Biomedical subjects

Hans Bosma

Publications and source records attributed to Hans Bosma.

At least 19 recordsLinked to original sources

PubMed2006

Explanations of socioeconomic differences in changes in physical function in older adults: results from the Longitudinal Aging Study Amsterdam.

BACKGROUND: This study examines the association between socioeconomic status and changes in physical function in younger- (aged 55-70 years) and older-old (aged 70-85 years) adults and seeks to determine the relative contribution of diseases, behavioral, and psychosocial factors in explaining this association. METHODS: Data were from 2,366 men and women, aged 55-85 years, participating in the Longitudinal Aging Study Amsterdam (LASA). Two indicators of socioeconomic status were used: education and income. Physical function was measured by self-reported physical ability over nine years of follow-up. RESULTS: In older adults, low socioeconomic status was related to a poorer level of physical function during nine years of follow-up. In subjects who were between 55 and 70 years old, there was an additional significant socioeconomic-differential decline in physical function, while socioeconomic differentials did not further widen in subjects 70 years and older. Behavioral factors, mainly BMI and physical activity, largely explained the socioeconomic differences in physical function in the youngest age group, while psychosocial factors reduced socioeconomic status differences most in the oldest age group. CONCLUSION: The findings indicate age-specificity of both the pattern of socioeconomic status differences in function in older persons and the mechanisms underlying these associations.

Activities of Daily Living↗

PubMed2006

Effect of a structured course involving goal management training in older adults: A randomised controlled trial.

OBJECTIVE: The objective of this study was to investigate the effects of a structured 6-week neuropsychological course on the executive functioning of older adults with cognitive complaints. METHODS: A randomised controlled design was used involving 69 community dwelling individuals aged 55 years and older. Both objective and subjective measures were included to assess executive functioning. General linear model with repeated measures analysis of variance was used to examine the intervention effects. RESULTS: After the intervention, the participants in the intervention group were significantly less annoyed by their cognitive failures, were better able to manage their executive failures and reported less anxiety symptoms than those in the waiting list control group. CONCLUSION: These findings indicate that a combination of psycho-education and training has the potential to change the attitude of older individuals towards their cognitive functioning. PRACTICE IMPLICATIONS: Because this training focussed on cognitive functions that are among the first to decline in older adults and the subjective evaluation of the people after training was quite favourable, the proposed intervention may be considered a valuable contribution to cognitive interventions for older adults.

Activities of Daily Living↗

PubMed2006

Associations between lifestyle and depressed mood: longitudinal results from the Maastricht Aging Study.

OBJECTIVES: We examined whether healthy lifestyles are associated with absence of depressed mood. METHODS: A sample of 1169 adult participants in the Maastricht Aging Study provided baseline and 6-year follow-up data on smoking, alcohol use, physical exercise, body mass index, and mood. We examined associations between lifestyles and depressed mood using longitudinal analyses controlling for baseline depressive symptoms and covariates. RESULTS: Reports of excessive alcohol use at baseline predicted depressed mood at follow-up (relative risk [RR] = 2.48; 95% confidence interval [CI] = 1.08, 5.69), and reports of more than 30 minutes of physical exercise per day at baseline were associated with an absence of depressed mood at follow-up (RR=0.52; 95% CI=0.29, 0.92). Reports of being engaged in physical exercise throughout the 6-year follow-up period were also associated with absence of depressed mood (RR=0.56; 95% CI=0.34, 0.93). CONCLUSIONS: In this relatively healthy population sample, certain lifestyles either predicted or protected against depressed mood. Adopting or maintaining healthy lifestyles might be a starting point in preventing or treating depressed mood over time.

Adult↗

PubMed2006

Socioeconomic differences in incident depression in older adults: the role of psychosocial factors, physical health status, and behavioral factors.

OBJECTIVE: The objective of this study was to examine the association between socioeconomic status (SES) and the onset of depression in older adults and to determine the relative contribution of psychosocial factors, physical health status, and behavioral factors in explaining this link. METHODS: Data were from 2593 men and women, aged 55-85 years, participating in the Longitudinal Aging Study Amsterdam. Two indicators of SES were used: education and income. The onset of depression was measured over 9 years of follow-up. RESULTS: Adjusted hazard ratios of incident depression were significantly higher in those with low education and low income. Psychosocial factors explained on average 16% of the SES differences in incident depression, physical health status on average 7%, and behavioral factors less than 5%. CONCLUSION: In older adults, low SES predicted the incidence of depression. Part of this association was explained by psychosocial factors and physical health status.

