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Depression is an important, potentially modifiable dementia risk factor. However, it is not known whether effective treatment of depression through psychological therapies is associated with reduced dementia incidence. The aim of this study was to investigate associations between reduction in depressive symptoms following psychological therapy and the subsequent incidence of dementia.
Methods
National psychological therapy data were linked with hospital records of dementia diagnosis for 119808 people aged 65+. Participants received a course of psychological therapy treatment in Improving Access to Psychological Therapies (IAPT) services between 2012 and 2019. Cox proportional hazards models were run to test associations between improvement in depression following psychological therapy and incidence of dementia diagnosis up to eight years later.
Results
Improvements in depression following treatment were associated with reduced rates of dementia diagnosis up to 8 years later (HR = 0.88, 95% CI 0.83–0.94), after adjustment for key covariates. Strongest effects were observed for vascular dementia (HR = 0.86, 95% CI 0.77–0.97) compared with Alzheimer's disease (HR = 0.91, 95% CI 0.83–1.00).
Conclusions
Reliable improvement in depression across psychological therapy was associated with reduced incidence of future dementia. Results are consistent with at least two possibilities. Firstly, psychological interventions to improve symptoms of depression may have the potential to contribute to dementia risk reduction efforts. Secondly, psychological therapies may be less effective in people with underlying dementia pathology or they may be more likely to drop out of therapy (reverse causality). Tackling the under-representation of older people in psychological therapies and optimizing therapy outcomes is an important goal for future research.
To examine the cross-sectional and longitudinal (2-year follow-up) associations between dietary diversity (DD) and depressive symptoms.
Design:
An energy-adjusted dietary diversity score (DDS) was assessed using a validated FFQ and was categorised into quartiles (Q). The variety in each food group was classified into four categories of diversity (C). Depressive symptoms were assessed with Beck Depression Inventory-II (Beck II) questionnaire and depression cases defined as physician-diagnosed or Beck II >= 18. Linear and logistic regression models were used.
Setting:
Spanish older adults with metabolic syndrome (MetS).
Participants:
A total of 6625 adults aged 55–75 years from the PREDIMED-Plus study with overweight or obesity and MetS.
Results:
Total DDS was inversely and statistically significantly associated with depression in the cross-sectional analysis conducted; OR Q4 v. Q1 = 0·76 (95 % CI (0·64, 0·90)). This was driven by high diversity compared to low diversity (C3 v. C1) of vegetables (OR = 0·75, 95 % CI (0·57, 0·93)), cereals (OR = 0·72 (95 % CI (0·56, 0·94)) and proteins (OR = 0·27, 95 % CI (0·11, 0·62)). In the longitudinal analysis, there was no significant association between the baseline DDS and changes in depressive symptoms after 2 years of follow-up, except for DD in vegetables C4 v. C1 = (β = 0·70, 95 % CI (0·05, 1·35)).
Conclusions:
According to our results, DD is inversely associated with depressive symptoms, but eating more diverse does not seem to reduce the risk of future depression. Additional longitudinal studies (with longer follow-up) are needed to confirm these findings.
The burden of depression is increasing worldwide, specifically in older adults. Unhealthy dietary patterns may partly explain this phenomenon. In the Spanish PREDIMED-Plus study, we explored (1) the cross-sectional association between the adherence to the Prime Diet Quality Score (PDQS), an a priori-defined high-quality food pattern, and the prevalence of depressive symptoms at baseline (cross-sectional analysis) and (2) the prospective association of baseline PDQS with changes in depressive symptomatology after 2 years of follow-up. After exclusions, we assessed 6612 participants in the cross-sectional analysis and 5523 participants in the prospective analysis. An energy-adjusted high-quality dietary score (PDQS) was assessed using a validated FFQ. The cross-sectional association between PDQS and the prevalence of depression or presence of depressive symptoms and the prospective changes in depressive symptoms were evaluated through multivariable regression models (logistic and linear models and mixed linear-effects models). PDQS was inversely associated with depressive status in the cross-sectional analysis. Participants in the highest quintile of PDQS (Q5) showed a significantly reduced odds of depression prevalence as compared to participants in the lowest quartile of PDQS (Q1) (OR (95 %) CI = 0·82 (0·68, 0·98))). The baseline prevalence of depression decreased across PDQS quintiles (Pfor trend = 0·015). A statistically significant association between PDQS and changes in depressive symptoms after 2-years follow-up was found (β (95 %) CI = −0·67 z-score (–1·17, −0·18). A higher PDQS was cross-sectionally related to a lower depressive status. Nevertheless, the null finding in our prospective analysis raises the possibility of reverse causality. Further prospective investigation is required to ascertain the association between PDQS and changes in depressive symptoms along time.
