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Biomedical subjects

J H Smit

Publications and source records attributed to J H Smit.

At least 37 records · Page 2Linked to original sources
PubMed1999

Quantitative ultrasound measurements of the tibia and calcaneus in comparison with DXA measurements at various skeletal sites.

The performance of quantitative ultrasound (QUS) measurements of the tibia and calcaneus was studied in 109 elderly people (age range 65-87 years). Broadband ultrasound attenuation (BUA) and speed of sound (SOS) were measured at the calcaneus and SOS was assessed at the tibia. Short-term precision of tibial QUS was studied in 16 volunteers. The coefficient of variation (CV) was 0.4% and the standardized CV (sCV) was 4.4%. We compared the calcaneal and tibial QUS measurements with bone mineral density (BMD) measurements of the lumbar spine, femoral neck, trochanter and total body assessed by dual-energy X-ray absorptiometry (DXA). Calcaneal QUS correlated better with BMD at various skeletal sites than tibial QUS. Calcaneal BUA showed higher correlations with BMD values of the lumbar spine, femoral neck, trochanter and total body than calcaneal and tibial SOS (r = 0.48-0.64, r = 0.30-0.47, r = 0.35-0.47, respectively; p < 0.001). Body weight modified the relationships between calcaneal and tibial QUS and BMD measurements of the hip. Higher body weight was associated with higher BMD values at the femoral neck and trochanter for the same calcaneal and tibial QUS values. After adjustments for body weight correlations of tibial and calcaneal QUS with BMD improved and were very similar. This suggests that correction for body weight is important and could add to the predictive value of QUS measurements.

Aged↗
PubMed1999

[Normal values for a short form of the Raven Colored Progressive Matrices].

Psychometric data are presented for the Raven Coloured Progressive Matrices (RCPM), shortened to series A and B. The data were derived from a sample of 2791 persons aged 55 to 85 years. Six 5-year age strata were equally represented, as well as both sexes. The distribution of educational attainment was representative for the elderly population. Norms were stratified for age and education; gender differences were too small to necessitate separate norms. Analysis of reliability according to Mokken's IRT-model indicated modest scalability, but high internal consistency. A loss of 2 to 4 points at retest (depending on personal characteristics) is interpretable as a loss of capacity. Ample attention is paid to qualitative aspects of test performance, but it is concluded that error analysis is mainly useful to def1p4 positional preferences.

Age Factors↗
PubMed1998

Anxiety disorders in later life: a report from the Longitudinal Aging Study Amsterdam.

OBJECTIVE: To study the prevalence and risk factors of anxiety disorders in the older (55-85) population of The Netherlands. METHOD: The Longitudinal Aging Study Amsterdam (LASA) is based on a random sample of 3107 older adults, stratified for age and sex, which was drawn from the community registries of 11 municipalities in three regions in The Netherlands. Anxiety disorders were diagnosed using the Diagnostic Interview Schedule in a two-stage screening design. The risk factors under study comprise vulnerability, stress and network-related variables. Both bivariate and multivariate statistical methods were used to evaluate the risk factors. RESULTS: The overall prevalence of anxiety disorders was estimated at 10.2%. Generalized anxiety disorder was the most common disorder (7.3%), followed by phobic disorders (3.1%). Both panic disorder (1.0%) and obsessive compulsive disorder (0.6%) were rare. These figures are roughly similar to previous findings. Ageing itself did not have any impact on the prevalence in both bivariate and multivariate analyses. The impact of other factors did not change much with age. Vulnerability factors (female sex, lower levels of education, having suffered extreme experiences during World War II and external locus of control) appeared to dominate, while stresses commonly experienced by older people (recent losses in the family and chronic physical illness) also played a part. Of the network-related variables, only a smaller size of the network was associated with anxiety disorders. CONCLUSIONS: Anxiety disorders are common in later life. The risk factors support using a vulnerability-stress model to conceptualize anxiety disorders. Although the prevalence of risk factors changes dramatically with age, their impact is not age-dependent. The risk factors indicate which groups of older people are at a high risk for anxiety disorders and in whom active screening and treatment may be warranted.

