Depression as a powerful discriminator between physically active and sedentary middle-aged men

This study identifies the relative importance of psychological dimensions that discriminate between habitually physically active and sedentary men. The data support the notion that physical activity has psychological benefits. Subjects (N = 22) were normal, medically healthy middle-aged men (40–60 years of age). Data were collected on selected physiological (treadmill) and psychological (MMPI) variables and replicated within four months. The Student's t-test and discriminant function analysis were used in the statistical analysis. Physically active men (n = 11) have lower depression (scale 2) and lower social introversion (scale 10) than the sedentary men (n = 11). The physically active men may exhibit MMPI scale differences in ‘neurotic’ tendencies from the sedentary men, but there is no apparent difference in scales suggestive of ‘psychotic’ tendencies. Depression (scale 2) is the most powerful discriminator between physically active and sedentary men, followed by hysteria (scale 3) and social introversion (scale 10). In conclusion, our data identify depression as the most important MMPI scale that discriminates between physically active and sedentary men.     

Beta-endorphin and components of emotionality discriminate between physically active and sedentary men

Differences between physically active and sedentary men were tested by profile comparison. The study identifies the relative importance of circulating beta-endorphin (BE), atherosclerotic disease risk (ADR) index, and selected components of emotionality in discriminating between physically active and sedentary men. The subjects were psychologically normal and medically healthy middle-aged men. Jogging activity was the subject classification criterion. The data were collected on selected physiological (treadmill), biochemical (blood collected from resting subjects), and psychological (Eysenck and MMPI) variables. The physical fitness score (PFS) was used as an index of fitness. Physically active men with a high PFS (n = 21), when compared to the sedentary men with a low PFS (n = 15), exhibited lower basal plasma BE, lower ADR, lower anxiety index (AI), and lower MMPI depression score (D). Canonical correlation analysis showed that PFS and BE in one set were correlated with D and neuroticism (NS) in another set of variables. Discriminant function analysis showed that the AI was the most powerful discriminator between the physically active and sedentary men, followed by BE and NS. Interestingly, BE and NS exhibited the same magnitude of discrimination power. The ADR exhibited less discrimination power, relative to AI, BE, and NS. In conclusion, the physically active men, compared to the sedentary men in this study, exhibited lower basal plasma BE, which appeared to be associated with less atherosclerotic disease risk, less neuroticism, less anxiety, and less depression.     

Calculated bioavailable testosterone levels and depression in middle-aged men

BACKGROUND: The association between circulating total testosterone (TT) levels and depressive symptoms remains unclear. We sought to determine the relationship between physiologically active bioavailable testosterone (BT) and depressive symptoms in middle-aged men with and without major depressive disorder (MDD). METHODS: We assessed and compared calculated BT levels in two groups of middle-aged men (40-65 years): untreated subjects meeting DSM-IV-TR-defined criteria for a major depressive episode as part of major depressive disorder (N=44) and a matched non-depressed control group (N=50). RESULTS: Depressed men had lower mean BT levels (3.51+/-1.69 vs. 4.69+/-2.04 nmol/L; p=0.008) and TT levels (11.94+/-4.63 vs. 17.64+/-1.02 nmol/L; p<0.001) when compared to the control group. Biochemical hypogonadism (i.e., BT level< or =2.4 nmol/L or TT level< or =12.14 nmol/L) was also more prevalent in depressed men vs. non-depressed controls (34% vs. 6%, p<0.001; 61% vs. 14%, p<0.001, respectively). CONCLUSIONS: Changes in physiologically active BT concentration may be a vulnerability factor for depressive symptoms in middle-aged depressed men.     

