Biomedical subjects

A F Jorm

Publications and source records attributed to A F Jorm.

At least 19 recordsLinked to original sources

PubMed2006

Pulmonary function, cognitive impairment and brain atrophy in a middle-aged community sample.

OBJECTIVE: To determine the relationship of lung function to brain anatomical parameters and cognitive function and to examine the mediating factors for any relationships. METHODS: A random sub-sample of 469 persons (men = 252) aged 60-64 years from a larger community sample underwent brain magnetic resonance imaging scans and pulmonary function tests (forced vital capacity, FVC, forced expiratory volume in the first second, FEV(1)). Subjects were assessed for global cognitive function, episodic memory, working memory, information processing speed, fine motor dexterity and grip strength. The magnetic resonance imaging scans were analysed for overall brain atrophy, subcortical atrophy (ventricle-to-brain ratio, VBR), hippocampal volume, and white matter hyperintensity (WMH) volume. RESULTS: FEV(1) had a significant negative correlation with overall brain atrophy and VBR in men. The FEV(1)/FVC ratio had a significant correlation with WMHs in both men and women. In regression models that controlled for sex, age, height, level of activity, smoking, chronic respiratory disease and education, FEV(1) and FVC were significant predictors of VBR but no other structural brain measure. Pulmonary function was also significantly related to information processing speed and fine motor dexterity. Male subjects with chronic respiratory disease had more deep WMHs. Path analyses to examine if structural measures mediated between lung function and cognition, and whether markers of inflammation and oxidative stress or cortisol mediated between lung function and brain measures were negative. CONCLUSIONS: Decreased lung function is related to poorer cognitive function and increased subcortical atrophy in mid-adult life. Presence of chronic respiratory disease may be related to deep WMHs in men.

Atrophy↗

PubMed2005

Age group differences in psychological distress: the role of psychosocial risk factors that vary with age.

BACKGROUND: There is continuing controversy about how age affects depression and anxiety, with a lack of consistent results across studies. Two reasons for this inconsistency are age bias in measures and different patterns of exposure to risk factors across age groups in various studies. METHOD: Data on anxiety and depression symptoms were collected in a community survey of 7485 persons aged 20-24, 40-44 or 60-64 years. These measures were investigated for factorial invariance across age groups. Data were also collected on a wide range of potential risk factors, including social, physical health and personal factors, with the aim of determining whether these factors might partly or wholly account for age group differences. RESULTS: The invariance of correlated latent factors representing anxiety and depression was examined across age groups, and a generalized measure of psychological distress was computed. Depression, anxiety and psychological distress showed a decline across age groups for females and a decline from 40-44 to 60-64 years for males. Some of these age differences were accounted for by other risk factors, with the most important being recent crises at work and negative social relationships with family and friends. CONCLUSION: Psychological distress generally declined across the age range 20-64 years and this was not attributable to measurement bias. Differential exposure to risk factors explained some, but not all, of the age group difference. Therefore other mechanisms that explain the lower level of distress in older age groups remain to be identified.

Adolescent↗

PubMed2005

Associations between plasma antioxidants and hypertension in a community-based sample of 415 Australians aged 60-64.

It has been suggested that increased oxidative stress may be both a cause as well as a consequence of hypertension. In vivo oxidation of low-density lipoproteins by oxygen-free radicals may increase hypertension-related atherogenesis, and antioxidants may be beneficial in this regard. Previous findings concerning associations between serum measures of antioxidants and hypertension have however been inconsistent. Plasma levels of beta-carotene, Vitamin A, E, uric acid, homocysteine and total antioxidant capacity, as well as two markers of oxidative stress, malondialdehyde (MDA) and protein carbonyls, were measured in morning fasting blood samples provided by 415 Australians aged 60-64 years, selected randomly from the community. Participants also provided information on sociodemographic attributes, mental and physical health, and provided two measures of resting blood pressure, allowing a diagnosis of definite or borderline hypertension. Those with hypertension had lower levels of beta-carotene and higher levels of uric acid and MDA compared to normotensive participants. The last two of these associations persisted when the analyses controlled for lifestyle and health factors. The findings from this study offer limited support for the proposition that lower antioxidant status and higher oxidative stress are associated with hypertension, and suggest the need for longitudinal studies to examine causality and intervention studies to determine the benefit of antioxidants in this group.

Age Factors↗

PubMed2005

Reproductive period and cognitive function in a representative sample of naturally postmenopausal women aged 60-64 years.