Activities of Daily Living↗

PubMed2006

Memory self-efficacy predicts memory performance: results from a 6-year follow-up study.

The purpose of this study was to examine the relationship between memory self-efficacy (MSE) and a 6-year follow-up assessment of memory functioning in a sample of Dutch older adults. MSE was assessed by a Dutch abridged version of the Metamemory in Adulthood questionnaire (MIA; R. A. Dixon, D. F. Hultsch, & C. Hertzog, 1988; C. Hertzog, D. F. Hultsch, & R. A. Dixon, 1989; R. W. H. M. Ponds & J. Jolles, 1996). The total MSE score predicted memory performance at 6 years, as measured by the Visual Verbal Learning Task (VVLT; N. Brand & J. Jolles, 1985). A separate analysis of the different MSE subscales indicated that the MIA Change score was the most salient domain-specific MSE predictor of subsequent memory performance after 6 years. An extreme groups analysis of the MIA Change score revealed a pattern of performance for those who perceived that their memory was worsening, performing less well on the 3 trials of the VVLT when these were readministered at the 6-year follow-up.

Age Factors↗

PubMed2006

Association of inflammatory markers with socioeconomic status.

BACKGROUND: This study examines the association between socioeconomic status (SES) and inflammatory markers in well-functioning older adults and seeks to determine whether any association remains after adjusting for biomedical and behavioral factors typically related to elevated serum levels of inflammatory markers. METHODS: Data were obtained from 3044 men and women, aged 70-79 from Pittsburgh, Pennsylvania and Memphis, Tennessee participating in the Health, Aging and Body Composition study. Three indicators of SES were used: education, income, and ownership of financial assets. Serum levels of interleukin-6, C-reactive protein, and tumor necrosis factor-alpha were measured. RESULTS: Low SES was associated with significantly elevated levels of interleukin-6, C-reactive protein, and tumor necrosis factor-alpha compared to high SES. Behavioral factors (including smoking, drinking, obesity) explained a substantial part of the inverse association between SES and inflammatory markers. Adjustment for prevalent diseases (including heart diseases, lung disease, and diabetes) associated with inflammation explained less of the association. CONCLUSIONS: This study suggests that interventions to improve health behaviors, even in old age and especially in low SES groups, may be useful in reducing risks associated with inflammation.

Aged↗

PubMed2006

Chronic patients in undergraduate education: didactic value as perceived by students.

OBJECTIVES: Medical education should prepare students for future clinical practice. However, this preparation is inadequate for the most prevalent problem in health care: chronic disease. This applies to the continuous aspect of chronic disease. Within the context of a newly developed programme, we investigated what makes a chronic patient interesting in the eyes of medical students, what they learned from a specific programme in which each student had contact with a chronic patient 4 times in 8 months, and what they learned from their patients. METHODS: A total of 240 Year 3 students were enrolled in the programme, 89 of whom filled in questionnaires at both the start and end of the programme. Topics included the characteristics of the ideal and the actual patient, the Ideal Physician Questionnaire, and several questions on the expected and actual amount of knowledge gained from the patient. RESULTS: Students preferred patients who demonstrated clear symptoms and had frequent contacts with health care professionals during the programme to 'well adapted' patients. The perceived knowledge obtained from the patient was less than they had expected at the start of the programme. A didactic gain perceived as low was mainly due to low expectations of gaining knowledge at the start of the programme, a doctor-centred attitude and a high level of discrepancy between the student's ideal patient and the actual patient. CONCLUSIONS: Programmes that aim to present chronic patients to medical students focus on patient selection so that patients who differ only very slightly from healthy persons are eliminated. In addition, realistic information on the types of patients with whom students can expect to have contact may help students appreciate the knowledge to be gained from these patients.

Adolescent↗

PubMed2005

The role of psychosocial factors in explaining socio-economic differences in mobility decline in a chronically ill population: results from the GLOBE study.

