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Biomedical subjects

C Hooijer

Publications and source records attributed to C Hooijer.

At least 19 recordsLinked to original sources
PubMed1998

Apolipoprotein E phenotype is not related to late-life depression in a population-based sample.

Apolipoprotein E (ApoE) allele frequencies were examined in a population-based sample (n = 475: age range 65-84 years: Amsterdam Study of the Elderly). The relation of ApoE epsilon 4 with dementia and with various types of late-life depression was studied. Depression was measured with the Geriatric Mental State schedule. Dementia was diagnosed by DSM-III-R criteria. It was expected that ApoE epsilon 4 allele frequencies would be elevated not only in Alzheimer's disease and dementia in general, but also in first episode, late-life depression accompanied by subtle cognitive impairment (possibly organic depression). However, the results indicated that epsilon 4 allele frequency is related to (family history of) dementia and cognitive impairment, but not to possibly organic depression. The main predictor of late-life depression is an episode of psychiatric problems before the age of 65 years.

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PubMed1997

Low education is a genuine risk factor for accelerated memory decline and dementia.

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 levels 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.

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PubMed1996

Memory complaints and memory impairment in older individuals.

OBJECTIVE: To examine whether subjective memory complaints, measured with a series of four questions, are associated with performance on cognitive tests. DESIGN: Cross-sectional study of individuals, 65 to 85 years of age, who lived in the community of Amsterdam. PARTICIPANTS: Individuals were selected randomly within 5-year age strata from the patient lists of 30 general practitioners. Of the 4051 participants, 2537 nondepressed and nondemented respondents were included in the analysis. MEASURES: Four categories of subjective memory complaints were developed on the basis of answers to questions about the presence or absence of memory complaints and memory-related problems in daily functioning. Tests of cognitive function were derived from the subscales of the CAMCOG. MAIN RESULTS: Individuals with complaints and memory-related problems performed more poorly on tests of memory and memory-related functions. This relationship was strengthened after adjusting for age, sex, and premorbid verbal intelligence, all of which were related to complaint status and to performance on cognitive tests. CONCLUSION: Simple questions about memory function are related to memory performance in nondepressed, nondemented community-dwelling older people. Subjective memory complaints may be a promising indicator of memory impairment that signals the need for follow-up.

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PubMed1996

Subjective memory complaints may announce dementia.

Whether subjective memory complaints in the absence of objective memory decline can predict future dementia has been investigated only in highly selected clinical and volunteer cohorts. Our study examines this question in a subsample of AMSTEL (Amsterdam Study of the Elderly), a longitudinal population study on cognitive decline and dementia. Subjects (aged 65 to 84 years; n = 357) without dementia or other psychiatric disorders at baseline were followed for 3 years. After this interval, 16 of 203 re-examined patients developed a dementia. Logistic regression analyses indicated that memory complaints at baseline contributed a small but significant amount of diagnostic information. However, the most powerful predictor of future dementia was deficient memory performance. We conclude that subjective memory complaints may predict dementia within 3 years, particularly when there are objective signs of memory deterioration.

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PubMed1996

[Item series of the cognitive screening test compared to those of the mini-mental status examination].

The items of the ¿mini-mental state examination' (MMSE) and a Dutch dementia screening instrument, the ¿cognitive screening test' (CST), as well as the ¿geriatric mental status schedule' (GMS) and the ¿Dutch adult reading test' (DART), were administered to 4051 elderly people aged 65 to 84 years. This study was part of the Amsterdam Study of the Elderly (AMSTEL-project), which is a population survey of cognitive decline and dementia. Based on the item-pool, CST and MMSE scores were calculated. Both tests were comparable as far as their validity as dementia screeners is concerned (dementia criterion was GMS Organic syndrome, cut-point 2/3). The abbreviated version of the CST (CST-14) has a somewhat lower validity. The reliabilities of the unabbreviated CST (CST-20) and the MMSE are also comparable. The influence of age, education, depression, and premorbid intelligence (DART-IQ) was most notable in the MMSE. Thus, the CST-20 item set has slightly better psychometric properties than the MMSE. A figure is presented by which CST scores can be transformed into MMSE scores.

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PubMed1995

Major and minor depression in later life: a study of prevalence and risk factors.

In this paper, the results of a community-based study into the prevalence and risk factors associated with depression in the older (55-85 years) population of The Netherlands are presented. The prevalence of major depression was 2.02%, that of minor depression 12.9%, while 14.9% had clinically relevant levels of depressive symptoms. Associations with a comprehensive set of risk factors were not affected dramatically by age or sex. However, comparing major to minor depression, risks were substantially differently distributed. It appears that major depression is more often an exacerbation of a chronic mood disturbance, with roots in long-standing vulnerability factors; while minor depression is more often a reaction to the stresses commonly experienced in later life.

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PubMed1995

Late-life depressive disorder in the community, early onset and the decrease of vulnerability with increasing age.