El Niño cave, located on the south-eastern border of the Spanish Meseta, hosts a discontinuous sequence including Middle Palaeolithic and Neolithic levels, along with Upper Palaeolithic and Levantine style paintings. It is a key site for understanding human occupations of inland Iberia during the Palaeolithic and early prehistory. This paper summarises the main results of a multidisciplinary project aimed at defining the prehistoric human occupations at the site.
Since work organizations became the subject of scientific research, how to operationalize and measure dimensions of work design has been an issue, mainly due to concerns about internal consistency and factor structure. In response, Morgeson and Humphrey (2006) built the Work Design Questionnaire –WDQ–, an instrument that identifies and measures these dimensions in different work and organizational contexts. This paper presents the instruent’s adaptation into Spanish using reliability and validity analysis and drawing on a sample of 1035 Spanish workers who hold various jobs in an array of occupational categories. The total instrument’s internal consistency was Cronbach’s alpha of .92 and the various scales’ reliability ranged from .70 to .96, except for three dimensions. There was initially a difference in the comparative fit of the two versions’ factor structures, but the model with 21 work characteristics (motivational -task and knowledge-, social, and work context) showed the highest goodness of fit of the various models tested, confirming previous results from the U.S. version as well as adaptations into other languages and contexts. CFA results indicated goodness of fit of factor configurations corresponding to each of the four major categories of work characteristics, with CFI and TLI around .90, as well as SRMR and RMSEA below .08. Thus it brings to the table a reliable, valid measure of work design with clear potential applications in research as well as professional practice, applications that could improve working conditions, boost productivity, and generate more personal and professional development opportunities for workers.
The consumption of food and beverages containing high amounts of biogenic amines (BA) can have toxicological effects. BA found in foods and beverages are synthesized by the microbial decarboxylation of certain amino acids. This paper reports the concentrations of BAs in a number of commercial cheeses, as determined by HPLC. The cheeses studied were made from raw and pasteurized milk of different origin, and were subjected to different ripening periods. BA concentrations were lower in short ripening period than in long ripening period cheeses, and higher in cheeses made from raw milk than in those made from pasteurized milk. The highest BA concentrations were recorded in blue cheeses made from raw milk. Tyramine was the most commonly recorded and abundant BA. The presence of tyramine-producing bacteria was determined by PCR, and a good correlation obtained between the results of this method and tyramine detection by HPLC. These methods could be used to complement one another in the detection and quantification of tyramine in cheese prevention of tyramine accumulation in cheese.
The photocatalytic reduction of Cr (VI) and oxidation of naphthalene using UV light and TiO2 were investigated with variations in the pH and Cr (VI)/naphthalene ratio. The photochemical reduction of Cr (VI) single system was not observed, whereas the photochemical oxidation of naphthalene was significantly high. However, the reduction reaction rates of Cr (VI) and oxidation of naphthalene were improved in the system UV/TiO2. The removal of Cr (VI) decreased dramatically with increasing pH, in contrast, the naphthalene removal was not influenced by the pH. The presence of naphthalene functioned as a hole scavenger enhancing the photocatalytic reduction of Cr (VI) by the photogenerated electrons, while the removal of naphthalene was decreasing at increasing Cr (VI) content.
Public inoculation centers are examples of facilities providing service to customers whose demand is elastic to travel and waiting time. That is, people will not travel too far, or stay in line for too long to obtain the service. The goal, when planning such services, is to maximize the demand they attract, by locating centers and staffing them so as to reduce customers' travel time and time spent in queue. In the case of inoculation centers, the goal is to maximize the people that travel to the centers and stay in line until inoculated. We propose a procedure for the allocation of multiple servers to centers, so that this goal is achieved. An integer programming model is formulated. Since demand is elastic, a supply-demand equilibrium equation must be explicitly included in the optimization model, which then becomes nonlinear. As there are no exact procedures to solve such problems, we propose a heuristic procedure, based on Heuristic Concentration, which finds a good solution to this problem. Numerical examples are presented.
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