Aged↗
PubMed1998

Depression in survivor of stroke: a community-based study of prevalence, risk factors and consequences.

Depression in survivors of stroke is both common and clinically relevant. It is associated with excess suffering, handicap, suicidal ideation and mortality and it hampers rehabilitation. Most of the data currently available are derived from clinical studies. The objective of the present study was to study the prevalence, risk factors and consequences of depression in survivors of stroke, in a large (n = 3050) community-based study of older (55-85 years) people in three regions of the Netherlands. Depression was measured using the CES-D scale; histories of stroke were obtained using self-reports and data from general practitioners. The study was designed as a case-control study, using both bivariate and multivariate analyses. The prevalence of depression in stroke survivors was 27%, which was significantly higher than the base rate (OR 2.28, 95% CI 1.61-3.24). Both stroke-related disease characteristics and psychosocial characteristics of the respondents were predictors of depression. The consequences of depression were most evident in the realm of disability and impairment of well-being. The patterns of service utilization showed that depressed survivors of stroke are relatively high users of a wide range of health services.

Aged↗
PubMed1998

Confirmatory factor analysis of the General Self-Efficacy Scale.

A confirmatory factor analysis of the factor structure of the adapted General Self-Efficacy Scale, created by Sherer et al. (1982) [Psychological Reports, 51, 663-671], was conducted to assess whether the scale's purported 3 factors emerged. The results generally supported the 3-factor model, but a model with 3 correlated factors and one higher-order factor (general self-efficacy) proved to fit the data even better.

Aged↗
PubMed1998

Elder abuse in the community: prevalence and consequences.

OBJECTIVES: (1) To assess the prevalence and the consequences of chronic verbal aggression, physical aggression, financial mistreatment, and neglect in a community-based sample; (2) to investigate the circumstances that led to the abuse and the ways in which the victims handled the problem. DESIGN: Prevalence was assessed in a population-based sample of 1797 older people living independently in Amsterdam, the Netherlands. In a follow-up study 1 year later, the victims were questioned again about the background and consequences of the abuse. RESULTS: The 1-year prevalence of elder abuse was 5.6%. The prevalence of the various types of elder abuse was: verbal aggression 3.2%, physical aggression 1.2%, financial mistreatment 1.4%, and neglect 0.2%. Most victims reported emotional reactions immediately after the abuse. Seven of 36 victims experienced physical or financial damage as a consequence of the abuse. More than 70% of the victims were able to stop the abuse, either by themselves or with the help of others. CONCLUSION: The rate of occurrence and the consequences of elder abuse in the Netherlands was established. Elder abuse is more widely spread if not only close relatives or people with whom the older person lives are considered as possible perpetrators but other familiar and trusted people are considered as well. Intervention should be focused on the roughly 40% of victims who were not able to stop the abuse.

Aged↗
PubMed1998

Predictors for falls and fractures in the Longitudinal Aging Study Amsterdam.

The objective of this study was to identify easily measurable predictors for falls, recurrent falls, and fractures using a population-based prospective cohort study of 1469 elderly, born before 1931, in three regions of the Netherlands. The baseline at-home interview was in 1992. In 1995, falls experienced in the preceding year and fractures over the preceding 38-month period were registered. In a period of 1 year, 32% of the participants fell at least once, and 15% fell two or more times. The rate of recurrent falls was similar in men and women up until the age of 75 years. The total number of fractures was 85, including 23 wrist fractures, 12 hip fractures, and 9 humerus fractures. The incidence density per 1000 person-years for any fracture was 25.1 (95% confidence interval [CI], 18.9-31.4) for women and 8.2 (95% CI, 4.5-12.0) for men, respectively. Multiple logistic regression identified urinary incontinence, impaired mobility, use of analgetics, and use of antiepileptic drugs as the predictors most strongly associated with recurrent falls. Female gender, living alone, past fractures, inactivity, body height, and use of analgetics proved to be the predictors most strongly associated with fractures. The probabilities of recurrent falls were 4.7% (95% CI, 2.9-7.5%) to 59. 2% (95% CI, 24.1-86.9%) with zero to four predictors, respectively. The probability of fractures ranged from 0.0% (95% CI, 0.0-0.4%) without any of the identified predictors to 12.9% (95% CI, 4.4-32. 2%) with all six predictors present. Our study shows that the risk of recurrent falls and of fractures can be predicted using up to, respectively, four and six easily measurable predictors. This study emphasizes the importance of impaired mobility and inactivity as predictors for falls and fractures.

