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The article discusses research which was conducted to investigate the association between depression and cognition in older adults. Researchers evaluated 896 adults between the ages of 70 and 97. They found that depression often preceded cognitive impairment in older adults and that the association between the two is related to physical health and perceptions of a lack of control.

The Interpersonal-Psychological Theory of Suicide (IPTS) has been supported by recent research. However, the nature of the models? three major constructs - perceived burdensomeness, thwarted belongingness and acquired capability - requires further investigation. In this paper, we test a number of hypotheses about the predictors and correlates of the IPTS constructs. Participants aged 32-38 from an Australian population-based longitudinal cohort study (n=1167) were assessed. IPTS constructs were measured by items from the Interpersonal Needs Questionnaire (INQ) and Acquired Capability for Suicide Scale (ACSS), alongside demographic and additional measures, measured concurrently or approximately 8 years earlier. Cross-sectional analyses evaluating the IPTS supported earlier work. Mental health was significantly related to all three IPTS constructs, but depression and anxiety caseness were associated only with perceived burdensomeness. Various social support measures were differentially associated with the three constructs. Stressful events and lifetime traumas had robust independent associations with acquired capability for suicide only. The IPTS model provides a useful framework for conceptualising suicide risk. The findings highlight the importance of perceived social support in suicide risk, identify the importance of personality and other factors as new avenues of research, and provide some validation for the independence of the constructs. [ABSTRACT FROM AUTHOR]

The article describes a cohort study of the association of apolipoprotein E (APOE) genotype and cognitive and motor performance. 590 subjects over the age of 70 underwent APOE genotyping, then evaluated for cognitive abilities such as verbal fluency, episodic memory, and facial recognition and noncognitive functions such as grip strength and reaction time. The results indicated that APOE allele was not strongly correlated with cognitive decline after correction for preclinical dementia.

OBJECTIVES: Presence of the apolipoprotein E (APOE) 4 allele is a risk factor for dementia, whereas the 2 allele offers protection against dementia. There is also evidence for a relationship between APOE genotype and changes in cognitive function. It is not clear, however, whether this relationship stems from undetected disease in persons genetically more vulnerable to dementia. This study examined whether APOE genotype was associated with either initial performance or change in performance on a range of cognitive and noncognitive tasks, after accounting for possible preclinical dementia. DESIGN: A population-based cohort was assessed up to four times over 12 years. PARTICIPANTS: The sample was an Australian cohort of 590 participants age 70 years and older who were genotyped for APOE. MEASUREMENTS: The outcomes were processing speed, verbal fluency, episodic memory, word recognition, face recognition, grip strength, and reaction time. RESULTS: Adjusted latent growth models indicated that 4 carriers had significantly poorer initial memory performance and greater declines in processing speed and word recognition than 2 and 3 carriers. In addition, 2 carriers exhibited significantly less decline in right grip strength than 3 carriers. However, after excluding 125 participants with low global cognition scores, all genotype effects became nonsignificant. CONCLUSIONS: Over a 12-year period, findings indicate that APOE 4-related cognitive decline in older community-dwelling populations is due to a higher likelihood of preclinical dementia among 4 carriers. When possible dementia cases are removed from the analyses, 4 associations with cognitive decline become statistically unreliable. [ABSTRACT FROM AUTHOR]

Background: Evidence remains unclear as to whether folic acid (FA) and vitamin B-12 supplementation is effective in reducing depressive symptoms. Objectives: The objective was to determine whether oral FA + vitamin B-12 supplementation prevented cognitive decline in a cohort of community-dwelling older adults with elevated psychological distress. Design: A randomized controlled trial (RCT) with a completely crossed 2 × 2 × 2 factorial design comprising daily oral 400 βg FA + 100 βg vitamin B-12 supplementation (compared with placebo), physical activity promotion, and depression literacy with comparator control interventions for reducing depressive symptoms was conducted in 900 adults aged 60-74 y with elevated psychological distress (Kessler Distress 10-Scale; scores >15). The 2-y intervention was delivered in 10 modules via mail with concurrent telephone tracking calls. Main outcome measures examined change in cognitive functioning at 12 and 24 mo by using the Telephone Interview for Cognitive Status-Modified (TICS-M) and the Brief Test of Adult Cognition by Telephone (processing speed); the Informant Questionnaire on Cognitive Decline in the Elderly was administered at 24 mo. Results: FA + vitamin B-12 improved the TICS-M total (P = 0.032; effect size d = 0.17), TICS-M immediate (P = 0.046; d = 0.15), and TICS-M delayed recall (P = 0.013; effect size d = 0.18) scores at 24 mo in comparison with placebo. No significant changes were evident in orientation, attention, semantic memory, processing speed, or informant reports. Conclusion: Long-term supplementation of daily oral 400 βg FA + 100 βg vitamin B-12 promotes improvement in cognitive functioning after 24 mo, particularly in immediate and delayed memory performance. [ABSTRACT FROM AUTHOR]

