years) of the Longitudinal Aging Study Amsterdam (LASA) participated in this study. In all participants, QUS measurements were assessed, as well as serum osteocalcin (OC) and urine deoxypyridinolin (DPD/Cr urine). Follow-up of fractures was done each three months. In a subsample (n = 604), total body bone mineral content (BMC) and BMD of the hip and lumbar spine were measured. In addition, prevalent vertebral deformities were identified on radiographs. In women, the presence of ApoE epsilon4 was associated with significantly lower femoral neck BMD (g/cm(2); mean +/- SEM; epsilon4+, 0.64 +/- 0.01 vs. epsilon4-, 0.67 +/- 0.01; p = 0.04), lower trochanter BMD (g/cm(2); mean +/- SEM; epsilon4+, 0.58 +/- 0.01 vs. epsilon4-, 0.61 +/- 0.01; p = 0.01) and lower total body BMC (g; mean +/- SEM; epsilon4+, 1787 +/- 40.0 vs. epsilon4-, 1863 +/- 23.8; p = 0.04). Women with ApoE epsilon4 also had a higher risk of severe vertebral deformities (OR=2.78; 95%CI: 1.21-6.34). In men, the associations between ApoE status and both hip BMD and QUS depended on age. Only among the younger men (65-69 years) was the presence of ApoE epsilon4 associated with lower BMD values. Bone markers and fractures were not associated with ApoE epsilon4 in either women, or men. In conclusion, this large community-based study confirms the importance of ApoE epsilon4 as a possible genetic risk factor related to BMD and vertebral deformities and demonstrates that its effect is gender related, and depends on age in men only.
Van Doorne-Huiskes, J., Dykstra, P.A., Nievers, E., Oppelaar, J., Schippers, J.J. (2002). Mantelzorg: Tussen vraag en aanbod. NiDi rapport no. 63, Den Haag (pp. 29-66).
No abstract available.
Van Schoor , N.M., Smit, J.H., Pluijm, S.M.F., Jonker, C., Lips, P.T.A. (2002). Different cognitive functions in relation to falls among older persons: Immediate memory as an independent risk factor for falls. Journal of Clinical Epidemiology, 55, 855-862.
It is not clear which specific cognitive function is strongest related to falls. To investigate this, not only \"general cognitive functioning,\" but also \"nonverbal and abstract reasoning,\" \"information processing speed,\" and \"immediate memory\" were related to falls. Furthermore, relevant effect modifiers, confounders, and mediators were identified. This study was performed within the Longitudinal Aging Study Amsterdam (LASA), a multidisciplinary, prospective cohort study. In this study (n = 1437), an interaction between \"immediate memory\" and age was found. In persons aged 75 years and over, \"immediate memory,\" as measured by the 15 Words Test, showed to be an independent risk factor for falls. Part of this relationship was explained by the mediating effects of activity, mobility, and grip strength. The association between the other cognitive functions and falls was only statistically significant in univariate analysis. We conclude that \"immediate memory\" is an independent risk factor for recurrent falls in persons aged 75 years and older.
Van Tilburg, T.G., Broese van Groenou, M.I. (2002). Network and health changes among older Dutch adults. Journal of Social Issues, 58, 4, 697-713. > Full Text.
A negative effect of good health on the instrumental support received can be viewed as an effect of the mobilization. of helpers. A positive effect of good health on the personal network size and the instrumental support given demonstrates that people in poor health have difficulty actively maintaining their relationships. Furthermore, the support received and given is positively related to the support given and received in the past. In four waves of a seven-year longitudinal study, personal interviews were conducted with 2,302 older Dutch adults (aged 60 to 85) who live on their own. The hypotheses have been confirmed. An implication is that investing in relationships by giving support might pay off in times of need.
Visser, G., Klinkenberg, M. (2002). Mantelzorg in de laatste levensfase. Gern, Tijdschrift over ouder worden en maatschappij, 4, 3, 33-39.
No abstract available.
Visser, M., Pluijm, S.M.F., Stel, V.S., Bosscher, R.J., Deeg, D.J.H. (2002). Physical activity as a determinant of change in mobility performance: The Longitudinal Aging Study Amsterdam. Journal of the American Geriatrics Society, 50, 1774-1781. >Full Text.
No abstract available.

2001

Beekman, A.T.F., Comijs, H.C. (2001). Dementie en depressie. Hoe beinvloeden dementie en depressie elkaar? In J.C. van Es, J.N. Keeman, P.W. de Leeuw & F.G. Zitman (Eds.), Het medisch jaar 2001 (pp. 161-166), Houten/Diegem: Bohn Stafleu Van Loghum.
No abstract available.
Beekman, A.T.F., Deeg, D.J.H., Geerlings, S.W., Schoevers, R.A., Smit, J.H., Van Tilburg, W. (2001). Emergence and persistence of late life depression: A 3-year follow-up of the Longitudinal Aging Study Amsterdam. Journal of Affective Disorders, 65, 131-138. > Full Text.
Background: The present study was designed to assess onset and persistence of late-life depression, systematically comparing the factors associated with prevalence, onset and prognosis. Methods: The data were derived from a large (n = 2200), random, age and sex stratified sample of the elderly (55-85 years) in The Netherlands. Using a 3-year, prospective longitudinal design, both the onset and the persistence of depression were assessed. Depression was measured using the Center for Epidemiologic Studies Depression Scale. Risk factors associated with prevalence, onset and persistence were compared using both bivariate and multivariate analyses. Results: In those not depressed at index assessment, the onset of depression was 9.7%. Among those depressed at baseline, persistence occurred in 50.4%. Risk factors predicting onset were almost identical to those associated with prevalence, Persistence was predicted by very few factors (external locus of control and chronic physical illness). Conclusions: The data suggest that cross- sectional studies are biased due to their overrepresenting chronic depressive episodes. However, the risk factors derived from cross-sectional studies do seem to adequately reflect factors associated with onset. The prognosis is not adequately predicted by variables usually included in epidemiological studies of late life depression. It is speculated that including more biological correlates of depression and data concerning positive life-changes may improve our understanding of the prognosis of late life depression.
Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, W. (2001). Van observatie naar experiment: De epidemiologie van depressie bij ouderen. In A.H. Schene, F. Boer, T.J. Heeren, H.W.J. Henselmans, R.W. Trijsburg, W. Vandereycken, K. van der Velden (ED.), Jaarboek voor psychiatrie en psychotherapie 2001-2002 (pp. 194-212). Houten: Bohn, Stafleu, Van Loghum.
No abstract available.
Braam, A.W., Van den Eeden, P., Prince, M.J., Beekman, A.T.F., Kivelä, S.-L., Lawlor, B.A., Birkhofer, A., Fuhrer, R., Lobo, A., Magnsson, H., Mann, A.H., Meller, I., Roelands, M., Skoog, I., Turrina, C., Copeland, J.R.M. (2001). Religion as a cross-cultural determinant of depression in elderly Europeans: Results from the EURODEP collaboration. Psychological Medicine, 31, 803-814. >Full Text.
Background. The protective effects of religion against late life depression may depend on the broader sociocultural environment. This paper examines whether the prevailing religious climate is related to cross-cultural differences of depression in elderly Europeans. Methods. Two approaches were employed, using data from the EURODEP collaboration. First, associations were studied between church-attendance, religious denomination and depression at the syndrome level for six EURODEP study centres (five countries, N = 8398). Secondly, ecological associations were computed by multi-level analysis between national estimates of religious climate, derived from the European Value Survey and depressive symptoms, for the pooled dataset of 13 EURODEP study centres (11 countries, N = 17739). Results. In the first study, depression rates were lower among regular church-attenders, most prominently among Roman Catholics. In the second study, fewer depressive symptoms were found among the female elderly in countries, generally Roman Catholic, with high rates of regular church-attendance. Higher levels of depressive symptoms were found among the male elderly in Protestant countries. Conclusions. Religious practice is associated with less depression in elderly Europeans, both on the individual and the national level. Religious practice, especially when it is embedded within a traditional value-orientation, may facilitate coping with adversity in later life.
Comijs, H.C. (2001). Mild cognitive impairment: Een illustratie en aanpak. Alzheimer Magazine, 5(3): 19-20.
Een verhaal uit de praktijk van een geheugenpoli. Een mevrouw klaagt over haar geheugen, is somber en bang voor dementie. Ze wordt jarenlang regelmatig onderzocht. Een chronologisch verslag van de bevindingen.
Comijs, H.C., Jonker, C., Beekman, A.T.F., Deeg, D.J.H. (2001). The association between depressive symptoms and cognitive decline in community-dwelling elderly persons. International Journal of Geriatric Psychiatry, 16, 361-367. >Full Text.
Objective To investigate whether depressive symptoms predict specific types of cognitive decline in order to elucidate the association between late life depression and cognitive decline. Background Mechanisms underlying the association between late life depression and cognitive decline are still unclear. Method Six hundred and forty-one elderly persons of the Longitudinal Aging Study Amsterdam (LASA) aged 70-85 were examined by means of two measurement occasions over a period of 3 years. Depressive symptoms were assessed by means of the CES-D. Various cognitive functions were examined using neuropsychological tests. Results Depressive symptoms were associated with decline in speed of information processing over a 3-year period, whereas there was no association between depression and increasing memory impairment or global mental deterioration. Conclusion These findings suggest that depressive symptoms are associated with subcortical pathology, most probable white matter lesions.
De Beurs, E., Beekman, A.T.F., Geerlings, S.W., Deeg, D.J.H., Van Dyck, R., Van Tilburg, W. (2001). On becoming depressed or anxious in late life: similar vulnerability factors but different effects of stressful life events. British Journal of Psychiatry, 179, 426-431. > Full Text.
Background. Little research has been done on the uniqueness of risk profiles for depression and anxiety in late life. Aims. Delineating risk factors for the decline of mental health in older persons, comparing risk profiles for developing symptoms of pure depression, pure anxiety and both anxiety and depression in a prospective design. Method. Self-report data on depression and anxiety were collected from community-dwelling older respondents (greater than or equal to 55 years) on two occasions, 3 years apart. Data from emotionally healthy respondents (n = 1810) were used to investigate the effects of long-standing vulnerability factors and stressful life events. Results. After 3 years 9% of the subjects had scored beyond the thresholds for symptoms. Vulnerability for depression and anxiety was quite similar, but life events differed: onset of depression was predicted by death of a partner or other relatives; onset of anxiety was best predicted by having a partner who developed a major illness. No support for moderator effects between vulnerability factors and stress was found; the effects were purely additive. Conclusions. Depression and anxiety have many risk factors in common, but specific risk factors also were found, especially in subjects developing both depression and anxiety.
Dik, M.G., Jonker, C., Comijs, H.C., Bouter, L.M., Twisk, J.W.R., Van Kamp, G.J., Deeg, D.J.H. (2001). Memory complaints and APOE-epsilon4 accelerate cognitive decline in cognitively normal elderly. Neurology, 57, 2217-2222.
Objective. To investigate to what extent subjective memory complaints and APOE-epsilon4 predict future cognitive decline in cognitively intact elderly, evaluating both their separate and combined effects. Methods. We selected 1,168 subjects from the population-based Longitudinal Aging Study Amsterdam (LASA), aged 62-85 years, with no obvious cognitive impairment at baseline (Mini-Mental State Examination (MMSE) >= 27). Memory complaints and APOE phenotypes were assessed at baseline. We studied cognitive decline using the MMSE, the Auditory Verbal Learning Test (memory: immediate and delayed recall) and the Coding Task (information processing speed). Follow-up data were collected after three and six years. Data were analyzed with Generalized Estimating Equations (GEE), adjusted for age, sex, education and depression. Results. Baseline memory complaints were reported by 25.5% of the cognitively intact elderly. Overall, 25.3% were carrier of at least one APOE-epsilon4 allele. Memory complaints were associated with a greater rate of decline on all cognitive measures, except on immediate recall. Also, APOE-epsilon4 carriers showed a greater rate of decline on MMSE and information processing speed after six years. The effects of both memory complaints and APOE-epsilon4 were additive, with an almost two times higher decline compared to subjects without both factors. Conclusions. Both memory complaints and APOE-epsilon4 predict cognitive decline at an early stage. This highlights the importance of subjective memory complaints, also at an early stage when objective tests are still unable to detect cognitive deficits, and especially in elderly with APOE-epsilon4 since they carry an additional risk.
Geerlings, S.W., Beekman, A.T.F., Deeg, D.J.H., Twisk, J.W.R., Van Tilburg, W. (2001). The longitudinal effect of depression on functional limitations and disability in older adults: An eight-wave prospective community-based study. Psychological Medicine, 31, 1361-1371.
Background. The temporal relationship between depression and adverse functional outcomes in older adults is ambiguous. In the present eight-wave prospective community-based study, the longitudinal effect of depression on functional limitations and disability (in terms of disability days and bed days) was studied, thereby taking into account the role of chronic physical diseases. Methods. The study is based on a sample which at the outset consisted of 325 non-depressed and 327 depressed persons (55-85 years) drawn from a larger random community based sample in the Netherlands. Generalized estimating equations time-lag models were used to examine the longitudinal relation between depression and both functional limitations and disability. Results. Functional limitations were very persistent over time, whereas disability days and bed days were more fluctuating functional outcomes. Only in the presence of chronic physical diseases, there was a significant longitudinal association between depression at the previous measurement and functional limitations, disability days and bed days at the next measurement. The effect on functional limitations was small, which was probably partly due to their persistent nature. Conclusions. The finding of a longitudinal relationship between depression and functional outcomes in older adults with a compromised health status provides a rationale for treatment of chronic physical diseases as well as depression in depressed chronically ill elderly, in order to prevent a spiralling decline in psychological and physical health.
Jelicic, M., Jonker, C., Deeg, D.J.H. (2001). Effect of low levels of serum vitamin B-12 and folic acid on cognitive performance in old age: A population-based study. Developmental Neuropsychology, 20, 3, 565-571.
Abstract: We studied the effect of low levels of vitamin B-12 and folic acid, alone or combined, on cognitive performance in a population-based sample of 698 older adults (mean age = 68.7 years). No evidence was found for a vitamin-related memory deficit, but research participants with low levels of vitamin B12 exhibited reduced information processing speed relative to participants with normal vitamin B12 levels.
Kriegsman, D.M.W., Beekman, A.T.F., Westendorp-de Seriere, M., Deeg, D.J.H. (2001). The Longitudinal Aging Study Amsterdam: Introduction. In D.J.H. Deeg, M. Westendorp-de Seriere, A.T.F. Beekman, D.M.W. Kriegsman (Eds.), Autonomy and well-being in the aging population: report from the Longitudinal Aging Study Amsterdam 2, 1992-1996 (pp. 1-7). Amsterdam: VU University press.
No abstract available.
Penninx, B.W.J.H., Beekman, A.T.F., Honig, A., Deeg, D.J.H., Schoevers, R.A., Van Eijk, J.Th.M., Van Tilburg, W. (2001). *Depression and cardiac mortality: Results from a community-based longitudinal study. Archives of General Psychiatry, 58, 221-227. > Full Text.
Background: Depression may be a potential risk factor for subsequent cardiac death. The impact of depression on cardiac mortality has been suggested to depend on cardiac disease status, and to be stronger among cardiac patients. This study examined and compared the effect of depression on cardiac mortality in community-dwelling persons with and without cardiac disease. Methods: A cohort of 2847 men and women aged 55 to 85 years was evaluated for 4 years. Major depression was defined according to psychiatric DSM-III criteria. Minor depression was defined by Center for Epidemiologic Studies- Depression Scale scores of 16 or higher. Effects of minor and major depression on cardiac mortality were examined separately in 450 subjects with a diagnosis of cardiac disease and in 2397 subjects without cardiac disease after adjusting for demographics, smoking, alcohol use, blood pressure, body mass index, and comorbidity. Results: Compared with nondepressed cardiac patients, the relative risk of subsequent cardiac mortality was 1.6 (95% confidence interval ICI], 1.0-2.7) for cardiac patients with minor depression and 3.0 (95% CI, 1.1- 7.8) for cardiac patients with major depression, after adjustment for confounding variables. Among subjects without cardiac disease at baseline, similar increased cardiac mortality risks were found for minor depression (1.5 [95% CI, 0.9-2.61) and major depression (3.9 [95% CI, 1.4-10.9]). Conclusion: Depression increases the risk for cardiac mortality in subjects with and without cardiac disease at baseline. The excess cardiac mortality risk was more than twice as high for major depression as for minor depression
Penninx, B.W.J.H., Beekman, A.T.F., Deeg, D.J.H. (2001). *Cognitive impairment with chronic disease in depression and mortality - Reply. Archives of General Psychiatry, 58, 307. > Full Text.
No abstract available.
Pluijm, S.M.F., Visser, M., Smit, J.H., Popp-Snijders, C., Roos, J.C., Lips, P.T.A. (2001). *Determinants of bone mineral density in older men and women: body composition as mediator. Journal of Bone and Mineral Research, 16, 2142-2151. >Full Text.
This study aimed to assess the relative importance of several determinants of bone mineral density (BMD) and to examine to what extent these potential determinants influence total hip BMD through body composition. The study population consisted of 522 participants (264 women and 258 men) of the Longitudinal Aging Study Amsterdam (LASA), aged 65 years and over, and living in Amsterdam and its vicinity. BMD of the total hip was measured using dual-energy X-ray absorptiometry (DXA). Potential determinants of BMD were age, weight change since age 25 years, lifestyle factors, chronic diseases, medication use, and hormonal factors. Potential mediators between the possible determinants and BMD were two measures of body composition: fat mass (FM) and appendicular muscle mass (AMM). Multiple regression analyses including all potential determinants in one model without body composition identified age, weight change, walking activity, and sex hormone-binding globulin (SHBG) as independent determinants for total hip BMD in women. In men, current smoking, participation in sports, and parathyroid hormone (PTH) concentration were independently associated with total hip BMD. When total hip BMD was regressed on the potential determinants and each measure of body composition, it appeared that FM, and to a lesser extent, muscle mass (MM), were independently related to BMD. In women, adjustment for FM reduced the strength of the associations of weight change, walking activity, and SHBG with total hip BMD. Adjustments for MM did not influence the associations between the determinants and BMD. In men, neither FM nor MM appeared to play a mediating role between the determinants and BMD. It can be concluded that (1) FM and MM are strong independent determinants of total hip BMD and that (2) FM possibly plays a mediating role in the association of weight change, walking activity, and SHBG with total hip BMD in women.
Pluijm, S.M.F. (2001). Predictors and consequences of falls and fractures in the elderly. PhD Dissertation, VU University Amsterdam.
No abstract available.
Portrait, F.R.M., Lindeboom, M., Deeg, D.J.H. (2001). Life expectancies in specific health states: Results from a joint model of health status and mortality of older persons. Demography, 38, 525-536. > Full Text.
With the trend toward aging, increases in health care expenditures are expected. Insight into (future) needs for care services requires a taxonomy of older persons\' health conditions: how health status develops as people age and how these health conditions determine residual life expectancy. In this paper we provide this information for the Netherlands. We apply a flexible nonparametric method-the Grade of Membership method-to a national database and summarize the multidimensional concept of health status into a limited set of interpretable indices. We then use these indices in our panel data model for health status and mortality. The model results are used to calculate age-health profiles and expected residual life-times in specific health states.
Tromp, E.A.M., Pluijm, S.M.F., Smit, J.H., Deeg, D.J.H., Bouter, L.M., Lips, P.T.A. (2001). Fall-risk screening test: A prospective study on predictors for falls in community dwelling elderly. Journal of Clinical Epidemiology, 54, 837-844.
This large prospective cohort study was undertaken to construct a fall-risk model for elderly. The emphasis of the study rests on easily measurable predictors for any falls and recurrent falls. The occurrence of falls among 1285 community-dwelling elderly aged 65 years and over was followed during 1 year by means of a \"fall calendar.\" Physical, cognitive, emotional and social functioning preceding the registration of falls were studied as potential predictors of fall-risk. Previous falls, visual impairment, urinary incontinence and use of benzodiazepines were the strongest predictors identified in the risk profile model for any falls (area under the curve [AUC] = 0.65), whereas previous falls, visual impairment, urinary incontinence and functional limitations: proved to be the strongest predictors in the model for recurrent falls (AUC = 0.71). The probability of recurrent falls for subsequent scores of the screening lest ranged from 4.7% (95% Confidence Interval [CI]: 4.0-5.4%) to 46.8% (95% CI: 43.0-50.6%). Our study provides: a fall-risk screening test based on four easily measurable predictors that can be used for fall-risk stratification in community-dwelling elderly.