This study examined reports of a history of psychiatric illness related to age and depression in 4051 community residents aged 65-84. Depression was twice as common among subjects with a history of psychiatric illness before age 65. 78% of depressed subjects reported no history. The rate of reported history was inversely proportionate to the subjects actual age. This did not appear to be due to recollection bias but it did match the proportions previously reported to result from excess mortality of individuals with a psychiatric history. A psychiatric history may be an important risk factor for late-life depression but in the aging process after age 65 it may become increasingly uncommon.

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PubMed1995

The prevalence of depression in elderly medical inpatients.

To estimate the point-prevalence of major depression in elderly medical inpatients according to a computerized diagnostic system, a two-phase design was carried out. A consecutive series of 198 elderly medical inpatients completed two self-rating scales for depression (Beck Depression Inventory, Geriatric Depression Scale) and the Mini-Mental State Examination. According to these screening instruments, 69 'probable cases' were identified and were referred for psychiatric evaluation using the Geriatric Mental State Schedule. Only 10 patients were identified as diagnostic cases of depression according to the GMS-AGECAT package. The estimated prevalence rate for depression according to AGECAT in this population was 5.9% (95% confidence limits 2.3-9.3%). This is lower than has been found in previous studies in elderly medical inpatients. Possible reasons for this finding are discussed.

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PubMed1995

Relation between education and dementia: the role of test bias revisited.

Several authors have suggested that dementia screening tests may be biased against low levels of education, whereas others find that a low level of education is a genuine risk factor for dementia. The present paper attempts to reconcile these conflicting views by examining item bias and test bias indices of the mini mental state examination (MMSE). Psychometric calculations and receiver operating characteristics (ROC) analyses of sensitivity and specificity as performed by earlier studies were replicated and extended from the database of the Amsterdam Study of the Elderly. This is a population survey on cognitive decline and dementia (age range 65-84). Subjects with a low level of education (primary school) were compared with better educated subjects (at least some secondary education). Cases were matched by age and sex. The results indicate that the MMSE is not educationally biased as far as item characteristics, reliability, and construct validity are concerned. Yet its predictive validity as a screening test for dementia is educationally biased. This bias will effectively be eliminated with a two point higher cut off score for the subjects whose education extends beyond primary school. Even after such score correction, a low level of education probably remains a genuine risk factor for dementia.

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PubMed1995

Late-life depressive disorder in the community. I. The relationship between MMSE score and depression in subjects with and without psychiatric history.

BACKGROUND: In previous studies cognitive impairment in depressed elderly in-patients tends to be associated with a late onset of depression. This study tests the hypothesis that cognitive impairment is associated with depression only in elderly individuals with no history of psychiatric illness. METHOD: We investigated an age-stratified sample of 4051 elderly people living in the community, aged between 65 and 84 (AMSTEL). The relationship between depression (GMS-AGECAT diagnosis) and scores on the Mini Mental State Examination was studied in subjects with and without a reported psychiatric history (CAMDEX questionnaire). RESULTS: Low MMSE scores (MMSE < or = 25) were only associated with depression in subjects with no psychiatric history (young/old: OR = 2.75, 95% CI = 1.83, 4.19; old/old: OR = 2.21, 95% CI = 1.61, 3.03). CONCLUSIONS: We concluded that the combination of cognitive impairment and first-episode depression in elderly individuals may indicate cerebral deterioration. Depression as such may not be associated with cognitive impairment.

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PubMed1995

Late-life depressive disorder in the community. II. The relationship between psychiatric history, MMSE and family history.

BACKGROUND: In previous studies, dementia was linked to a family history of dementia and Down's syndrome. This study tested the hypothesis that late-life depression accompanied by cognitive impairment in elderly individuals with no history of psychiatric illness is also associated with these family histories. METHOD: We investigated an age-stratified sample of 4051 elderly people in the community aged 65-84 (AMSTEL). The relationship between family history (CAMDEX questionnaire) and depression (GMS-AGECAT diagnosis) was studied. RESULTS: A family history of mental health problems was associated with all subtypes of depression. Family history of dementia was associated with depression in subjects with a psychiatric history, but a family history of Down's syndrome was only associated with the combination of depression and cognitive impairment in subjects with no history of psychiatric illness. CONCLUSIONS: The heritability pattern confirms the concept of a dementia-related subtype of late-life depression.

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PubMed1994

[Low serum vitamin B 12 level and vitamin B 12 deficiency in the elderly. When should supplement be provided?].

Low serum vitamin B12 levels and vitamin B12 deficiencies are frequently found in the elderly. The full syndrome of a vitamin B12 deficiency is rather simple to diagnose. The large applicability of the vitamin B12 assay also gives rise to many probably incomplete features. Low/low-normal vitamin B12 levels in screening procedures raise uncertainty whether this finding represents deficiency and should be followed by supplementation. In this paper the occurrence of low serum levels of vitamin B12 are discussed. To assess the clinical relevance of low/low-normal outcomes supplementary diagnostic procedures will be needed. Within this scope we illustrate the d.o.s.-test and the MMA-assay. Especially the latter will probably provide more answers to the treatment question. Systematic research is needed to clarify this issue. Meanwhile supplementation of all low and low-normal outcomes of the B12-assay seems the best answer.

