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G A Kaplan

Publications and source records attributed to G A Kaplan.

At least 19 recordsLinked to original sources
PubMed2006

Low maximal oxygen uptake is associated with elevated depressive symptoms in middle-aged men.

A low level of physical activity has been associated with depression, and increased physical activity has been found to have a positive effect on mood. However, the association between maximal oxygen uptake (VO(2max)) and mood has been poorly studied. In this study VO(2max) (ml/kg per min) was measured in a sample of 1,519 men aged 46-61 years during a cycle ergometer test by using respiratory gas exchange. Men with a history of psychiatric disorder or serious physical illness were excluded. Depressive symptoms were assessed using the 18-item Human Population Laboratory Depression Scale (HPL). Those who scored 5 or more in the HPL were considered to have elevated depressive symptoms. The participants were classified into quartiles according to the VO(2max). Those in the lowest quartile had a more than 3-fold (OR: 3.42; 95% CI: 1.65-7.09; p < 0.001) higher risk of having elevated depressive symptoms compared with those in the highest quartile, even after adjusting for several confounders (OR: 3.38; 95% CI: 1.60-7.14; p < 0.001). In conclusion, low VO(2max) is associated with having elevated depressive symptoms in middle-aged men.

Depression↗
PubMed2005

Homocysteine as a risk factor for CVD mortality in men with other CVD risk factors: the Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study.

OBJECTIVE: Based on case-control and prospective studies elevated blood total homocysteine (tHcy) has been suggested to be an independent risk factor for cardiovascular diseases (CVD). The purpose of the study was to explore the joint effect of increased serum tHcy concentration and other risk factors on the risk of CVD mortality in middle-aged men without a history of heart disease or stroke. DESIGN: A prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study. SETTING: Eastern Finland. Subjects. A total of 802 men aged 46-64 years, examined in 1991-93. MAIN OUTCOME MEASURES: CVD mortality event. RESULTS: The mean serum tHcy concentration was 10.8 micromol L(-1) (SD 3.3). During the average follow-up time of 10.8 years 50 men experienced a CVD death. The hazard rate ratio for CVD mortality was 1.80 (95% confidence interval: 1.02-3.19) in men in the highest serum tHcy third versus lower thirds after adjustment for cardiovascular risk factors. Furthermore, elevated serum tHcy concentration appeared to increase the risk of CVD death in men who smoke or who have high circulating concentrations of serum total or LDL cholesterol, apo-B apolipoprotein or plasma fibrinogen. CONCLUSION: We conclude that homocysteine may increase the risk of CVD mortality in middle-aged men from Eastern Finland, and it may especially increase the risk when present with other risk factors for CVD.

Biomarkers↗
PubMed2005

Depression and early retirement: prospective population based study in middle aged men.

BACKGROUND: Mental depression is an important health problem in many countries. It reduces productivity at work and is the fastest increasing reason for early retirement. METHODS: This study followed up a Finnish cohort of 1726 men from 1984 to 2000. Depression was assessed at baseline by HPL depression score. Pension records were obtained from the national pension registers. Cox's regression analysis was used to estimate the associations of depression with the risk of all disability pensions combined, separately for different causes of disability, and non-illness based pension. RESULTS: During the follow up, 839 men (48.6%) received a disability pension. A total of 142 men (16.9% of all disability pensions) retired because of mental disorder and of these, 75 (52.8%) because of depression. After adjustment for the potential confounders, men in the highest third of depression score had an increased risk of non-illness based pension (RR 1.86 95% CI 1.37 to 2.51) and disability pension attributable to mental disorders (RR 2.74, 95% CI 1.68 to 4.46), chronic somatic diseases (RR 1.68, 95% CI 1.05 to 2.71), cardiovascular diseases (RR 1.61, 95% CI 1.12 to 2.32). The mean age of retirement for men with a high and low depression score was 57.6 years (SD 3.87) and 59.1 years (SD 3.65) (p<0.001) respectively. CONCLUSIONS: A high depression score predicted disability attributable to any cause, especially mental disorders, and non-illness based pensions. Depressed people retired on average 1.5 years younger than those without depression. Further studies are needed to elucidate the pathways of how mental depression leads people to seek retirement pension.

Adult↗
PubMed2003

Prospective association between obesity and depression: evidence from the Alameda County Study.