Association between obesity and depression in middle-aged women

OBJECTIVE: Evaluate the association between obesity and depression among middle-aged women. METHODS: A total of 4641 female health plan enrollees aged 40-65 years completed a structured telephone interview including self-reported height and weight, the Patient Health Questionnaire (PHQ) assessment of depression; a brief measure of rate was 62%. RESULTS: Prevalence of moderate or severe depression increased from 6.5% among those with body mass index (BMI) under 25 to 25.9% among those with BMI over 35. Prevalence of obesity increased from 25.4% among those with no depressive symptoms to 57.8% among those with moderate to severe depression. Independent of obesity, depression was associated with significant reductions in frequency of moderate (4.6 vs. 5.4 times per week) or vigorous (2.8 vs. 3.7 times per week) physical activity. Depression was associated with significantly higher daily caloric intake (1831 vs. 1543) among those with BMI over 30. CONCLUSIONS: Among middle-aged women, depression is strongly and consistently associated with obesity, lower physical activity and (among the obese) higher caloric intake. Public health approaches to reducing the burden of obesity or depression must consider the strong association between these two common conditions.     

Neuropsychological tests as discriminators between dementia of alzheimer type and frontotemporal dementia

The aim of this study was to examine whether cognitive test performance alone could distinguish patients with dementia of Alzheimer type (DAT) from those with frontotemporal dementia (FTD). Scores from three neuropsychological tests were used as discriminating variables in 28 cases with postmortem verified diagnoses. The selected tests measured verbal ability, visuospatial ability and verbal memory. Eighty-nine per cent of the sample was correctly classified by discriminant analysis. Evaluating the ability of the obtained discriminant function to differentiate between groups of DAT and FTD in a new, clinically diagnosed sample of 38 cases yielded an overall success rate of 84%. The results suggest that cognitive tests may be helpful for differential diagnosis in the context of a neuropsychiatric examination.     

Relationship between lipid peroxidation and plasma fibrinogen in middle-aged men

The relationship between lipid peroxidation (plasma malondialdehyde [MDA] concentration) and plasma fibrinogen level was analyzed in 144 men, aged 53-62 years. MDA was measured colorimetrically and fibrinogen with the thrombin method. Mean plasma MDA concentration was 12.6 (SD 1.2) micromol/L, plasma fibrinogen level 2.91 (0.47) g/L, and body mass index 27.1 (3.5) kg/m(2). Prevalence of smoking was 17%. MDA correlated moderately with fibrinogen. Both MDA and fibrinogen correlated positively with waist hip ratio (WHR) and blood leukocyte count, but inversely with VO(2)max. Both MDA and fibrinogen levels were higher in smokers than in non-smokers (p<0. 01). In multiple stepwise regression analysis, plasma MDA, VO(2)max, smoking, and leukocyte count explained 38.1% of the variance in plasma fibrinogen level, with the individual contributions reaching 20.6%, 9.7%, 5.5%, and 2.3%, respectively. WHR, serum triglycerides, and age did not enter the model. These data suggest that increased lipid peroxidation is associated with elevated plasma fibrinogen level in middle-aged men.     

Relationship between trait-anger and sleep disturbances in middle-aged men and women

OBJECTIVE: The present study was performed to determine whether high levels of trait-anger (T-Anger) are independently associated with sleep disturbances and quantitative and qualitative measurements of sleep in middle-aged adults. METHODS: Enrolled in the study were 2404 men and 2291 women derived from the Korean Health and Genome Study (KHGS), which is an ongoing population-based prospective study. The Spielberger Trait Anger Scale was used to measure T-Anger. RESULTS: Sleep disturbances, including difficulty in initiating and maintaining sleep (DIS and DMS, respectively) and early morning awakening (EMA), significantly increased with increasing levels of T-Anger (P<.05 by test for trend). Nonrestorative feelings in the morning and excessive daytime sleepiness were also strongly associated with higher levels of T-Anger. After adjusting for other potential risk factors, the high and/or moderate T-Anger showed 40% to 70% increases in the odds for sleep disturbances. CONCLUSION: The present study provides evidence that high levels of T-Anger are independently associated with symptoms of disturbed sleep in middle-aged adult population.     

