Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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    Somatic cormobidities and comorbid depression are associated with mortality among patients with rheumatoid arthritis: a 14-year prospective cohort study
    Hoek, J. van den; Boshuizen, H.C. ; Roorda, L.D. ; Tijhuis, G.J. ; Nurmohamed, M.T. ; Dekker, J. ; Bos, G.A. van den - \ 2014
    In: Scientific Abstracts EULAR 2014. - - p. 453 - 453.
    Background Patients with rheumatoid arthritis (RA) have a significantly increased risk of mortality compared with the general population [1]. Although the management of RA improved in the last decades, the survival in patients with RA has not improved to the same degree as that of the general population [2,3]. One of the most important predictors for mortality is somatic comorbidity. Moreover, studies have demonstrated that comorbid depression is associated with mortality. Which specific comorbidities are associated with mortality is less investigated. Objectives To investigate the association of a wide range of comorbidities with mortality in patients with RA. Methods Longitudinal data over a 14-year period were collected from 882 patients with RA. Data were assessed with self-reported questionnaires. The mortality status was obtained from the Statistics Netherlands for the period 1996-2011 for almost all of the participants included at baseline (99,8%). Somatic comorbidity was assessed in 1997, 1998, 1999 and 2008. Somatic comorbidity was measured by a national population-based questionnaire including 20 chronic diseases, of which nine categories of chronic somatic comorbidity were created. Comorbid depression was assessed in 1997, 1998 and 1999. Comorbid depression was measured with the Center for Epidemiologic Depression Scale. Cox regression was used to study the relationship between comorbidity and mortality. Results At baseline, 72% of the patients were women. The mean age was 59.3 (SD 14.8) years and the median disease duration was 5.0 (IQR 2.0-14.0) years. Comorbidities that were associated (Hazard Ratio [95% confidence intervals]) with mortality were circulatory conditions (1.62 [1.17-2.26]), respiratory conditions (1.46 [1.11-1.93]), digestive conditions (1.51 [1.02–2.22]), cancer (2.03 [1.30-3.18]) and depression (1.39 [1.09-1.77]). Conclusions Comorbid cardiovascular conditions, respiratory conditions, digestive conditions, cancer, and depression are associated with mortality among patients with RA. Careful monitoring of these comorbidities during the course of the disease and adequate referral may improve health outcomes and chances of surviving.
    Somatic comorbidity and comorbid depression are associated with mortality among patients with established rheumatoid arthritis: an eleven years follow-up cohort study
    Hoek, J. ; Roorda, L.D. ; Boshuizen, H.C. ; Tijhuis, G.J. ; Dekker, J. ; Bos, G.A. van den - \ 2013
    Annals of the Rheumatic Diseases 72 (2013)Suppl.3. - ISSN 0003-4967
    Background Rheumatoid Arthritis (RA) is associated with premature mortality (1). Somatic comorbidity has been found to be one of the most important predictors for premature mortality (2). Comorbid conditions that are associated with premature mortality are: cardiovascular diseases, respiratory diseases, gastrointestinal system disorders, genitourinary diseases, hematologic diseases, infectious diseases, and malignancies. A few studies have found comorbid depression to be associated with an increased risk for mortality (3). The combination of both somatic comorbidity and comorbid depression as a risk factor for mortality has not yet been investigated. Whether this combination is an additional risk factor for premature mortality is important information for clinicians to be able to adapt their screening process and when necessary their treatment.

    Objectives To investigate which comorbid conditions are associated with premature mortality and if the combination of a somatic comorbid condition and comorbid depression is more associated with premature mortality than one of these conditions alone.

    Methods Longitudinal data over a period of eleven years were collected from 882 patients with RA at study inclusion. Data by means of self-reported questionnaires were collected in 1997, 1998, 1999, 2002 and 2008. Of all of the participants included at baseline, the mortality status was obtained from the register of the Statistics Netherlands. Somatic comorbidity was measured by a questionnaire including 20 chronic diseases. Comorbid depression was measured with the Center for Epidemiologic Depression Scale. To study the relationship between comorbidity and survival among RA patients, we performed a Cox regression analysis.

    Results 78% of the patients at baseline were women. The mean age was 59.3 (SD 14.8) years and the median disease duration was 5.0 (IQR 2.0-14.0) years. Comorbid conditions that were associated with premature mortality were respiratory conditions, gastrointestinal conditions, cancer and comorbid depression. The combination of a somatic comorbid condition and comorbid depression did not lead to an additional risk for premature mortality.