Van Baarsen, B. (2001). How's life? Adaption to widowhood in later life and the consequences of partner death on the experienced emotional and social loneliness. PhD Dissertation, VU University Amsterdam.
No abstract available.
Van der Zouwen, J., Van Tilburg, T.G. (2001). Reactivity in panel studies and its consequences for testing causal hypotheses. Sociological Methods & Research, 30, 1, 35-56. >Full Text.
No abstract available.
Van Zelst, W.H., De Beurs, E. (2001). Angstige ouderen. Modern Medicine, 10, 910-912.
No abstract available.

2000

Aartsen, M.J., Van Tilburg, T.G., Smits, C.H.M. (2000). Cognitieve achteruitgang: ook verlies van het persoonlijk netwerk? In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn and C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA)(pp 183-189). Amsterdam: Thela Thesis.
No abstract available.
Beekman, A.T.F. (2000). Depression and medical illness in later life. Primary Care Companion Journal of Clinical Psychiatry, 2, Suppl 5, 9-16. > Full Text.
No abstract available.
Beekman, A.T.F., De Beurs, E., Van Balkom, A.J.L.M., Deeg, D.J.H., Van Dyck, R., Van Tilburg, W. (2000). Anxiety and depression in later life: Co-occurrence and communality of risk factors. American Journal of Psychiatry, 157, 1, 89-95. >Full Text.
Objective: The purpose of this study was to examine the comorbidity of and communality of risk factors associated with major depressive disorder and anxiety disorders in later life. Method: A random age- and sex-stratified community-based sample (N=3,056) of the elderly (age 55-85 years) in the Netherlands was studied. A two-stage screening design was used, with the Center for Epidemiologic Studies Depression Scale as a screening instrument and the National Institute of Mental Health Diagnostic Interview Schedule as a criterion instrument. Risk factors were measured with well-validated instruments and represented a broad range of vulnerability and stress-related factors associated with anxiety and depression. Multivariate analyses examined risk factors associated with pure major depressive disorder, pure anxiety disorders, and comorbid conditions. Results: Comorbidity was highly prevalent: 47.5% of those with major depressive disorder also met criteria for anxiety disorders, whereas 26.1% of those with anxiety disorders also met criteria for major depressive disorder. While the only variables associated with pure major depressive disorder were younger age and external locus of control, risk factors representing a wide range of both vulnerability and stress were associated with pure anxiety disorders. External locus of control was the only common factor. The group with anxiety disorders plus major depressive disorder had a distinct risk factor profile and may represent those with a more severe disorder. Conclusions: Although high levels of comorbidity between major depressive disorder and anxiety disorders were found, comparing risk factors associated with pure major depressive disorder and pure anxiety disorders revealed more differences than similarities. Anxiety disorders in later life merit separate study.
Beekman, A.T.F., Deeg, D.J.H., Braam, A.W., Van Tilburg, W. (2000). Depressie in gerontologisch perspectief. Psychologie en Maatschappij, 92, 238-247.
No abstract available.
Beekman, A.T.F., De Beurs, E., Penninx, B.W.J.H., Geerlings, S.W. (2000). Kansen voor preventie: tien jaar onderzoek naar angst en depressie bij ouderen. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Ed.). Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA) (pp. 59-67). Amsterdam: Thela Thesis.
No abstract available.
Boshuizen, H.C., Chorus, A.M.J., Deeg, D.J.H. (2000). Test-hertest betrouwbaarheid van de OECD vragenlijst voor lichamelijke beperkingen [Test-retest reliability of the OECD questionnaire on physical limitations]. Tijdschrijft voor Gezondheidswetenschappen, 78, 3, 172-179.
No abstract available.
Bosscher, R.J. (2000). Meer bewegen, minder depressief? In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Ed.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (207-213). Amsterdam: Thela Thesis.
No abstract available.
Key Measurements: First Dataset
Braam, A.W., Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, W. (2000). Gereformeerde depressie of depressies bij gereformeerden? Gegevens uit ouderenonderzoek. Psyche en Geloof 11, 114-129.
De suggestie van de \"gereformeerde depressie\" staat in deze empirische studie ter discussie. Daarbij luidt de onderzoeksvraag of onder (groepen van) gereformeerde ouderen meer depressie voorkomt, en zo ja, of het dan depressieve klachten betreft die te rijmen zijn met de gereformeerde leer. Deze vraag wordt onderzocht aan de hand van interviewgegevens verkregen bij 3020 deelnemers van de Longitudinal Aging Study Amsterdam. De mate van depressieve symptomen en depressie (ook na drie jaar), gemeten met de CES-D, is gerelateerd aan kerkelijke gezindte en aan politiek-religieus klimaat per woongemeente. Uit de resultaten blijkt dat de depressiepercentage het laagst zijn onder synodaal gereformeerde ouderen. Onder ouderen van een bevindelijk gereformeerde signatuur, die in de huidige steekproef met name in Genemuiden voorkomen, wordt echter veel depressie gevonden, in gelijke mate als in Amsterdam. De symptomatologie verschilt echter niet voor de Genemuidenaren. De suggestie van de \"gereformeerde depressie\" kan derhalve beter worden verruild voor \"depressies onder gereformeerden\".
Braam, A.W., Sonnenberg, C.M., Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, W. (2000). Religious demonimation as a symptom-formation factor of depression in older Dutch citizens. International Journal of Geriatric Psychiatry, 15, 458-466. > Full Text.
Objectives. The type of symptoms in depression is likely to be influenced by cultural environment. As religion represents an important cultural resource for older adults, it is hypothesised that religious denomination represents a symptom-formation factor of depression in the older generation. Focusing on older Dutch citizens, it is expected that depressed Calvinists report: (1) less depressed affect, (2) more vegetative symptoms, and (3) more guilt feelings, than Roman Catholics and non-church members. Methods and procedures. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to distinguish depressed (N = 395) and non-depressed (N = 2333) older adults. and to assess depressive symptom-profiles. The Diagnostic Interview Schedule (DIS) was used to assess major depressive episodes and criterion-symptoms of depression. Results. Depressed Calvinists, especially males, had higher scores on the vegetative CES-D subscale. The same was found for non-church members with Calvinist parents. Among those who have had a major depressive episode in later life (N = 84), support was found for all hypotheses. Feelings of guilt were also more prevalent among Roman Catholics. Conclusions. Religious denomination modified the type of symptoms in late-lift depression. As a Calvinist background was associated with less depressive affect and more inhibition, there is a risk of underdiagnosis of major depression in older Calvinists in the Netherlands.
Broese van Groenou, M.I. (2000). Minder gezond, dus meer zorg? Een onderzoek naar sociaal-economische verschillen in zorggebruik door ouderen. In D.J.H. Deeg, R.J. Bosscher, MI. Broese van Groenou, L.M. Horn, C. Jonker (Ed.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA)(pp. 147-154). Amsterdam: Thela Thesis.
No abstract available.
Broese van Groenou, M.I., Deeg, D.J.H. (2000). Sociaal-economische gezondheidsverschillen bij ouderen [Socio-economic dimensions of changes in health of older adults]. Tijdschrift voor Gezondheidswetenschappen, 78, 5, 294-302.
In dit artikel is nagegaan in hoeverre sociaal-economische verschillen in (veranderingen in) gezondheid bij ouderen bestaan en zo ja, of deze sekse- en leeftijdsgebonden zijn. Drie dimensies van gezondheid (functionele beperkingen, ervaren gezondheid en sterfte) zijn gerelateerd aan drie dimensies van sociaal-economische status (opleidingsniveau, inkomen en beroepsniveau). Cross-sectionele en longitudinale gegevens zijn afkomstig van 3107 ouderen (55-85 jaar) die deelnamen aan waarnemingen van LASA in 1992/93 en 1995/96. Resultaten wijzen uit dat SES-verschillen in functionele beperkingen en ervaren gezondheid tot op hoge leeftijd bestaan, maar bij mannen het grootst zijn onder de 65 jaar en bij vrouwen tussen de 65 en 75 jaar. In alle leeftijdsgroepen geldt dat hoe lager de SES, hoe groter de kans op beperkingen en een als slecht ervaren gezondheid. Longitudinaal bezien houdt SES, na controle voor leeftijd en gezondheid in 1992/93, bij de manen maar niet bij de vrouwen, een effect op de toename in beperkingen, op afname in ervaren gezondheid en op sterfte. Bij de mannen is de differentiatie in sterfte het grootst onder de 65 jaar. Bij de vrouwen bestaan alleen in de oudste groep een differentiatie in de toename van functionele beperkingen. Geconcludeerd wordt dat SES-differentiatie in gezondheid en sterfte tot op hoge leeftijd bestaat, maar verschilt naar sekse en gehanteerde gezondheidsmaat.
Broese van Groenou, M.I., Deeg, D.J.H. (2000). Sociaal-economische ongelijkheid in sterfte bij oudere mannen en vrouwen. Een onderzoek naar de rol van gezondheid, leefstijl, ouderlijke sociaal-economische status en psychosociale condities [Socio-economic inequalities in mortality among older men and women: The impact of health, behavior, childhood socio-economic status and psychosocial conditions]. Tijdschrift voor Gerontologie en Geriatrie, 31, 219-228.
This article describes to what degree socio-economic differences exist among community living older men and women, and to what degree these differences are to be explained by health, behavior, childhood and psychosocial conditions. The data are available from 1427 men and 1503 women (aged 55-85), participating in the Longitudinal Aging Study Amsterdam (LASA) in 1992/1993. As an indicator of socio-economic status (SES) we used the highest level of education and net monthly income. Age-adjusted mortality risks for men and women with low income and for men with a low level of education are about 1.5 times as high compared to the persons with high income and educational level. Among men, but not among women, the difference in mortality risk remains between low and high status persons after adjustment for age, health status, and several risk factors. Differences in lifestyle, parental SES and psychosocial characteristics explain little to nothing of the age-adjusted SES-differentiation in mortality. It is concluded that SES-inequalities in mortality are present among Dutch men and, to a lesser extent among women, until high age, and are partly explained by the relatively large health problems of the lower status group.
Broese van Groenou, M.I., Van der Pas, S., Deeg, D.J.H. (2000). Zorg voor ouderen: Verwachtingen en werkelijkheid. Geron (Tijdschrift voor Sociale Gerontologie), 2, 3, 24-29.
In dit artikel sluiten wij aan bij de maatschappelijke discussie over de rol van familieleden en professionals in de zorg voor ouderen. Onze inbreng heeft tot doel meer inzicht te leveren in het perspectief van de huidige ouderen: wat zijn hun verwachtingen en wat de feiten betreffende het gebruik van informele en formele zorg? Aan de hand van gegevens van de Longitudinal Aging Study Amsterdam (LASA) bespreken wij de informele en formele hulpbronnen van ouderen, de zorgverwachtingen van ouderen en de zorg van kinderen voor hun ouders.
Comijs, H.C., Jonker, C. (2000). Zijn geheugenklachten indicatief voor cognitief verval? In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M.Horn, C. Jonker (Ed.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (pp. 175-182). Amsterdam: Thela Thesis.
No abstract available.
Cuijpers, P. (2000). Preventie van depressie bij ouderen: "State of the art". In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Ed.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (pp. 89-100). Amsterdam: Thela Thesis.
No abstract available.
De Beurs, E., Beekman, A.T.F., Deeg, D.J.H., Van Dyck, R., Van Tilburg, W. (2000). Predictors of change in anxiety symptoms of older persons: results from the Longitudinal Aging Study Amsterdam. Psychological Medicine, 30, 515-527. >Full Text.
Background. Data on the course of anxiety in late life are scarce. The present study sets out to investigate the course of anxiety, as measured by the HADS-A (Zigmond & Snaith, 1983) in community dwelling older persons, and to evaluate predictive factors for change over 3 years in anxiety symptoms following the vulnerability/stress model. Method. Based on the first anxiety assessment, two cohorts were formed: subjects with and subjects without anxiety symptoms. In the non-anxious cohort (N = 1602) we studied risk factors for the development of anxiety symptoms; in the anxious cohort (N = 563) the same factors were evaluated on their predictive value for restitution of symptoms. Risk factors included vulnerability factors (demographics, health status, personality characteristics and social resources) and stressors (life events occurring in between both anxiety assessments). Logistic regression models estimated the effects of vulnerability factors, stress and their interaction on the likelihood of becoming anxious and chronicity of anxiety symptoms. Results. It was indicated that the best predictors for becoming anxious were being female, high neuroticism, hearing/eyesight problems and Life-events. Female sex and neuroticism also increased the likelihood of chronicity of anxiety symptoms in older adults, but life events were not related to chronicity. The main stressful event in late life associated with anxiety was death of one\\\'s partner. Vulnerability factors and stress added on to each other rather than their interaction being associated with development or chronicity of anxiety. Conclusion. The vulnerability/stress model offers a useful framework for organizing risk factors for development and chronicity of anxiety symptoms in older persons, but no support was attained for the hypothesis that vulnerability and stress amplify each others effects. Finally, the results indicate to whom preventive efforts should be directed: persons high in neuroticism, women, and those who experience distressing life events.
De Beurs, E., Deeg, D.J.H., Beekman, A.T.F. (2000). Physical health and anxiety of older persons. A longitudinal perspective. Tijdschrift voor Gerontologie en Geriatrie, 31, 203-210.
The prognostic value of physical health for changes in anxiety symptoms in older people was investigated in a prospective longitudinal study design with data from the Longitudinal Aging Study Amsterdam (LASA). Anxiety symptoms were measured twice over a three year interval with the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A). Utilizing a cut-off value of 4 on the HADS-A, subjects were considered as anxious or as non-anxious. Based on the first assessment two groups were formed: subjects with and subjects without anxiety symptoms. In the non-anxious cohort the effect of physical health on the development of anxiety symptoms was studied; in the anxious cohort the same factors were evaluated on their predictive value for chronicity of anxiety. Indices of physical health included the presence of chronic diseases, functional limitations, and self-perceived health at the first assessment and changes on these variables over time. Results revealed that poor self-perceived health, and suffering from more than one chronic disease were factors predictive of becoming anxious and chronicity of anxiety; a decrease in self-perceived health and an increase in functional limitations were also associated with developing and keeping anxiety symptom. The subjective rating of health was more strongly related to change in anxiety than the number of chronic diseases. Specific chronic diseases were not strongly related to anxiety levels. Thus, somatic diseases not only lead to depression, a finding reported in numerous studies, but also increase the likelihood of anxiety symptoms at a later point in time.
De Beurs, E., Deeg, D.J.H., Beekman, A.T.F. (2000). De lichamelijke gezondheid en angst van ouderen. Tijdschrift voor Gerontologie en Geriatrie, 31, 203-210.
No abstract available.
De Beurs, E. (2000). Angst bij ouderen: een onderbelicht fenomeen. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Ed.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA) (pp. 79-87). Amsterdam: Thela Thesis.
No abstract available.
De Jong Gierveld, J. (2000). Tussen solitude en solidariteit: Nieuwe levensstrategieën van senioren. Koninklijke Nederlandse Akademie van Wetenschappen, Amsterdam, Mededelingen van de Afdeling Letterkunde, deel 62, nr. 8.
No abstract available.
Deeg, D.J.H. (2000). Lichaamsbeleving in de Longitudinal Aging Study Amsterdam. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA) (pp. 201-205). Amsterdam; Thela-Thesis.
No abstract available.
Deeg, D.J.H. (2000). Sex-differences in the evolution of life expectancy and health in older age. In J.-M. Robine, T.B.L. Kirkwood, M. Allard (Ed.), Sex and longevity: Sexuality, gender, reproduction, parenthood (pp. 129-140). Berlin: Springer-Verlag.
Since the middle of the 19th century, there have been considerable gains in life expectancy at all ages, especially during the first two decades of the 20th century. Throughout this period, women have had greater survival chances than males. Nevertheless, there are some notable sex differences in survival gains. Male infant survival increased faster than female infant survival, indicating narrowing sex differentials. The opposite is observed for survival to older ages. For instance, female survival to ages 50 and 65 increased faster than male survival to these ages, indicating a widening sex differential. The question is raised, how these differences in cohort survival history affect health and mortality at ages above 65 years. The role of cohort survival history was examined as an explanatory factor of sex differences in three-year survival in older persons in two surveys on health and aging, the Dutch Longitudinal Study among the Elderly (DLSE, baseline 1955-1957) and the Longitudinal Aging Study Amsterdam (LASA, baseline 1992-93). Both surveys are based on representative samples across the Netherlands, stratified by age and sex, with over 2000 persons in the common age group of 65-84 years. Cohort survival history was expressed as the percent surviving up to ages 1, 15, 40, 50, and 65 based on cohort survival tables of the birth cohorts included in the study. Both in 1955-57 and in 1992-93, when controlling for number of chronic diseases, functional limitations, and self-rated health, multiple logistic regression models showed that survival was significantly associated with sex, indicating that females had better survival than males. Inclusion of cohort survival history in the model raised these Risk Ratios to values closer to 1. Inclusion of survival to age 1 in DLSE resulted in a reversal of the sex differential. In LASA, inclusion of survival to age 1 increased the Risk Ratio significantly, but did not bring about a reversal of the risk. Inclusion of survival to age 50 in both surveys resulted in sex being no longer significantly associated with survival. The consistent findings in both surveys suggest that the more favorable cohort survival history of females explains part of the female over male advantage in survival in later life, given the same level of health. This is true even for infant mortality experience of the cohort. The better survival of females at all ages appears to perpetuate itself in older age.
Deeg, D.J.H., Bosscher, R.J., Broese van Groenou, M.I., Horn, L.M., Jonker, C. (2000). Ouder worden in Nederland: Tien jaar Longitudinal Aging Study Amsterdam (LASA). Amsterdam: Thela Thesis. ISBN 90-5170-534-4. inhoudsopgave
No abstract available.
Deeg, D.J.H. (2000). Gebrek en wijsheid komen met de jaren. Aanpassing aan ziekte tijdens het ouder worden. In D.J.H. Deeg, J. Gierveld, C.P.M. Knipscheer, E. Lutjens, G. van der Wal (Eds.), Ouder worden, nieuwe perspectieven (pp. 27-46). Amsterdam: VU Uitgeverij.
No abstract available.
Deeg, D.J.H. (2000). Tien jaar Longitudinal Aging Study Amsterdam. Tijdschrift voor Gerontologie en Geriatrie, 31, 182-183.
No abstract available.
Dik, M.G., Deeg, D.J.H., Bouter, L.M., Corder, E.H., Kok, A., Jonker, C. (2000). Stroke and apolipoprotein E epsilon4 are independent risk factors for cognitive decline: A population-based study. Stroke, 31, 2431-2436.
Background and Purpose. Stroke and apolipoprotein E epsilon4 (ApoE epsilon4) are individually important risk factors for cognitive decline, including Alzheimer disease. It has been suggested that ApoE epsilon4 multiplies the risk for cognitive decline following stroke. In a population-based sample, using well-defined sensitive cognitive measures, this study investigates whether cognitive decline following stroke is worse for patients who carry the ApoE epsilon4 allele. Methods. Subjects were participants in the Longitudinal Aging Study Amsterdam (LASA). The sample consisted of 1224 subjects, aged 62 to 85 years, who participated in the 3-year follow-up examination and for whom ApoE and stroke data were complete. We assessed cognitive decline using the Mini-Mental State Examination, the Auditory Verbal Learning Test (memory: immediate and delayed recall), and the Coding Task (information processing speed). The effects of stroke and ApoE epsilon4 on cognitive decline were evaluated with ANOVA and multiple logistic regression analysis, adjusted for age, sex, education, and baseline cognition. Results. A synergistic effect modification for stroke and ApoE epsilon4 on cognitive decline was not observed. Unexpectedly, instead, stroke patients carrying the epsilon4 allele demonstrated a nonsignificantly lowered risk for Mini-Mental State Examination decline (OR=0.3; 95% CI 0.1 to 1.1). ApoE epsilon4 was associated with declines in information processing speed (OR=1.5; 95% CI 1.1 to 2.1) and small declines for immediate and delayed recall. Conclusions. Stroke and ApoE epsilon4 may impair cognition through distinct nonsynergistic mechanisms. The slowing of information processing speed for ApoE epsilon4 carriers was more evident than impairment in memory.
Dik, M.G., Jonker, C., Bouter, L.M., Geerlings, M.I., Van Kamp, G.J., Deeg, D.J.H. (2000). APOE-epsilon4 is associated with memory decline in cognitively impaired elderly. Neurology, 54, 1492-1497.