Anxiety as an outcome symptom of depression in elderly and middle-aged adults

Early morning anxiety was reported as a symptom in 32.1% of 131 elderly and middle-aged patients hospitalized for depression one to two years following hospitalization. Two-thirds of those patients complaining of early morning anxiety also complained of anxiety at other times during the day. The demographic and system profile of subjects complaining of early morning anxiety did not differ on a variety of indices from subjects complaining of anxiety throughtou the day at follow-up, except that early morning anxiety was associated with a less severe symptom profile at follow-up. These results suggest that early morning anxiety is a less severe presentation of mixed depression/anxiety in patients who do not recover completely from an episode of major depression, regardless of age.     

Alexithymia and risk of death in middle-aged men

We prospectively examined the association between alexithymia and risk of death over an average follow-up time of nearly 5.5 years in 42- to 60-year-old men (N = 2297) participating in the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD). Alexithymia, impairment in identification, processing, and verbal expression of inner feelings, was assessed by the validated Toronto Alexithymia Scale (TAS) In age-adjusted survival analyses, men in the highest alexithymia quintile had a twofold greater risk of all-cause death (p<0.001) and a threefold greater risk of death from accidents, injury, or violence (p<0.02) relative to the men in the three lowest alexithymia quintiles. There was little evidence for confounding by behavioral factors (smoking, alcohol consumption, physical activity), physiological risk factors (LDL, HDL, body mass index, hypertension), socioeconomic status, marital status, perceived health, prior diseases and diagnoses, depressive symptoms or social connections. Consistent and even stronger associations between alexithymia and all-cause death were found in a healthy subgroup (N = 1650). Why difficulties in dealing with emotions associate with increased mortality remains unclear. Our findings suggest that the association is independent from the effect of well-known behavioral, biological, and psychosocial risk factors.     

Premotor and occipital theta asymmetries as discriminators of memory- and stimulus-guided tasks

The saccadic paradigm has been used to investigate specific cortical networks involving visuospatial attention. We examined whether asymmetry in theta and beta band differentiates the role of the hemispheres during the execution of two different prosacadic conditions: a fixed condition, where the stimulus was presented at the same location; and a random condition, where the stimulus was unpredictable. Twelve healthy volunteers (3 male; mean age: 26.25) performed the task while their brain activity pattern was recorded using quantitative electroencephalography. We did not find any significant difference for beta, slow- and fast-alpha frequencies for the pairs of electrodes analyzed. The results for theta band showed a superiority of the left hemisphere in the frontal region when responding to the random condition on the right, which is related to the planning and selection of responses, and also a greater activation of the right hemisphere during the random condition, in the occipital region, related to the identification and recognition of patterns. These results indicate that asymmetries in the premotor area and the occipital cortex differentiate memory- and stimulus-driven tasks.     

A possible association between paternal longevity and major depression among elderly men

Abstract  Ancestral longevity is sometimes thought to contribute to psychosocial well-being in late life. The resent paper aims to examine if parental longevity is associated with mental health among the elderly. The age at death of the parents was compared between 68 patients with major depression who were aged 65 or over and 40 subjects of the same age range without any history of psychiatric disorder. Cox regression revealed that the fathers of the elderly men with unipolar depression died at a significantly younger age than those of the control group. Several hypotheses are advanced to explain this unexpected and intriguing association.     

An association between plasma free protein s concentration and risk of coronary heart disease in middle-aged men

