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Max L Stek

Publications and source records attributed to Max L Stek.

6 recordsLinked to original sources
PubMed2006

Natural history of depression in the oldest old: population-based prospective study.

BACKGROUND: Despite its negative consequences, little is known about the natural history of depression in the oldest old. AIMS: To study the incidence, course and predictors of depression in the general population of the oldest old. METHOD: The Leiden 85-plus Study is a prospective population-based study of 500 people from their 85th to their 89th birthdays. Depressive symptoms were annually assessed with the 15-item Geriatric Depression Scale, using a cut-off of 4 points. RESULTS: During a mean follow-up of 3.9 years, the annual risk for the emergence of depression was 6.8%. Poor daily functioning and institutionalisation predicted depression. Among the 77 participants with depression at baseline (prevalence 15%) the annual remission rate was ony 14%. In more than half of the participants with a remission of depression, we observed a relapse of depression during follow-up. No predictors of remission could be identified. CONCLUSIONS: Among the oldest old, depression is frequent and highly persistent. More active case-finding and treatment would be potentially rewarding.

Aged, 80 and over↗
PubMed2005

Is depression in old age fatal only when people feel lonely?

OBJECTIVE: The impact of depression and perceived loneliness in the oldest old is largely unknown. The authors studied the relationship between the presence of depressive symptoms and all-cause mortality in old age, especially the potential distorting effect of perceived loneliness. METHOD: Within a prospective population-based study of 85-year-olds, the 15-item Geriatric Depression Scale and the Loneliness Scale were annually applied in all 476 participants with a Mini-Mental State Examination score of 18 points or more. RESULTS: Depression was present in 23% and associated with marital state, institutionalization, and perceived loneliness. When depression and perceived loneliness were assessed during follow-up, neither depression nor perceived loneliness had a significant effect on mortality. However, those who suffered from both depression and feelings of loneliness had a 2.1 times higher mortality risk. CONCLUSIONS: The data suggest that the increased mortality risk attributable to depression in the presence of perceived loneliness may result from motivational depletion.

Aged↗
PubMed2004

Temporal relation between depression and cognitive impairment in old age: prospective population based study.

OBJECTIVE: To examine the temporal relation between depression and cognitive impairment in old age. DESIGN: Prospective, population based study with four years of follow up. SETTING: City of Leiden, the Netherlands. PARTICIPANTS: 500 people aged 85 years at recruitment. MAIN OUTCOME MEASURES: Annual assessments of depressive symptoms (15 item geriatric depression scale), global cognitive function (mini-mental state examination), attention (Stroop test), processing speed (letter digit coding test), and immediate and delayed recall (12 word learning test). RESULTS: At 85 years old, participants' depressive symptoms and cognitive impairment were highly significantly correlated (P < 0.001). During follow up, an accelerated annual increase of depressive symptoms was associated with impaired attention (0.08 points (95% confidence interval 0.01 to 0.16)), immediate recall (0.17 points (0.09 to 0.25)), and delayed recall (0.10 points (0.02 to 0.18)) at baseline. In contrast, depressive symptoms at baseline were not related to an accelerated cognitive decline during follow up (P > 0.05). CONCLUSION: Caregivers should be aware of the development of depressive symptoms when cognitive impairment is present. However, the presence of depression only does not increase the risk of cognitive decline.

Aged↗
PubMed2004

The 15-item Geriatric Depression Scale (GDS-15) detects changes in depressive symptoms after a major negative life event. The Leiden 85-plus Study.

BACKGROUND: The 15-item Geriatric Depression Scale (GDS-15) is a widely used screening instrument for depressive symptoms in the elderly, but its ability to detect alterations in depressive symptoms over time has not been established. OBJECTIVE: To assess the change of the GDS-15 score after a major negative life event. METHODS: Within the Leiden 85-plus Study, we prospectively followed a population-based cohort of 599 subjects from 85 years onwards. The GDS-15 was applied annually to participants with a Mini-Mental State Examination (MMSE) score above 18 points. The change in GDS-15 score of 32 subjects who had lost their partner during follow-up was compared with a control group of 32 subjects who had not lost their partner, matched for age, sex, and initial GDS-15 score. RESULTS: At baseline, 241 subjects lived together with a partner. During a mean follow-up of 3.2 years, 55 participants (23%) lost their partner. Of those, 32 subjects completed the GDS-15 before and after the loss of their partner. All subjects reported the bereavement to be a major negative life event. The mean increase of the GDS-15 score after the death of a partner was 1.2 points (paired t-test, p = 0.013). This was significantly higher than the mean change of -0.06 points in the matched control group (independent t-test, p = 0.032), and independent of sex, level of education, pre-bereavement GDS-15 score, and time period since the loss of a partner. CONCLUSION: This study shows that the GDS-15 detects change in depressive symptoms after loss of a partner, a negative life event that is the most important risk factor for depression in the elderly. Therefore, it may be concluded that the GDS-15 has the ability to measure longitudinal alterations in depressive symptomatology.

Aged↗
PubMed2004

Does depression in old age increase only cardiovascular mortality? The Leiden 85-plus Study.

BACKGROUND: Depression in old age is associated with an increased mortality risk of cardiovascular disease but the mortality risk from non-cardiovascular causes is disputed. OBJECTIVE: To investigate the effect of depression on cardiovascular and non-cardiovascular mortality in old age. METHODS: We prospectively followed 500 subjects from age 85 years onwards within the population-based Leiden 85-plus Study. Depressive symptoms were assessed annually with the 15-item Geriatric Depression Scale (GDS-15). Mortality risks were estimated in a Cox proportional-hazards model with the annual assessment of depression (GDS-15> or =4 points) as a time-dependent covariate. RESULTS: During 1654 person-years of follow-up (mean per person, 3.2 years), depression was associated with a two-fold increase of all cause mortality [Relative Risk (RR), 1.83; 95% Confidence Interval (CI), 1.24-2.69] that was not explained by comorbid conditions. Both cardiovascular mortality and non-cardiovascular mortality contributed equally to the excess mortality (RR 1.95 and 1.75 respectively). CONCLUSION: Depression in old age contributes to an increase of both cardiovascular and non-cardiovascular mortality. Motivational depletion may play an important role in the increased mortality in elderly with depression.

Aged↗