Objective: To investigate whether the association between APOE-epsilon4 and memory decline is modified by baseline cognition and age in a population-based elderly sample. Methods: The study sample consisted of 1,243 subjects, 62 to 85 years old, with a Mini-Mental State Examination (MMSE) score between 21 and 30 and known APOE phenotypes. Memory performance was measured with an abbreviated Auditory Verbal Learning Test (AVLT) at baseline and repeated after 3 years (n = 854). Memory decline was defined as a decrease of at least 1 SD from the mean change score on immediate recall (IR), delayed recall (DR), and retention, based on the AVLT. Results: Multivariate logistic regression analyses showed that APOE-epsilon4 is associated with memory decline in cognitively impaired subjects (MMSE score, 21 to 26) (OR for decline on IR adjusted for age, sex, education, and baseline recall score, 3.8; 95% CI, 1.4 to 10.0; adjusted OR for decline on DR, 2.9; 95% CI, 1.2 to 7.0; adjusted OR for decline on retention, 3.3; 95% CI, 1.1 to 10. 1), but not in cognitively normal subjects (MMSE score, 27 to 30) (adjusted OR for decline on IR, 1.1; 95% CI, 0.6 to 2.0; adjusted OR for decline on DR, 1.0; 95% CI, 0.6 to 1.8; adjusted OR for decline on retention, 1.5; 95% CI, 0.7 to 3.0). In particular, cognitively impaired epsilon4 carriers older than 75 years were at high risk of memory decline (adjusted OR for decline on IR, 4.5; 95% CI, 1.4 to 13.8; adjusted OR for decline on DR, 3.6; 95% CI, 1.2 to 10.8; adjusted OR for decline on retention, 6.6; 95% CI, 1.5 to 29.7). Conclusions: APOE-epsilon4 was associated with memory decline in subjects with cognitive impairment, but not in normally functioning subjects. Contrary to AD studies, our study suggests that the risk of APOE-epsilon4 on memory decline does not decrease at higher ages.
Geerlings, M.I., Schoevers, R.A., Beekman, A.T.F., Jonker, C., Deeg, D.J.H., Schmand, B.A., Adèr, H.J., Bouter, L.M., Van Tilburg, W. (2000). Depression and risk of cognitive decline and Alzheimer\'s disease: Results of two prospective community-based studies in The Netherlands. British Journal of Psychiatry, 176, 560-575.
Background. Depression may be associated with cognitive decline in elderly people with impaired cognition. Aims. To investigate whether depressed elderly people with normal cognition are at increased risk of cognitive decline and Alzheimer\'s disease. Methods. Two independent samples of older people with normal cognition were selected from the community-based Amsterdam study of the Elderly (AMSTEL) and the Longitudinal Aging Study Amsterdam (LASA). In AMSTEL, depression was assessed by means of the Geriatric Mental State Schedule. Clinical diagnoses of incident Alzheimer\'s disease were made using a two-step procedure. In LASA, depression was assessed with the Center for Epidemiologic Studies Depression Scale. Cognitive decline was defined asa drop of greater than or equal to 3 on the Mini-Mental State Examination at follow-up. Results. Both in the AMSTEL and the LASA sample, depression was associated with an increased risk of Alzheimer\'s disease and cognitive decline, respectively, but only in subjects with higher levels of education. Conclusions. In a subgroup of more highly educated elderly people, depression may be an early manifestation of Alzheimer\'s disease before cognitive symptoms become apparent.
Geerlings, S.W., Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, W. (2000). Physical health and the onset and persistence of depression in older adults: An eight-wave prospective community based study. Psychological Medicine, 30, 369-380.
Background. Poor physical health has long been recognized to be one of the most important risk factors for depression in older adults. Since many aspects of physical health can be targeted for improvement in primary care, it is important to know whether physical health problems predict the onset and/or the persistence of depression. Methods. The study is based on a sample which at the outset consisted of 327 depressed and 325 non-depressed older adults (55-85) drawn from a larger random community-based sample in the Netherlands. Depression was measured using the Center for Epidemiologic Studies Depression scale (CES-D) at eight successive waves. Results. From all incident episodes, the majority (57 %) was short-lived. These short episodes could generally not be predicted by physical health problems. The remaining incident episodes (43 %) were not short-lived and could be predicted by poor physical health. Chronicity (34 %) was also predicted by physical health problems. Conclusions. The study design with its frequent measurements recognized more incident cases than previous studies; these cases however did have a better prognosis than is often assumed. The prognosis of prevalent cases was rather poor. Physical health problems were demonstrated to be a predictor of both the onset and the persistence of depression. This may well have implications for prevention and intervention.
Geerlings, S.W., Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, W. (2000). Het onstaan en het beloop van depressie bij ouderen en de rol van lichamelijke gezondheid. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA) (chapter 3.2, pp. 69-77). Amsterdam: Thela Thesis.
No abstract available.
Hommel, A. (2000). Ongelijkheid in netwerken en zorg: issue voor ouderenbeleid? In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA)(chapter 5.4, pp. 155-163). Amsterdam: Thela Thesis.
No abstract available.
Horn, L.M. (2000). Het motief van LASA: verbeteren van het leven van ouderen. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA) (pp. 11-20). Amsterdam: Thela Thesis.
No abstract available.
Jonker, C. (2000). Cognitief functioneren. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA) (chapter 6.1, pp. 165-173). Amsterdam: Thela Thesis.
No abstract available.
Jonker, C., Dik, M.G., Van Kamp, G.J., Deeg, D.J.H. (2000). Apolipoproteine E4 en achteruitgang van het geheugen bij ouderen [Apolipoprotein E4 and memory decline in the elderly]. Tijdschrift voor Gerontologie en Geriatrie, 31, 198-202.
The objective of this study was to investigate whether the association between Apolipoprotein E4 (ApoE4) and memory decline is modified by baseline general cognitive impairment and age in a population-based elderly sample. Subjects were participants in the Longitudinal Aging Study Amsterdam (LASA). The study sample consisted of 1,243 subjects, 62-85 years old, with a Mini-Mental State Examination (MMSE) score between 21-30 and known ApoE phenotypes. Memory performance was measured with a short version of the Auditory Verbal Learning Test (AVLT) at baseline and repeated after three years (N = 854). Memory decline was defined as a decrease of at least one standard deviation from the mean change score on immediate recall, delayed recall and retention. ApoE4 was associated with memory decline in cognitively impaired subjects (MMSE 21-26), but not in cognitively normal subjects (MMSE 27-30). In particular cognitively impaired E4 carriers older than 75 years were at high risk of memory decline. Contrary to AD studies, our study suggests that the risk of ApoE4 on memory decline does not decrease with ageing.
Klein Ikkink, C.E. (2000). If I Scratch Your Back......? Reciprocity and social support exchanges in personal relationships of older adults. PhD Dissertation, VU University Amsterdam.
No abstract available.
Knipscheer, C.P.M., Broese van Groenou, M.I., Leene, G.J.F., Beekman, A.T.F., Deeg, D.J.H. (2000). The effects of environmental context and personal resources on depressive symptomatology in older age: A test of the Lawton-model. Ageing & Society, 20, 183-202. >Full Text.
No abstract available.
Knipscheer, C.P.M., Deeg, D.J.H., Leene, G.J.F. (2000). Veranderingen in lichamelijk functioneren en wonen in de tweede levenshelft. In H. Priemus, E. Philipsen (Eds.), Levensloopbestendig wonen in Europees perspectief (pp 35-47). Delft: University Press.
No abstract available.
Kriegsman, D.M.W., Deeg, D.J.H. (2000). Lichamelijk gezondheid en lichamelijk functioneren in lASA: inleiding. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA) (pp. 101-106). Amsterdam: Thela Thesis.
No abstract available.
Kriegsman, D.M.W. (2000). Meer ziekten, meer beperkingen? De invloed van chronische ziekten op achteruitgang in het lichamelijk functioneren van ouderen. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA) (pp. 107-115). Amsterdam: Thela Thesis.
No abstract available.
Linnemann, M.A. (2000). Bewegingen van senioren: onderzoek naar factoren die deelname aan sport bevorderen. Geron, 2, 4, 34-44.
No abstract available.
Lips, P.T.A. (2000). Vallen en fracturen: een inleiding. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA) (pp. 35-37). Amsterdam: Thela Thesis.
No abstract available.
Montgomery, S.A., Beekman, A.T.F., Sadavoy, J., Salzman, C., Thompson, C., Zisook, S. (2000). Concensus statement on depression in the elderly. Primary Care Companion Journal of Clinical Psychiatry, 2, Suppl 5, 46-52. > Full Text.
A consensus meeting of experts in the treatment of depression was held with the aim of providing primary care clinicians with a better understanding of depression in the elderly and to guide clinical practice with recommendations on management issues. The consensus statement is based on consideration of the review articles published in this supplement and the scientific literature relevant to these articles. The consensus statement identifies diagnostic indicators for depression in the elderly and an appropriate management strategy. Selective serotonin reuptake inhibitors are recommended as the antidepressants of first choice in the elderly, including those with severe depression, the very old, and hospitalized patients. Psychosocial support and psychotherapy, where available, are other components of a comprehensive strategy. Early intervention is important in late-life depression, and the more pervasive, persistent, or severe the depression, the greater is the need to start drug therapy without delay.
Pennekamp, P.H.B. (2000). Onderzoek en implementatie. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker(Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA) (pp. 21-25). Amsterdam, Thela Thesis.
No abstract available.
Penninx, B.W.J.H., Deeg, D.J.H., Van Eijk, J.Th.M., Beekman, A.T.F., Guralnik, J.M. (2000). Changes in depression and physical decline in older adults: A longitudinal perspective. Journal of Affective Disorders, 61, 1-12.
Background: The impact of chronicity and changes in depression on physical decline over time in older persons has not been elucidated. Methods: This prospective cohort study of 2121 community-dwelling persons aged 55-85 years uses two measurement occasions of depression (CES-D scale) over 3 years to distinguish persons with chronic, remitted, or emerging depression and persons who were never depressed. physical function is assessed by self-reported physical ability as well as by observed performance on a short battery of tests. Results: After adjustment for baseline physical function, health status and sociodemographic factors, chronic depression was associated with significantly greater decline in self- reported physical ability over 3 years when compared to never depressed persons (odds ratio (OR) = 2.83, 95% confidence interval (CI)= 1.86-4.30). In the oldest old, but not in the youngest old, chronic depression was also significantly predictive of greater decline in observed physical performance over 3 years (OR = 2.22, 95% CI = 1.43-3.79). Comparable effects were found for older persons with emerging depression. persons with remitted depression did not have greater decline in reported physical ability or observed performance than persons who were never depressed. Conclusions: Our findings among community-dwelling older persons show that chronicity of depression has: a large impact on physical decline over time. Since persons with remitted depression did not have greater physical decline than never depressed persons, these findings suggest that early recognition and treatment of depression in older persons could be protective for subsequent physical decline.
Penninx, B.W.J.H., Deeg, D.J.H. (2000). Aging and psychological stress. Encyclopedia of stress, volume 1, 104-111.
No abstract available.
Penninx, B.W.J.H., Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, W. (2000). Gevolgen van depressie voor het lichamelijk functioneren en sterfte van ouderen. Longitudinale resultaten van het LASA-onderzoek. Tijdschrift voor Gerontologie en Geriatrie, 31, 211-218.
No abstract available.
Pluijm, S.M.F., Tromp, E.A.M., Smit, J.H., Deeg, D.J.H., Lips, P.T.A. (2000). Consequences of vertebral deformities in older men and women. Journal of Bone and Mineral Research, 15, 1564-1572. > Full Text.
The objectives of this study were to ascertain the prevalence of the number and severity of vertebral deformities in elderly people, and to determine the extent to which these are associated with several aspects of functioning. The study was conducted in a subsample of the Longitudinal Aging Study Amsterdam (LASA) consisting of 527 participants (260 men and 267 women), aged 65 years or over. Lateral radiographs of the spine (T4-L5) were made of each participant and a semiquantitative method was used to assess the number and degree of vertebral deformities. The prevalence of having at least one vertebral deformity was 39% in both men and women. 6% of the men and 5% of the women had at least three vertebral deformities. For severe deformities, the prevalence was 8% in men and 12% in women. The number of vertebral deformities was significantly associated with a height loss of more than 5 cm, difficulties in activities of daily living, a poor performance, more than 3 days in bed and more than 3 days with limited activities due to health problems past month and a poor self perceived health. For most of these outcome measures, associations were strongest when three or more deformities were present. The presence of a severe deformity was associated with a height loss of more than 5 cm, a poor performance, more than 3 days with limited activities in the past month, and a poor self-perceived health. None of the associations between number and severity of vertebral deformities and the level of functioning were modified by sex. We can conclude that vertebral deformities are very common in both older men and older women and that vertebral deformities, even if they are not clinically manifest, have a substantial impact on the level of functioning and well-being of older people.
Pluijm, S.M.F., Tromp, E.A.M., Stel, V.S., Deeg, D.J.H., Smit, J.H., Lips, P.T.A. (2000). Wie komt ten val? In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA (pp. 39-45. Amsterdam: Thela Thesis.
No abstract available.
Portrait, F.R.M. (2000). Long-term care services for the Dutch elderly: An investigation into the process of utilization. PhD Dissertation, VU University Amsterdam.
No abstract available.
Portrait, F.R.M., Lindeboom, M., Deeg, D.J.H. (2000). The use of long-term care services by the Dutch elderly. Health Economics, 9, 513-531. >Full Text.
The main focus of this paper is the development of an appropriate framework to characterize the process of long-term care utilization by the Dutch elderly. Three broad categories of care services are considered, namely, informal care, formal care at home, and institutional care. The use of these care alternatives is modelled jointly, and stochastic dependence is allowed between the various care options. Special attention is given to the concept of health status and to the potential endogeneity of this variable in the model. We apply a flexible non-parametric method to summarize the multidimensional concept of health status into a limited set of interpretable indices. The model is applied on the Longitudinal Aging Study Amsterdam (LASA). We find strong effects of health status, gender, socio-economic variables, and prices on the utilization of long-term care services.
Portrait, F.R.M., Deeg, D.J.H., Lindeboom, J. (2000). Ziekteprofielen, levensverwachtingen en zorggebruik. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA)(pp. 117-124). Amsterdam: Thela Thesis.
No abstract available.
Smit, J.H., Comijs, H.C. (2000). Longitudinaal onderzoek bij oudere respondenten: Participatie en de kwaliteit van gegevens [Longitudinal research in elderly populations: Participation and quality of data collected with questionnaires]. Tijdschrift voor Gerontologie en Geriatrie, 31, 184-189.
Methods are discussed which may keep participation in a longitudinal study among the elderly high, for example adaptation of the interviews and proxy interviews. The LASA sample is described from the start at 1992 until now. The non-response is evaluated and we found that refusals are particularly important in the first part of the longitudinal traject. Also data quality is studied in relation to the aging of the respondents. Although there are theoretical reasons to expect that aging of respondents may impair data quality, no support for this hypothesis was found in the present study. Data quality was stable during a period of six years. But data quality seemed poorer for those respondents who dropped out of the study. Item non-response and duration of the interview were higher for drop outs.
Sonnenberg, C.M., Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, T.G. (2000). Sex-differences in late-life depression. Acta Psychiatrica Scandinavica, 101, 286-292. > Full Text.
Objective: The primary aim of this study was to assess sex differences in depression in later life. Method: In a random, age and sex-stratified community sample of 3056 older Dutch people (55-85 years) the prevalence, symptom-reporting and risk factors associated with depression in later life were studied. Depression was measured with the Center for Epidemiologic Studies Depression scale (CES-D). Bivariate, multivariate and factor analyses were used. Results: Prevalence of depression in women was almost twice as high as in men. Controlling for age and competing risk factors reduced the relative risk for females with more than half. Symptom-patterns in men and women were very much alike. Sex differences in associations with risk factors were small, but exposure to these risk factors was considerably higher in females. Conclusion: Very little evidence for a typical \'female depression\' was found. Female preponderance in depression was related to a greater exposure to risk factors.
Stel, V.S., Pluijm, S.M.F., Deeg, D.J.H., Smit, J.H., Lips, P.T.A. (2000). Mobiliteit en activiteit bij vallers. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Eds), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA) (pp. 47-51). Amsterdam: Thela Thesis.
No abstract available.
Stevens, N.L., Van Tilburg, T.G. (2000). Stimulating friendship in later life: A strategy for reducing loneliness among older women. Educational Gerontology, 26, 15-35. >Full Text.
In order to promote well-being and alleviate loneliness among older women, a course was developed to help them improve or develop new friendships. Thirty-two participants in the course were interviewed on their friendships and loneliness at two points in time, immediately following the course and a year later. Loneliness scores were compared to those of a matched control group. Both groups were very lonely initially and demonstrated a significant reduction in loneliness a year later. However, more women in the friendship course were successful in reducing their loneliness; a majority had made new friends, slightly less than half had improved existing friendships. There was a significant increase in the complexity of their friendship networks following the course.
Tromp, E.A.M. (2000). Risk assessment of falls and fractures in the elderly. PhD Dissertation, VU University Amsterdam.
No abstract available.
Van Balkom, A.J.L.M., Beekman, A.T.F., De Beurs, E., Deeg, D.J.H., Van Dyck, R., Van Tilburg, W. (2000). Comorbidity of the anxiety disorders in a community-based older population in The Netherlands. Acta Psychiatrica Scandinavica, 101, 37-45.
Objective: The aim of the study was to investigate patterns of comorbidity among the anxiety disorders in a community-based older population: and the relationship of these disorders with major depression, use of alcohol and benzodiazepines, cognitive impairment and chronic somatic illnesses. Method: The data were derived from the Longitudinal Aging Study Amsterdam (LASA) study. A two-stage screening design was adopted to identify respondents with anxiety disorders. Results: In total, 10%, of the elderly with an anxiety diagnosis suffered from two or more anxiety disorders. Major depression (13% vs. 3%), benzodiazepine use (24% vs. 11%) and chronic somatic diseases (12% vs. 7%) were significantly more prevalent in respondents with an anxiety disorder than in respondents without anxiety disorders. Heavy or excessive alcohol intake (5% vs. 4%) and cognitive impairment (11% vs. 13%) were not significantly associated with any anxiety disorder. Conclusion: When anxiety disorders are diagnosed, in older people there is a relatively high probability of comorbid conditions being present.
Van Exel, E., Stek, M.L., Deeg, D.J.H., Beekman, A.T.F. (2000). The implication of selection bias in clinical studies of late life depression: An empirical approach. International Journal of Geriatric Psychiatry, 15, 488-492. > Full Text.
Objectives. It is supposed that selection bias precludes the extrapolation of results of studies carried out in a clinical setting to the general population. There is little empirical evidence demonstrating the degree to which those depressed in the community are different From those treated in clinical settings. This study compared elderly patients with major depression admitted to a psychiatric hospital with those living in the community. Methods. All elderly (55 years and older) patients admitted between 1990 and 1992 to a psychiatric hospital with DSM major depression as the primary diagnosis (n = 104), were compared with all elderly patients with the same diagnosis (n = 59) who were participating in a large community study (Longitudinal Aging Study, Amsterdam). Data were gathered from the clinical sample using chart-reviews while the community-based sample was interviewed. The two groups were compared with respect to differences in demographic variables, presenting symptoms, risk factors and treatment. Results. The following characteristics were significantly more prevalent in the clinical sample: late onset of the depression, threat of suicide, conflicts with significant others and use of antidepressant medication. Chronic physical illness was the only characteristic that was more prevalent in the community sample. Conclusion. The results confirm that elderly patients treated in clinical psychiatry represent a group with more threatening and more disruptive depressive illness. Major depression in the community was more often associated with chronic physical illness, which may hamper the recognition and treatment of depression. As the two samples were similar in all other respects, selection bias, hampering comparison of results of studies carried out across treatment settings, appears to have a very limited effect.
Van Tilburg, T.G., Aartsen, M.J., Knipscheer, C.P.M. (2000). Effects of changes in physical capacity on the personal network among older adults. Tijdschrift voor Gerontologie en Geriatrie, 31, 190-197.
