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Biomedical subjects

B Rodgers

Publications and source records attributed to B Rodgers.

At least 55 records · Page 3Linked to original sources
PubMed1999

An analysis of diversity in the cognitive performance of elderly community dwellers: individual differences in change scores as a function of age.

This longitudinal study investigated whether age is associated with increases in interindividual variability across 4 ability domains using a sample of 426 elderly community dwellers followed over 3.5 years. Interindividual variability in change scores increased with age for memory, spatial functioning, and speed but not for crystallized intelligence for the full sample and in a subsample that excluded dementia or probable dementia cases. Hierarchical regression analyses indicated that being female, having weaker muscle strength, and having greater symptoms of illness and greater depression were associated with overall greater variability in cognitive scores. Having a higher level of education was associated with reduced variability. These findings are consistent with the view that there is a greater range of responses at older ages, that certain domains of intelligence are less susceptible to variation than others and that variables other than age affect cognitive performance in later life.

Activities of Daily Living↗
PubMed1999

Heavy alcohol consumption and marital status: disentangling the relationship in a national study of young adults.

AIMS: To investigate why alcohol consumption varies by marital status, assessing (i) differences in heavy consumption prior to changes in marital status (indicating selection) and increases or decreases in heavy consumption associated with changes in marital status (indicating causation), (ii) whether such increases or decreases are transient, and (iii) the possible mediating effect of parental status. DESIGN: Longitudinal cohort. SETTING: Great Britain. PARTICIPANTS: Data from the 23- and 33-year surveys of the 1958 British birth cohort (all born in England, Wales and Scotland, 3-9 March 1958). MEASUREMENTS: Heavy drinking, defined as more than 35 (men) and 20 (women) units/week; changes between ages 23 and 33 in consumption and marital status. FINDINGS: The divorced had the highest consumption levels at both ages, the married had the lowest. Selection effects were minimal in both sexes. Overall, heavy drinking declined between ages 23 and 33 (21.4-13.0% in men, 6.4-3.4% in women), but increased among individuals who divorced, compared to the continuously married (adjusted OR = 2.05, 95% CI = 1.49, 2.83 for men; OR = 2.61, 95% CI = 1.67, 4.09 for women), most strikingly for recent divorces (adjusted OR = 4.97, 95% CI = 2.86, 8.57 and OR = 5.25, 95% CI = 2.60, 10.65). High rates of heavy drinking persisted for never married men (19.1%) and women (5.2%). CONCLUSIONS: The heavy drinking level of divorced young adults was not due to selection. Marital separation was accompanied by increases in heavy drinking, with pronounced short-term effects. Adverse alcohol-related health consequences may occur in the immediate period around divorce. Individuals who never marry appear to have a chronic heavy consumption pattern that may contribute to their increased mortality.

Adult↗
PubMed1999

Health, cognitive, and psychosocial factors as predictors of mortality in an elderly community sample.

STUDY OBJECTIVE: To examine whether cognitive and psychosocial factors predict mortality once physical health is controlled. DESIGN: A prospective study of community dwelling elderly. Mortality was assessed over a period of 3-4 years after the baseline assessment of predictors. The data were analysed using the Cox proportional hazards model. SETTING: Canberra and Queanbeyan, Australia. PARTICIPANTS: A sample of 897 people aged 70 or over and living in the community, drawn from the compulsory electoral roll. RESULTS: For the sample as a whole, the significant predictors of mortality were male sex, poor physical health, poor cognitive functioning, and low neuroticism. Men had an adjusted relative risk of mortality of 2.5 compared with women. For the male sub-sample, poor self rated health and a poor performance on a speeded cognitive task were significant predictors, while for women, greater disability, low systolic blood pressure, and a low score on a dementia screening test were the strongest predictors. CONCLUSIONS: Mortality was predicted by physical ill health and poor cognitive functioning. Psychosocial factors such as socioeconomic status, psychiatric symptoms, and social support did not add to the prediction of mortality, once sex, physical health, and cognitive functioning were controlled. Mortality among men was more than twice that of women, even when adjusted for other predictors.

Aged↗
PubMed1998

Psychotic symptoms in the elderly: a prospective study in a population sample.

BACKGROUND: Most of what is known about psychotic symptoms in older persons is based on hospital series of severe disorders. METHOD: In the course of a longitudinal community-based survey of older persons, the presence of psychotic symptoms was assessed on two occasions 3-4 years apart. RESULTS: The point prevalence was 5.7%. Risk factors were cognitive impairment, living alone, being male, having had limited education, social isolation, poor health and depressive symptoms. Of the 65 persons who were symptomatic at the start, only six of those still alive had one or more psychotic symptoms after 3-4 years. The incidence was 6.0% over a period of 3.6 years. CONCLUSIONS: Risk factors for psychotic symptoms in later life lie in age-related cognitive impairment in interaction with a range of environmental and psychosocial variables.