In chronically ill patients, mobility develops more unfavorably in persons with low socio-economic status (SES) than in their better-off counterparts. Using longitudinal data from the Dutch GLOBE study (a study of health and living conditions in Eindhoven and its surroundings), the present study examines whether psychosocial factors can explain socio-economic differences in mobility decline, independent of disease severity, co-morbidity, and health-related behavior in a chronically ill population. Data were from 1384 men and woman, aged 15-74 years, suffering from at least one of the four chronic diseases: asthma/COPD, heart disease, diabetes mellitus, and low back pain. Three indicators of SES were used: education, occupational class, and income. Change in physical mobility between 1991 and 1997 was measured with the Nottingham Health Profile (NHP). Psychosocial factors were measured extensively and included life events, long-term difficulties, coping styles, social support, and personality characteristics. Low occupational level and low income predicted an increased risk of mobility decline in comparison to people with a higher occupational level and income, even after controlling for sociodemographics, disease severity, co-morbidity, and health-related behavior. Additional adjustment for psychosocial factors hardly reduced the SES-related odds ratios of mobility decline. We conclude that psychosocial factors (and also health-related behaviors, disease severity and co-morbidity) cannot explain socio-economic differences in mobility decline in a chronically ill population. Our findings will not give us new tools for prevention and intervention strategies in order to reduce physical disability and particularly the SES differences therein.

Adolescent↗

PubMed2005

Influence of cognitive functioning on functional status in an older population: 3- and 6-year follow-up of the Maastricht Aging Study.

BACKGROUND: To date, it remains unclear to what extent cognitive competence is related to a change in general functional status in older adults. OBJECTIVES: To evaluate both the cross-sectional and the longitudinal relation between cognitive functioning and functional status. METHODS: Sensorimotor speed, memory, and executive functioning were assessed in a large population of healthy adults aged 60 years and older (n = 485) who participated in the Maastricht Aging Study. Data from the baseline (1993-1995), three-year follow-up, and six-year follow-up were used. Functional status was measured using the SF-36, which was coded into a physical and a mental component summary measure. RESULTS: After adjustment for age, sex, and educational level, a high level of cognitive functioning appeared to be associated with better functional status in the cross-sectional analysis. Longitudinal analyses demonstrated, that cognitive functioning was not a predictor of functional status three or six years later. CONCLUSIONS: Thus while cognitive functioning is useful clinically for predicting the short-term functional status of an older person, it is not useful for predicting that person's long-term (>3 years) functional status and thus the period of validity of the results of these tests in answering such questions is limited.

Aged↗

PubMed2005

Socioeconomic differences in cognitive decline and the role of biomedical factors.

PURPOSE: This study examines the association between socioeconomic status and cognitive decline in a community-based cohort of well-functioning older adults and seeks to determine whether this link could be explained by biomedical factors. METHODS: Data are from 2574 men and women aged 70 to 79 years from Pittsburgh, PA, and Memphis, TN, participating in the Health, Aging and Body Composition study (Health ABC). Three indicators of socioeconomic status were used: education, income, and ownership of financial assets. Cognitive decline over 4 years was defined as a decrease of five points or more in the Modified Mini-Mental State Examination (3MS) score. Biomedical factors measured at baseline, included heart disease, cerebrovascular disease, diabetes, hypertension, poor pulmonary function, and high serum levels of inflammatory markers. RESULTS: Adjusted odds ratios were significantly higher in those with low education, low income, and few assets. Odds ratios ranged from 1.51 to 2.16 in the lowest socioeconomic groups. Additional adjustment for biomedical factors reduced the odds ratios of cognitive decline by an average of 2% for education, 5% for income, and 8% for the number of assets. CONCLUSIONS: Low socioeconomic status predicts a decline in cognitive function in older adults and this relationship is not mediated by biomedical factors.

Aged↗

PubMed2005

The effect of two types of memory training on subjective and objective memory performance in healthy individuals aged 55 years and older: a randomized controlled trial.

The objective of the study was to examine the effectiveness of two types of memory training (collective and individual), compared to control (waiting list), on memory performance. Participants were 139 community-dwelling older individuals recruited through media advertisements asking for people with subjective memory complaints to participate in a study. Data were collected at baseline, and at 1 week and 4 months after the intervention. Training efficacy was assessed using measures of subjective and objective memory performance. After the intervention, participants in the collective training group reported more stability in memory functioning and had fewer feelings of anxiety and stress about memory functioning. In addition, positive effects were found on objective memory functioning. Compared with the other two groups, the collective training group participants had an improved recall of a previously learned word list. Compared to controls, participants in the individual training group reported fewer feelings of anxiety and stress in relation to memory functioning.

Affect↗

PubMed2005

Reviewing the effort-reward imbalance model: drawing up the balance of 45 empirical studies.