The aim of the research is to assess whether there is change in the size and composition of older adults\' personal network. Furthermore, change in contact frequency and received instrumental support within the relationships is studied. Five relationship types are distinguished: children, other kin, friends, neighbors and acquaintances. Older adults with a decline in physical capacity are compared with those with stable and increased capacities. Furthermore, differences according to (change in) partner status and age are investigated. Data are from the Longitudinal Aging Study Amsterdam, including the first and fourth observation of 1634 older adults living independently. The observation interval is 7 years. A decline in physical capacities is observed for 35% of the older adults, the capacities are stable for 60% and an increase is observed for 5%. In general, network size and composition did not change. The frequency of contact within the relationships decreased. Decline was high for parent - child relationships, but relatively low among older adults who faced a moderate to strong physical decline. Among older adults who did not have a partner at the fourth observation and among the oldest the frequency of contact with children increased independent from the degree of physical decline. The decline in contact with neighbors was nearly absent for older adults who faced a moderate to strong physical decline; the contact increased when there was no partner at the fourth observation. The instrumental support received increased within all relationship types, independent from the degree of physical decline. It is concluded that research into determinants of the decline in parent-child contacts is needed and that the meaning of neighbors should receive attention.
Van Tilburg, T.G., Aartsen, M.J., Knipscheer, C.P.M. (2000). Gevolgen van veranderingen in fysiek functioneren voor het persoonlijk relatienetwerk. Tijdschrift voor Gerontologie en Geriatrie, 31, 190-197.
No abstract available.
Van Tilburg, T.G. (2000). Persoonlijke relatienetwerken van ouderen: een inleiding. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA) (pp. 131-136). Amsterdam: Thela Thesis.
No abstract available.
Visser, M., Deeg, D.J.H., Lips, P.T.A., Harris, T.B., Bouter, L.M. (2000). Skeletal muscle mass and muscle strength in relation to lower-extremity performance in older men and women. Journal of the American Geriatrics Society, 48, 381-386.
Objective: Low muscle strength is associated with poorer physical function, but limited empirical evidence is available to prove the relationship between muscle mass and physical function. We tested the hypothesis that persons with lower muscle mass or muscle strength have poorer lower-extremity performance (LEP). Design: A cross-sectional, population-based study. Participants: A cohort of 449 men and women aged 65 years and older living in Amsterdam and its surroundings participating in the second examination (1995-1996) of the Longitudinal Aging Study Amsterdam. Measurements: Leg skeletal muscle mass was measured using dual-energy X-ray absorptiometry. Grip strength was used as an indicator of muscle strength. Timed functional performance tests, including walking and repeated chair stands, were used to assess LEP. Results: After adjustment for body height and age, leg muscle mass was positively associated with LEP in men (regression coefficient .178 (95% confidence interval .013-.343), p=.035). In women an inverse association was observed, which became positive after additional adjustment for body mass index (.202 (-.001-.405), p=.052). Grip strength was positively associated with LEP in men and women. After additional adjustment for behavioral, physiological, and psychological variables, the associations between leg muscle mass and LEP disappeared, whereas grip strength remained to be independently associated with LEP in men (.079 (.042-.116), p=.0001), with a tendency in women (.046 (-.009-.101), p=.11). Results were similar when quartiles of leg muscle mass or grip strength were used. Conclusion: These results suggest that low muscle strength, but not low muscle mass, is associated with poor physical function in elderly men and women. However, prospective studies are needed to investigate the association between loss of muscle mass and physical function.
Visser, G., Broese van Groenou, M.I. (2000). Minder status, minder steun? Sociaal-economische verschillen in netwerken en steun bij ouderen in de Nederlandse samenleving. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA) (pp. 137-146). Amsterdam: Thela Thesis.
No abstract available.
Visser, M. (2000). De invloed van lichaamsbeweging op de mobiliteit van ouderen: bewegen houd je op de been. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L.M. Horn, C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (LASA) (pp. 215-221). Amsterdam: Thela Thesis.
No abstract available.

1999

Beekman, A.T.F., Copeland, J.R.M., Prince, M.J. (1999). Review of community prevalence of depression in later life. British Journal of Psychiatry, 174, 307-311. > Full Text.
Background. Despite considerable interest, there is no consensus regarding the prevalence of depression in later life. Aims. To assess the prevalence of late-life depression in the community. Method. A systematic review of community-based studies of the prevalence of depression in later life (55+). Literature was analysed by level of caseness at which depression was defined and measured. Results. Thirty-four studies eligible for inclusion were found. The reported prevalence rates vary enormously (0.4-35%). Arranged according to level of caseness, major depression is relatively rare among the elderly (weighted average prevalence 1.8%), minor depression is more common (weighted average prevalence 9.8%), while all depressive syndromes deemed clinically yield an average prevalence of 13.5%. There is consistent evidence for higher prevalence rates for women and among older people living under adverse socio-economic circumstances. Conclusions. Depression is common in later life. Methodological differences between studies preclude firm conclusions about cross-cultural and geographical variation. Improving the comparability of epidemiological research constitutes an important step forward.
Blazer, D.G. (1999). EURODEP Consortium and late-life depression. British Journal of Psychiatry, 174, 284-285. > Full Text.
The EURODEP Consortium is a large, international collaboration which aggregates data to permit methodologically sound secondary analyses of extant epidemiological data across multiple sites throughout Europe. The effort, as exemplified in the papers presented here, can help clarify issues which have been debated among old age psychiatrists throughout the developed world for many years. Perhaps of more importance, however, is that the cross-national nature of the study can bring new questions to the centre of discussions about late-life depression, questions of far more interest, in my opinion, than some of the questions which have dominated the epidemiological study of mood disorders among the elderly in recent years (Blazer,1997). I first address the methods of this collaboration, which must be understood by anyone who reviews these reports critically. Next I focus upon a question addressed by the investigators which should fade to the background with the publication of these studies and a review of studies already published. I then suggest another question, raised by the investigators, that should proceed to centre stage.
Braam, A.W., Beekman, A.T.F., Van den Eeden, P., Deeg, D.J.H., Knipscheer, C.P.M., Van Tilburg, W. (1999). Religious climate and geographical distribution of depressive symptoms in older Dutch citizens. Journal of Affective Disorders, 54, 149-159. >Full Text.
This study examines whether the degree of conservatism of the religious climate affects the geographical distribution of late life depressive symptoms. A U-shaped relationship is hypothesized: high levels of depressive symptoms at the extremes (both a-religious and hyperconservative), and a low level in the middle (moderate-conservative). Subjects are 3051 older Dutch citizens (55-85 years), living in 11 municipalities. Depressive symtoms are assessed using the CES-D. Religious climate is estimated on the municipality level, using percentages votes on political parties with a Christian background (moderate-conservative versus hyperconservative). Using multi-level analysis, the results support the U-curve hypothesis.
Braam, A.W. (1999). Religion and Depressionin Later Life: An emperical Approach. PhD Dissertation, VU University Amsterdam.
No abstract available.
Broese van Groenou, M.I., Knipscheer, C.P.M. (1999). The onset of physical impairment of independently living older adults and the support received from sons and daughters in The Netherlands. International Journal of Aging and Human Development, 48, 4, 263-278. > Full Text.
This study examined the changes in support intensity in parent-child relationships of older parents who experienced an onset of physical impairment in one year time. The relationships were compared with the support in the child relationships of parents who remained in good health. The results indicated that, given the onset of impairment, both sons and daughters are likely to increase the intensity of instrumental and emotional support to their parent, but the increase is the strongest in the mother-daughter relationships. Multivariate regression analyses showed that the intensity of support was significantly determined by the onset of parental physical impairment, but even more so by the type of parent-child relationship.
Copeland, J.R.M., Beekman, A.T.F., Dewey, M.E., Hooijer, C., Jordan, A., Lawlor, B.A., Lobo, A., Magnsson, H., Mann, A.H., Meller, I., Prince, M.J., Reischies, F.M., Turrina, C., De Vries, M.W., Wilson, K.C.M. (1999). Depression in Europe: Geographical distribution among older people. British Journal of Psychiatry, 174, 312-321. > Full Text.
No abstract available.
Copeland, J.R.M., Beekman, A.T.F., Dewey, M.E., Jordan, A., Lawlor, B.A., Linden, M., Lobo, A., Magnsson, H., Mann, A.H., Fichter, M., Prince, M.J., Saz, P., Turrina, C., Wilson, K.C.M. (1999). Cross-cultural comparison of depressive symptoms in Europe does not support stereotypes of ageing. British Journal of Psychiatry, 174, 322-329. > Full Text.
No abstract available.
Copeland, J.R.M. (1999). Depression of older age. Origins of the study. British Journal of Psychiatry, 174, 304-306. > Full Text.
BACKGROUND: The EURODEP collaboration was formed to take advantage of existing studies of random community samples of older people in Europe, using GMS-AGECAT for case identification and diagnosis. Later, other centres joined, and the EURO-D scale was developed to harmonise the different methods used with the GMS. Previous studies had revealed different levels of depression in Europe but had been confounded by the use of unreconcilable methods. These studies attempt to overcome this problem. AIMS: To introduce the first set of publications from the EURODEP collaboration. METHOD, RESULTS AND CONCLUSIONS: Presented in five accompanying papers (pp. 307-345, this issue). DECLARATION OF INTEREST:The European Commission BIOMED/initiative funded this Concerted Action Programma.
De Beurs, E., Beekman, A.T.F., Van Balkom, A.J.L.M., Deeg, D.J.H., Van Dyck, R., Van Tilburg, W. (1999). Consequences of anxiety in older persons: its effect on disability, well-being and use of health services. Psychological Medicine, 29, 583-593. >Full Text.
Background. Although anxiety is quite prevalent in late life, its impact on disability, well-being, and health care utilization of older persons has not been studied. Older persons are a highly relevant age group for studying the consequences of anxiety, since their increasing numbers put an extra strain on already limited health care resources. Methods, Data of a large community-based random probability sample (N = 659) of older subjects (55-85 year) in the Netherlands were used to select three groups: subjects with a diagnosed anxiety disorder, subjects with merely anxiety symptoms and a reference group without anxiety. These groups were compared with regard to their functioning, subjective well-being, and use of health care services, while controlling for potentially confounding variables. Results. Anxiety was associated with increased disability and diminished well-being. Older persons with a diagnosed anxiety disorder were equally affected in their functioning as those with merely anxiety symptoms. Although use of health services was increased in anxiety sufferers, their use of appropriate care was generally low. Conclusions. Anxiety has a clear negative impact on the functioning and well-being of older subjects. The similarity of participants with an anxiety disorder and those having merely anxiety symptoms regarding quality of life variables and health care use was quite striking. Finally, in spite of its grave consequences for the quality of life, appropriate care for anxiety is seldom received. Efforts to improve recognition, disseminate effective treatments in primary care, and referring to specialized care may have positive effects on the management of anxiety in late life.
Geerlings, S.W., Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, W., Smit, J.H. (1999). The Center for Epidemiologic Studies Depression scale (CES-D) in a mixed-mode repeated measurements design: sex and age effects in older adults. International Journal of Methods in Psychiatric Research, 8, no. 2, 102-108.
In order to obtain repeated measurements of depression in an efficient and relatively inexpensive design, a mixture of face-to-face interviews and mail questionnaires was employed. The aims of the study were to examine mode effects of face-to-face interviews versus mail questionnaires on depression scores and to test potential interactions between mode of data collection and sex and age of the respondents. In the study sample, which at the outset consisted of 327 depressed and 325 non-depressed older adults (55-85 years) drawn from a larger random community based sample in the Netherlands, depression was measured in successive waves (cycles), using the Center for Epidemiologic Studies of Depression scale (CES-D). With mode of data collection and sex and age of the respondents of the respondents as independent variables, differences in CES-D scores were analysed. The CES-D scores were higher when collected by mail questionnaires than when face-to-face interviews were used. No systematic interactions between sex and age of the respondents with mode of data collection were found. For the scores based on mail questionnaires, a transformation is proposed, resulting in scores that are comparable to those obtained by interviews. In studying depression in older adults, more cost-effective mail questionnaires may be used in addition to face-to-face interviews, provided that a transformation is performed before embarking on the analysis.
Jelicic, M., Jonker, C., Deeg, D.J.H. (1999). Do health factors affect memory performance in old age? International Journal of Geriatric Psychiatry, 14, 572-576.
Objectives: The aim of this study was to examine the effect of health factors on memory performance in a population-based sample of 679 older people (mean age=69.2 years). Methods: Both subjective and objective indices of health were used as predictor variables. Memory performance was measured with an immediate recall test and a delayed recall test. Results: Some of the objective health indices were correlated with performance on the memory tasks, but regression analysis showed that they hardly had a unique effect on memory performance. Conclusion: Health factors have only a weak relationship with memory performance in older adults.
Klein Ikkink, C.E., Van Tilburg, T.G. (1999). Broken ties: Reciprocity and other factors affecting the termination of older adult's relationships. Social Networks, 21, 131-146.
Exchange theory assumes that people prefer balanced support exchanges in their relationships. If there is an imbalance and no expectation of change in the future, a relationship might be terminated. The question is which relationships are discontinued. The data are from a longitudinal study of 2,057 older adults who identify 18,915 relationships at T1. A relationship is regarded as discontinued if it is not identified by the older adult at the second and third measurement moments. Of the T1 relationships, 4,042 have since been discontinued. The results of a multilevel logistic regression analysis show that the more intensive the support exchanges are at T1, the more likely it is for relationships to be continued. Relationships where older adults are overbenefited with instrumental support, i.e. receive more than they give, have a higher chance of being continued. However, if older adults are overbenefited with emotional support, this decreases the chance of the relationships continuing. The type of relationship has a significant effect on whether or not it is continued. Close kin relationships are most likely to be continued, and relationships with less close kin, friends and neighbors have a higher chance of being discontinued. The costs of the relationship are also decisive; the higher the contact frequency and the lower the traveling time to the network member, the higher the chance of the relationship being continued. Furthermore, the larger the network of the older adult, the more likely it is for an unbalanced relationship to be discontinued.
Kriegsman, D.M.W., Deeg, D.J.H. (1999). Contribution to discussion about \'alternative definitions of disability: relation to health-care expenditures\'. Implications of alternative definitions of disability beyond health and care expenditures. Disability and Rehabilitation, 21, 8, 388-391. >Full Text.
The paper of Tepper et al. (Tepper S., Sutton J., Beatty P., DeJong G. Alternative definitions of disability: relationship to health-care expenditure. Disability and Rehabilitation 1997; 19: 556-558.) deals with the relationship between alternative definitions of disability and individual health expenditures. Unfortunately, the main issue, namely that alternative definitions of a determinant may influence the magnitude o the outcomes, is obscured by the fact that the paper lacks a clear focus: the message is obscured by the broader issues referred to in both the introduction and the discussion sections, which are not substantiated by the data. In addition, there appear to be several methodological shortcomings in the paper that are not addressed properly. As a result, we feel that the importance of the results presented is generalized for beyond what the study and the data allow. In this commentary, we will first discuss the paper of Tepper et al. and, thereafter, provide a more generalized view on the policy relevance of alternative definitions of determinants in relation to health-care expenditures.
Lindeboom, J., Smits, C.H.M., Smit, J.H., Jonker, C. (1999). Gebruiksgegevens voor een korte vorm van de Raven Coloured Progressive Matrices. Tijdschrif voor Gerontologie en Geriatrie, 30, 249-255.
No abstract available.
Penninx, B.W.J.H., Leveille, S., Ferruci, L., Van Eijk, J.Th.M., Guralnik, J.M. (1999). Exploring the effect of depression on physical disability: longitudinal evidence from the established populations for epidemiologic studies of the elderly. American Journal of Public Health, 89, 9, 1346-1352. > Full Text.
Objectives. This study examined the effect of depression on the incidence of physical disability and the role of confounding and explanatory variables in this relationship. Methods. A cohort of 6247 subjects 65 years and older who were initially free of disability was followed up for 6 years. Baseline depression was assessed by the Center for Epidemiological Studies Depression Scale. Disability in mobility and disability in activities of daily living were measured annually. Results. Compared with the 5751 nondepressed subjects, the 496 depressed subjects had a relative risk (95% confidence interval) of 1.67 (1.44, 1.95) and 1.73 (1.54, 1.94) for incident disability in activities of daily living and mobility, respectively. Adjustment for sociodemographic characteristics and baseline chronic conditions reduced the risks to 1.39 (1.18, 1.63) and 1.45 (1.29, 1.93), respectively. Less physical activity and fewer social contacts among depressed persons further explained part of their increased disability risk. Conclusions. Depression in older persons may increase the risk for incident disability. This excess risk is partly explained by depressed persons\' decreased physical activity and social interaction. The role of other factors (e.g., biological mechanisms) should be examined.
Penninx, B.W.J.H., Van Tilburg, T.G., Kriegsman, D.M.W., Boeke, A.J.P., Deeg, D.J.H., Van Eijk, J.Th.M. (1999). Social network, social support, and loneliness in older persons with different chronic diseases. Journal of Aging and Health, 11, 2, 151-168. >Full Text.
Objectives: This study examines whether patterns of social network size, functional social support, and loneliness are different for older persons with different types of chronic diseases. Methods: In a community-based sample of 2,788 men and women age 55 to 85 years participating in the Longitudinal Aging Study Amsterdam, chronic diseases status, social network size, support exchanges, and loneliness were assessed. Results: Social network size and emotional support exchanges were not associated with disease status. The only differences between healthy and chronically ill people were found for receipt of instrumental support and loneliness. Disease characteristics played a differential role: greater feelings of loneliness were mainly found for persons with lung disease or arthritis, and receiving more instrumental support was mainly found for persons with arthritis or stroke. Discussion: The specifics of a disease appear to play a (small) role in the receipt of instrumental support and feelings of loneliness of chronically ill older persons.
Penninx, B.W.J.H., Geerlings, S.W., Deeg, D.J.H., Van Eijk, J.Th.M., Van Tilburg, W., Beekman, A.T.F. (1999). Minor and major depression and the risk of death in older persons. Archives of General Psychiatry, 56, 889-895. > Full Text.
Background: The association between depression and mortality in older community-dwelling populations is still unresolved. This study determined the effect of both minor and major depression on mortality and examined the role of confounding and explanatory variables on this relationship. Methods: A cohort of 3056 men and women from the Netherlands aged 55 to 85 years were followed up for 4 years. Major depression was defined according to DSM-III criteria by means of the Diagnostic Interview Schedule. Minor depression was defined as clinically relevant depression (defined by a Center for Epidemiologic Studies Depression score 16) not fulfilling diagnostic criteria for major depression. Results: After adjustment for confounding variables (sociodemographics, health status), men with minor depression had a 1.80-fold higher risk of death (95% confidence interval, 1.35-2.39) during follow-up than nondepressed men. In women, minor depression did not significantly increase the mortality risk. Irrespective of sex, major depression was associated with a 1.83-fold higher mortality risk (95% confidence interval, 1.09-3.10) after adjustment for sociodemographics and health status. Health behaviors such as smoking and physical inactivity explained only a small part of the excess mortality risk associated with depression. Conclusion: Even after adjustment for sociodemographics, health status, and health behaviors, minor depression in older men and major depression in both older men and women increase the risk of dying.
Portrait, F.R.M., Lindeboom, M., Deeg, D.J.H. (1999). Health and mortality of the elderly: the grade of membership method, classification and determination. Health Economics and Econometrics, 8, 441-457. >Full Text.
With the aging of society, issues concerning the reform of the Dutch health care systems are ranked high on the political agenda. Sensible reforms of the health care system for the elderly require a thorough understanding of the health status of the old and of its dynamics preceding death. The health status of the elderly is intrinsically a multidimensional and dynamic concept and a rich set of indicators is needed to capture this concept in its full extent. This feature of health requires techniques to reduce dimensionality as, in general, it is difficult to simultaneously handle all indicators in any economic analysis. In the first part of this paper we focus on methods that comprise these multidimensional measures into a limited number of indices. The Grade of Membership (GoM) approach introduces by Manton and Woodbury (Methods of Information in Medicine 1982; 21) is specially designed to characterize the complex concept of health. The method simultaneously identifies all dimensions of the concept of interest and the degrees to which an individual belongs to each of these types (i.e. grades of membership). We apply the method to a set of 21 indicators from a rich database of the Longitudinal Aging Study Amsterdam (LASA). The individual degrees of involvement in the different health dimensions obtained from this method are used in subsequent analyses of health and mortality.
Prince, M.J., Reischies, F.M., Beekman, A.T.F., Fuhrer, R., Jonker, C., Kivelä, S.-L., Lawlor, B.A., Lobo, A., Magnsson, H., Fichter, M., Van Oyen, H., Roelands, M., Skoog, I., Turrina, C., Copeland, J.R.M. (1999). Development of the EURO-D scale: a European Union initiative to compare symptoms of depression in 14 European centres. British Journal of Psychiatry, 174, 330-338. > Full Text.