Abstract: Background: Observational studies link low folate levels to depressive symptoms and to poor antidepressant medication response. Evidence supports a role for folate in potentiating the effect of antidepressant medications. Aim: This prospective study examines the effects of folic acid+vitamin B12 supplementation and antidepressant medication in a community-based study of older adults with depressive symptoms. Method: A randomised controlled trial investigated the effectiveness of a medicinal and two behavioural preventive interventions over a two year period. The medicinal intervention compared dietary supplementation of 400mcg/d folic acid+100mcg/d vitamin B12 to placebo. Self reported use of antidepressant medication over two years was recorded. Participants were screened for psychological distress using the Kessler Distress 10-Scale (K-10; >15 eligible) and the main outcome measure was change in depressive symptoms on the Patient Health Questionnaire-9 (PHQ-9) at six weeks, six, 12 and 24months. Nine hundred adults aged 60–74years were included in the analysis, of whom 209 (23.2%) reported antidepressant use during the follow-up period. Results: A mixed model repeated measures analysis of variance for reduction in depressive symptoms found no significant three-way interaction between supplement group and antidepressant use over time on the PHQ-9 [F4, 825.1=0.32, p=0.87]. A small interaction between supplement group and antidepressant use over time was found for K-10 scores (F4, 799.5=2.50, p=0.0414). Conclusions: There was little evidence for the potentiation of antidepressant medication by folic acid+B12 supplementation on depressive symptomatology. Further research should examine whether effects might be found at higher folic acid dosages or among clinical populations. [Copyright &y& Elsevier]

Abstract: The long-term relationship between lower intelligence and mortality risk in later life is well established, even when controlling for a range of health and sociodemographic measures. However, there is some evidence for differential effects in various domains of cognitive performance. Specifically, tests of fluid intelligence may have a stronger association with mortality than do tests of crystallized intelligence. The present study examines the relationship between intelligence and mortality in a sample of 896 Australian community-dwelling males and females, aged 70–97 at recruitment and followed for up to 17 years. There were 687 deaths during the follow-up period. Cox proportional hazard regression models examined whether the relationship between intelligence and mortality might be mediated by socioeconomic status, by health behaviors, by health status, or a combination of these. Higher fluid intelligence — as measured by the Symbol–Letter Modalities Test — was strongly associated with lower mortality rates (Hazard ratio=0.80; 95% confidence interval=0.72–0.88), even after accounting for any combination of potential mediators and confounders. A significant association between crystallized intelligence, as measured by the National Adult Reading Test, and mortality (HR=0.89; 95% CI=0.80–0.99) was attenuated by the inclusion of socioeconomic, health status measures, and health behavior measures and when deaths from the first four years of the study were excluded. The findings show little support for the hypothesized mechanisms of the intelligence–mortality relationship. [Copyright &y& Elsevier]

Abstract: A systematic review was conducted of school-based prevention and early intervention programs for anxiety. The aim of the review was to identify and describe the programs available, and to evaluate their effectiveness in reducing symptoms of anxiety. Twenty-seven outcome trials, describing 20 individual programs, were identified through the Cochrane Library, PsycInfo and PubMed databases. Results of the review indicated that most universal, selective and indicated prevention programs are effective in reducing symptoms of anxiety in children and adolescents, with effect sizes ranging from 0.11 to 1.37. Most programs targeted adolescents (59%), were aimed at reducing the symptoms of nonspecific anxiety (67%), and delivered cognitive behavioural therapy (CBT; 78%). Further quality school-based research is required that involves longer-term follow-up, the use of attention control conditions and evaluates teacher delivery. [Copyright &y& Elsevier]

Objectives: To examine one version of the brain reserve hypothesis in a community sample of young-old participants. The authors investigated whether atrophy and white matter hyperintensities (WMH) were associated with cognitive decline, and whether this relationship was modified by the endowment of greater "reserve" as measured by years of education and brain size (intracranial volume ICy). Design: Longitudinal cohort study with 4-year follow-up. Paiticipants: A community sample of 416 adults aged 60- 64 years at baseline. Measurements: Years of education and brain size were examined as measures of brain reserve. The association between these measures and brain atrophy and white matter hyperintensities (WMH) on magnetic resonance imaging and change in cognitive function over 4 years was determined. Results: Changes in cognitive test scores over 4 years had no correlation with years of education, atrophy, WMH, or ICy. There was no interaction of atrophy or level of WMH with education or brain size on cognitive change. Conclusion: In a young-old sample, there is no direct evidence to support the brain reserve hypothesis as operationalized in this study. WMH and atrophy were not associated with cognitive change. [ABSTRACT FROM AUTHOR]