The present paper provides a review of 45 studies on the Effort-Reward Imbalance (ERI) Model published from 1986 to 2003 (inclusive). In 1986, the ERI Model was introduced by Siegrist et al. (Biological and Psychological Factors in Cardiovascular Disease, Springer, Berlin, 1986, pp. 104-126; Social Science & Medicine 22 (1986) 247). The central tenet of the ERI Model is that an imbalance between (high) efforts and (low) rewards leads to (sustained) strain reactions. Besides efforts and rewards, overcommitment (i.e., a personality characteristic) is a crucial aspect of the model. Essentially, the ERI Model contains three main assumptions, which could be labeled as (1) the extrinsic ERI hypothesis: high efforts in combination with low rewards increase the risk of poor health, (2) the intrinsic overcommitment hypothesis: a high level of overcommitment may increase the risk of poor health, and (3) the interaction hypothesis: employees reporting an extrinsic ERI and a high level of overcommitment have an even higher risk of poor health. The review showed that the extrinsic ERI hypothesis has gained considerable empirical support. Results for overcommitment remain inconsistent and the moderating effect of overcommitment on the relation between ERI and employee health has been scarcely examined. Based on these review results suggestions for future research are proposed.

Cardiovascular Diseases↗

PubMed2005

Is there a biomedical explanation for socioeconomic differences in incident mobility limitation?

BACKGROUND: The association between low socioeconomic status and poor physical functioning has been well described; biomedical factors may play an important role in explaining these differences. This study examines the association between socioeconomic status and incident mobility limitation in well-functioning older adults, and seeks to determine whether this link could be explained by biomedical factors. METHODS: Data were obtained from 3066 men and women, aged 70--79 years from Pittsburgh, Pennsylvania and Memphis, Tennessee participating in the Health, Aging and Body Composition (Health ABC) study. Three indicators of socioeconomic status were used: education, income, and ownership of financial assets. Mobility limitation was defined as reporting difficulty walking 1/4 mile or climbing 10 steps during two consecutive semiannual assessments over 4.5 years. Biomedical factors included a wide range of diseases (e.g., heart and cerebrovascular disease) and biological risk factors (e.g. hypertension, poor pulmonary function, and high serum levels of inflammatory markers). RESULTS: Adjusted hazard ratios of incident mobility limitation were significantly higher in those persons with low education, low income, and few assets. Hazard ratios ranged from 1.66 to 2.80 in the lowest socioeconomic groups. Additional adjustment for biomedical factors reduced the hazard ratios by an average of 41% for education, 17% for income, and 29% for assets. CONCLUSION: Biomedical factors can account for some of the association between socioeconomic status and incident mobility limitation. However, to reduce physical disabilities and, in particular, the socioeconomic differences therein, it may not be sufficient to solely intervene upon biological risk factors and risks of diseases.

Aged↗

PubMed2005

Relation between health status and cognitive functioning: a 6-year follow-up of the Maastricht Aging Study.

The aim of this study was to determine whether physical and psychological functioning can predict 6-year cognitive decline in older adults. A group of 669 participants aged 60 to 81 years was recruited from a longitudinal study (the Maastricht Aging Study). Physical functioning was measured in terms of perceived health and instrumental activities of daily living. Psychological functioning or mood was evaluated by the Depression and Anxiety subscales of the Symptom Check List-90. Although physical functioning and psychological functioning were related to several measures of cognitive functioning at baseline, psychological functioning was specifically related to memory functioning 6 years later. Poor psychological functioning (i.e., depressive and anxiety symptomatology), rather than poor physical health, may have the strongest implications for long-term cognitive functioning in older men and women.

Activities of Daily Living↗

PubMed2005

Change in sensory functioning predicts change in cognitive functioning: results from a 6-year follow-up in the maastricht aging study.

OBJECTIVES: To examine the longitudinal relationship between sensory functioning and a broad range of cognitive functions after 6 years follow-up and whether cataract surgery or first-time hearing aid use affected cognition. DESIGN: Hierarchical regression procedures were employed to determine whether sensory functioning was predictive of cognitive performance. SETTING: Maastricht University and the University Hospital Maastricht, the Netherlands. PARTICIPANTS: Older Dutch adults (>/=55) enrolled in the Maastricht Aging Study (N=418). MEASUREMENTS: Visual and auditory acuity, the Visual Verbal Learning Test (VVLT), the Stroop Color Word Test (SCWT), the Concept Shifting Task (CST), the Verbal Fluency Test, and the Letter-Digit Substitution Test (LDST). RESULTS: A change in visual acuity was associated with change in most cognitive measures, including the total and recall scores of the VVLT, the mean score of the first two SCWT cards, the mean score of the first two CST cards and the LDST. In addition, a change in auditory acuity predicted change in memory performance (VVLT total and recall scores), and auditory acuity measured at baseline predicted change in the mean score of the first two SCWT cards and the LDST. CONCLUSION: The findings support the notion of a strong connection between sensory acuity in auditory and visual domains and cognitive performance measures, both from a cross-sectional and a longitudinal perspective. They also suggest that it is essential to screen older individuals in a clinical context for sensory functioning so that changes in visual or auditory acuity are not interpreted as changes in cognitive performance.

