Changes in activities of daily living during treatment of late‐life depression*

Background: Patients with late‐life depression often exhibit cognitive deficits or disability. The relationship between late‐life depression and disability is an area of significance for geriatric psychiatry. The purpose of the present study was to investigate the association between changes in the severity of depression and activities of daily living (ADL) during treatment of late‐life depression. Methods: We examined the severity of depression, cognitive function and ADL among 70 subjects aged 65 years or older with a history or a current episode of major depression. Examination with the Hamilton Depression Rating Scale (Ham‐D), the Mini‐Mental State Examination (MMSE), the Barthel Index (BI) and the Hyogo Activities of Daily Living Scale (HADLS) were performed twice at an interval of approximately 1 month. All patients were receiving drug therapy for their depression. Results: Participants presented with varied depressive severity on the Ham‐D and a slight cognitive deficit on the MMSE; approximately 60% had at least one problem on the HADLS. Between baseline and the follow‐up examination, significant improvements were noted in Ham‐D, MMSE and HADLS scores, but not the BI score. The correlations between the Ham‐D and ADL scores were significant at baseline and at the follow up examinations. In a multiple regression analysis, the difference in follow‐up and baseline scores on the Ham‐D contributed significantly to that of HADLS. Conclusions: The present study demonstrates that many patients with late‐life depression have some problems with ADL and that a substantial improvement in ADL occurs in association with temporal improvement of depressive severity among subjects with late‐life depression.     

Occupational Exposure to N,N-Dimethylformamide in the Summer and Winter

We evaluated total body burden of N,N-dimethylformamide (DMF) taken through the lung and skin by personal exposure of workers to DMF and urinalysis of N-methylformamide (NMF) and N-acetyl-S(N-methylcarbamoyl)-cysteine (AMCC). A total of 270 workers were engaged in four different jobs in a workplace distant from main production lines emanating high levels of DMF. They were not required to wear any personal protective equipment including respirators or gloves. We found that log-transformed urinary levels of NMF and AMCC increased with an increase in log-transformed concentrations of exposure to DMF. Urinary levels of NMF and AMCC were significantly higher in the summer than the winter, although there was no significant seasonal difference in the concentrations of exposure to DMF. Our findings suggested that the increased urinary levels of NMF and AMCC in the summer resulted in increased skin absorption of DMF due to an increased amount of DMF absorbed by the moisturized skin under humid and hot conditions. Seasonal changes in the relative internal exposure index confirmed the present finding of enhanced summertime skin absorption of DMF. AMCC is thought to be a useful biomarker for assessments of cumulative exposure to DMF over a workweek and for evaluations of workers’ health effects.     

A novel device (SD-101) with high accuracy for screening sleep apnoea-hypopnoea syndrome

Background and objective:   The SD-101 is a non-restrictive, sheet-like medical device with an array of pressure sensors, to detect sleep-disordered breathing by sensing gravitational alterations in the body corresponding to respiratory movements. This study evaluated the accuracy of the SD-101 for screening sleep apnoea-hypopnoea syndrome (SAHS) by comparison with polysomnography.
Methods:   Nocturnal polysomnography and SD-101 monitoring were conducted simultaneously and compared in 201 patients with suspected SAHS (suspected SAHS group) and 165 male employees of a transport company (screening group).
Results:   Polysomnography revealed an AHI of <5, 5 ≤ AHI < 15, 15 ≤ AHI < 30, 30 ≤ AHI < 60 and AHI ≥ 60 events/h in 39, 35, 38, 68 and 21 subjects in the suspected SAHS group and 103, 34, 12, 12 and four subjects in the screening group, respectively. Central SAHS and obstructive SAHS were subsequently diagnosed in 11 (5.5%) and 135 (67.2%) of subjects in the suspected SAHS group and five (3.0%) and 39 (23.6%) of subjects in the screening group, respectively. Significant correlations were apparent between AHI and the respiratory disturbance index (RDI) measured with the SD-101 in both the suspected SAHS group ( r  = 0.88) and screening group ( r  = 0.92). Receiver operating characteristic curve analysis revealed 89.5% sensitivity and 85.8% specificity in identifying SAHS, using an RDI of 14.0 events/h.
Conclusions:   These findings suggest that the SD-101 is a useful device for screening SAHS.