Aged↗
PubMed1998

Symptoms of depression and anxiety during adult life: evidence for a decline in prevalence with age.

BACKGROUND: To test the hypothesis that the prevalence, in the general population, of symptoms of depression and anxiety declines with age. METHODS: A general population sample of 2725 persons aged 18 to 79 years was administered two inventories for current symptoms of depression and anxiety, together with measures of neuroticism and of exposures that may confer increased risk of such symptoms. RESULTS: Symptoms of depression showed a decline with age in both men and women. For anxiety, the decline was statistically significant for women but not consistently so for men. For the risk factors examined, there was a decline with age in the neuroticism score, the frequency of adverse life events, being seriously short of money and having had parents who separated or divorced. Further analysis showed that the association between age and a declining symptom score cannot be entirely attributed to these risk factors, with the single exception of neuroticism. The latter is itself likely to be contaminated by current symptoms. CONCLUSION: Unless these findings are due to bias in the sample of those who agreed to participate, they add to the evidence that symptoms of depression and to a lesser extent of anxiety decline in prevalence with age. Some risk factors also decline with age. It now has to be determined if these cross-sectional observations are also to be found in longitudinal data; and what process may underlie this striking change in mental health during adulthood.

Adolescent↗
PubMed1998

An association study of a functional polymorphism of the serotonin transporter gene with personality and psychiatric symptoms.

A functional polymorphism in the regulatory region of the serotonin transporter gene has been reported to be associated with anxiety-related personality traits. We attempted to replicate this finding in an association study involving 759 Caucasians selected from the general Australian population. We found no associations with personality traits (including neuroticism, negative affect and behavioral inhibition), anxiety and depressive symptoms, or alcohol misuse.

Alcoholism↗
PubMed1998

The relationship between parental separation in childhood and problem drinking in adulthood.

AIMS: To investigate the association between parental separation and alcohol consumption and problem drinking in early adulthood (at ages 23 and 33). DESIGN: The study used longitudinal data from the 1958 British birth cohort study, a large representative national sample followed to age 33. SETTING: Great Britain. PARTICIPANTS: 11,407 subjects were interviewed at age 33 in 1991 (69% of the target population). Analyses are based on 4606 men and 4892 women with data at ages 23 and 33. MEASUREMENTS: Units of alcohol consumed in the previous week at ages 23 and 33. Heavy drinking was defined as more than 20 units/week (women) and more than 35 units/week (men). Problem drinking was indicated by the four-item CAGE measure. Information on parental separation was reported by subjects at age 33; parental deaths were ascertained from data recorded in childhood sweeps of the survey. FINDINGS: At age 23, the relationship between parental separation and alcohol consumption was weak and inconsistent, but by age 33 a stronger and more consistent relationship had emerged. Higher levels of alcohol consumption, heavy drinking and problem drinking (odds ratios 1.29-1.90) were found for those who had experienced parental divorce in childhood, but not later parental divorce or parental death. These results were not substantially attenuated by possible mediating factors, such as marital status or socio-economic circumstances. CONCLUSIONS: The risk associated with early parental divorce appeared to strengthen between ages 23 and 33. Life-course factors influencing the manifestation of alcohol problems in those from divorced families need to be identified.

Adult↗
PubMed1998

Occupation type as a predictor of cognitive decline and dementia in old age.

OBJECTIVE: To assess whether an individual's main occupation predicts cognitive decline or dementia. METHODS: The data were taken from a longitudinal study of 518 men aged 70 or over. Main occupation was coded into one of John Holland's six occupational categories. The subjects completed four cognitive tests and were diagnosed for dementia on two occasions three and a half years apart. The cognitive tests were the Mini-Mental State Examination, Episodic Memory Test, Symbol-Letter Modalities Test and National Adult Reading Test. Informants also completed the Informant Questionnaire on Cognitive Decline in the Elderly. Dementia was diagnosed by the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised (DSM-III-R) and ICD-10 criteria using the Canberra Interview for the Elderly. RESULTS: Cross-sectional analysis of the wave 1 data showed that the realistic occupations, which include trade, technical and some service occupations, had poorer cognitive performance and a higher prevalence of DSM-III-R dementia. These differences held even when age, education and native English were statistically controlled. The greatest occupational difference was on the National Adult Reading Test, which estimates pre-morbid ability. By contrast, there were no occupational differences in longitudinal change in cognitive test performance, informant reports of cognitive decline or incident cases of dementia over three and a half years. CONCLUSION: Cross-sectional occupational differences on cognitive tests and in dementia prevalence are due to differences in pre-morbid ability rather than to differences in rate of cognitive decline.