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PubMed1993

Are age and education independent correlates of the Mini-Mental State Exam performance of community-dwelling elderly?

We examined the effects of selected health conditions and sensory functions, socioeconomic status, age, and education on cognitive functioning in 3,974 community-dwelling individuals aged 65-84 years. Logistic regression analysis was used to examine the independent and joint effects of these variables on borderline (Mini-Mental State Exam [MMSE] of 22-25) and poor (MMSE of < or = 21) functioning relative to adequate functioning (MMSE of 26-30). The effect of age and of education on MMSE performance was relatively stable, even after adjusting for age- and education-related health conditions and sensory impairments that also influenced level of cognitive functioning. These conditions included poor vision, Parkinson's disease, diabetes, depression, stroke (in 65-74-year-olds), and low socioeconomic status (in 75-84-year-olds). Education did not modify the effect of these variables on MMSE performance. Additional studies elucidating further the mechanisms that relate these sociodemographic factors to cognitive performance are warranted, as are studies of the relationship between these factors and the incidence of cognitive impairment.

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PubMed1991

[Validity of the cognitive screening tests and the mini-mental status examination in a group of elderly hospital patients].

OBJECTIVE: To study the validity of the cognitive screening test (CST) and of the mini-mental state examination (MMS). DESIGN: Prospective administration of both CST and MMS (in balanced order) by laymen as well as by experienced users, and retrospective comparison of the scores with the clinical diagnosis and with the degree of functioning in activities of everyday life. SETTING: Clinical and outpatient departments of Geriatrics and Neurology of the Slotervaart Hospital, Amsterdam. PATIENTS AND METHOD: Ninety-five patients of the clinical and nine patients of the outpatient departments, with an acute somatic diagnostic problem and multiple pathology attending the above-named departments in the period from September 1989 to February 1990: 20 patients (group SOM) were found not to have a dementia syndrome; 25 patients (group DEM) had a dementia syndrome as the main diagnosis; 14 patients (group CVA) had a cerebrovascular accident as the main diagnosis without clinical signs of dementia; 45 patients were excluded from the comparison (30 because of main diagnosis from several groups and 15 because of pathology that might influence the test scores to an unpredictable degree). The data were analysed statistically by means of analyses of confidence and of variance. RESULTS: The CST was found to be more reliable and less time-consuming than the MMS. The sensitivities of the two tests with regard to the distinction between dementia and somatic pathology were similar (80%). However, specificity of the CST was better than that of the MMS (80% and 60%, respectively). CONCLUSION: For the screening of older patients for dementia, the CST constitutes a good alternative to the MMS.

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PubMed1990

Reliability, validity and follow-up of the EEG in senile dementia: sequelae of sequential measurement.

In a longitudinal study, slowing of the EEG in SDAT patients and elderly controls is investigated using both visual and power spectral analyses. For this a reliability study in 20 SDAT patients is performed and results for intra-rater, inter-rater and test-retest reliability (in 24 h) are used in the selection of parameters. Next, the diagnostic efficacy of the chosen parameters for SDAT is confirmed in a validity study in 43 SDAT patients, 41 elderly non-organic psychiatric patients and 51 elderly normals. In the longitudinal study 78 of these subjects could be retested after 20 months. The parameter for visual analysis appeared to be superior in actually showing a progress of slowing of the EEG in 20/21 SDAT patients over time. The parameter for power spectral analysis was superior in measuring the more subtle processes in the normal elderly. Results of these studies are used to discuss some problems in the measurement of EEG in SDAT over time.

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PubMed1988

[The Geriatric Mental Status Schedule, the GMS: psychiatric tool in psychogeriatrics].

An instrument in geriatric psychiatry, the GMS, is introduced. The use of measurement in psychiatry is briefly touched upon. The use of standardized interview like the GMS mainly serves differential diagnosis in psychiatry. The essence of this method is that questions and the appraisal of answers are submitted to rules and regulations. The application of this method in geriatric psychiatry is still in its infancy. The history of the GMS and the choice of maternal instruments following international consensus is described. In former investigations results of reliability and validity studies were satisfactory. In our own Dutch investigation reliability and validity in the (differential) diagnosis of senile dementia were consistent with those of previous studies. Some claims and restrictions in the application of the instrument are discussed.

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PubMed1987

Anterior temporal focal abnormalities in EEG in normal aged subjects; correlations with psychopathological and CT brain scan findings.

Normal aged subjects (65-83 years) were examined by EEG and CT brain scan; also a Geriatric Mental Scale (GMS) and Neuropsychologic Assessment Battery were administered. Based on the EEG findings 2 subgroups could be distinguished: one with focal abnormalities in the left fronto-temporal region and one without these focal abnormalities. The focal delta subgroup proved to perform poorly on the Fluency Test, a simple quick bedside, but very sensitive, test for word association productivity. Also this subgroup showed more ventricular dilatation than the non-focal group. Therefore slight left-sided antero-temporal abnormalities in normal aged subjects are not irrelevant but an early (subclinical) sign of temporal lobe pathology as expressed in deterioration of language function.

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