    Conclusions Both somatic comorbidity and comorbid depression are a risk factor for premature mortality among patients with RA. These results emphasize the importance of paying attention to both somatic comorbidity and comorbid depression in clinical practice, and highlight the importance of ascertaining the presence of such comorbidities and to adjust treatment when necessary.
    Mental functioning in patients with rheumatoid arthritis over an eleven years follow-up period: the role of comorbidity
    Hoek, J. van den; Roorda, L.D. ; Boshuizen, H.C. ; Bos, G.A. van den; Hees, J. van; Rupp, I. ; Tijhuis, G. ; Dekker, J. - \ 2012
    Annals of the Rheumatic Diseases 71 (2012)Suppl.3. - ISSN 0003-4967 - p. 737 - 737.
    Background Mental functioning is reported as an important outcome measure in patients with Rheumatoid Arthritis (RA). Patients show lower mental functioning scores than the general population (1). A factor that has great impact on the overall health outcomes is comorbidity (2). Both somatic and depression comorbidity are common in patients with RA. Investigating the influence of comorbidity on mental functioning provides clinicians long term information for a particular patient. Objectives To asses the long term association of somatic and depression comorbidity and mental functioning in patients with RA. Methods Longitudinal data over a period of eleven years were collected among 882 patients with RA of varying disease duration. Patient reported outcomes were collected in 1997, 1998, 1999, 2002 and 2008. Mental functioning was measured with the Mental Component Scale of the Short Form-36 Health Survey. Somatic comorbidity was measured by a self administered questionnaire including 13 chronic diseases. Depression comorbidity was measured with the Center for Epidemiologic Depression Scale. We distinguished four groups of patients based on comorbidity at baseline: patients 1) without comorbidity 2) with only somatic comorbidity 3) with only depression comorbidity and 4) with both somatic and depression comorbidity. The influence of comorbidity at baseline on mental functioning over time was investigated in a longitudinal analysis. Results 882 patients responded to the questionnaire, of whom 78% were women. The mean age of the patients at baseline was 59.3 (SD 14.8) years and the mean disease duration was 8.9 (SD 9.9) years. For the total group of patients with RA mental functioning stayed stable over time. There was no difference in mental functioning between patients without comorbidity and patients with somatic comorbidity. Patients without comorbidity at baseline had better mental functioning at all time points than patients with depression comorbidity and patients with both somatic and depression comorbidity (p<0.01). However, the difference in mental functioning between patients without comorbidity and patients with both somatic and depression comorbidity decreased between baseline and eleven years follow up (p<0.01). Conclusions Depression comorbidity and the combination of both somatic and depression comorbidity was negatively associated with mental functioning and this association was present during eleven years follow up. Because of its long term consequences, early screening for depression comorbidity in RA would be recommended, so additional intervention can start early in the disease process to reduce the negative effects of this comorbidity.
    The influence of somatic and depression comorbidity on physical functioning over eleven years in patients with rhematoid arthritis (FRI0116)
    Hoek, J. ; Roorda, L.D. ; Boshuizen, H.C. ; Dekker, J. ; Hees, J. van; Rupp, I. ; Tijhuis, G. ; Bos, G.A. van den - \ 2012
    Annals of the Rheumatic Diseases 71 (2012)S3. - ISSN 0003-4967 - p. 349 - 349.
    Background The prevalence of comorbidity in patients with rheumatoid arthritis (RA) is higher than in the general population (1). There is increasing evidence that comorbidity plays an important role in determining RA-related outcomes, like physical functioning (2). Little is known about the impact of comorbidity on the long term. Further, the studies that investigated the effects of comorbidity on physical functioning, did not compare the influence of both somatic and depression comorbidity. With this information clinicians can early adjust their treatment to the comorbidity. Objectives To asses the long term association of comorbidity and physical functioning in patients with established RA. Methods Longitudinal data were collected among 882 patients with RA of varying disease duration at inclusion in the study. Patient reported outcomes were collected in 1997, 1998, 1999, 2002 and 2008. Physical functioning was measured with the Health Assessment Questionnaire and the Physical Component Scale of the SF-36 Health Survey. Somatic comorbidity was measured by a self administered questionnaire including 13 chronic diseases. Depression comorbidity was measured with the Center for Epidemiologic Depression Scale. We distinguished four groups of patients based on comorbidity at baseline: patients 1) without comorbidity 2) with only somatic comorbidity 3) with only depression comorbidity and 4) with both somatic and depression comorbidity. The influence of comorbidity on physical functioning over time was investigated in a longitudinal analysis. Results 882 patients respond to the questionnaire, of whom 78% were woman. The mean (SD) age of the patients at baseline was 59.3 (SD 14.8) years and the mean (SD) disease duration was 8.9(SD 9.9) years. For the total group of patients with RA, physical functioning improved over an eleven year period. Patients with comorbidity had a worse physical functioning than patients without comorbidity at all time points, by which both groups with depression comorbidity had the lowest score (p
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