OBJECTIVE: To examine the temporal relation between obesity and depression to determine if each constitutes a risk factor for the other. DESIGN: A two-wave, 5-y-observational study with all measures at both times. SUBJECTS: A total of 2123 subjects, 50 y of age and older, who participated in the 1994 and 1999 waves of the Alameda County Study. MEASUREMENTS: Obesity defined as body mass index (BMI)> or =30. Depression assessed using DSM-IV symptom criteria for major depressive episodes. Covariates include indicators of age, gender, education, marital status, social support, life events, physical health problems, and functional limitations. RESULTS: Obesity at baseline was associated with increased risk of depression 5 y later, even after controlling for depression at baseline and an array of covariates. The reverse was not true; depression did not increase the risk of future obesity. CONCLUSION: These results, the first ever on reciprocal effects between obesity and depression, add to a growing body of evidence concerning the adverse effects of obesity on mental health. More studies are needed on the relation between obesity and mental health and implications for prevention and treatment.

Aged↗
PubMed2002

Obesity and weight gain are associated with increased incidence of hyperinsulinemia in non-diabetic men.

We investigated the temporal relationships between obesity, weight change and hyperinsulinemia in a population-based 4-year follow-up study of 695 middle-aged, non-diabetic, and normoinsulinemic men. Thirty-eight men developed hyperinsulinemia during the follow-up (fasting serum insulin > or = 12.0 mU/l). In logistic regression analysis adjusting for other risk factors, men with body mass index of > or = 26.7 kg/m2 (highest third) had a 6.6-fold (p = 0.001) risk of developing hyperinsulinemia, compared with men with body mass index of < 24.4 kg/m2 (lowest third). Correspondingly, men with waist-to-hip ratio of > or = 0.95 (highest third) had a 3.5-fold (p = 0.028) incidence of hyperinsulinemia compared with men with waist-to-hip ratio of < 0.90 (lowest third). Weight gain in middle age and weight gain from the age of 20 years to middle age were also associated with increased risk of hyperinsulinemia. Hyperinsulinemia at baseline was not associated with weight gain during the follow-up. This prospective population-based study emphasizes the importance of avoiding obesity and weight gain during adulthood in preventing hyperinsulinemia.

Adult↗
PubMed2001

Psychosocial predictors of hypertension in men and women.

BACKGROUND: Psychosocial stressors have been shown to predict hypertension in several cohort studies; patterns of importance, sex differences, and interactions with standard risk factors have not been fully characterized. METHODS: Among 2357 adults in a population sample of Alameda County, California, free of hypertension in 1974, 637 reported in 1994 having ever used antihypertensive medication (27.9% of the men and 26.3% of the women). The effects of baseline psychosocial, behavioral, and sociodemographic factors on the incidence of treated hypertension were examined using multiple logistic regression. RESULTS: Low education, African American race, low occupational prestige, worry about job stability, feeling less than very good at one's job, social alienation, and depressive symptoms each had significant (P<.05) age-adjusted associations with incident hypertension. Associations were weakened by adjustment for body mass index, alcohol consumption, smoking status, and leisure time physical activity, especially the associations of anomy and depression, which persisted in women but not in men. In multivariate models, job insecurity (odds ratio, 1.6), unemployment (odds ratio, 2.7), and low self-reported job performance (odds ratio, 2.1) remained independent predictors of hypertension in men, whereas low-status work (odds ratio, 1.3) was an independent predictor of hypertension in women. CONCLUSIONS: In the general population, low occupational status and performance and the threat or reality of unemployment increase the likelihood of developing hypertension, especially among men, independent of demographic and behavioral risk factors. Psychological distress and social alienation may also increase hypertension incidence, especially in women, chiefly through an association with health risk behaviors.

Adult↗
PubMed2001

Abdominal obesity is associated with accelerated progression of carotid atherosclerosis in men.