No abstract available.
Prince, M.J., Beekman, A.T.F., Deeg, D.J.H., Fuhrer, R., Kivelä, S.-L., Lawlor, B.A., Lobo, A., Magnsson, H., Meller, I., Van Oyen, H., Reischies, F.M., Roelands, M., Skoog, I., Turrina, C., Copeland, J.R.M. (1999). Depression symptoms in late life assessed using the EURO-D scale: Effect of age, gender and marital status in 14 European centres. British Journal of Psychiatry, 174, 339-345. > Full Text.
No abstract available.
Smit, J.H., Dijkstra, W. (1999). Het verzamelen van survey gegevens bij oudere respondenten. In A.E. Bronner, P. Dekker, A.J. Olivier, W.F. van Raaij, M. Wedel, & B. Wierenga (Eds.), Recente ontwikkelingen in het marktonderzoek (pp. 51-57). Haarlem: de Vrieseborch.
No abstract available.
Smits, C.H.M., Deeg, D.J.H., Kriegsman, D.M.W., Schmand, B.A. (1999). Cognitive functioning and health as determinants of mortality in an older population. American Journal of Epidemiology, 150, 9, 978-986. > Full Text.
The authors studied whether the ability of cognitive functioning to predict mortality is pervasive or specific, and they considered the role of health in the cognition-mortality association. Data were taken from a sample of 2,380 persons aged 55-85 years who took part in the Netherlands\' Longitudinal Aging Study Amsterdam in 1992-1993. Five cognitive measures were distinguished: general cognitive functioning, information processing speed, fluid intelligence, learning, and proportion retained. Mortality data were obtained during an average follow-up period of 1,215 days. Cox proportional hazards regression models revealed that all cognitive functions predicted mortality independent of age, sex, education, and depressive symptoms. When health (self-rated health, medication use, physical performance, functional limitations, lung function, specific chronic diseases) was also taken into account, information processing speed, fluid intelligence, and proportion retained remained independent predictors of mortality; whereas the ability of general cognitive functioning and learning to determine mortality was lost. The authors concluded that the ability of cognitive functioning to predict mortality is pervasive to all cognitive functions that were included in the study when age, sex, education, and depressive symptoms are considered and is more specific to some functions when also controlling for health.
Smits, C.H.M., Bosscher, R.J. (1999). Determinanten van competentie- en controleverwachtingen. Bewegen & Hulpverlening, 16, 174-182.
No abstract available.
Tromp, E.A.M., Smit, J.H., Deeg, D.J.H., Lips, P.T.A. (1999). Quantitative ultrasound measurements of the tibia and calcaneus in comparison to DXA measurements at various skeletal sites. Osteoporosis International, 9, 230-235.
The performance of Quantitative Ultrasound (QUS) measurements of the tibia and calcaneus was studied in 109 elderly (age range 65 -87 years). Broadband ultrasound attenuation (BUA) and speed of sound (SOS) were measured at the calcaneus and SOS was assessed at the tibia. Short-term precision of tibial QUS was studied in 16 volunteers. The coefficient of variation (CV) was 0.4% and the standardized CV (sCV) was 4.4%. We compared the calcaneal and tibial QUS measurements with bone mineral density (BMD) measurements of the lumbar spine, femoral neck, trochanter and total body assessed by dual X-ray absorptiometry (DXA). Calcaneal BUA showed higher correlations with BMD values of the lumbar spine, femoral neck, trochanter and total body than calcaneal and tibial SOS (r = 0.48-0.64, r = 0.30-0.47, r = 0.35-0.47, respectively; p < 0.001). Body weight modified the relationships between calcaneal and tibial QUS and BMD measurements of the hip. Higher body weight was associated with higher BMD values at the femoral neck and trochanter for the same calcaneal and tibial QUS values. After adjustments for body weight correlations of tibial and calcaneal QUS with BMD improved and were very similar. This suggests that correction for body weight is important and could add to the predictive value of QUS measurements.
Van Grootheest, D.S., Beekman, A.T.F., Broese van Groenou, M.I., Deeg, D.J.H. (1999). Sex differences in depression after widowhood: Do men suffer more? Social Psychiatry and Psychiatric Epidemiology, 34, 391-398.
This study focuses on sex differences in depression of the widowed. Previous research showed different results in sex differences and in depression after bereavement. We assessed the effects of widowhood on depressive symptoms for men and women and examined whether environmental strain like social support, finances and housekeeping-concerns explain these effects. Data were used from a large community-based study of older people in three regions of the Netherlands. Our study sample consists of 2626 widowed and married subjects in the age group of 55-85 years. Depression was measured using the CES-D scale; the various strains were obtained by structured interviews. Multiple linear regression, performed for men and women separately, were used. The results show that widowhood is associated with higher levels of depressive symptoms and that this association is stronger for men than for women. The effect of widowhood is mediated by different types of environmental strain for men and women. However, a strong direct main effect of widowhood on depression remains. The difference in depression rates between men and women is most evident among those widowed for a longer period of time. It appears that, over times, women adapt to widowhood more successfully than men. From a clinical point of view this is important, as it suggests that men who remain alone after losing their partner are at a higher risk of developing symptoms of chronic depression.
Van Tilburg, T.G. (1999). Changes over time in the personal networks and health of older adults. Gedrag & Gezondheid, 27, 61-66. Amsterdam: VU University Press.
No abstract available.
Visser, M., Launer, L.J., Deurenberg, P., Deeg, D.J.H. (1999). Past and current smoking in relation to body fat distribution in older men and women. Journal of Gerontology, 54A, 6, M293-M298.
Smoking is reported to be positively related to abdominal fat in young and middle-aged persons, however, it is unclear whether this relationship exists in elderly persons. Behavioral influence on fat distribution is of importance due to the accumulation of abdominal fat with age and its associated health risks. The relationship was investigated in a population-based sample of 1,178 men and 1,163 women aged 55-85 years, representative of the Dutch older population in 1992-1993. Waist and hip circumference and their ratio (WHR) were used as indices of fat distribution. Past and current smoking habits were obtained by questionnaire. Smoking was associated with waist/hip-ratio (WHR) in men, with current smokers having the highest WHR and never smokers the lowest. A dose-response relationship between the daily number of cigarettes smoked and WHR was observed in men. These associations remained significant after adjustment for confounding due to age, education, body mass index, health status, alcohol intake, and sport activity. The dose-response relationship did not change after additional adjustment for duration of smoking. Among former smoking men, recent quitters had a higher WHR compared to longterm quitters. Additional analysis showed that smoking was more strongly associated with waist than with hip circumference. In women the relationship between smoking and fat distribution was not clear. In conclusion, past and current smoking habits are positively associated with abdominal fat in older men, but not in older women.

1998

Aartsen, M.J., Smits, C.H.M. (1998). Age, gender, level of education and functional limitation as determinants of change in cognitive functions. In D.J.H Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam 1992-1996 (pp. 71-82). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Beekman, A.T.F., Bremmer, M.A., Deeg, D.J.H., Van Balkom, A.J.L.M., Smit, J.H., De Beurs, E., Van Dyck, R., Van Tilburg, W. (1998). Anxiety disorders in later life: A report from the Longitudinal Aging Study Amsterdam. International Journal of Geriatric Psychiatry, 13, 717-726. > Full Text.
Objective. To study the prevalence and risk factors of anxiety disorders in the older (55-85) population of The Netherlands. Method. The Longitudinal Aging Study Amsterdam (LASA) is based on a random sample of 3107 older adults stratified for age and sex, which was drawn from the community registries of 11 municipalities in three regions in The Netherlands. Anxiety disorders were diagnosed using the Diagnostic Interview Schedule in a two-stage screening design. The risk factors under study comprise vulnerability, stress and network-related variables. Both bivariate and multivariate statistical methods were used to evaluate the risk factors. Results. The overall prevalence of anxiety disorders was estimated at 10.2%. Generalized anxiety disorder was the most common disorder (7.3), followed by phobic disorders (3.1%). Both panic disorder (1.0%) and obsessive compulsive disorder (0.6%) were rare. These figures are roughly similar to previous findings. Ageing itself did not change much with age. Vulnerability factors (female sex, lower levels of education, having suffered extreme experiences during World War II and external locus of control) appeared to dominate, while stresses commonly experienced by older people (recent losses in the family and chronic physical illness) also played a part. Of the network-related variables, only a smaller size of the network was associated with anxiety disorders. Conclusions. Anxiety disorders are common in later life. The risk factors support using a vulnerability-stress model to conceptualize anxiety disorders. Although the prevalence of risk factors changes dramatically with age, their impact is not age-dependent. The risk factors indicate which groups of older people are at a high risk for anxiety disorders and in whom active screening and treatment may be warranted.
Beekman, A.T.F., Penninx, B.W.J.H., Deeg, D.J.H., Ormel, J., Smit, J.H., Braam, A.W., Van Tilburg, W. (1998). Depression in survivors of stroke: A community-based study of prevalence, risk factors and consequences. Social Psychiatry and Psychiatric Epidemiology, 33, 463-470. > Full Text.
Depression in survivors of stroke is both common and clinically relevant. It is associated with excess suffering, handicap, suicidal ideation and mortality and it hampers rehabilitation. Most of the data currently available are derived from clinical studies. The objective of the present study was to study the prevalence, risk factors and consequences of depression in survivors of stroke, in a large (n = 3050) community-based study of older (55-85 years) people in three regions of the Netherlands. Depression was measured using the CES-D scale: histories of stroke were obtained using self-reports and data from general practitioners. The study was designed as a case- control study, using both bivariate and multivariate analyses. The prevalence of depression in stroke survivors was 27%, which was significantly higher than the base rate (OR 2.28. 95% CI 1.61- 3.24). Both stroke-related disease characteristics and psychosocial characteristics of the respondents were predictors of depression. The consequences of depression were most evident in the realm of disability and impairment of well-being. The patterns of service utilization showed that depressed survivors of stroke are relatively high users of a wide range of health services.
Beekman, A.T.F., Deeg, D.J.H., Heeren, T.J., Van Tilburg, W. (1998). The epidemiology of depression in later life: a primary care perspective. CNS disorders in primary care, 2, 1.
No abstract available.
Beekman, A.T.F., Deeg, D.J.H., Kriegsman, D.M.W., Westendorp-de Seriere, M. (1998). Consequences of Changes in Functioning. In D.J.H Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam 1992-1996 (pp. 149-166). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Beekman, A.T.F., Braam, A.W., Deeg, D.J.H. (1998). Depressie in gerontologisch perspectief. In M.I. Broese van Groenou, D.J.H. Deeg, C.P.M. Knipscheer, G.J. Ligthart (Ed.), VU-visies op veroudering (pp. 37-42). Amsterdam: Thela Thesis. ISBN 90-5170-464-X
No abstract available.
Beekman, A.T.F., Braam, A.W., Van Tilburg, W. (1998). Scenario: Emotional functioning. In D.J.H Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam 1992-1996 (pp. 85-92). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Beekman, A.T.F., Geerlings, S.W., Van Tilburg, W. (1998). Depression in later life: Emergence and prognosis. In D.J.H Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam 1992-1996 (pp. 93-104). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Bosscher, R.J., Smit, J.H. (1998). Confirmatory factor analysis of the General Self-Efficacy Scale. Behaviour Research and Therapy, 36, 339-343. >Full Text.
A confirmatory factor analysis of the factor structure of the adapted General Self-Efficacy Scale, created by Sherer et al. 1982 [Psychological Reports 51, 663-671], was conducted to assess whether the scale\'s purported 3 factors emerged. The results generally supported the 3-factor model, but a model with 3 correlated factors and one higher-order factor (general self-efficacy), proved to fit the data even better.
Bosscher, R.J. (1998). Competentieverwachtingen van ouderen: van algemeen tot bijzonder. In M.I. Broese van Groenou, D.J.H. Deeg, C.P.M. Knipscheer, G.J. Ligthart (Ed.), VU-visies op veroudering (pp.187-191). Amsterdam: Thela Thesis. ISBN 90-5170-464-X.
No abstract available.
Braam, A.W., Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, W. (1998). De gedifferentieerde relatie tussen religie en depressie. Een empirisch onderzoek onder ouderen. In G. Glas (ED.), Psychiatrie en Religie. De bijne verloren dimensie (pp. 98-115). Nijmegen: Katholiek Studie Centrum voor Geestelijke Volksgezondheid. ISBN 90-75886-07-1.
No abstract available.
Braam, A.W., Beekman, A.T.F., Knipscheer, C.P.M., Deeg, D.J.H., Van den Eeden, P., Van Tilburg, W. (1998). Religious denomination and depression among older Dutch citizens: Patterns and models. Journal of Aging and Health, 10, 4, 483-503. >Full Text.
This study describes the distribution of depressive symptoms in older Dutch citizens (n=3,020) across religious denominations. Reformed-Calvinists had the lowest depression scores (CES-D); Protestants from liberal denominations the highest; Roman Catholics, Dutch Reformed and non-church members were in between. Two types of explanatory mechanisms are examined, (1) social integration and (2) positive self-perceptions, which both help to prevent depression. Alternatively, strict Calvinist doctrines are hypothesized to enforce negative self-perceptions, facilitating depression. For 2,509 respondents, complete data were available on social integration and self-perceptions, as well as on the parental religious denomination. Explanatory effects were tested using hierarchic regression models. The negative association between Calvinist background and depressive symptoms was partly explained by size of social network, and between Roman Catholic background and depressive symptoms by self-esteem. Leaving church had a positive association with depressive symptoms. This depressogenic effect remained after controlling for explanatory variables.
Braam, A.W., Deeg, D.J.H., Van Tilburg, T.G., Beekman, A.T.F., Van Tilburg, W. (1998). Gerotranscendence as a life cycle perspective: A first empirical approach among older adults in the Netherlands Tijdschrift voor Gerontologie en Geriatrie, 29, 24-32.
Gerotranscendence has been defined as a shift in meta-perspective, from a materialistic and rationalistic perspective to a more cosmic and transcendent one that accompanies the process of aging. The present study describes scale characteristics of the Dutch translation of Tornstam\'s gerotranscendence scale, using data from a sample among adults aged 56-76 years (N=556). Two subscales evolve from scale analysis, similar to those found by Tornstam: cosmic transcendence and egotranscendence. Scores on both subscales are higher for the older old, as well as for the unmarried, divorced or widowed respondents who suffer from physical impairments. Scale scores are also higher for respondents with depressive complaints. On the subscale cosmic transcendence Roman Catholics have higher scores than Protestants and non-church members. On the subscale egotranscendence well educated respondents and those with few social contacts have higher scores than persons with less education and those with many contacts. The strength of the associations is modest and the variance explained is small. The findings warrant further research into the question whether gerotranscendence adds to competence in later life.
Braam, A.W., Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, W. (1998). Religie en de verwerking van ouderdomsproblemen. In M.I. Broese van Groenou, D.J.H. Deeg, C.P.M. Knipscheer, G.J. Ligthart (Ed.), VU-visies op veroudering (pp. 181-186). Amsterdam: Thela Thesis.
No abstract available.
Broese van Groenou, M.I. (1998). Het Centrum voor Verouderingsonderzoek. In M.I. Broese van Groenou, D.J.H. Deeg, C.P.M. Knipscheer, G.J. Ligthart (Ed.), VU-visies op veroudering (pp. 11-15). Amsterdam: Thela Thesis.
No abstract available.
Deeg, D.J.H., Beekman, A.T.F., Kriegsman, D.M.W., Westendorp-de Seriere, M. (1998). Integration: Summary and perspective. In D.J.H Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam 1992-1996 (pp. 167-175). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Deeg, D.J.H. (1998). Ervaren gezondheid verschilt naar tijd en plaats. In M.I. Broese van Groenou, D.J.H. Deeg, C.P.M. Knipscheer, G.J. Ligthat (Eds.), VU-visies op veroudering (pp. 131-135). Amsterdam: Thela-Thesis.
No abstract available.
Deeg, D.J.H., Kriegsman, D.M.W. (1998). Methods to assess physical ability: Which is best for monitoring change? In D.J.H. Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam, 1992-1996 (pp. 43-54). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Jagger, C., Ritchie, K., Bronnum-Hansen, H., Deeg, D.J.H., Gispert, R., Grimley Evans, J., Hibbett, M., Lawlor, B.A. (1998). Mental health expectancy - the European perspective: A synopsis of results presented at the conference of the European Network for the Calculation of Health Expectancies (Euro-REVES). Acta Psychiatrica Scandinavica, 98, 85-91.
The increase in life expectancy observed over the last decade has particular relevance for mental health conditions of old age, such as dementia. Although mental disorders have been estimated to be responsible for 60% of all disabilities, until recently population health indicators such as health expectancies have concentrated on calculating disability-free life expectancy based on physical functioning. In 1994, a European Network for the Calculation of Health Expectancies (Euro-REVES) was established, one of its aims being the development and promotion of mental health expectancies. Such indicators may have an important role in monitoring future changes in the mental health of populations and predicting service needs. This article summarizes the proceedings and recommendations of the first European Conference on Mental Health Expectancy.
Jelicic, M., Jonker, C., Deeg, D.J.H. (1998). Het geheugen op latere leeftijd: Spelen gezondheidsfactoren een rol? In M.I. Broese van Groenou, D.J.H. Deeg, C.P.M. Knipscheer, G.J. Ligthart (Eds.), VU-Visies op Veroudering (pp. 53-56). Amsterdam: Thela Thesis. ISBN 90-5170-464-X.
No abstract available.
Jonker, C. (1998). Scenario: Change in cognitive function. In D.J.H. Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam, 1992-1996 (pp. 65-70). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Knipscheer, C.P.M., Broese van Groenou, M.I., Van Rijsselt, R.J.T. (1998). Determinants of changes in societal participation. In D.J.H Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam 1992-1996 (pp. 141-147). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Knipscheer, C.P.M., Van Tilburg, T.G., Broese van Groenou, M.I. (1998). Scenario: Social involvement and aging. In D.J.H Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam 1992-1996 (pp. 117-121). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Kriegsman, D.M.W., Deeg, D.J.H., Lips, P.T.A., Bosscher, R.J. (1998). Scenario: course and consequences of chronic diseases. In D.J.H. Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam (pp. 23-25). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Kriegsman, D.M.W., Deeg, D.J.H. (1998). Chronic diseases: incidence and influence on self-reported mobility limitations and mortality. In D.J.H. Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam 1992-1996 (pp. 27-41). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Kriegsman, D.M.W., Beekman, A.T.F., Westendorp-de Seriere, M., Deeg, D.J.H. (1998). The Longitudinal Aging Study Amsterdam: Introduction. In D.J.H Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam 1992-1996 (pp. 1-7). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Lamme, S.P., Linnemann, M.A., Deeg, D.J.H., Schuyt, T.N.M. (1998). Armoede, social participatie en eenzaamheid bij ouderen [Poverty, social participation and loneliness in older persons]. In G. Engbersen, J.C. Vrooman, E. Snel (Eds.), Effecten van armoede. Derde jaarrapport armoede en sociale uitsluiting [Effects of poverty](pp. 129-227). Amsterdam: University Press.
In older persons, the association between poverty and social participation is a subtle one. Older persons with a low income maintain fewer personal relationships, are less involved in clubs and organizations, and participate less in socio-cultural activities than older persons with a higher income. However, older age and poorer health are better predictors of all these forms of social participation than a low income is. Moreover, no association was demonstrated between low income and loneliness.
Lips, P.T.A., Tromp, E.A.M. (1998). Vallen en fracturen. In M.I. Broese van Groenou, D.J.H. Deeg, C.P.M. Knipscheer, G.J. Ligthart (Eds.), VU-visies op veroudering (pp. 29-31). Amsterdam:Thela Thesis. ISBN 905170-464X.
No abstract available.
Parkatti, T., Deeg, D.J.H., Bosscher, R.J., Launer, L.J. (1998). Physical activity and self-rated health among 55- to 89-year-old Dutch people. Journal of Aging & Health, 10, 311-326. >Full Text.
The aim of this study was to examine the effects of physical activity and the possible mediating role of perceived physical self-efficacy (PPSE) on self-rated health (SRH) in the 55- to 89-year-old Dutch population. The data are based on a structured interview carried out in a random sample of 120 subjects-60 men and 60 women with the average ages of 69 and 71 years, respectively-in Sassenheim, the Netherlands, as a pilot study of the Longitudinal Aging Study Amsterdam (LASA). The results of linear multiple regression analyses showed that physical activity was a significant predictor of self-rated health. Moreover, the results supported the role of PPSE as a mediator in the association between physical activity and self-rated health status even when age, gender, and chronic diseases were controlled. These findings suggest that in the elder population, increasing perceived physical self-efficacy may be more important for perceived health than raising the level of physical activity.
