Depression Treatment: The Relationship Between Cognitive Function and Physical Function in Rheumatoid Arthritis.

The Relationship Between Cognitive Function and Physical Function in Rheumatoid Arthritis.

Filed under: Depression Treatment

J Rheumatol. 2013 Jan 15;
Shin SY, Julian L, Katz P

OBJECTIVE: To examine the relationship between cognitive impairment and functional limitations and disability in persons with rheumatoid arthritis (RA). METHODS: Individuals from a longitudinal cohort study of RA participated in study visits that included physical, psychosocial, and biological metrics. Cognitive function was assessed using a battery of 12 standardized neuropsychological measures yielding 16 indices covering a range of cognitive domains. On each test, subjects were classified as “impaired” if they performed 1 SD below age-based population norms. Total cognitive function scores were calculated by summing the number of tests on which individuals were classified as “impaired” (higher scores = greater impairment). Performance-based and self-reported functional limitations were assessed with the Short Physical Performance Battery (SPPB) and the Health Assessment Questionnaire (HAQ), respectively. Self-reported disability was measured with the Valued Life Activities (VLA) scale. Multiple regression analyses controlling for sex, race, education, cardiovascular comorbidity, disease duration, disease severity, and depression were conducted to identify whether cognitive impairment was independently associated with physical function difficulties. RESULTS: There were 122 subjects with mean (SD) age of 58.4 (± 10.8) years; 62% were female and 80% were white. In multivariate regression models, total cognitive function score was significantly associated with greater functional limitations (SPPB: ? = -0.24, p = 0.014; HAQ: ? = 0.24, p = 0.003) but not with disability (VLA: ? = 0.10, p = 0.207). CONCLUSION: Cognitive impairment was significantly associated with greater functional limitations in patients with RA, suggesting that cognitive impairment may play a role in poor functional status in persons with RA.
HubMed – depression


Subjective sleep in premenopausal and postmenopausal women during workdays and leisure days: a sleep diary study.

Filed under: Depression Treatment

Menopause. 2013 Jan 14;
Lampio L, Saaresranta T, Polo O, Polo-Kantola P

OBJECTIVE: This study aims to evaluate subjective sleep in premenopausal and postmenopausal women by assessing differences between workdays and leisure days. METHODS: Ninety-one regularly working women-of which 58 were premenopausal (aged 44-48 y) and 33 were postmenopausal (aged 53-58 y)-were recruited. A 14-day sleep diary was used to investigate total sleep time (TST), nocturnal sleep time (ST), sleep latency, and number of awakenings after workdays and leisure days. RESULTS: TST (P = 0.002 during the 14-d period, P < 0.001 during workdays) and ST (P < 0.001 and P < 0.001) were shorter, and the number of awakenings (P = 0.033 and P = 0.043) during the entire 14-day period and after workdays was higher in postmenopausal women than in premenopausal women. No differences were observed during leisure days. Falling asleep took longer in postmenopausal women during the entire 14-day period (P = 0.011), during workdays (P = 0.040), and during leisure days (P = 0.010). After adjustment for the depression score, TST and ST during the 14-day period (P = 0.006 for TST, P = 0.004 for ST) and during workdays (P < 0.001 and P < 0.001) remained shorter in postmenopausal women. CONCLUSIONS: Self-reported sleep problems are more common in postmenopausal women than in premenopausal women, and the difference is more pronounced during workdays than during leisure days. These observations suggest that postmenopausal women have the capacity for good sleep but are more vulnerable to sleep problems related to work-related stress. HubMed – depression


Longitudinal assessment of chlorpyrifos exposure and effect biomarkers in adolescent Egyptian agricultural workers.

Filed under: Depression Treatment

J Expo Sci Environ Epidemiol. 2013 Jan 16;
Crane AL, Abdel Rasoul G, Ismail AA, Hendy O, Bonner MR, Lasarev MR, Al-Batanony M, Singleton ST, Khan K, Olson JR, Rohlman DS

Chlorpyrifos (CPF) is applied seasonally in Egypt by adolescent agricultural workers and the extent of occupational exposure and the potential for environmental CPF exposure in this population is poorly understood. Adolescent pesticide applicators (n=57; 12-21 years of age) and age-matched non-applicators (n=38) from the same villages were followed for 10 months in 2010, spanning pre-application through post-application. Eight urine and five blood samples were collected from participants within this time period. Blood acetylcholinesterase and butyrylcholinesterase (BChE; exposure/effect biomarker) and urine 3,5,6-trichloro-2-pyridinol (TCPy; exposure biomarker) were used to assess occupational CPF exposures in pesticide applicators and environmental exposures in non-applicators. Applicators demonstrated significantly higher TCPy concentration and BChE depression than non-applicators throughout CPF application. This difference persisted for 4-7 weeks after the cessation of agricultural spraying. However, both groups exhibited significantly elevated TCPy and depressed BChE, compared with their respective baseline. The peak TCPy levels during the spray season (95% confidence interval (CI)) for non-applicators and applicators reached 16.8 (9.87-28.5) and 137 (57.4-329)?ug/g creatinine, respectively. BChE levels (95% CIs) during the spray were as follows: 1.47 (1.28-1.68) for non-applicators and 0.47 (0.24-0.94)?U/ml for applicators. The longitudinal assessment of CPF biomarkers provided robust measures of exposure and effect throughout CPF application in adolescents and revealed significant exposures in both applicators and non-applicators. Biomarker data in the non-applicators, which mirrored that of the applicators, indicated that non-applicators received environmental CPF exposures. This suggests that similar exposures may occur in other residents of this region during periods of pesticide application.Journal of Exposure Science and Environmental Epidemiology advance online publication, 16 January 2013; doi:10.1038/jes.2012.113.
HubMed – depression


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