BACKGROUND: Greater lifetime estrogen exposure has been postulated to result in better cognition in later life, particularly in the area of verbal memory. In women, the highest levels of endogenous estrogen occur during their reproductive period, between menarche and menopause. OBJECTIVE: To investigate the association between reproductive period and cognition. METHODS: The sample consisted of 760 naturally postmenopausal women aged 60-64 years (mean age 62.5 +/- 1.5 years) participating in the PATH Through Life Study who were randomly drawn from the population of Canberra, Australia. Participants were administered a verbal learning test (immediate recall and 1-minute delay), the Mini-Mental State Examination (MMSE), digit span backwards, the Symbol-Digit Modalities Test and simple and choice reaction time tests. RESULTS: There were no significant associations detected between reproductive period and performance on any of the cognitive tests, either before or after controlling for potential confounding variables. CONCLUSIONS: Reproductive period, a surrogate measure of endogenous estrogen exposure, had no detectable effect on cognitive performance in this sample.

Australia↗

PubMed2005

White matter hyperintensities are related to physical disability and poor motor function.

OBJECTIVE: To determine the impact of white matter hyperintensities (WMHs) on physical health and cognitive function in 60-64 year old individuals residing in the community. METHODS: A subsample of 478 persons aged 60-64 from a larger community sample underwent brain magnetic resonance imaging (MRI) scans. WMHs on T2 weighted FLAIR (fluid attenuated inversion recovery) MRI scans were assessed using an automated procedure. Subjects were assessed for global cognitive function, episodic memory, working memory (digit span), information processing speed (Symbol Digit Modalities Test; SDMT), fine motor dexterity (Purdue Pegboard), and grip strength, and completed the Physical Component Summary of the Short Form Health Survey (SF-12). Regression analyses were used to examine the effect of WMHs on physical and cognitive function. RESULTS: Deep and periventricular WMHs were present in all subjects, with women having slightly more lesions than men. WMHs were significantly associated with poorer reported physical health on the SF-12 scale, after adjusting for depression, cognitive function, and brain atrophy. WMHs were also related to lower scores on the Purdue Pegboard test, grip strength, choice reaction time, and SDMT, but not on tests of episodic memory, working memory, general intellectual function, and global cognitive function. On regression analyses, the Purdue Pegboard test and grip strength were related to physical disability. CONCLUSION: WMHs are common, albeit mild, in middle adult life. They are associated with physical disability, possibly through reduced speed, fine motor coordination, and muscular strength. They are also related to slowed information processing speed but not other cognitive functions.

Automation↗

PubMed2004

Memory complaints in nondemented men predict future pathologic diagnosis of Alzheimer disease.

The validity of memory complaints as a predictor of Alzheimer disease (AD) was assessed in 237 Japanese-American men autopsied at ages 74 to 97 years. These men were free of dementia at the time memory complaints were assessed 1 to 11 years earlier. Memory complaints were found to predict the neuropathologic diagnosis of AD after adjusting for age, time to death, education, depression, and cognitive functioning.

Aged↗

PubMed2004

Actions taken to cope with depression at different levels of severity: a community survey.

BACKGROUND: Many people with symptoms of psychological distress do not seek professional help. Little is known about the actions taken by these people to reduce their symptoms. The present study aimed to assess, in a community sample, actions taken to cope with depression at different levels of psychological distress. METHOD: A postal survey was carried out with 6618 adults living in Canberra and south-east New South Wales, Australia. Measures covered psychological distress and a checklist of actions taken to cope with depression in the previous 6 months. RESULTS: Actions taken to cope with depression could be classified as: intensification of everyday strategies, initiation of new self-help (including complementary therapies, non-prescription medication and dietary changes) and seeking professional help. Use of everyday strategies peaked with mild psychological distress, new self-help showed a peak in moderate distress, while professional help-seeking peaked in severe distress. CONCLUSION: Self-help strategies are very commonly used, particularly in mild-moderate psychological distress. More evidence is needed to evaluate their effectiveness, so that optimal self-help can be encouraged.

Adaptation, Psychological↗

PubMed2004

Memory complaints in a community sample aged 60-64 years: associations with cognitive functioning, psychiatric symptoms, medical conditions, APOE genotype, hippocampus and amygdala volumes, and white-matter hyperintensities.