Abdominal obesity increases the risk of clinical atherosclerotic diseases, but whether it accelerates the progression of preclinical atherosclerosis is unknown. We studied whether waist-to-hip ratio (WHR) and waist circumference are associated with 4-year increase in indicators of common carotid atherosclerosis, assessed by B-mode ultrasonography, in 774 Finnish men aged 42-60 years without atherosclerotic diseases. Men with WHR of <0.91, 0.91-0.96 and >0.96 (thirds) had increase in maximal intima-media thickness (IMT) of 0.230, 0.255 and 0.281 mm/4 years (P=0.007 for linear trend; P=0.025 for difference) and plaque height of 0.241, 0.254 and 0.291 mm/4 years (P=0.005, P=0.013) adjusting for age, body mass index and technical covariates. Men with waist circumference of <85, 85-93 and >93 cm (thirds) had increase in maximal IMT of 0.227, 0.251 and 0.290 mm/4 years (P=0.011, P=0.035) and plaque height of 0.229, 0.263 and 0.296 mm/4 years (P=0.003, P=0.013). These associations were stronger in men with high (> or =3.8 mmol/l) than lower serum LDL cholesterol (P<0.05 for interaction). This is the first documentation that abdominal obesity is associated with accelerated progression of atherosclerosis, and supports the view that it is an important cardiovascular risk factor. This study emphasizes the role of avoiding abdominal obesity to prevent atherosclerotic diseases.

Abdomen↗
PubMed2001

Cardiorespiratory fitness and the progression of carotid atherosclerosis in middle-aged men.

BACKGROUND: Good cardiorespiratory fitness has been associated with reduced risk for clinical events of atherosclerotic vascular diseases, but whether it is related to slower progression of early atherosclerosis is unclear. OBJECTIVE: To study the association between cardiorespiratory fitness and the progression of early carotid atherosclerosis. DESIGN: 4-year follow-up study. SETTING: Eastem Finland. PARTICIPANTS: Population-based sample of 854 men 42 to 60 years of age. MEASUREMENTS: Maximal oxygen uptake (VO2max [mL/kg per minute]) was measured directly by using respiratory gas exchange in a cycle ergometer exercise test. Carotid atherosclerosis was assessed by using B-mode ultrasonography. RESULTS: After adjustments for age, technical covariates, and cigarette smoking, VO2max had strong, inverse, and graded associations with 4-year increases in maximal intima-media thickness (IMT) (standardized regression coefficient beta = -0.120; P = 0.002), plaque height (beta = -0.140; P < 0.001), surface roughness (beta = -0.147; P < 0.001), and mean IMT (beta = -0.080; P = 0.035). These associations weakened but remained statistically significant after additional adjustment for systolic blood pressure, serum levels of apolipoprotein B, diabetes, and plasma fibrinogen levels. The increases in maximal IMT, surface roughness, and mean IMT (23%, 31%, and 100%, respectively) were larger among men in the lowest quartile of VO2max (<26.1 mL/kg per minute) than among those in the highest quartile (>36.2 mL/kg per minute). CONCLUSIONS: Good cardiorespiratory fitness is associated with slower progression of early atherosclerosis in middle-aged men. These findings are important because they emphasize that middle-aged men can be evaluated for cardiorespiratory fitness to estimate their future risk for atherosclerotic vascular diseases. Additional research is warranted to investigate a possible causal relationship between cardiorespiratory fitness and atherosclerosis.

Adult↗
PubMed2001

Associations between apolipoprotein E phenotype, glucose metabolism and cognitive function in men. An explorative study in a population sample.

AIMS: To investigate the associations of the apolipoprotein E phenotype (apoE) and disturbed glucose metabolism with cognitive function in a random population sample. METHODS: A cross-sectional study was conducted, in which 528 men aged 54 or 60 years were recruited randomly from a larger population-based sample of 1516 men. A subject was defined as having abnormal glucose tolerance (AGT), if he had a clinical diagnosis of diabetes, with either dietary or oral antidiabetic treatment or showed impaired glucose tolerance in an oral glucose tolerance test. The subjects were divided into three groups according to apolipoprotein E phenotypes: (a) E2/4, E3/4 or E4/4 (apoE E4); (b) E 3/3 (apoE E3); and (c) E2/2 or E2/3 (apoE E2). Memory function was examined using a word-list learning with Buschke's selective reminding method and test. Executive functions were assessed with the Trail Making Test A and B. RESULTS: Those subjects with apoE E2 and abnormal glucose metabolism demonstrated the worst cognitive executive control compared to other groups. Simple cognitive speed did not differ between the groups. CONCLUSIONS: The exploratory analyses revealed that subjects with apoE E2 allele and AGT had worse glycaemic control and cognitive executive control compared to other groups. Different apolipoprotein phenotypes together with impaired glucose tolerance may have different cumulative adverse effects on age-related cognitive performance. Some subgroups of subjects may be especially vulnerable to cognitive impairment.