Penninx, B.W.J.H., Van Tilburg, T.G., Boeke, A.J.P., Deeg, D.J.H., Kriegsman, D.M.W., Van Eijk, J.Th.M. (1998). Effects of social support and personal coping resources on depressive symptoms: Different for various chronic diseases? Health Psychology, 17, 6, 551-558. > Full Text.
Effects of psychosocial coping resources on depressive symptoms were examined and compared in older persons with no chronic disease or with recently symptomatic diabetes mellitus, lung disease, cardiac disease, arthritis, or cancer. The 719 persons without diseases reported less depressive symptoms than the chronically ill. Direct favorable effects on depressive symptoms were found for having a partner, having many close relationships, greater feelings of mastery, greater self-efficacy expectations, and high self-esteem. Buffer effects were observed for feelings of mastery, having many diffuse relationships, and receiving emotional support. Buffer effects were differential across diseases for emotional support (in cardiac disease and arthritis only) and for diffuse relationships (in lung disease). Receiving instrumental support was associated with more depressive symptoms, especially in diabetes patients.
Smit, J.H., De Vries, M.Z., Poppelaars, J.L. (1998). Data collection and fieldwork procedures. In D.J.H. Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam 1992-1996 (pp. 9-20). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Smits, C.H.M., Bosscher, R.J. (1998). Predictors of self-efficacy and mastery. In D.J.H Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam 1992-1996 (pp. 105-114). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Sonnenberg, C.M., Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, W. (1998). Sekseverschillen bij depressie bij ouderen. In M.I. Broese van Groenou, D.J.H. Deeg, C.P.M. Knipscheer, C.J. Ligthout (Eds.), VU-Visies op veroudering (pp. 43-46). Amsterdam: Thela Thesis. ISBN 90-5170-464-X.
No abstract available.
Thomése, G.C.F. (1998). De levensloop van ouderen: wat is standaard? In M.I. Broese van Groenou, D.J.H. Deeg, C.P.M. Knipscheer, G.J. Ligthart (Eds.), Vu-visies op veroudering (pp. 137-143). Amsterdam: Thela Thesis.
No abstract available.
Thomése, G.C.F. (1998). Buurtnetwerken van ouderen. Een sociaal-wetenschappelijk onderzoek onder zelfstandig wonende ouderen in Nederland. PhD Dissertation, VU University Amsterdam.
No abstract available.
Tromp, E.A.M., Smit, J.H., Deeg, D.J.H., Bouter, L.M., Lips, P.T.A. (1998). Predictors for falls and fractures in the Longitudinal Aging Study Amsterdam. Journal of Bone and Mineral Research, 13, 12, 1932-1939.
The objective of this study was to identify easily measurable predictors for falls, recurrent falls, and fractures, using a population-based prospective cohort study of 1469 elderly, born before 1931, in three regions of the Netherlands. The baseline at-home interview was in 1992. In 1995, falls experienced in the preceding year and fractures over the preceding 38-month period were registered. In a period of 1 year, 32% of the participants fell at least once, and 15% fell two or more times. The rate of recurrent falls was similar in men and women up until the age of 75 years. The total number of fractures was 85, including 23 wrist fractures, 12 hip fractures, and 9 humerus fractures. The incidence density per 1000 person-years for any fracture was 25.1 (95% confidence interval [CI], 18.9-31.4) for women and 8.2 (95% CI: 4.5-12.0) for men, respectively. Multiple logistic regression identified urinary incontinence, impaired mobility, use of analgetics and use of anti-epileptic drugs as the predictors most strongly associated with recurrent falls. Female gender, living alone, past fractures, inactivity, body height, and use of analgetics proved to be the predictors most strongly associated with fractures. The probabilities of recurrent falls were 4.7% (95% CI, 2.9 - 7.5%) to 59.2% (95% CI, 24.1 - 86.9%) with zero to four predictors, respectively. The probability of fractures ranged from 0.0% (95% CI, 0.0 - 0.4%) without any of the identified predictors to 12.9% (95% CI, 4.4 - 32.2%) with all six predictors present. Our study shows that the risk of recurrent falls and of fractures can be predicted using up to, respectively, four and six easily measurable predictors. This study emphasizes the importance of impaired mobility and inactivity as predictors for falls and fractures.
Tromp, E.A.M., Pluijm, S.M.F., Lips, P.T.A. (1998). Predictoren voor vallen en fracturen bij ouderen. In M.I. Broese van Groenou, D.J.H. Deeg, C.P.M. Knipscheer, G.J. Ligthart (Eds.), VU-visies op veroudering (pp. 33-35). Amsterdam: hela Thesis. ISBN 90-5170-464-X.
No abstract available.
Tromp, E.A.M., Pluijm, S.M.F., Lips, P.T.A. (1998). Predictors of fractures. In D.J.H. Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam, 1992-1996 (pp. 55-62). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.
Van Tilburg, T.G. (1998). Losing and gaining in old age: Changes in personal network size and social support in a four-year longitudinal study. Journal of Gerontology: Social sciences, 53B, 6, S313-S323.
Objectives: Previous studies have shown that most older people have a significant number of relationships. However, the question of whether the aging of old people produces losses in their personal network remains open for discussion. This study models the individual variability of the changes affecting multiple personal network characteristics. Methods: Personal interviews were conducted with 2,903 older Dutch adults (aged 55-85) in three waves of a four-year longitudinal study. Results: A stable total network size was observed, with an increasing number of close relatives and a decreasing number of friends. Contact frequency decreased in relationships, and the instrumental support received and emotional support given increased. Age moderated the effect of time for some of the network characteristics and for many of them, effects of regression towards the mean were detected. Furthermore, major variations in the direction and the speed of the changes were detected among individual respondents, and non-linear trends were observed. Discussion: The widely varying patterns of losses and gains among the respondents squares with the focus on the heterogeneity of developments among aging people. The instability of the network composition might reflect the natural circulation in the membership of networks.
Van Tilburg, T.G. (1998). Changes over time in the personal networks and health of older adults. In D.J.H Deeg, A.T.F. Beekman, D.M.W. Kriegsman, M. Westendorp-de Seriere (Eds.), Autonomy and well-being in the aging population 2. Report from the Longitudinal Aging Study Amsterdam 1992-1996 (pp. 123-140). Amsterdam: VU University Press. ISBN 90-5383-622-5. > Full Text.
No abstract available.

1997

Beekman, A.T.F., Deeg, D.J.H., Van Limbeek, J., Braam, A.W., De Vries, M.Z., Van Tilburg, W. (1997). Criterion validity of the center for Epidemiologic Studies Depression scale (CES-D): Results from a community-based sample of older subjects in the Netherlands (Brief communication). Psychological Medicine, 27, 231-235. > Full Text.
The Center for Epidemiologic Studies Depression scale (CES-D) has been widely used in studies of late-life depression. Psychometric properties are generally favourable, but data on the criterion validity of the CES-D in elderly community based samples are lacking. In a sample of older (55-85 years) inhabitants of the Netherlands, 487 subjects were selected to study criterion validity of the CES-D. Using the one-month prevalence of major depression derived from the Diagnostic Interview Schedule (DIS) as criterion, the weighted sensitivity of the CES-D was 100%; specificity 88%; and positive predictive value 13,2%. False positives were not more likely among elderly with physical illness, cognitive decline or anxiety. We conclude that the criterion validity of the CES-D for major depression was very satisfactory in this sample of older adults.
Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, T.G., Schoevers, R.A., Smit, J.H., Hooijer, C., Van Tilburg, W. (1997). Depressie bij ouderen in de Nederlandse bevolking: Een onderzoek naar de prevalentie en risicofactoren [The prevalence and risk factors associated with major and minor depression in later life]. Tijdschrift voor Psychiatrie, 39, 294-308.
Studied depression at the syndrome level and at the diagnostic level in a large random sample of older adults as part of the Longitudinal Aging Study Amsterdam (D.J.H. Deeg et al., 1993) . Human Ss: 3,056 male and female Dutch middle-age, old, and very old adults (aged 55-85 yrs) (major depression in some Ss) (residents of 3 regions of the Netherlands). Ss were interviewed. A 2-stage screening procedure was used to diagnose depression. The Diagnostic and Statistical Manual of Mental Disorders-III (DSM-III) criteria for major depression were used. Tests used: The Center for Epidemiologic Studies Depression Scale, the Diagnostic Interview Schedule; National Institute of Mental Health and the Mini-Mental State Examination.
Beekman, A.T.F., Deeg, D.J.H., Braam, A.W., Smit, J.H., Van Tilburg, W. (1997). Consequences of major and minor depression in later life: A study of disability, well-being and service utilization. Psychological Medicine, 27, 1397-1409. >Full Text.
Background. The consequences of major depression for disability, impaired well-being and service utilization have been studied primarily in younger adults. In all age groups the consequences of minor depression are virtually unknown. In later life, the increased co-morbidity with physical illness may modify the consequences of depression, warranting special study of the elderly. With rising numbers of elderly people, excess service utilization by depressed elderly represents an increasingly important issue. Methods. Based on a large, random community- based sample of older inhabitants of the Netherlands (55-85 years) the associations of major and minor depression with various indicators of disability, well-being and service utilization were assessed, controlling for potential confounding factors. Depression was diagnosed using a two-stage screening design. Diagnosis took place in all subjects with high depressive symptom levels and a random sample of those with low depressive symptom levels. The study sample consists of all participants to diagnostic interviews (N = 646). Results. As in younger adults, associations of both major and minor depression with disability and well-being remained significant after controlling for chronic disease and functional limitations. Adequate treatment is often not administered, even in subjects with major depression. As the vast majority of those depressed were recently seen by their general practitioners, treatment could have been provided in most cases. Bivariate analyses show that major and minor depression are associated with an excess use of non-mental health services, underscoring the importance of recognition. In multivariate analyses the evidence of excess service utilization was less compelling. Conclusions. Both major and minor depression are consequential for well-being and disability, supporting efforts to improve the recognition and treatment in primary care. However, controlled trials are necessary to assess the impact this may have on service utilization.
Beekman, A.T.F., Penninx, B.W.J.H., Deeg, D.J.H., Ormel, J., Braam, A.W., Van Tilburg, W. (1997). Depression and physical health in later life: Results from the Longitudinal Aging Study Amsterdam (LASA). Journal of Affective Disorders, 46, 219-231. >Full Text.
Background: In later life, declining physical health is often thought to be one of the most important risk factors for depression. Major depressive disorders are relatively rare, while depressive syndromes which do not fulfil diagnostic criteria (minor depression) are common. Methods: Community-based sample of older adults (55-85) in the Netherlands: baseline sample n=3056; study sample in two stage screening procedure n=646. Both relative (odds ratios) and absolute (population attributable risks) measures of associations reported. Results: In multivariate analyses minor depression was related to physical health, while major depression was not. General aspects of physical health had stronger associations with depression than specific disease categories. Significant interactions between ill health and social support were found only for minor depression. Major depression was associated with variables reflecting long-standing vulnerability. Conclusion: Major and minor depression differ in their association with physical health. Limitation: Cross-sectional study relying largely on self-reported data. Clinical relevance: In major depression, with or without somatic co-morbidity, primary treatment of the affective disorder should not be delayed. In minor depression associated with declining physical health, intervention may be aimed at either of both conditions.
Beekman, A.T.F. (1997). Oorzaken en gevolgen van depressie bij ouderen. In M. Westendorp-de Seriere, D.J.H. Deeg, M. Spanjer, Ouderen in Nederland: van onderzoek naar beleid (pp. 41-43). Amsterdam: VU Uitgeverij.
No abstract available.
Boshuizen, H.C., Deeg, D.J.H. (1997). Ontwikkelingen in de (gezonde) levensverwachting in de laatste 75 jaar. Tijdschrift voor Sociale Gezondheidszorg, 75, 425-431.
No abstract available.
Bosscher, R.J., Smit, J.H., Kempen, G.I.J.M. (1997). Global expectations of self-efficacy in the elderly: An investigation of psychometric characteristics of the General Self-Efficacy Scale. Nederlands Tijdschrift voor de Psychologie, 52, 239-248.
This article reports on the investigation of the factor structure, reliability and validity of the General Self-Efficacy Scale (GSES; Sherer et al., 1982) administrated to two large samples of persons of 55 years and older. The Dutch version of the GSES (ALCOS-12) was subjected to exploratory and confirmatory factor analyses. The results generally supported a 3-factor model that is in line with previous findings. However, a 3-factor model subordinate to one second-order factor proved to be the most adequate model. The ALCOS-12 as well as the subscales appeared to be moderately reliable (internally consistent and homogeneous) and valid instruments to measure (aspects of) generalized expectations of self-efficacy.
Bosscher, R.J. (1997). Perceived competence and physical activity in relation to chronic disease and pain in elderly people. In G. Huber (Ed.), Healthy Aging, Activity and Sports (pp. 307-313). Gamburg: Health Promotion.
Purpose: Successful physical functioning is thought to have a positive influence on the perception of physical competence. How people perceive their physical competence may act as an important mediator between the capacities they have and their behavioral performance, thereby influencing autonomous functioning. The presentation will focus on the association between physical activity and perceived competence and possible impact of chronic disease and pain. Methods: Interview and questionnaire data were obtained from 3107 subjects between 55 and 85 years of age as part of the Longitudinal Aging Study Amsterdam (LASA). Results: Perceived competence and physical activity are positively associated, while a gradual decrease on both factors is shown as age increases. Furthermore, women systematically perceive their physical competence as weaker than men. Furthermore, both perceived competence and physical activity are negatively influenced by chronic disease and pain, although a few exceptions are noted. Conclusion: Perceived physical competence and physical activity are positively associated, while chronic disease and pa in have a negative impact on the interrelationship.
Braam, A.W., Beekman, A.T.F., Van Tilburg, T.G., Deeg, D.J.H., Van Tilburg, W. (1997). Religious involvement and depression in older Dutch citizens. Social Psychiatry and Psychiatric Epidemiology, 32, 284-291. > Full Text.
Examined the association between religious involvement and depression in older Dutch citizens, focusing on models of the mechanism in which religious involvement impacts other factors related to depression. Ss were 2,817 older adults aged 55-85 yrs living in the community who participated in the Longitudinal Aging Study Amsterdam. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, and religious involvement was assessed using items on frequency of church attendance and strength of church affiliation. Further data were collected on physical health, size of social network, social support, sense of mastery, and self-esteem. As in North American studies, religious involvement appeared to be inversely associated with depression, both on symptom and syndrome levels. Controlling for sociodemographics, physical impairment and network support did not substantially affect this association, particularly among 75-85 yr old Ss. The inverse association between religious involvement and depression was not selectively more pronounced among older people with physical impairments. However, the association appeared to be most specific for Ss with a small social network and those with a low sense of mastery.
Braam, A.W., Beekman, A.T.F., Deeg, D.J.H., Smit, J.H., Van Tilburg, W. (1997). Religiosity as a protective or prognostic factor of depression in later life: Results from a community survey in The Netherlands. Acta Psychiatrica Scandinavica, 96, 199-205. >Full Text.
This study examines the impact of religiosity on incidence and course of depressive syndromes in a community-based sample of older persons in the Netherlands (n=177). The course of depression was assessed in five waves of measurements, covering one year. Religiosity was operationalized as salience of religion as compared to the salience of other aspects of life. Religious salience was not associated with incidence of depression, but had a relatively strong association with improvement of depression among the respondents who were depressed at the first measurement. This association was most prominent among those with a poor physical health.
Braam, A.W., Beekman, A.T.F., Van den Eeden, P., Smit, J.H., Deeg, D.J.H., Van Tilburg, W. (1997). Geografische verschillen in depressieve klachten bij ouderen: verklaringen uit een bevolkingsstudie. Middenkatern, Tijdschrift voor Gezondheidswetenschappen, 7, 30.
Depressie onder ouderen vormt een gezondheidsvraagstuk waarvoor de aandacht toeneemt. Ondermeer is gebleken dat depressies bij ouderen het algemeen functioneren op nadelige wijze beinvloeden, met name als er sprake is van lichamelijke problemen. Het gaat hierbij niet alleen om ernstige depressies, maar ook om de veel voorkomende, moeilijk traceerbare milde depressies. Ouderen in verstedelijkte gebieden blijken meer depressive klachten te rapporteren dan ouderen op het platteland. Andere, deels geografisch bepaalde risicofactoren zijn sociaal-economische en culturele kenmerken. Religie blijkt bijvoorbeeld voor veel ouderen een beschermende fator te zijn, al wordt een streng calvinistisch milieu verondersteld kwetsbaar te maken voor depressie.
Bremmer, M.A., Beekman, A.T.F., Deeg, D.J.H., Van Balkom, A.J.L.M., Van Dyck, R., Van Tilburg, W. (1997). Angststoornissen bij ouderen: prevalentie en risicofactoren. Tijdschrift voor Psychiatrie, 39, 8, 634-648.
No abstract available.
Broese van Groenou, M.I., Van Tilburg, T.G. (1997). Changes in the support networks of older adults in the Netherlands. Journal of Cross-Cultural Gerontology, 12, 23-44. > Full Text.
Examined the type and stability of social support networks providing instrumental and/or emotional support to a sample of 2,709 older Dutch adults aged 55-89 yrs. Results show that the hierarchy of instrumental support differs by partner status of the older adult, but the hierarchy in emotional support does not vary with the availability of partner or children. Multi-level regression analyses using data at an 11 mo followup indicate that 46 bereaved older adults received increased instrumental support from their network, while their receipt of emotional support remained unchanged. Shifts in the hierarchy of instrumental support were observed, but not in the hierarchy of emotional support. Older people who suffered a decrease in physical mobility received more instrumental and emotional support, but the ranking of supporter types changed little. It is concluded that despite changes in intensity of support, the hierarchies of types of supporters have generally remained stable over time.
Deeg, D.J.H., Lips, P.T.A., Beekman, A.T.F., Lumey, L.H. (1997). Blootstelling aan de hongerwinter 1944-45 en gezondheid op latere leeftijd. Middenkatern, Tijdschrift voor Gezondheidswetenschappen, 7, 30.
Blootstelling aan ondervoeding op jonge leeftijd kan gevolgen hebben voor de kans op ziekten op latere leeftijd. In de bevolking van ons land zijn tegenwoordig echter verschillen in voedingstoestand op jongere leeftijd relatief klein, zodat een mogelijk effect tussen alle andere risicofactoren voor chronisch ziekten niet of nauwelijks zichtbaar wordt. De grote en systematische verschillen in voedingstoestand tussen mensen woonachtig in verschillende gebieden in Nederland tijdens de Hongerwinter van 1944-1945 bieden echter wel de mogelijkheid het effect van ondervoeding te bestuderen.
Deeg, D.J.H., Smit, J.H., Beekman, A.T.F. (1997). De dwang van de analysemethode bij het gebruik van longitudinale gegevens: Het geval van gezondheid en depressie [The coercion of the analytical method in working with longitudinal data: The case of health and depression]. Tijdschrift Sociale Gezondheidszorg, 75, 3, 129-135.
Many longitudinal data bases are underused. On reason is the researchers\' limited knowledge of suitable statistical methods. It is argued that this is not only a technical, but also a substantial problem. Researchers may feel that they are addressing one clear question, but dependent on the method of analysis chosen, they are addressing one of several possible subquestions. The relatedness of analytical technique and substance of the findings is illustrated using data from a series of four measurement points with intervals of three months on average, in the context of the Longitudinal Aging Study Amsterdam. The data were collected to assess the influence of self-perceived health on the course of depressive symptoms in older persons. Five different methods of analysis were derived from the literature on the relation health-depression. These methods distinguish themselves particularly with respect to the expression of the dependent variable: endpoint level, rate of change over time, or changeability. The expression of the independent variable may change as well: initial level, or rate of change. It is demonstrated that limitation to just one method of analysis usually corresponds to only one expression of the original research question, and therefore to only one aspect of the course of self-perceived health and depression. This aspect ought to be selected prior to the analyses, followed by the selection of the appropriate method of analysis.
Deeg, D.J.H., Braam, A.W. (1997). Het belang van kwaliteit van leven voor ouderen zelf. Een kwantitative banadering [What is important to older persons and how does it affect their quality of life? A quantitative approach]. Medische Antropologie, 9, 1, 136-149.