BACKGROUND: Previous research has found that depression is a major cause of memory complaints. However, there is evidence that memory complaints also weakly predict cognitive decline and dementia. The present study examined a range of possible determinants of memory complaints, covering psychiatric and personality factors, medical history, cognitive test performance, and biological risk factors for dementia (APOE genotype, hippocampus and amygdala volumes, and white-matter hyperintensities). METHOD: A community survey was carried out with 2546 persons aged 60-64 years living in Canberra and Queanbeyan, Australia. Participants were asked about memory problems which interfered with daily life and whether medical help had been sought. A randomly selected subsample of 476 persons was given a brain MRI scan. RESULTS: Participants with memory complaints were found to have poorer memory test performance, more depression and anxiety symptoms, have higher scores on personality traits involving negative affect, and to have worse physical health. Multivariate analyses showed that measures of cognitive performance did not make a unique contribution to the prediction of memory complaints above that of the other categories of predictors. Those with memory complaints did not differ on any of the biological risk factors for dementia. CONCLUSION: In a community sample aged 60-64 years, memory complaints were most closely related to psychiatric symptoms, personality characteristics and poor physical health. There was no evidence of brain changes indicating early dementia.

Amygdala↗

PubMed2004

General practice encounters for psychological problems in rural, remote and metropolitan areas in Australia.

OBJECTIVE: Previous Australian research suggests there is very little difference in the prevalence of mental health disorders across rural, remote and metropolitan areas. However, mental health specialists are particularly scarce in rural and remote areas and some researchers have argued that non-metropolitan residents rely heavily on general practitioners (GPs) for mental health care. This article investigated rates of GP services for psychological problems across rural, remote and metropolitan areas. METHOD: The Bettering the Evaluation and Care of Health (BEACH) program, Medicare and Pharmaceutical Benefits Scheme data were used in this report. Data included all psychological, depression and anxiety problems reported as managed by GPs and prescriptions for mental health medications (written and filled). Problem and medication rates are given per 100 patient encounters and per 1000 population. RESULTS: Only a few regional differences were evident in the rate of psychological problems and prescriptions for mental health medications per 100 GP-patient encounters. However, rural and remote residents visited GPs less frequently than their metropolitan counterparts. Lower rates of GP encounters for psychological problems were evident for residents of most non-metropolitan areas (per 1000 population). Additionally, GPs prescribed mental health medications at half the rate for residents of remote areas than capital cities. CONCLUSIONS: General practitioners provide fewer mental health services per capita in non-metropolitan areas. This difference could represent completely untreated psychological problems or fewer follow-up consultations. While non-metropolitan residents have limited access to specialists, rates of GP encounters for psychological problems are also very low.

Anti-Anxiety Agents↗

PubMed2003

Interaction between mother's and father's affection as a risk factor for anxiety and depression symptoms--evidence for increased risk in adults who rate their father as having been more affectionate than their mother.

BACKGROUND: Retrospective reports of low care from either parent are found to be associated with increased risk for anxiety and depression in adulthood. Furthermore, fathers are generally reported as having been less caring than mothers, which raises the issue of whether greater care from fathers across the whole population would benefit mental health. METHODS: A community survey was carried out in Canberra, Australia, with 2404 adults aged 20-24 and 2530 aged 40-44. Respondents retrospectively reported on affection shown by their parents and on other aspects of family functioning. These data were analysed in relation to risk for anxiety and depressive symptoms and neuroticism. RESULTS: Retrospective reporting of greater affection from both fathers and mothers was generally associated with fewer anxiety and depression symptoms and lower neuroticism. However, there was a significant interaction effect, such that mental health was worse in families where the father was reported to show a higher level of affection but the mother a lower level. Such families were found to have a range of problems, including higher rates of emotional problems in the parents, conflict in the home, parental separation or divorce, and parental mistreatment. These family problems accounted for much of the interaction effect observed. CONCLUSIONS: Greater affection from the father is not always associated with lower risk for anxiety and depression. Where the father is more affectionate than the mother there tends to be increased family problems and increased risk. It is possible that family problems lead fathers to show increased affection to their children or mothers to show reduced affection.

Adult↗

PubMed2003

Providing information about the effectiveness of treatment options to depressed people in the community: a randomized controlled trial of effects on mental health literacy, help-seeking and symptoms.