Apolipoprotein E3↗
PubMed2001

Comparative impact of hearing and vision impairment on subsequent functioning.

OBJECTIVES: The purpose of this study was to compare independent impacts of two levels of self-reported hearing and vision impairment on subsequent disability, physical functioning, mental health, and social functioning. DESIGN: A 1-year prospective cohort study. SETTING: San Francisco Bay Area, California. PARTICIPANTS: Two thousand four hundred forty-two community-dwelling men and women age 50 to 102 from the Alameda County Study (California). MEASUREMENTS: Hearing and vision impairment were assessed in 1994. Outcomes, measured in 1995, included physical disability (activities of daily living, instrumental activities of daily living, physical performance, mobility, and lack of participation in activities), mental health (self-assessed, major depressive episode), and social functioning (feeling left out, feeling lonely, hard to feel close to others, inability to pay attention). All 1995 outcomes were adjusted for baseline 1994 values. RESULTS: Both impairments had strong independent impacts on subsequent functioning. Vision impairment exerted a more wide-ranging impact on functional status, ranging from physical disability to social functioning. However, the results also highlighted the importance of hearing impairment, even when mild. CONCLUSIONS: These impairments can be partially ameliorated through prevention, assessment, and treatment strategies. Greater attention to sensory impairments by clinicians, patients, public health advocates, and researchers is needed to enhance functioning in older adults.

Activities of Daily Living↗
PubMed2001

Low serum lycopene concentration is associated with an excess incidence of acute coronary events and stroke: the Kuopio Ischaemic Heart Disease Risk Factor Study.

A number of epidemiological studies have shown an association between beta-carotene and the risk of cardiovascular diseases, whereas only a few studies are available concerning the association of lycopene with the risk of coronary events, and no studies have been undertaken concerning lycopene and stroke. Thus, we tested the hypothesis that low serum levels of lycopene are associated with increased risk of acute coronary events and stroke in middle-aged men previously free of CHD and stroke. The subjects were 725 men aged 46-64 years examined in 1991-3 in the Kuopio Ischaemic Heart Disease Risk Factor Study. Forty-one men had either a fatal or a non-fatal acute coronary event or a stroke by December 1997. In a Cox' proportional hazard's model adjusting for examination years, age, systolic blood pressure and three nutritional factors (serum folate, beta-carotene and plasma vitamin C), men in the lowest quarter of serum lycopene levels (< or =0.07 micromol/l) had a 3.3-fold (95 % CI 1.7, 6.4, risk of acute coronary events or stroke compared with the others. Our study suggests that a low serum level of lycopene is associated with an increased risk of atherosclerotic vascular events in middle-aged men previously free of CHD and stroke.

Adult↗
PubMed2001

Childhood socioeconomic position and cognitive function in adulthood.

BACKGROUND: Risk of dementia and Alzheimer's disease is higher among adults with limited education, and the less educated perform poorer on cognitive function tests. This study determines whether the socioeconomic environment experienced during childhood has an impact on cognitive functioning in middle age. METHODS: A population-based study of eastern Finnish men (n = 496) aged 58 and 64 for whom there were data on parent's socioeconomic position (SEP), their own education level, and performance on neuropsychological tests. Cognitive function was measured using the Trail Making Test, the Selective Reminding Test, the Verbal Fluency Test, the Visual Reproduction Test, and the Mini Mental State Exam. RESULTS: We found a significant and graded association between parental SEP (combined as an index) and cognitive function both prior to and after adjustment for respondent's education. Those from more disadvantaged backgrounds exhibited the poorest performance. When the separate components of the parental SEP measure were used, father's occupation and mother's education were independently associated with the respondent's score for three and five of the tests, respectively (there was no association with father's education and mother's occupation). After adjustment for the respondent's education, father's occupation was no longer associated with respondent's test score, however, the results were essentially unchanged for mother's education. CONCLUSIONS: Higher SEP during childhood and greater educational attainment are both associated with cognitive function in adulthood, with mothers and fathers each contributing to their offspring's formative cognitive development and later life cognitive ability (albeit in different ways). Improvements in both parental socioeconomic circumstances and the educational attainment of their offspring could possibly enhance cognitive function and decrease risk of dementia later in life.

Adult↗
PubMed2001

Women's exposure to early and later life socioeconomic disadvantage and coronary heart disease risk: the Stockholm Female Coronary Risk Study.