Abstract: Background: Surveys of the public in several countries have found that negative attitudes towards antidepressants are common. However, there has been little research into the factors associated with these attitudes. Methods: A national survey of 999 Australian adults assessed beliefs about the helpfulness or harmfulness of antidepressants for a person with depression and suicidal thoughts. Associated factors investigated were as follows: sociodemographic characteristics, exposure to depression, ability to recognize depression, beliefs about other depression interventions, beliefs about long-term outcomes with and without treatment, beliefs about causes, and stigmatizing attitudes. Results: Around a quarter of Australian adults believe that antidepressants would be harmful for a person who is depressed and suicidal. This group was less educated, had less exposure to depression, showed poorer recognition of depression, was less favorable about other standard interventions including psychological ones, was less pessimistic about the long-term outcome if the person did not have treatment, and was more likely to see depression as due to weakness and to be under the individual''s control. Limitations: The survey did not directly ask about reasons for believing that antidepressants would be harmful. Conclusions: Belief in the harmfulness of antidepressants is associated with a general lack of exposure to depression, leading to an underestimation of its seriousness and of the necessity for intervention. [Copyright &y& Elsevier]

Within Eysenck''s three-factor model, religiosity has mainly been associated with low Psychoticism, while within the five-factor model, associations have been reported with Agreeableness, Conscientiousness and Extraversion. However, the size of associations has generally been small. A limitation of previous research is that it has only investigated linear associations. The present study looked at associations in a large community sample of over 7000 adults covering three age groups: 20–24 years, 40–44 years and 60–64 years. The personality scales given to participants measured Eysenck''s three factors. Participants were divided into quartiles of religiosity and compared on the personality scales. The linear association with Psychoticism reported in previous studies was replicated. However, there were also quadratic associations with all personality traits, but particularly with Psychoticism and Extraversion. The most and least religious quartiles tended to be higher in Psychoticism and lower in Extraversion. These results show that previous research, which has examined only linear associations, has given an incomplete picture. [Copyright &y& Elsevier]

Background: Suicide is the leading cause of death among young Australians, therefore identifying factors that increase risk is important. The aims of this study was to investigate the association between personality domains and suicidal ideation, plans and attempts in a community-based sample of adolescents.Methods: 1428 students from thirteen secondary schools in Australia completed a survey consisting of demographic information (gender and age), personality risk across four domains (Hopelessness, Impulsivity, Sensation Seeking and Anxiety Sensitivity) as measured by the Substance Use Risk Profile Scale, and psychological distress measured by the Distress Questionnaire 5 scale. Outcome measures included suicidal ideation, plans and attempts measured by the Youth Risk Behavior Survey.Results: Students were aged between 11 and 17 years old (mean: 13.3, SD = 1.2) with 59% identifying as female. Proportions of participants reporting suicidal ideation, plans and at least one attempt were 14%, 9% and 7% respectively. Hopelessness was associated with twice the odds (OR = 3.1 and 2.9) of suicidal thoughts and plans respectively. Hopelessness also had 45% increased odds for suicide attempt (OR = 2.1), however this was not significant in the suicidal ideation sub-group. Impulsivity and sensation seeking were associated with suicidal ideation (OR = 1.3), while only impulsivity was associated with attempt (OR = 1.5).Limitations: The study was cross-sectional, considered suicidal thoughts and behaviors in past 12 months only and used one measure of personality.Conclusions: Personality traits may be important for determining suicide risk in adolescents. Developing screening and interventions targeting personality may have implications for the detection and prevention of suicide. [ABSTRACT FROM AUTHOR]

• The sources of strength program takes a social connectedness approach to suicide prevention. • A cluster randomised controlled trial was conducted with 13 schools in Australia. • The program increased awareness of help seeking but was not effective in increasing intentions or behaviour. • The program may be most suitable in schools with limited mental health programming or highly disconnected young people. Suicide is a significant public health problem and there is a clear need for interventions to improve help seeking for suicide and psychological distress in young people. This trial aimed to assess the effectiveness of the school-based Sources of Strength program in increasing help-seeking intentions and behaviours in adolescents. A cluster, randomised controlled trial was conducted in 13 Australian secondary schools (N = 1633), with each school randomly allocated to the intervention (n = 7) or wait-list control condition (n = 6). Participants in the intervention condition received the Sources of Strength program over two years and all participants completed self-report measures of help-seeking intentions and behaviour at four time-points. Staff and students in the intervention condition also provided qualitative feedback on the perceived impact of the program. Mixed model repeated measures analyses demonstrated no significant effect of the Sources of Strength program on help-seeking intentions or behaviour at post-intervention or 6- or 18-month follow-up. Staff and students reported, through qualitative feedback, that the program increased awareness of and openness to help seeking and promoted a common language and school community. The current study only included self-report measures that may have been influenced by situational factors or biases. Although the Sources of Strength program may have increased awareness of help seeking, there was no evidence that it is effective in increasing help-seeking intentions or behaviours in this cohort. The program may be more suitable for schools in disadvantaged areas where there may be limited existing connections to trusted adults. [ABSTRACT FROM AUTHOR]