BACKGROUND: Many people who are depressed do not receive any professional help and their beliefs about the helpfulness of treatment do not always correspond with those of health professionals. To facilitate choices about treatment, the present study examined the effects of providing depressed people in the community with evidence on whether various treatment options work. METHOD: A randomized controlled trial was carried out with 1094 persons selected at random from the community who screened positive for depressive symptoms and agreed to participate. Participants were mailed either an evidence-based consumer guide to treatments for depression or, as a control, a general brochure on depression. Outcomes were the rated usefulness of the information provided, changes in attitudes to depression treatments, actions taken to reduce depression, and changes in depressive symptoms, anxiety symptoms and disability. RESULTS: Participants rated the evidence-based consumer guide as more useful than the control brochure. Attitudes to some treatments changed. Improvements in symptoms and disability did not differ significantly between interventions. CONCLUSION: Providing people who are depressed with evidence on which treatments work produces some changes in attitudes and behaviour. However, this intervention may need to be enhanced if it is to produce symptom change.

Adult↗

PubMed2002

Patterns of association between alcohol consumption and symptoms of depression and anxiety in young adults.

AIMS: Recent epidemiological findings indicate that non-drinkers as well as hazardous/harmful drinkers experience higher levels of distress than moderate drinkers. Little is known about the age at which this develops. This paper examines levels of affect, depression and anxiety over the full range of alcohol consumption in young adults. DESIGN: Cross-sectional findings from the first wave of a prospective, longitudinal study are presented. PARTICIPANTS: The general population sample comprised of 2404 young adults (aged 20-24 years). living in the Canberra region. Measures included: the Goldberg Depression and Anxiety scales, the Positive and Negative Affect Schedule, and the Alcohol Use Disorders Identification Test. FINDINGS: For men, both non/occasional and hazardous/harmful consumption were associated with lower levels of positive affect and higher levels of anxiety and depression. The higher levels of distress evident for male abstainers were related to being less extroverted and less healthy and not to past hazardous/harmful alcohol consumption, current tobacco or marijuana use. For women, only hazardous/harmful drinkers were found to have higher levels of depression and negative affect. Hazardous/harmful consumption was related to using marijuana, tobacco and recent stressful events in both men and women. CONCLUSIONS: Higher levels of distress are already evident in male non-drinkers in early adulthood. The findings counter theories that distress in non-drinkers is due to past hazardous/harmful alcohol consumption, marijuana or tobacco use, or characteristics in common with hazardous/harmful drinkers. Alcohol use disorders and mental health problems are pertinent issues for young adults. However, more understanding is needed of the experiences of non-drinkers in an alcohol consuming culture.

Adult↗

PubMed2001

Association of a polymorphism of the dopamine transporter gene with externalizing behavior problems and associated temperament traits: a longitudinal study from infancy to the mid-teens.

There have been reports that a variable number of tandem repeats (VNTR) polymorphism situated in the 3' untranslated region of the dopamine transporter gene is associated with attention-deficit hyperactivity disorder. On the basis of these findings, we predicted an association of this polymorphism with hyperactivity, other externalizing behavior problems, and related temperament traits in a general population sample. The association was investigated using children participating in a longitudinal study of childhood temperament and development. DNA was taken from 660 children who had been assessed for temperament from 4-8 months to 15-16 years, and for behavior problems from 3-4 to 15-16 years. No significant associations were found at any age. There are a number of methodological differences from earlier studies that might explain the lack of associations with hyperactivity. It is also possible that the earlier findings are not replicable.

Adolescent↗

PubMed2001

The cognitive decline scale of the psychogeriatric assessment scales (PAS): longitudinal data on its validity.

OBJECTIVE: The Cognitive Decline scale of the Psychogeriatric Assessment Scales (PAS)1 uses informant data to assess retrospectively change from earlier in life. Data from a 7-8-year longitudinal study were used to assess the validity of this scale against changes in cognitive performance and mortality. DESIGN AND MEASURES: PAS data were collected on three occasions, with gaps of 3.6 and 4.1 years between the waves. The Cognitive Decline score at Wave 3 was validated retrospectively against actual change on a brief test of current cognitive status (the PAS Cognitive Impairment scale) over the three waves, while the Cognitive Decline score at Wave 1 was assessed for predictive validity against future mortality and cognitive change. SETTING: A community survey in the Australian cities of Canberra and Queanbeyan. PARTICIPANTS: Participants were aged 70+ at the beginning of the study. The sample size varied from 729 to 279, depending on the number of waves involved. RESULTS: Participants with scores of 4+ on the Cognitive Decline scale at Wave 3 showed substantial deterioration over the previous 7-8 years. Scores of 4+ at Wave 1 predicted mortality and further cognitive deterioration. CONCLUSIONS: The Cognitive Decline scale allows a valid retrospective assessment of change and has predictive validity for subsequent cognitive deterioration and increased mortality.