Quality of life is often defined as satisfaction with a series of aspects of life. This procedure yields a quality of life score that is considered to be generalizable across groups of older persons. However, the aspects of life selected need not be equally important to all older individuals, and thus may not have any relevance to their quality of life. Data from the Longitudinal Aging Study Amsterdam (nationally representative cohort, ages 55-85 years, n=2254) were used to examine to which aspects of life older persons attach priority, how this prioritization is associated with availability of each aspect, and whether a discrepancy between priority and availability affects quality of life. Subjects were asked to rank nine aspects of life: physical and mental health, housing, income, marriage, family, friends, religious belief, and time spending. For the purpose of this study, the three aspects ranked as most important are considered a priority. The great majority of older persons attached priority to good physical health. Over one half indicated a good marriage as very important. The other aspects of life were a priority to one-third or less. Older persons who did not have or no longer had an aspect available, attached lower priority to this aspect. Furthermore, having no longer available an aspect that was considered important (= a discrepancy between priority and availability), was associated with lower quality of life for the aspects marriage and religious belief. A possible explanation of this finding is sought in the notion of cognitive adaptation. It is concluded that the association between life conditions and quality of life is not a linear one, but is affected by the importance older persons attach to specific aspects of life.
Deeg, D.J.H., Pot, A.M. (1997). Gezondheid van ouderen. In T. Lagro-Janssen & G. Noordenbos (Eds.), Sekseverschillen in ziekte en gezondheid (Hoofdstuk 8, pp. 133-145). Nijmegen: SUN Press.
No abstract available.
Deeg, D.J.H., Van den Hombergh, C. (1997). Gezondheidsbeperkingen en zorggebruik door ouderen. In M. Westendorp-de Seriere, D.J.H. Deeg, M. Spanjer (Eds.), Ouderen van Nederland. Van onderzoek naar beleid (pp. 23-27). Amsterdam: VU University.
No abstract available.
Jonker, C., Smits, C.H.M. (1997). Kan cognitieve achteruitgang bij ouderen worden voorkomen? In M. Westendorp-de Seriere, D.J.H. Deeg, M. Spanjer (Eds.), Ouderen in Nederland: Van onderzoek naar beleid (chapter 6, pp. 37-40). Amsterdam: VU Uitgeverij.
No abstract available.
Jonker, C., Smits, C.H.M., Deeg, D.J.H. (1997). Affect-related metamemory and memory performance in a population-based sample of older adults. Educational Gerontology, 23, 115-128. >Full Text.
No abstract available.
Knipscheer, C.P.M., Kriegsman, D.M.W., Penninx, B.W.J.H., Broese van Groenou, M.I. (1997). Ziekte en informele hulpverlening aan ouderen. In M. Westendorp-de Seriere, D.J.H. Deeg, M. Spanjer (Eds.), Ouderen in Nederland: van onderzoek naar beleid (pp. 15-21). Amsterdam: VU Uitgeverij.
No abstract available.
Kriegsman, D.M.W., Deeg, D.J.H., Van Eijk, J.Th.M., Penninx, B.W.J.H., Boeke, A.J.P. (1997). Do disease specific characteristics add to the explanation of mobility limitations in patients with different chronic diseases?: A study in the Netherlands. Journal of Epidemiology and Community Health, 51, 676-685. >Full Text.
Study objectives. To determine, whether disease specific characteristics, reflecting clinical disease severity, add to the explanation of mobility limitations in patients with specific chronic diseases. Design and setting. Cross sectional study of survey data from community dwelling elderly people, aged 55-85 years, in the Netherlands. Participants and methods. The additional explanation of mobility limitations by disease specific characteristics was examined by logistic regression analyses on data from 2830 community dwelling elderly people. Main results. In the total sample, chronic non-specific lung disease, cardiac disease, peripheral atherosclerosis, diabetes mellitus, stroke, arthritis and cancer (the index diseases), were all independently associated with mobility limitations. Adjusted for age, sex, comorbidity, and medical treatment disease specific characteristics that explain the association between disease and mobility mostly reflect decreased endurance capacity (shortness of breath and disturbed night rest in chronic non-specific lung disease, angina pectoris and congestive heart failure in cardiac disease), or are directly related to mobility function (stiffness and lower body complaints in arthritis). For atherosclerosis and diabetes mellitus, disease specific characteristics did not add to the explanation of mobility limitations. Conclusions. The results provide evidence that, to obtain more detailed information about the differential impact of chronic diseases on morbidity, disease specific characteristics are important to take into account.
Kriegsman, D.M.W., Van Eijk, J.Th.M., Penninx, B.W.J.H., Deeg, D.J.H., Boeke, A.J.P. (1997). Does family support buffer the impact of specific diseases on mobility in community-dwelling elderly? Disability and Rehabilitation, 19, 71-83.
The present study explores whether different structural (presence of partner and children) and functional (amounts of instrumental and emotional support provided by partner and children) family characteristics buffer the influence of chronic diseases on physical functioning. Logistic regression analyses were performed in a population-based sample of 2830 community-dwelling elderly people with chronic diseases as independent, and mobility difficulties as dependent variable, for separate strata of family characteristics. The presence of buffer effects was ascertained by comparing the associations between disease variables and mobility difficulties across the strata of family characteristics, using the odds ratios and 95% confidence intervals. Living together with a partner appears to buffer the association between the presence of one chronic disease and mobility difficulties, but no such effect is present among subjects with more than one disease. Regarding specific chronic diseases, partner presence has a beneficial influence only on the association between stroke and mobility difficulties, regardless of whether the partner provides little or much support. For patients with chronic non-specific lung disease (asthma, chronic bronchitis or pulmonary emphysema), a small amount of instrumental support (help with daily chores in and around the house) received from the partner is associated with a higher risk for mobility difficulties, compared to patients who receive a large amount of instrumental support and to patients who are not living with a partner. Neither the presence of children, nor the amounts of support received from them, influence associations between specific chronic diseases and mobility difficulties. The present study provides limited evidence supporting a buffer effect of family characteristics on the association between chronic diseases and mobility. Only in elderly people with a relatively low burden of disease, family support mitigates the adverse effects of disease on physical functioning.
Lips, P.T.A. (1997). Vallen en botbreuken. In M. Westendorp-de Seriere, D.J.H. Deeg, M. Spanjer (Eds.), Ouderen in Nederland: van onderzoek naar beleid (pp. 27-32). Amsterdam: VU.
No abstract available.
Penninx, B.W.J.H., Van Tilburg, T.G., Deeg, D.J.H., Kriegsman, D.M.W., Boeke, A.J.P., Van Eijk, J.Th.M. (1997). Direct and buffer effects of social support and personal coping resources in individuals with arthritis. Social Science and Medicine, 44, 393-402.
Examined the direct and buffer effects of various aspects of social support and personal coping resources on depressive symptoms in a community-based sample of 1,690 55-85 yr olds, of whom 719 had no chronic disease, 612 had mild arthritis and 359 had severe arthritis. Results showed that persons with arthritis had more depressive symptoms than persons with no chronic diseases. Irrespective of arthritis, the presence of partner, having many close social relationships, feelings of mastery and a high self-esteem were found to have direct, favorable effects on psychological functioning. Mastery, having many diffuse social relationships, and receiving emotional support seem to mitigate the influence of arthritis on depressive symptoms, which is in conformity with the buffer hypothesis. Favorable effects of these variables on depressive symptomatology were only, or more strongly, found in persons with severe arthritis.
Penninx, B.W.J.H., Van Tilburg, T.G., Kriegsman, D.M.W., Deeg, D.J.H., Boeke, A.J.P., Van Eijk, J.Th.M. (1997). Effects of social support and personal coping resources on mortality in older age: The Longitudinal Aging Study Amsterdam. American Journal of Epidemiology, 146, 6, 510-519. > Full Text.
This study focuses on the role of social support and personal coping resources in relation to mortality among older persons in the Netherlands. Data are from a sample of 2,829 noninstitutionalized people aged between 55 and 85 years who took part in the Longitudinal Aging Study Amsterdam in 1992-1995. Social support was operationally defined by structural, functional, and perceived aspects, and personal coping resources included measures of mastery, self-efficacy, and self-esteem. Mortality data were obtained during a follow-up of 29 months, on average. Cox proportional hazards regression models revealed that having fewer feelings of loneliness and greater feelings of mastery are directly associated with a reduced mortality risk when age, sex, chronic diseases, use of alcohol, smoking, self-rated health, and functional limitations are controlled for. In addition, persons who received a moderate level of emotional support (odds ratio (OR) = 0.49, 95% confidence interval (CI) 0.33-0.72) and those who received a high level of support (OR = 0.68, 95% CI 0.47-0.98) had reduced mortality risks when compared with persons who received a low level of emotional support. Receipt of a high level of instrumental support was related to a higher risk of death (OR = 1.74, 95% CI 1.12-2.69). Interaction between disease status and social support or personal coping resources on mortality could not be demonstrated.
Schmand, B.A., Smit, J.H., Lindeboom, M., Lindeboom, J., Smits, C.H.M., Hooijer, C., Jonker, C., Deelman, B. (1997). Low education is a genuine risk factor for accelerated memory decline and dementia. Journal of Clinical Epidemiology, 50, 9, 1025-1033.
A relatively high prevalence and incidence of dementia have been found in population strata with low levels of education in comparison to population strata with high level of education. However, doubt remains whether this may be an artifact of education bias in the screening tests used. To investigate this matter, we analyzed results of two Dutch population surveys in which unbiased measures of memory decline were used. In the Longitudinal Aging Study Amsterdam (n = 1774) the percentage of words retained in a verbal learning test was found to be disproportionately low in the oldest age cohort (80-85 years) with less than 11 years of education. The Amsterdam Study of the Elderly (n = 4051) found a \"dose-response\" relationship between education and dementia prevalence. Cross-sectional and longitudinal results showed that, in less educated people, memory decline is faster and sets in at an earlier age. These findings indicate that the relationship between dementia and education is not just an artifact of case detection methods.
Smit, J.H., Deeg, D.J.H., Schmand, B.A. (1997). Asking the age question in elderly populations: A reverse record check study. Journal of Gerontology: Psychological Sciences, 52B, 4, P175-P177.
In two large-scale surveys among elderly respondents we evaluated the accuracy of answers obtained to three differently formulated age questions. Respondents included 6,149 individuals aged 65-86 living in The Netherlands. Because criterion age data were available from different sources, it was possible to compare the respondent\'s reported age with his or her actual age. Refusal rates were low for all three questions. Both age and cognitive capabilities influenced accuracy of the answers to the age questions. The results indicated that the most accurate data were obtained with the question, \"What is your date of birth?\" in combination with interview date.
Smit, J.H., Dijkstra, W., Van der Zouwen, J. (1997). Suggestive interviewer behaviour in surveys: An experimental study. Journal of Official Statistics, 13, 1, 19-28. > Full Text.
The consequences of suggestive interviewer behaviour as a potential source of bias in obtaining valid answers in survey settings are discussed. It is hypothesized that: (1) suggestive interviewer behaviour while asking closed questions, or during probing, influences the responses and their distributions; and (2) parameter estimations of relationships with variables measured with questions influenced by suggestive behaviour are affected too. Three kinds of more or less suggestive interviewer behaviour concerning the presentation of response alternatives, following a closed question about consequences of aging, were systematically varied in a field experiment across different groups of randomly selected older (55+) respondents (N = 235). After obtaining a response to the question, the interviewer asked for any reasons for that particular response, thereby systematically suggesting a particular aspect of aging. After these manipulations, respondents were asked to evaluate a number of aspects, among them those previously suggested to the respondent. The distributions of the responses to the closed question proved to differ between experimental groups: suggested answers were indeed mentioned more often (p <.001). Suggestive probing had an effect too: one of the suggested aspects was evaluated as having greater effect than aspects that were not suggested (p = .35). Finally, the correlation between the responses to the closed question and another variable, age, turned out to be dependent on the experimental condition, with correlation coefficients ranging from r = .03 to r = .35. The experiment shows that suggestive interviewing indeed affects the quality of the data collected.
Smits, C.H.M., Smit, J.H., Van den Heuvel, N., Jonker, C. (1997). Norms for an abbreviated Raven\'s Coloured Progressive Matrices in an older sample. Journal of Clinical Psychology, 53, 7, 687-697. > Full Text.
Percentile age norms for ages 55 to 85 using overlapping intervals at specified age midpoints are presented for the sum scores of sections A and B of Raven\'s Coloured Progressive Matrices (RCPM). The representative age and gender stratified sampled (N = 2.815) used is derived from the Longitudinal Aging Study Amsterdam (the Netherlands). As RCPM scores appear to be strongly associated with education, percentile norms for three educational levels are presented: low (0-9 years), middle (10-15 years) and high (16 years and more).
Smits, C.H.M., Deeg, D.J.H., Jonker, C. (1997). Cognitive and emotional predictors of disablement in older adults. Journal of Aging and Health, 9, 2, 204-221.
The present study focused on the association between aspects of emotional and cognitive functioning and two stages of the disablement process model (Verbrugge & Jette, 1994), functional limitations and Instrumental Activities of Daily Living (IADL) disability. The age and sex stratified sample aged 55-89 years consisted of 100 inhabitants of a small Dutch town who scored 24 or higher on the MMSE. Controlling for background factors (health problems, age, education and gender), depressive symptoms and fluid intelligence were independently associated with functional limitations. Of the cognitive functions, only everyday memory was independently associated with IADL disability. These findings expand on the disablement process model and demonstrate the importance of emotional functioning, fluid intelligence and everyday memory for the disablement process.
Smits, C.H.M., Braam, A.W., Bremmer, M.A. (1997). De psyche bij het ouder worden. In M. Westendorp-de Seriere, D.J.H. Deeg, M. Spanjer (Eds.), Ouderen in Nederland: Van onderzork naar beleid (pp. 33-36). Amsterdam: VU.
No abstract available.
Spanjer, M. (1997). Inleiding: Het waarom, hoe en wat van het LASA onderzoek aan de Vrije Universiteit van Amsterdam. In M. Westendorp-de Seriere, D.J.H. Deeg, M. Spanjer (Eds.), Ouderen in Nederland: van onderzoek naar beleid (pp. 7-13). Amsterdam: VU.
No abstract available.
Visser, M., Launer, L.J., Deurenberg, P., Deeg, D.J.H. (1997). Total and sports activity in older men and women: Relation with body fat distribution. American Journal of Epidemiology, 145, 752-761. > Full Text.
Physical activity is reported to be inversely associated with abdominal fat in young and middle-aged populations, which may partly explain its beneficial effect on health. However, it is unclear whether this inverse association exist in older people. The authors investigated the relationship of total and sport activity with fat distribution in a population-based sample of 1, 178 men and 1,163 women aged 55-85 years, representative of the Dutch elderly population in 1992-1993. Waist and hip circumference and their ratio (WHR) were used as indicators of fat distribution. Physical activity of the previous 2 weeks was obtained by questionnaire. Among men, total physical activity time was negatively associated with waist (98.3+/- 0.4 cm in the most active quartile vs. 100.5+/- 0.4 cm in the least active quartile, p=0.0001 (mean+/- standard error)) and WHR (0.98+/- 0.00 vs. 0.99+/- 0.00, p=0.005) after adjustment for age, education level, body mass index, smoking, and season of the year. This association was not observed among women. Men and women who participated in sports activity had a smaller waist and WHR than those who did not. After adjustment, the time spent on sports activity was negatively associated with waist (p=0.004 for men and p=0.07 for women) and WHR (p=0.03 for men and 0.09 for women) in both sexes. No relation between total physical activity time and body fat distribution was observed among respondents who were not participating in any sports activity (p3 0.17), suggesting that performance of activities of low/moderate intensity has no effect on body fat distribution. No associations with hip circumference were observed. The results did not change after additional adjustment for chronic illness. The results of this large-scale study show that physical activity, and specifically intensive activity, is negatively associated with abdominal fat in older people.

1996

Beekman, A.T.F. (1996). Depression in later life: Studies in the community. PhD Dissertation, VU University Amsterdam.
No abstract available.
Beekman, A.T.F., Godderis, J. (1996). De depressieve bejaarde. Geriatrie-informatorium, 35, D1035, 1-27.
No abstract available.
Bosscher, R.J., Faas, S., Van der Woord, M., Deeg, D.J.H. (1996). Ouder worden: competentie, activiteit, chronische ziekte en pijn [Aging: Competence, activity, chronic illness and pain]. Bewegen & Hulpverlening, 13, 183-197.
This study focussed on the effects of chronic diseases and pain on physical self-efficacy and physical activity in persons between 55 and 85 years of age. Data were used from the Longitudinal Aging Study Amsterdam (LASA). A total of 1694 subjects, 862 men and 832 women, had complete data on all measurements. After controlling for age and sex, subjects with chronic diseases had lower physical self-efficacy scores and were physically less active than subjects without chronic diseases. Physical self-efficacy of subjects with chronic diseases who experienced pain was lower than in subjects with chronic diseases but without pain. Nevertheless, the presence or absence of pain in the chronically diseased did not influence the amount of time that was spent in physical activities. For subjects without pain, physical self-efficacy and physical activity of subjects with chronic diseases were lower than for subjects without chronic diseases. Chronic diseases had a negative influence on physical self-efficacy and physical activity of the elderly. Within the group of respondents with chronic diseases, pain diminished physical self-efficacy even more, but had, contrary to the expectation, no negative influence on physical activity.
Braam, A.W., Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, W. (1996). Kerkelijke gezindte en depressieve symptomen bij ouderen [Religious denomination and depressive symptoms among elderly persons]. Tijdschrift voor Psychiatrie, 38, 4, 325-330.
Among elderly in the community of Sassenheim (The Netherlands) is examined whether protestants suffer more depressive symptoms than Roman-Catholics and non-church members. Taken into account are salience of religion among the chronic diseased and, in a second sample, a measure of traditionality of belief-contents (orthodoxy). Concluded is that a depressogenic effect of protestantism can be detected among those elderly who do not consider religion to be salient and who disagree with a traditional content of belief.
De Jong Gierveld, J., Dykstra, P.A. (1996). Eenzaamheid komt en gaat met de tijd: Effecten van veranderingen in het sociale netwerk en in gezondheid van 55-plussers op de mate van hun eenzaamheid [Loneliness comes and goes: Unraveling the impact on loneliness of changes in the network of social relationships and changes in the health of older adults]. Mens en Maatschappij, 96, 189-208.
The purpose of the present study was to examine the implications of changes in the network and changes in health for loneliness in old age. Respondents were 2895 men and women ranging in age from 55 to 89. All were interviewed in 1992 and 1993 in a face-to-face setting. The results of the panel study indicate that changes in the network and in health were associated with 'appropriate' changes in loneliness. For example, those who lost their partner over the course of the year were more lonely at T2, while those whose health improved became less lonely. However, contrary to expectations, when no changes in the network and health were observed, the loneliness score still changed, and always in the direction of a reduction of loneliness. Several substantial and methodological explanations for the latter finding are discussed.
Deeg, D.J.H., Kriegsman, D.M.W., Beekman, A.T.F. (1996). De samenhang van lichamelijke en psychische chronische aandoeningen met prestatie op tests van dagelijkse handelingen en mortaliteit [Association of chronic physical and mental conditions with physical test performance and mortality]. Gedrag en Gezondheid, 24, 6, 323-333.
This contribution examines the association between (i) conditions frequently occurring in the older population and (ii) aspects of physical ability and mortality. Self-reported data on chronic diseases (cardiovascular diseases, stroke, diabetes, chronic respiratory disease, cancer, arthritis), depressive syndromes (Center for Epidemiologic Studies Depression scale), and cognitive impairments (MiniMental State Examination) were collected in the nationally representative, age- and sex stratified sample of the Longitudinal Aging Study Amsterdam (3107 participants aged 55-85 years). Performance tests of physical ability measured flexibility, mobility, strength, balance and gait. Mortality was ascertained one and a half years after baseline. Multiple regression models of performance tests and mortality on all chronic conditions were evaluated, controlling for age and sex. Among the most disabling physical conditions were stroke, diabetes, and arthritis. Depressive syndromes and cognitive impairment were even more strongly associated with physical performance. A raised mortality risk was associated with arterial disease, diabetes, respiratory disease, and cognitive impairment. Physical performance explained part of the association with mortality only for respiratory diseases and cognitive impairment. These findings clarify pathways from specific conditions to disability and mortality, and indicate that physical disability and mortality can be considered as largely exclusive aspects of severity of disease. These findings also highlight the significance of mental conditions for physical disability.