Adult↗

PubMed2004

Socioeconomic inequalities in mobility decline in chronic disease groups (asthma/COPD, heart disease, diabetes mellitus, low back pain): only a minor role for disease severity and comorbidity.

OBJECTIVE: This study examined the association between socioeconomic status and mobility decline and whether this could be explained by disease severity and comorbidity in four different chronic disease groups (asthma/COPD, heart disease, diabetes mellitus, and low back pain). It is not clear, whether the adverse course of physical functioning in persons with a low socioeconomic status can be explained by a higher prevalence of more severe disease or comorbidity in these persons. DESIGN: Dutch GLOBE study: prospective cohort study. SETTING: Region of Eindhoven (south east of the Netherlands). PARTICIPANTS: 1384 persons suffering from at least one of the four chronic diseases were selected. The number of respondents in each group was: asthma/COPD 465, heart disease 788, diabetes mellitus 137, and low back pain 707. There were 580 respondents who suffered from more than one condition. MAIN RESULTS: Odds ratios of mobility decline between 1991 and 1997, adjusted for age, sex, marital status, and baseline mobility, were significantly higher in low socioeconomic groups in comparison with high socioeconomic groups. Only very little of this association could be explained by the higher disease severity and comorbidity in these patients. Findings were similar in patients with asthma/COPD, heart disease, diabetes mellitus, and chronic low back pain. CONCLUSION: These findings indicate that to reduce physical disabilities and particularly the socioeconomic differences therein, it may not be sufficient to solely intervene upon the risks of severe disease and comorbidities.

Activities of Daily Living↗

PubMed2002

Subjective sleep problems in later life as predictors of cognitive decline. Report from the Maastricht Ageing Study (MAAS).

BACKGROUND: Although biological sleep criteria seem to be associated with cognitive changes in older people, it is not clear if subjective sleep parameters are related to cognitive decline in later life. OBJECTIVES: The aim of this study was to determine whether subjective sleep complaints in a population-based sample of 838 middle aged and older adults (>or= 50 years) predicted cognitive decline over a period of 3 years. METHODS: Sleep complaints at baseline, assessed with the subscale Sleep Problems of the Symptoms Checklist-90, were used as a predictor variable. Cognitive performance at follow-up, measured with the Mini Mental Status Examination, was employed as a dependent variable. RESULTS: Controlling for the effects of age, gender, length of follow-up interval, systemic diseases, and cognitive function at baseline, subjective sleep complaints were negatively associated with cognitive performance at follow-up. CONCLUSION: Subjective sleep complaints predict cognitive decline in middle aged and older adults. Mechanisms behind the effect of subjective sleep complaints on cognitive performance are discussed.

Aged↗

PubMed2002

Engaged lifestyle and cognitive function in middle and old-aged, non-demented persons: a reciprocal association?

Some studies have shown that cognitive function is positively affected by an engaged and active lifestyle. However, a recent study found evidence for an opposite causal direction, i.e., persons with good cognitive function more often start to engage in leisure-time activities. Here, we longitudinally examine the causal direction of the association between an engaged lifestyle and cognitive function in middle and old-aged Dutch men and women. The participants in the prospective cohort study "Maastricht Aging Study" (MAAS) were recruited from a register of 15 family practices in the South of the Netherlands. There were 830 non-demented men and women, aged 49 to 81 in 1993-1995 (baseline phase). They were re-examined three years later (follow-up phase). During both phases, all persons reported on their participation in mental, social, and physical activities. Six separate neuropsychological tests, including the Mini-Mental State Examination, were used to define cognitive function at baseline and follow-up. All three activities measured were negatively related to cognitive decline between both phases. Effects were moderate, but consistent. Persons participating in all three activities were particularly protected against longitudinal decline. Furthermore, persons with the best baseline cognitive performance were more likely to increase their number of activities during follow-up compared with persons with the poorest scores. In summary, an engaged lifestyle and cognitive function mutually influence each other in middle and old aged, non-demented persons. This reciprocal association is characterized by simultaneous positive effects of leisure-time activities and good cognitive function on cognitive function and leisure-time activities, respectively. This reciprocal association may create a self-reinforcing, beneficial or adverse life-course in middle and old age.

Age Factors↗