Aged↗
PubMed1998

Predictors of GP service use: a community survey of an elderly Australian sample.

As part of a study of an elderly community-dwelling Australian population, predictors of general practitioner (GP) service use were identified. The sample of 897 persons, aged 70 years or older and living in Canberra and Queanbeyan, were interviewed about their health and well-being. Data on the number of GP visits in the following 12-month period were obtained from the Health Insurance Commission. There were important gender differences in the prediction of both contact and volume of service use. Need variables (physical health in men, and disability and anxiety in women) were the most important predictors. Men who were older or who had lower occupational status used more medical services, as did women with less education or higher levels of extraversion. Men with lower social support were less likely to contact a GP, but social support was not related to volume of service use for either men or women. Since at most 21% of the variance in the volume of GP service use could be explained, despite the wide range of predictors considered and the different statistical approaches adopted, better measures of service use and predictors need to be developed.

Activities of Daily Living↗
PubMed1997

Impact of pet ownership on elderly Australians' use of medical services: an analysis using Medicare data.

OBJECTIVES: To determine whether pet ownership by elderly people is associated with lower use of health services. DESIGN: Survey of physical and mental health, and retrospective 12-month review of Medicare records of the number of general practitioner and specialist services. PARTICIPANTS AND SETTING: Elderly people living in Canberra (Australian Capital Territory) and Queanbeyan (New South Wales), surveyed in 1994 for the second stage of a larger longitudinal study. RESULTS: Elderly pet owners did not differ from non-owners on any of the physical or mental health measures or in use of health services. CONCLUSION: Given the high use of health services by older people, our findings suggest that the claim that pet ownership leads to savings in health services should be viewed with caution.

Aged↗
PubMed1997

"Mental health literacy": a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment.

OBJECTIVES: To assess the public's recognition of mental disorders and their beliefs about the effectiveness of various treatments ("mental health literacy"). DESIGN: A cross-sectional survey, in 1995, with structured interviews using vignettes of a person with either depression or schizophrenia. PARTICIPANTS: A representative national sample of 2031 individuals aged 18-74 years; 1010 participants were questioned about the depression vignette and 1021 about the schizophrenia vignette. RESULTS: Most of the participants recognised the presence of some sort of mental disorder: 72% for the depression vignette (correctly labelled as depression by 39%) and 84% for the schizophrenia vignette (correctly labelled by 27%). When various people were rated as likely to be helpful or harmful for the person described in the vignette for depression, general practitioners (83%) and counsellors (74%) were most often rated as helpful, with psychiatrists (51%) and psychologists (49%) less so. Corresponding data for the schizophrenia vignette were: counsellors (81%), GPs (74%), psychiatrists (71%) and psychologists (62%). Many standard psychiatric treatments (antidepressants, antipsychotics, electroconvulsive therapy, admission to a psychiatric ward) were more often rated as harmful than helpful, and some nonstandard treatments were rated highly (increased physical or social activity, relaxation and stress management, reading about people with similar problems). Vitamins and special diets were more often rated as helpful than were antidepressants and antipsychotics. CONCLUSION: If mental disorders are to be recognised early in the community and appropriate intervention sought, the level of mental health literacy needs to be raised. Further, public understanding of psychiatric treatments can be considerably improved.

Adolescent↗
PubMed1997

GP attendance by elderly Australians: evidence for unmet need in elderly men.

OBJECTIVES: To examine GP service use by elderly people and, in particular, to compare those who had not consulted a GP in one year with those who were low attenders and those who were high attenders. DESIGN: Medicare data on GP service use were matched to data collected by interview in 1990-1991 and reinterview in 1994 as part of a community study on health and well-being. SETTING: Canberra and Queanbeyan in the Australian Capital Territory. PARTICIPANTS: People aged 70 years and over, living in the community. MAIN OUTCOME MEASURES: The number of visits made to a GP in 12 months. RESULTS: Medicare data were available for 624 of the 897 participants interviewed (70%). While the women non-attenders reported similar levels of physical illness and symptoms to the low attenders, men non-attenders reported significantly higher levels of illness (P < 0.01) than the low-attender group. The health of men who were non-attenders was very similar to men who were high attenders of GP services. Men who had not seen a GP in one year reported significantly more pain (P = 0.002) and less social support than both low attenders and high attenders (P = 0.012 and P = 0.049, respectively). CONCLUSION: We identified a group of men who had not attended a GP in one year, despite significant levels of morbidity. Such a group may benefit from consultation with a GP and could be targeted in any attempt to improve elderly men's health.