Protein S is a vitamin K-dependent protein with anticoagulant properties. Case series have reported reduced plasma concentrations in patients with arterial thromboses, while other studies have reported increased levels in patients with coronary heart disease (CHD). The present study sought to clarify the relation between free protein S and risk of CHD. A prospective survey was conducted of 3000 men aged 50 to 61 years, free of clinical CHD at baseline. Free protein S was measured by commercial immunoassay. End-points recorded were sudden coronary death, first nonfatal and fatal myocardial infarction (MI), surgical intervention for symptomatic, angiographically demonstrated CHD, and all-causes mortality. Statistical analysis employed univariate incidence rate ratios followed by Cox proportional hazards regression. There were 168 CHD events recorded during 21,000 person-years of risk. Mean free protein S concentration was 6% higher in those who developed CHD than in the remainder, the crude hazard ratio (HR) for a one standard deviation (S.D.) increase in free protein S being 1.25 (95% CI, 1.08-1.25). Free protein S was associated with cholesterol concentration and other conventional CHD risk factors. In multivariate regression analysis, after adjustment for conventional CHD risk factors a 1 S.D. increase in free protein S was associated with a HR of 1.15 (0.98-1.35) for CHD, of borderline conventional statistical significance. This association of free protein S with risk of CHD may reflect effects of plaque-destabilising inflammatory activity on protein S levels.     

Lifetime history of depression and carotid atherosclerosis in middle-aged women

BACKGROUND: Depression is associated with clinical coronary events, but the association between history of major depression and subclinical cardiovascular disease in women is not yet known. We determined the association between lifetime history of major depression and subclinical carotid atherosclerosis in middle-aged women. METHODS: Participants included 336 healthy middle-aged women (one third African American) from 1 of the 7 sites of the Study of Women's Health Around the Nation, a prospective study of the perimenopausal transition. Psychiatric diagnoses were assessed using the Structured Clinical Interview for the DSM-IV Axis I Disorders-Non-Patient Edition. Two measures of subclinical carotid atherosclerosis were assessed using B-mode ultrasonography: plaque and intima-media thickness. RESULTS: Lifetime history of major depression was associated with plaque, and substance abuse was related to intima-media thickness. Lifetime history of an anxiety disorder was not associated with either measure. After controlling for standard cardiovascular risk factors, only the association between major depression and plaque was maintained. The risk of plaque was 2-fold in women with a lifetime history of recurrent major depressive episodes relative to women with no history of depression (odds ratio = 2.30; 95% confidence interval, 1.10-4.82). Lifetime history of a single major depressive episode was not associated with plaque. CONCLUSIONS: Recurrent major depressive episodes may be a risk factor for subclinical atherosclerosis. Prevention of recurrent episodes may also prevent further progression of atherosclerosis.     

Behavioral theory of depression: reinforcement as a mediating variable between avoidance and depression

Behavioral theory posits that certain environmental changes and avoidant behaviors inhibit individuals from experiencing environmental reward and reinforcement and subsequently leads to the development and maintenance of depressive symptoms. Using self-report and behavioral (daily diary) indices of environmental reward as proxy measures for positive reinforcement, this investigation examined whether environmental reward mediated the relationship between avoidance and depression. When controlling for anxiety, both indices of environmental reward significantly mediated the relationships of depression with cognitive, behavioral and total avoidance. Post-hoc mediation analyses were conducted to examine potential gender differences. Self-reported environmental reward significantly mediated the relationship between avoidance and depression across both genders. Among females, however, daily diary-measured reward only mediated the relation between cognitive avoidance and depression. In males daily diary reward was a mediator with all three forms of avoidance and depression. This investigation provides initial support for reinforcement as a significant mediator between avoidance and depression and further highlights the relevance of avoidance and reinforcement in behavioral conceptualizations of depression.     

Treating Type A behaviours and mild hypertension in middle-aged men

Unmedicated mildly hypertensive Type A men were randomly allocated to one of three conditions: stress management intervention training (N = 15), Type A management (N = 15), and delayed Type A management intervention. Significantly greater reductions in blood pressure at rest and during the Type A structured interview were found following the active interventions than during the minimal treatment control period of the delayed intervention. Type A management was more successful in changing a number of Type A behaviours, including anger, hostility and global Type A behaviour. Changes on measures of anger-in, -out, hostility, and SI ratings of Type A behaviour were associated with changes in systolic and diastolic blood pressure reactivity during interview.