BACKGROUND: Measures of low socioeconomic position have been associated with increased risk for coronary heart disease (CHD) among women. A more complete understanding of this association is gained when socioeconomic position is conceptualized from a life course perspective where socioeconomic position is measured both in early and later life. We examined various life course socioeconomic indicators in relation to CHD risk among women. METHODS: The Stockholm Female Coronary Risk Study is a population-based case-control study, in which 292 women with CHD aged < or =65 years and 292 age-matched controls were investigated using a wide range of socioeconomic, behavioural, psychosocial and physiological risk factors. Socioeconomic disadvantage in early life (large family size in childhood, being born last, low education), and in later life (housewife or blue-collar occupation at labour force entry, blue-collar occupation at examination, economic hardships prior to examination) was assessed. RESULTS: Exposure to early (OR = 2.65, 95% CI : 1.12-6.54) or later (OR = 5.38, 95% CI : 2.01-11.43) life socioeconomic disadvantage was associated with increased CHD risk as compared to not being exposed. After simultaneous adjustment for marital status and traditional CHD risk factors, early and later socioeconomic disadvantage, exposure to three instances of socioeconomic disadvantage in early life was associated with an increased CHD risk of 2.48 (95% CI : 0.90-6.83) as compared to not being exposed to any disadvantage. The corresponding adjusted risk associated with exposure to later life disadvantage was 3.22 (95% CI : 1.02-10.53). Further analyses did not show statistical evidence of interaction effects between early and later life exposures (P = 0.12), although being exposed to both resulted in a 4.2-fold (95% CI : 1.4-12.1) increased CHD risk. Exposure to cumulative socioeconomic disadvantage (combining both early and later life), across all stages in the life course showed strong, graded associations with CHD risk after adjusting for traditional CHD risk factors. Stratification of cumulative disadvantage by body height showed that exposure to more than three periods of cumulative socioeconomic disadvantage had a 1.7- (95% CI : 0.9-3.2) and 1.9- (95% CI : 1.0-7.7) fold increased CHD risk for taller and shorter women, respectively. The combination of both short stature and more than two periods of cumulative socioeconomic disadvantage resulted in a 4.4-fold (95% CI : 1.7-9.3) increased CHD risk. CONCLUSIONS: Both early and later exposure to socioeconomic disadvantage were associated with increased CHD risk in women. Later life exposure seems to be more harmful for women's cardiovascular health than early life exposure to socioeconomic disadvantage. However, being exposed to socioeconomic disadvantage in both early and later life magnified the risk for CHD in women. Cumulative exposure to socioeconomic disadvantage resulted in greater likelihood of CHD risk, even among women who were above median height. In terms of better understanding health inequalities among women, measures of socioeconomic disadvantage over the life course are both conceptually and empirically superior to using socioeconomic indicators from one point in time.

Adult↗
PubMed2001

Stress-induced blood pressure reactivity and incident stroke in middle-aged men.

BACKGROUND AND PURPOSE: Exaggerated blood pressure reactivity to stress is associated with atherosclerosis and hypertension, which are known stroke risk factors, but its relation to stroke is unknown. Previous work also indicates that the association between reactivity and cardiovascular diseases may be influenced by socioeconomic status. METHODS: The impact of blood pressure reactivity and socioeconomic status on incident stroke was examined in 2303 men (mean age, 52.8+/-5.1 years) from a population-based, longitudinal study of risk factors for ischemic heart disease in eastern FINLAND: Reactivity was calculated as the difference between blood pressure measured during the anticipatory phase of an exercise tolerance test (before exercise) and resting blood pressure, measured 1 week earlier. Mean systolic reactivity was 20 mm Hg (+/-15.9), and mean diastolic reactivity was 8.6 mm Hg (+/-8.5). Socioeconomic status was assessed as years of education. One hundred thirteen incident strokes (90 ischemic) occurred in 11.2 (+/-1.6) years of follow-up. RESULTS: Men with exaggerated systolic reactivity (>/=20 mm Hg) had 72% greater risk of any stroke (relative hazard ratio [RH], 1.72; 95% CI, 1.17 to 2.54) and 87% greater risk of ischemic stroke (RH, 1.87; 95% CI, 1.20 to 2.89) relative to less reactive men. Moreover, men who were high reactors and poorly educated were nearly 3 times more likely to suffer a stroke than better educated, less reactive men (RH, 2.90; 95% CI, 1.66 to 5.08). Adjustment for stroke risk factors had little impact on these associations. Diastolic reactivity was unrelated to stroke risk. CONCLUSIONS: Excessive sympathetic reactivity to stress may be etiologically important in stroke, especially ischemic strokes, and low socioeconomic status confers added risk.