Aged↗

PubMed2001

Age is no kinder to the better educated: absence of an association investigated using latent growth techniques in a community sample.

BACKGROUND: Higher education has been posited to protect against cognitive decline, either because the rate of decline is slower in the more highly educated or the start of decline is delayed. Latent growth models provide improved methodology to examine this issue. METHODS: The sample consisted of 887 participants aged 70-93 years in 1991 and followed up in 1994 and 1998. Latent growth models and standard regression techniques were used to examine the rate of cognitive decline in four cognitive measures while controlling for health status and sex. A delayed start model was examined by incorporating interaction effects in a regression model. RESULTS: Neither the latent growth models nor the regression techniques revealed a slower rate of decline for the more highly educated. The proportion of the highly educated showing no change was no larger than the proportion of the less well educated. There were no significant age by education interaction effects, no chronologically later accelerations in the rate of change as a function of education, and no differences in rate of decline between the first measurement interval and the second. CONCLUSIONS: Education may not protect against cognitive decline although it is associated with long-term individual differences in level of functioning. The discrepancy between our study and others may be attributable to attrition effects, follow-up length, sample age, scaling artefacts and negative publication bias. Most importantly, practice effects may favour the better educated and hence account for the supposed protective effect in many longitudinal studies of cognitive change.

Activities of Daily Living↗

PubMed2001

The "common cause hypothesis" of cognitive aging: evidence for not only a common factor but also specific associations of age with vision and grip strength in a cross-sectional analysis.

A prominent hypothesis in cognitive aging is the existence of a common factor that is responsible for age-related deterioration in cognitive and noncognitive processes. A multiple indicators, multiple causes model was used to examine the nature of this common factor and its relationship to age, gender, and the apolipoprotein E (APOE) genotype. The common factor was modeled by using 10 indicator variables with 374 participants aged between 77.4 and 98.7 years. A latent factor was identified, with all indicators except blood pressure loading significantly. This factor could be established in 2 age strata within the sample. After controlling for the effects of gender, APOE, and level of education, direct effects of age were seen on visual functioning and grip strength. APOE was significantly associated with memory but not with the common factor. The findings suggest that a number of specific processes may operate concurrently with any common cause factor.

Aged↗

PubMed2001

Mental health nurses' beliefs about likely outcomes for people with schizophrenia or depression: a comparison with the public and other healthcare professionals.

This paper explores mental health nurses' beliefs about prognosis, long-term outcomes and discrimination in response to vignettes describing a person with either schizophrenia or depression. Mental health nurses were added to previous research describing the beliefs of professionals (psychiatrists, general practitioners and clinical psychologists) and the public. This study used a self- completion, postal survey procedure. Mental health nurses tended to be more negative than the community but more positive than the other professional groups (particularly the medical professions) about long-term outcomes and prognosis. Nurses were similar to the medical professional groups in believing that considerable discrimination occurs within the community. Given the potential impact on consumers and the public, all practitioners need to be aware of their own beliefs and those of their professional colleagues.

Adult↗

PubMed2001

Predictors of types of help provided to people using services for mental health problems: an analysis of the Australian National Survey of Mental Health and Wellbeing.

OBJECTIVE: Using the 1997 National Survey of Mental Health and Wellbeing, this study examined the types of mental health help provided to those Australians who use mental health services. We also sought to identify the extent to which sociodemographic factors, patterns of psychiatric morbidity and type of health practitioner seen were associated with receiving different types of mental health help. METHOD: Multiple logistic regressions were undertaken to identify predictor variables associated with receiving information, medication, psychological therapy, practical help and help looking after oneself or one's home. A total of 25 predictor variables provided in the National Survey were considered including age, sex, marital status, labour force status, geographical location, education, psychological symptoms, neuroticism, diagnoses of affective, anxiety and substance-abuse disorders and self-identified depression, anxiety and substance abuse. The type of practitioner seen for mental health reasons was also considered. RESULTS: Of the sociodemographic factors, age was the most consistently associated with receiving particular types of help. Younger respondents were more likely to have received information whereas older patients reported receiving more medication. As might be expected, the type and severity of psychiatric morbidity and the category of health professional seen were also associated with receiving particular types of mental health help. CONCLUSIONS: There are relatively few predictor variables that suggest possible bias in the types of help provided. Age group of recipient is an important exception. Our findings suggest that older recipients of mental health care are not provided the range of mental health treatments offered younger people who present with similar problems.

Adult↗