Accidental Falls↗
PubMed1997

Norms for an abbreviated Raven's Coloured Progressive Matrices in an older sample.

Percentile age norms for ages 55 to 85 using overlapping intervals at specified age midpoints are presented for the sum scores of sections A and B of Raven's Coloured Progressive Matrices (RCPM). The representative age and gender stratified sample (N = 2,815) used is derived from the Longitudinal Aging Study Amsterdam (the Netherlands). As RCPM scores appear to be strongly associated with education, percentile norms for three educational levels are presented: low (0-9 years), middle (10-15 years) and high (16 years and more).

Aged↗
PubMed1997

The effects of intelligence and education on the development of dementia. A test of the brain reserve hypothesis.

BACKGROUND: A number of recent epidemiological studies have shown that the prevalence and incidence of dementia are increased in population strata with low compared to high levels of education. This has been explained as a consequence of a greater 'brain reserve capacity' in people with a high level of education. Theoretically, however, brain reserve capacity is better reflected by intelligence than by level of education. Thus, the emergence of dementia will be better predicted by low pre-morbid intelligence than by low education. METHODS: This prediction was tested in a population based sample of elderly subjects (N = 2063; age range 65-84; Amsterdam Study of the Elderly) who were followed over 4 years. Dementia was diagnosed using the Geriatric Mental State examination (GMS). Pre-morbid intelligence was measured using the Dutch Adult Reading Test (DART), a short reading test which gives a good estimate of verbal intelligence, and is relatively insensitive to brain dysfunction. The effects of age, gender, occupational level, number of diseases affecting the central nervous system and family history of dementia or extreme forgetfulness were also examined. RESULTS: Logistic regression analysis showed that low DART-IQ predicted incident dementia better than low level of education. A high occupational level (having been in charge of subordinates) had a protective effect. CONCLUSIONS: This result supports the brain reserve theory. It also indicates that low pre-morbid intelligence is an important risk factor for cognitive decline and dementia. Use of reading ability tests is to be preferred over years of education as estimator of pre-morbid cognitive level in (epidemiological) dementia research.

Adult↗
PubMed1997

Consequences of major and minor depression in later life: a study of disability, well-being and service utilization.

BACKGROUND: The consequences of major depression for disability, impaired well-being and service utilization have been studied primarily in younger adults. In all age groups the consequences of minor depression are virtually unknown. In later life, the increased co-morbidity with physical illness may modify the consequences of depression, warranting special study of the elderly. With rising numbers of elderly people, excess service utilization by depressed elderly represents an increasingly important issue. METHODS: Based on a large, random community-based sample of older inhabitants of the Netherlands (55-85 years), the associations of major and minor depression with various indicators of disability, well-being and service utilization were assessed, controlling for potential confounding factors. Depression was diagnosed using a two-stage screening design. Diagnosis took place in all subjects with high depressive symptom levels and a random sample of those with low depressive symptom levels. The study sample consists of all participants to diagnostic interviews (N = 646). RESULTS: As in younger adults, associations of both major and minor depression with disability and well-being remained significant after controlling for chronic disease and functional limitations. Adequate treatment is often not administered, even in subjects with major depression. As the vast majority of those depressed were recently seen by their general practitioners, treatment could have been provided in most cases. Bivariate analyses show that major and minor depression are associated with an excess use of non-mental health services, underscoring the importance of recognition. In multivariate analyses the evidence of excess service utilization was less compelling. CONCLUSIONS: Both major and minor depression are consequential for well-being and disability, supporting efforts to improve the recognition and treatment in primary care. However, controlled trials are necessary to assess the impact this may have on service utilization.