Kriegsman, D.M.W., Penninx, B.W.J.H., Van Eijk, J.Th.M., Boeke, A.J.P., Deeg, D.J.H. (1996). Self-reports and general practitioner information on the presence of chronic diseases in community-dwelling elderly: a study on the accuracy of patients\' self-reports and on determinants of inaccuracy. Journal of Clinical Epidemiology, 49, 1407-1417.
Self-reports and general practitioner information on the presence of chronic diseases in community-dwelling elderly: a study on the accuracy of patients\' self-reports and on determinants of inaccuracy. The object of the study is to investigate the (in)accuracy of patients\' self-reports, as compared to general practitioners\' information, regarding the presence of specific chronic diseases, and the influence of patient characteristics. Questionnaire data of 2380 community-dwelling elderly patients, aged 55-85 years, on the presence of chronic non-specific lung disease, cardiac disease, peripheral atherosclerosis, stroke, diabetes, malignancies, and osteoarthritis/rheumatoid arthritis were compared with data from the general practitioners, using the kappa-statistic. Associations between the accuracy of self-reports and patient characteristics were studied by multiple logistic regression analyses. Kappa\'s ranged from 0.30-0.40 for osteoarthritis/rheumatoid arthritis and atherosclerosis, to 0.85 for diabetes mellitus. In the multivariate analyses, educational level, level of urbanization, deviations in cognitive function, and depressive symptomatology had no influence on the level of accuracy. An influence of gender, age, mobility limitations and recent contact with the general practitioner was shown for specific diseases. For chronic non-specific lung disease, both \'underreporting\' and \'overreporting\' are more prevalent in males, compared to females. Furthermore, males tend to \'overreport\' stroke and \'underreport\' malignancies and arthritis, whereas females tend to \'overreport\' malignancies and arthritis. Both \'overreporting\' and \'underreporting\' of cardiac disease are more prevalent as people are older. Also, older age is associated with \'overreporting\' of stroke, and with \'underreporting\' of arthritis. The self-reported presence of mobility limitations is associated with \'overreporting\' of all specific diseases studied, except for diabetes mellitus, and its absence is associated with \'underreporting\', except for diabetes mellitus and atherosclerosis. Recent contact with the general practitioner is associated with \'overreporting\' of cardiac disease, atherosclerosis, malignancies and arthritis, and with less frequent \'underreporting\' of diabetes and arthritis. Results suggest that patients\' self-reports on selected chronic diseases are fairly accurate, with the exceptions of atherosclerosis and arthritis. The associations found with certain patient characteristics may be explained by the tendency of patients to label symptoms, denial by the patient, or inaccuracy of medical records.
Molenaar, N.J., Smit, J.H. (1996). Asking and answering yes/no-questions in survey interviews: A conversational approach. Quality & Quantity, 30, 115-136. > Full Text.
The authors discuss the process of asking and answering yes/no-questions in personal survey interviews form a conversational perspective. They examine the process with regard to yes/no-questions as given in the questionnaire and with regard to the yes/no-questions that interviewers may pose in the subsequent stages of sequence, when they are probing on the respondent\'s initial answer or are trying to solve other problems. Hypotheses are derived from the co-operation principle and the politeness principle of conversation, and then empirically evaluated for survey interview settings. In the relatively informal stages of the answering process (subsequences) the conversations appear to go quite well according to the conversation rules, but in the beginning formal stage to a much lesser degree. In particular it has been observed that interviewers strongly prefer to ask one-sided positive yes/no-questions. It is argued that this \'normal\' conversation strategy may seriously affect the validity of the information obtained, and, more generally, that the practical demands from the conversation rules on the interviewer\'s behaviour set limits on the researcher\'s abstract demands on that behaviour.
Penninx, B.W.J.H. (1996). Social support in elderly people with chronic diseases: Does it really help? PhD Dissertation, VU University Amsterdam.
No abstract available.
Penninx, B.W.J.H., Beekman, A.T.F., Ormel, J., Kriegsman, D.M.W., Boeke, A.J.P., Van Eijk, J.Th.M., Deeg, D.J.H. (1996). Psychological status among elderly people with chronic diseases: Does type of disease play a part? Journal of Psychosomatic Research, 40, 5, 521-534.
Psychological status, including depressive symptoms, anxiety and mastery, was measured in a community-based sample of 3076 persons aged 55 to 85 with various chronic diseases. Strong, linear associations were found between the number of chronic diseases and depressive symptoms and anxiety, indicating that psychological distress among elderly people is more apparent in the presence of (more) diseases. Furthermore, in contrast to general assumptions that mastery is a relatively stable state, our results indicated that mastery is affected by having chronic diseases. The eight groups of chronically ill patients (with cardiac disease, peripheral atherosclerosis, stroke, diabetes, lung disease, osteoarthritis, rheumatoid arthritis or cancer) did differ in their associations with psychological distress. Psychological distress is most frequently experienced by patients with osteoarthritis, rheumatoid arthritis and stroke, while diabetic and cardiac patients appear to be least psychologically distressed. Differences in disease-characteristics, such as functional incapacitation and illness-controllability, may partly explain these observed psychological differences across diseases.
Tromp, E.A.M., Smit, J.H., Deeg, D.J.H., Bouter, L.M., Lips, P.T.A. (1996). Risk factors for osteoporotic fractures in elderly people: An additional study to the Longitudinal Aging Study Amsterdam (LASA). Osteoporosis International, 6 (Suppl. 1), 154 > Full Text.
The Longitudinal Aging Study Amsterdam (LASA) is a longitudinal survey on predictors and consequences of changes in physical, cognitive, emotional and social functioning in elderly people. The study constitutes a random sample of the urban and rural population in three culturally distinct geographical areas in the West, East, and South of the Netherlands. Key variables in the study are mobility, coordination, vision, ADL, intelligence, memory, depression and social participation. About 1600 subjects (> 65 year) will participate in an additional study on easily measurable risk factors for osteoporotic fractures. The emphasis rests on risk factors for falls, factors which modify the impact of the fall and risk factors which influence bone mass, bone structure and bone quality. The additional study includes a medical interview, balance tests, chair stands, grip strength, anthropometry, biochemical markers and ultrasound attenuation of the heel. More complex parameters such as body composition, bone mass and a spine radiograph will be measured in one region (600 subjects) for comparison with the easily measurable variables. The measurements of the additional study have started in October 1995 and will take approximately one year to be completed. A follow up on falls and fractures will be done during 3 years after initial examination This includes a calender on falls and fractures with follow-up every 3 months. For this follow-up study a memory-aid calender will be provided to assist the subjects\' recall of falls and fractures. The subjects will asked to fill out a questionnaire about new falls and fractures every 3 months. The study will participate in an EEC study in the program \"European Prospective Osteoporosis Study\" (EPOS).
Van den Eeden, P., Smit, J.H. (1996). Indicator variables as a tool for analysis of interviewer effects on covariance structures: An application of the multilevel model. In H. Ernste (Ed.), Multilevel Analysis with structural Equation Models (pp. 51-61). Zrich: Swiss Federal Institute of Technology.
This study is based on data which were collected in the context of the Longitudinal Aging Study Amsterdam (LASA), conducted at the departments of Psychiatry of the Faculty of Medicine and the Department of Sociology and Social Gerontology of the Faculty of Social and Cultural Sciences of the Vrije Universiteit in Amsterdam. The study is funded bu the Dutch State Ministry of Welfare, Health, and Sports. We wish to thank the members of the department of Social Research methodology for their fruitful comments on an earlier version of this paper.
Van den Eeden, P., Smit, J.H., Deeg, D.J.H., Beekman, A.T.F. (1996). The effects of interviewer and respondent characteristics on answer behaviour in survey research: A multilevel approach. Bulletin de Methodologie Sociologique, 51, 64-79.
No abstract available.
Van den Eeden, P., Smit, J.H., Beekman, A.T.F. (1996). Time-, respondent- and interviewer-related causes of item-nonresponse on the CES-D depression scale: a multilevel model. Proceedings of Statistics Canada Symposium 1996, 195-205.
No abstract available.
Van den Heuvel, N., Smits, C.H.M., Deeg, D.J.H., Beekman, A.T.F. (1996). Personality: A moderator of the relation between cognitive functioning and depression in adults aged 55-85? Journal of Affective Disorders, 41, 229-240.
Previous studies found modest associations between cognitive functioning and depressive symptoms in community samples of older adults. Low levels of cognitive functioning are associated with depressive symptoms. The present study investigates whether personality (locus of control and neurotism) moderates this relation, and whether gender-differences in moderating effects can be established. The study is based on data of the baseline sample of 3107 participants of the Longitudinal Aging Study Amsterdam, which was age (55-89 years) and sex-stratified. Multiple regression analyses are used to detect moderating effects. The findings show modest effects, indicating that personality is a moderator of the relation between cognitive functioning and depressive symptoms, particularly in women. In women, a relatively strong internal locus of control is protective of becoming depressed when experiencing impairment in general cognitive functioning (MMSE), and impairment in fluid intelligence and information processing speed. In men a low level of neurotism is protective of becoming depressed when experiencing memory impairment. If these findings are replicated and extended in future studies, pertinent interventions such as cognitive therapy or memory training may be designed to alleviate depressive symptoms.
Van Tilburg, W. (1996). Psychische (on)gezondheid van ouderen. In J.M. Timmermans, A. van den Berg Jeths, B.M. Jansen, P.H.B. Pennekamp (Eds.), Mythen en feiten over ouderen (pp. 26-36). Houten: Bohn, Stafleu, van Loghum.
No abstract available.

1995

Beekman, A.T.F., Kriegsman, D.M.W., Deeg, D.J.H., Van Tilburg, W. (1995). The association of physical health and depressive symptoms in the older population: Age and sex differences. Social Psychiatry and Psychiatric Epidemiology, 30, 32-38. > Full Text.
Physical health and depression are closely related in the elderly. This has been found in both cross-sectional and longitudinal studies. In this study the relation between four aspects of physical health and depressive symptom levels are studied in a community-based sample of older inhabitants of a small town in the Netherlands (n=224). Results indicate that depression as measured with the CES-D is sufficiently different from physical health to be distinguished from it, and that it is sufficiently related to physical health to be relevant for further study. The more subjective measures of physical health used in this study (pain and subjective health) appear to have a much stronger relation with depression than the more objective health-measures (chronic diseases and functional limitations). Physical health and aspects of the social environment such as marital status appear to have independent effects on mood. In this study these effects were moderated by age and sex. In women and the young-old none of the associations between physical health and depression were significant. In men and the old-old all associations were highly significant.
Beekman, A.T.F., Stek, M.L., Deeg, D.J.H. (1995). Het beloop van depressie bij ouderen [The course of depression in the elderly]. Tijdschrijft voor Psychiatrie, 37, 568-581.
In this review the course of depression in elderly patients treated at psychiatric in- or outpatient clinics is compared to results of studies carried out among community- dwelling elderly. With psychiatric treatment 50%-80% of elderly depressed patients have a favourable response. A considerable percentage of patients relapses, of which most recover with treatment. Comparing the findings of 15 studies, employing global criteria, a favourable long term course can be expected in about 50%-60% of treated elderly patients. Physical illness, the duration and severity of the index-episode, age at onset, and comorbid cognitive and personality disorders appear to be predictors of the course. All other variables studied either have no association with the course, or show equivocal results. In community based studies the course of depression appears to be less favourable than among patients treated at psychiatric services. Using 10 criteria, methodological shortcomings of the available studies are elaborated on. In the conclusions section the relevance of these findings for clinical practice and for future research are discussed.
Beekman, A.T.F., Deeg, D.J.H., Van Tilburg, T.G., Smit, J.H., Hooijer, C., Van Tilburg, W. (1995). Major and minor depression in later life: A study of prevalence and risk factors. Journal of Affective Disorders, 36, 65-75. >Full Text.
Presents results from the Longitudinal Aging Study Amsterdam regarding the prevalence of both major (MaD) and minor depression (MiD) and age-related shifts in the patterns of associations with both vulnerability and stress. A random sample of 3,056 adults (aged 55-85 yrs) was obtained from 3 regions in the Netherlands. The prevalence of MaD was 2.02% and that of MiD, 12.9%. 14.9% had clinically relevant levels of depressive symptoms. Except in the youngest age group, women had higher prevalence rates for both MaD and MiD. Rising rates of depression with age were only found for women. Bivariate associations of both MaD and MiD with a broad range of risk factors did not differ dramatically between the sexes or age groups. Results suggest that MaD in the elderly is more often the exacerbation of a chronic mood disturbance, with roots in long-standing vulnerability, while MiD is more often a reaction to the stress encountered in later life.
Beekman, A.T.F., Deeg, D.J.H., Smit, J.H., Van Tilburg, W. (1995). Predicting the course of depression in the older population: Results from a community-based study in The Netherlands. Journal of Affective Disorders, 34, 41-49.
This article is a report on the course of depressive syndromes in a community-based sample of older subjects in the Netherlands (n=238). Following base-line, the course of depression was assessed in five waves of follow-up measurements, covering 1 year. 52% of the subjects were never depressed; 16% suffered an incident depression, half of which remitted during the study; 8% had a depression at outset, which remitted during the study; 14% were chronically depressed and in 10% the course was variable. Of those depressed at the start of the study, 32% remitted without relapse, 25% remitted but relapsed later and 43% were chronically depressed. While demographic variables were not predictive, health-related variables were predictive of both the onset and the course of depressive syndromes. Chronicity was associated with recent visits to general practitioners, indicating that treatment could have been provided relatively easily in many cases.
Bosscher, R.J., Van der Aa, H., Van Dasler, M., Deeg, D.J.H., Smit, J.H. (1995). Physical performance and physical self-efficacy in the elderly: A pilot study. Journal of Aging & Health, 7, 4, 459-475. >Full Text.
This study examined the relationship between physical performance and physical self-efficacy beliefs in older adults. It was hypothesized that subjects who perform better on physical tasks would show more positive beliefs of physical self-efficacy. Information was obtained from 124 subjects (61 men and 63 women) aged 55 to 85 years. Tests of mobility, strength, and dexterity were administered, as well as a self-report questionnaire of physical self-efficacy. Although most physical performance indexes were observed to be at lower levels after 75 years of age, physical self-efficacy beliefs in women did not show this pattern if the drop in physical performance was relatively small. Male subjects in the age group of 75 years and older however, showed substantial lower levels of performance in most of the tests, which was associated with more negative beliefs of physical self-efficacy. This was corroborated by multiple regression analyses, showing that sex was a significant predictor of physical self-efficacy beliefs in most performance tests. This prediction was moderated by age such that older men had more negative beliefs of physical self-efficacy than older women.
Deeg, D.J.H. (1995). Research and the promotion of quality of life in older persons in the Netherlands. In E. Heikkinen, J. Kuusinen, & I. Ruoppila (Eds.),Preparation for aging (pp. 155-163). New York: Plenum.
This chapter briefly reviews possible agents instrumental in promoting and maintaining quality of life. The broad objective of promotion of health-related quality of life can be specified in two directions. First, to provide adequate health care, either cure or care or both. Second, to find non-health factors that compensate for a loss of good health. In this chapter the second direction to substantiated. Evidence from a study of 243 persons aged 55-59 through 85-89 years suggests that as people are confronted with disease, they employ a cognitive strategy that enables them to maintain their life satisfaction by reconsidering the importance of good health in favor of other domains of life. This may help them to find compensation for their loss of health in non-health factors by shifting their priorities to other domains of life.
Deeg, D.J.H., Smits, C.H.M. (1995). Even ziek maar minder hulp?: Factoren die invloed hebben op het zorggebruik van oudere vrouwen [Equally ill but less assistance?: Factors influencing use of care in older women]. In C.H.M. Smits, M.J.F.J. Vernooij-Dassen(Eds.), De toekomst van vrouwen. Oudere vrouwen in onderzoek, beleid en praktijk [The future of women: Older women in research, policy, and practice] (pp. 49-57). Amsterdam: VU-Uitgeverij.
The issue addressed in this chapter is how differences in informal and formal care received by older women with similar levels of health can be explained by material and immaterial resources. Data were used pertaining to 1600 women aged 55-85 years in various parts of the Netherlands. Self-perceived health variables appeared to be the most important correlates of care received. In excess of these, only material resources explained some variation in care received. Women in more rural towns received more help. Also, women with higher education levels received more care. Marital status or living arrangements did not affect care received. Equally, personality characteristics did not differentiate between women with respect to care received.
Kriegsman, D.M.W., Van Eijk, J.Th.M., Deeg, D.J.H. (1995). Psychometrische eigenschappen van de Nederlandse versie van de RAND General Health Perceptions Questionnaire. De vragenlijst Algemene Gezondheidsbelevering (VAGB). Tijdschrift voor Sociale Gezondheidszorg, 73, 390-398.
No abstract available.
Kriegsman, D.M.W. (1995). Chronic diseases, family features and physical functioning in elderly people. PhD dissertation, VU University Amasterdam.
No abstract available.
Smit, J.H., Van den Eeden, P., Deeg, D.J.H., Beekman, A.T.F. (1995). De effecten van interviewer- en respondentkenmerken op antwoordgedrag in survey-onderzoek: Een multi-level benadering [The effects of interviewer and respondent characteristics on response behaviour in survey research: A multilevel approach]. Sociologische Gids, 42, 285-297.
Until recently, the study of interviewer effects has focused on establishing direct effects of interviewer chracteristics on respondent response. An alternative approach emphasizes the conditioning influence of the interviewer characteristic on the respondent\'s answering process. This paper supports the alternative approach with empirical evidence. First, the answering process is described at the level of the respondent. Subsequently, respondent-specific parameters are related to interviewer-specific vaiables. This two-level model is applied to data collected in the Longitudinal Study Amsterdam (LASA; 2838 respondents within 43 interviewers). The dependent variables are the items belonging to the \'postivie affect\' dimension of well-being (Center for Epidemiologic Studies Depression Scale); relevant variables on respondent level and interviewer level are incorporated in the analysis. It turns out that all items depend on respondent characteristics, and that the means of the items \'worthfulness\', \'hopefulness\' and \'pleasure in life\' per interviewer depend on their age. The means of \'worthfulness\' also depend on \'interviewer security\'. A more interesting outcome is that the regressions of \'worthfulness\' and \'hopefulness\' on respondent age, are effected by interviewer age.
Smit, J.H. (1995). Suggestieve vragen in survey-interviews. Voorkomen, oorzaken en gevolgen. PhD Dissertation, VU University Amsterdam.
No abstract available.
Smits, C.H.M., Deeg, D.J.H., Bosscher, R.J. (1995). Well-being and control in older persons: The prediction of well-being from control measures. International Journal of Aging and Human Development, 40, 3, 237-251.
Studied the interrelation of 6 facets of control and their ability to predict well-being in 90 older Dutch persons in an age and gender stratified community sample (aged 55-89 yrs). Assessment instruments included translated versions of the Sense of Coherence questionnaire, the General Self-efficacy scale, and Multiple Health Locus of Control scale. An interview and a postal questionnaire included measures of the control facets and the Affect Balance Scale. Correlations between control measures were mostly modest. Negative affect was predicted by neuroticism and sense of coherence. Tendencies of independent association of mastery with global well-being and of social inadequacy with positive affect were established.
Smits, C.H.M., Van Rijsselt, R.J.T., Jonker, C., Deeg, D.J.H. (1995). Social participation and cognitive functioning in older adults. International Journal of Geriatric Psychiatry, 10, 325-331. > Full Text.
The association between aspects of social participation and components of cognitive functioning and the ability of these aspects to predict cognitive performance was studies in an age and gender stratified sample of 116 individuals aged 65 to 89 years in The Netherlands. Measures of social participation included questionnaires on societal participation, socio-cultural activities and media use. Cognitive functioning was measured by tests of fluid intelligence, processing speed, word learning and recall, and everyday memory. All aspects of social participation showed significant bivariate correlations with all components of cognitive functioning. Independant of age, gender, education and functional limitations, societal participation and socio-cultural activities contributed significantly to the prediction of processing speed. Societal participation also contributed to the prediction of delayed recall. Tendencies of independant association were apparent between both societal participation and socio-cultural activities and word learning. No aspects of social participation independently predicted fluid intelligence or everyday memory. The evidence suggests independent associations between environmental stimulation and basic components of cognitive functioning, such as information-processing speed and measures of learning and delayed recall. Further research needs to clarify the process underlying the causal relation between cognitive functioning and forms of participation.
Van den Eeden, P., Smit, J.H. (1995). Interviewer effects on covariance