Adult↗
PubMed2001

Religious attendance increases survival by improving and maintaining good health behaviors, mental health, and social relationships.

Several recent prospective analyses involving community-based populations have demonstrated a protective effect on survival for frequent attendance at religious services. How such involvement increases survival are unclear. To test the hypothesis that religious attendance might serve to improve and maintain good health behaviors, mental health, and social relationships, changes and consistencies in these variables were studied between 1965 and 1994 for 2,676 Alameda County Study participants, from 17 to 65 years of age in 1965, who survived to 1994. Measures included smoking, physical activity, alcohol consumption, medical checkups, depression, social interactions, and marital status. Those reporting weekly religious attendance in 1965 were more likely to both improve poor health behaviors and maintain good ones by 1994 than were those whose attendance was less or none. Weekly attendance was also associated with improving and maintaining good mental health, increased social relationships, and marital stability. Results were stronger for women in improving poor health behaviors and mental health, consistent with known gender differences in associations between religious attendance and survival. Further understanding the mechanisms involved could aid health promotion and intervention efforts.

Adolescent↗
PubMed2000

Anticipatory blood pressure responses to exercise are associated with left ventricular mass in Finnish men: Kuopio Ischemic Heart Disease Risk Factor Study.

BACKGROUND: Exaggerated cardiovascular reactivity to psychological demands may contribute to the development of left ventricular (LV) hypertrophy. We examined the cross-sectional association between anticipatory blood pressure (BP) responses to bicycle exercise and LV mass in the Kuopio Ischemic Heart Disease Risk Factor Study, a population-based epidemiological sample. METHODS AND RESULTS: Among 876 men from 4 age cohorts (ages 42, 48, 58, and 64 years), we collected echocardiographic assessments of LV mass along with measures of BP response taken before bicycle ergometry testing. Anticipatory BP responses were positively associated with LV mass, with significant associations only among younger (age <50 years) subjects with elevated resting pressures (3-way interactions for anticipatory BP x age x resting pressure for systolic and diastolic BP, all P:<0.05; for younger subjects with elevated systolic BP, P:<0. 01; and for younger subjects with elevated diastolic BP, P:<0.001). Among these subgroups, exaggerated anticipatory BP responses (top quartile) were associated with an incremental increase in LV mass of 10% or greater, corrected for body surface area. Results remained significant after adjusting for age, education, salt consumption, and resting BP, and the pattern of findings was maintained among men with no previous history of cardiovascular disease. CONCLUSIONS: The tendency to show exaggerated pressor responses to psychological demands may be a significant independent correlate of LV mass, especially among young men with high resting pressures. This is the first study to examine such associations in a middle-aged population sample.

Adult↗
PubMed2000

Are the obese at greater risk for depression?

Two waves of data from a community-based study (Alameda County Study, 1994-1995) were used to investigate the association between obesity and depression. Depression was measured with 12 items covering Diagnostic and Statistical Manual of Mental Disorders: DSM-IV diagnostic criteria for major depressive episode. Following US Public Health Service criteria, obese subjects were defined as those with body mass index scores at the 85th percentile or higher. Covariates were age, sex, education, marital status, social isolation and social support, chronic medical conditions, functional impairment, life events, and financial strain. Results were mixed. In cross-sectional analyses, greater odds for depression in 1994 were observed for the obese, with and without adjustment for covariates. When obesity and depression were examined prospectively, controlling for other variables, obesity in 1994 predicted depression in 1995 (odds ratio (OR) = 1.73, 95% confidence interval (CI): 1.04, 2.87). When the data were analyzed with obesity defined as a body mass index of > or = 30, cross-sectional results were the same. However, the prospective multivariate analyses were not significant (OR = 1.43, 95% CI: 0.85, 2.43). Although these data do not resolve the role of obesity as a risk factor for depression, overall the results suggest an association between obesity and depression. The authors found no support for the "jolly fat" hypothesis (obesity reduces risk of depression). However, there has been sufficient disparity of results thus far to justify continued research.

Aged↗