Activities of Daily Living↗
PubMed1997

Asking the age question in elderly populations: a reverse record check study.

In two large-scale surveys among elderly respondents we evaluated the accuracy of answers obtained to three differently formulated age questions. Respondents included 6,149 individuals aged 65-86 living in The Netherlands. Because criterion age data were available from different sources, it was possible to compare the respondent's reported age with his or her actual age. Refusal rates were low for all three questions. Both age and cognitive capabilities influenced accuracy of the answers to the age questions. The results indicated that the most accurate data were obtained with the question, "What is your date of birth?" in combination with interview date.

Aged↗
PubMed1997

Religiosity as a protective or prognostic factor of depression in later life; results from a community survey in The Netherlands.

This study examines the impact of religiosity on the incidence and course of depressive syndromes in a community-based sample of elderly people in The Netherlands (n = 177). The course of depression was assessed in five waves of measurements, covering a period of 1 year. Religiosity was defined as salience of religion compared to the salience of other aspects of life. Religious salience was not associated with incidence of depression, but showed a relatively strong association with improvement of depression among the respondents who were depressed at the first measurement. This association was most prominent among subjects with poor physical health.

Adaptation, Psychological↗
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.

Aged↗
PubMed1995

Predicting the course of depression in the older population: results from a community-based study in The Netherlands.

This article is a report on the course of depressive syndromes in a community-based sample of older subjects in The Netherlands (n = 238). After baseline, the course of depression was assessed in five waves of follow-up measurements, covering 1 year. 52% of the subjects were never depressed; 16% suffered an incident depression, half of which remitted during the study; 8% had a depression at the start which remitted during the study; 14% were chronically depressed and in 10% the course was variable. Of those depressed at the start of the study, 32% remitted without relapse, 25% remitted but relapsed later and 43% were chronically depressed. While demographic variables were not predictive, health-related variables were predictive of both the onset and the course of depressive syndromes. Chronicity was associated with recent visits to general practitioners, indicating that treatment could have been provided relatively easily in many cases.

Aged↗
PubMed1995

Physical performance and physical self-efficacy in the elderly. A pilot study.

This study examined the relationship between physical performance and physical self-efficacy beliefs in older adults. It was hypothesized that subjects who perform better on physical tasks would show more positive beliefs of physical self-efficacy. Information was obtained from 124 subjects (61 men and 63 women) aged 55 to 85 years. Tests of mobility, strength, and dexterity were administered, as well as a self-report questionnaire of physical self-efficacy. Although most physical performance indexes were observed to be at lower levels after 75 years of age, physical self-efficacy beliefs in women did not show this pattern if the drop in physical performance was relatively small. Male subjects in the age group of 75 years and older however, showed substantial lower levels of performance in most of the tests, which was associated with more negative beliefs of physical self-efficacy. This was corroborated by multiple regression analyses, showing that sex was a significant predictor of physical self-efficacy beliefs in most performance tests. This prediction was moderated by age such that older men had more negative beliefs of physical self-efficacy than older women.

Age Factors↗
PubMed1994

Writing a philosophy of nursing?

Nurses in education and management settings are often required to write a philosophy for the facility. In this paper, the use of the concept of 'philosophy' in nursing education and nursing management is explored. The nature of philosophy is then outlined, with specific reference to its relationship with a special science such as nursing. In the light of this discussion, the real nature of the document that nursing authors call a 'philosophy' is discussed. The concepts of a life and world view and a mission statement are discussed in this regard. Specific proposals are then made for nurses in approaching the task of producing this planning document.

Curriculum↗