Aged↗
PubMed1997

Education and decline in cognitive performance: compensatory but not protective.

The association between education and cognitive change was investigated in a large community sample of elderly people followed up after 3.6 years. Lower education was predictive of decline on the Mini-Mental State Examination (MMSE) and on tests of language and knowledge, but not on tests of cognitive speed, memory or reaction time. The effects of education were not attenuated when adjusted for health, disability or activity level. The findings suggest that education slows the rate of decline on crystallized intelligence, but not other cognitive abilities. Education may compensate for neurodegenerative changes rather than protect against them.

Activities of Daily Living↗
PubMed1997

Belief systems of the general public concerning the appropriate treatments for mental disorders.

A study was conducted to assess the belief systems of the general public concerning the appropriate treatments for mental disorders and correlates of these belief systems. The study was based on the results of a household survey of the general public in Australia, using a national random sample of 2,031 adults aged 18-74 years. Respondents were given a vignette describing either a person with depression or one with schizophrenia, and were asked for their opinions about the helpfulness of various professional and non-professional treatments for the person described. A principal components analysis of the helpfulness ratings gave three factors: a Medical factor with high loadings on all drug treatments (except Vitamins) and on Psychiatric ward and ECT; a Psychological factor with high loadings on Counsellor, Social Worker, Phone counselling, Psychiatrist, Psychologist, Psychotherapy and Hypnosis; and a Lifestyle factor with high loadings on Close family, Close friends, Naturopath, Vitamins, Physical activity and Get out more. The same factors emerged from ratings of the two vignettes. Mean scores on scales constructed from the items with high loadings showed that the public tend to have a negative view of medical treatments and a positive view of psychological and lifestyle ones. However, medical treatments were rated more negatively for depression than for schizophrenia, psychological treatments were rated more positively for schizophrenia, and lifestyle treatments more positively for depression. Age, sex and education of respondents showed few associations with scores on the scales, although the better educated were more in favour of psychological treatments for both depression and schizophrenia and were less opposed to medical treatments for schizophrenia. Respondents who had suffered from the symptoms described in the schizophrenia vignette were more negative towards medical treatments. These findings about public belief systems could have implications for the provision of treatment: where there is a discrepancy in belief system between the patient and the clinician there may be poor adherence to treatment.

Adolescent↗
PubMed1997

Public beliefs about causes and risk factors for depression and schizophrenia.

The objective of this study was to carry out a national survey to assess the Australian public's beliefs about causes and risk factors for mental disorders. A national household survey of 2,031 Australian adults was carried out. Half the respondents were presented with a vignette describing a person with major depression and the other half with a vignette describing schizophrenia. Respondents were asked to rate whether various factors are likely causes of problems such as that described in the vignette and to rate whether various groups are at higher or lower risk. For depression, social environmental factors were often seen as likely causes, which is consistent with the epidemiological evidence. However, genetic factors were considered as a likely cause by only half the population. For schizophrenia, social environmental factors were also often seen as causes, which is in contrast to the weak epidemiological evidence for such a role. Genetic factors attracted more support as a cause of schizophrenia than of depression. These findings point to areas where the mental health literacy of the population could be improved, particularly the over-emphasis on social environmental factors in schizophrenia. Of some concern was the belief of half the population that weakness of character is a likely cause of both depression and schizophrenia. This belief implies a negative evaluation of the sufferer as a person.

Adult↗
PubMed1997

The course of depression in the elderly: a longitudinal community-based study in Australia.

BACKGROUND: We report the outcome of depressive states after 3-4 years in a community sample of the elderly. METHODS: A sample of 1045 persons aged 70+ years in 1990-1 was re-interviewed after 3.6 years. RESULTS: Mortality (21.7%) and refusal or non-availability (10.4%) were higher in those who initially had had a diagnosis or symptoms of depression. Of those with an ICD-10 depressive episode in 1990-1, 13% retained that diagnosis. Of those who were not depressed initially only 2.5% had become cases. Depression was unrelated to age or apolipoprotein E genotype. The best predictors of the number of depressive symptoms at follow-up was the number at Wave 1, followed by deterioration in health and in activities of daily living, high neuroticism, poor current health, poor social support, low current activity levels and high service use. Depressive symptoms at Wave 1 did not predict subsequent cognitive decline or dementia. CONCLUSIONS: Non-random sample attrition is unavoidable. ICD-10 criteria yield more cases than other systems, while continuous measures of symptoms confer analytical advantages. Risk factors for depressive states in the elderly have been further identified. The prognosis for these states is favourable. At the community level, depressive symptoms do not seem to predict cognitive decline, as they do in referred series.

Activities of Daily Living↗