Screening for psychological distress may assist in identifying at-risk adolescents. While several measures of adolescent psychological distress have been used, most have limited or suboptimal psychometric properties. This study aimed to assess the psychometric properties of the Distress Questionnaire-5 (DQ5), a brief measure of psychological distress, in a large community-based sample of adolescents. Data for the study (n = 3117) were drawn from the baseline and 6-week follow-up assessments of the Future Proofing Study, which collected data from three cohorts of Year 8 students (M = 13.9 years; 48% female) between August 2019 and May 2022. Participants completed the DQ5 at each measurement occasion, as well as measures of depression, generalised and social anxiety, and suicidal ideation. The DQ5 had good fit to a unidimensional construct, with standardised factor loadings ranging between 0.69 and 0.90. The scale had strong criterion (AUC ranged from 0.84 to 0.93) and predictive (AUC ranged from 0.81 to 0.87) validity when compared against indicators for depression, generalised anxiety, social anxiety and suicidal ideation. The DQ5 cut-point of ≥14 had 80% sensitivity and 90% specificity for identifying adolescents meeting symptom thresholds for any of the assessed mental health conditions. Changes in DQ5 scores over 6 weeks had moderate associations with changes in other symptom scales, suggesting sensitivity to change. In conclusion, the DQ5 demonstrates strong psychometric properties and is a reliable measure of psychological distress in adolescents. Given its brevity and ease of interpretation, the DQ5 could be readily used in schools to screen for psychological distress in students. • Measures of adolescent psychological distress have suboptimal psychometric properties. • The Distress Questionnaire-5 (DQ5) is a 5-item measure of psychological distress. • We tested the measurement properties of the DQ5 in a longitudinal adolescent sample. • The DQ5 was unidimensional, with strong criterion and predictive validity. • The DQ5 may be used for school-based screening and measuring intervention response. [ABSTRACT FROM AUTHOR]

The Panic Disorder Screener (PADIS) was developed as a new screener to identify panic disorder in the community and to assess severity of symptoms. The PADIS was developed to fill a gap in existing screening measures, as there are no brief panic screeners available that assess severity. The current study aimed to test the performance of the screener relative to the Patient Health Questionnaire-panic scale (PHQ-panic). The 4-item PADIS was administered to 12,336 young Australian adults, together with the PHQ-panic. A subsample of 1674 participants also completed a phone-based clinical interview to determine whether they met DSM-IV criteria for panic disorder. The PADIS (77% sensitivity, 84% specificity) had higher sensitivity for identifying panic disorder based on clinical criteria than the PHQ-panic (57% sensitivity, 91% specificity), although with reduced specificity. Administration of the PADIS required a mean of 1.9 items, compared to 4.7 items for the PHQ-panic. Each one-point increase in PADIS score was associated with 69% increased odds of meeting clinical criteria for panic disorder. The PADIS was found to be a valid, reliable and brief panic screener that is freely available for use in research and clinical settings. [ABSTRACT FROM AUTHOR]

Background: The uptake of professional mental health services among people with suicidal ideation remains low, yet few community-based studies have characterised modifiable individual barriers to service use. Our aims were (1) to identify factors associated with use of professional mental health services among people experiencing suicidal ideation, and (2) to distinguish subgroups with varying levels of service use.Methods: 1462 Australian adults (78.8% female) were recruited online to participate in a cross-sectional survey. Logistic regression analysis was used to identify factors associated with professional service use. A decision tree model was used to identify subgroups with varying rates of professional service use.Results: Most participants (62%) had used professional services for mental health concerns in the past 12 months. Greater rates of service use were observed in participants who were middle aged, spoke English, disclosed to informal sources or helplines, met criteria for a mental health disorder, had higher levels of entrapment, psychological distress, and disinhibition, and lower levels of detachment and antagonism. At the terminal nodes of the decision tree analysis, service use ranged from 21% to 94%. The most important determinants of service use were meeting criteria for a mental disorder and disclosure of suicidal ideation to family/friends and helplines.Conclusion: These findings suggest that interventions to support the safe disclosure of suicidal ideation may assist in increasing service use. There is also the need for services that meet the needs of individuals who do not meet criteria for a mental health condition. [ABSTRACT FROM AUTHOR]