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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    Repositioning of the global epicentre of non-optimal cholesterol
    Taddei, Cristina ; Zhou, Bin ; Bixby, Honor ; Carrillo-Larco, Rodrigo M. ; Danaei, Goodarz ; Jackson, Rod T. ; Farzadfar, Farshad ; Sophiea, Marisa K. ; Cesare, Mariachiara Di; Iurilli, Maria Laura Caminia ; Martinez, Andrea Rodriguez ; Asghari, Golaleh ; Dhana, Klodian ; Gulayin, Pablo ; Kakarmath, Sujay ; Santero, Marilina ; Voortman, Trudy ; Riley, Leanne M. ; Cowan, Melanie J. ; Savin, Stefan ; Bennett, James E. ; Stevens, Gretchen A. ; Paciorek, Christopher J. ; Aekplakorn, Wichai ; Cifkova, Renata ; Giampaoli, Simona ; Kengne, Andre Pascal ; Khang, Young Ho ; Kuulasmaa, Kari ; Laxmaiah, Avula ; Margozzini, Paula ; Mathur, Prashant ; Nordestgaard, Børge G. ; Zhao, Dong ; Aadahl, Mette ; Abarca-Gómez, Leandra ; Rahim, Hanan Abdul ; Abu-Rmeileh, Niveen M. ; Acosta-Cazares, Benjamin ; Adams, Robert J. ; Ferrieres, Jean ; Geleijnse, Johanna M. ; He, Yuna ; Jacobs, Jeremy M. ; Kromhout, Daan ; Ma, Guansheng ; Dam, Rob M. van; Wang, Qian ; Wang, Ya Xing ; Wang, Ying Wei - \ 2020
    Nature 582 (2020)7810. - ISSN 0028-0836 - p. 73 - 77.

    High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.

    Association of Cardiometabolic Multimorbidity With Mortality
    Angelantonio, Emanuele Di; Kaptoge, Stephen ; Wormser, David ; Willeit, Peter ; Butterworth, Adam S. ; Bansal, Narinder ; O’Keeffe, Linda M. ; Gao, Pei ; Wood, Angela M. ; Burgess, Stephen ; Freitag, Daniel F. ; Pennells, Lisa ; Peters, Sanne A. ; Hart, Carole L. ; Håheim, Lise Lund ; Gillum, Richard F. ; Nordestgaard, Børge G. ; Psaty, Bruce M. ; Yeap, Bu B. ; Knuiman, Matthew W. ; Nietert, Paul J. ; Kauhanen, Jussi ; Salonen, Jukka T. ; Kuller, Lewis H. ; Simons, Leon A. ; Schouw, Yvonne T. van der; Barrett-Connor, Elizabeth ; Selmer, Randi ; Crespo, Carlos J. ; Rodriguez, Beatriz ; Verschuren, Monique W.M. ; Salomaa, Veikko ; Svärdsudd, Kurt ; Harst, Pim Van Der; Björkelund, Cecilia ; Wilhelmsen, Lars ; Wallace, Robert B. ; Brenner, Hermann ; Amouyel, Philippe ; Barr, Elizabeth L.M. ; Iso, Hiroyasu ; Onat, Altan ; Trevisan, Maurizio ; agostino, Ralph B. D'; Cooper, Cyrus ; Kavousi, Maryam ; Welin, Lennart ; Roussel, Ronan ; Hu, Frank B. ; Sato, Shinichi ; Davidson, Karina W. ; Howard, Barbara V. ; Leening, Maarten J.G. ; Rosengren, Annika ; Dörr, Marcus ; Deeg, Dorly J.H. ; Kiechl, Stefan ; Stehouwer, Coen D.A. ; Nissinen, Aulikki ; Giampaoli, Simona ; Donfrancesco, Chiara ; Kromhout, Daan ; Price, Jackie F. ; Peters, Annette ; Meade, Tom W. ; Casiglia, Edoardo ; Lawlor, Debbie A. ; Gallacher, John ; Nagel, Dorothea ; Franco, Oscar H. ; Assmann, Gerd ; Dagenais, Gilles R. ; Jukema, Wouter J. ; Sundström, Johan ; Woodward, Mark ; Brunner, Eric J. ; Khaw, Kay-Tee ; Wareham, Nicholas J. ; Whitsel, Eric A. ; Njølstad, Inger ; Hedblad, Bo ; Wassertheil-Smoller, Sylvia ; Engström, Gunnar ; Rosamond, Wayne D. ; Selvin, Elizabeth ; Sattar, Naveed ; Thompson, Simon G. ; Danesh, John - \ 2015
    JAMA: The Journal of the American Medical Association 314 (2015)1. - ISSN 0098-7484 - p. 52 - 60.
    Importance The prevalence of cardiometabolic multimorbidity is increasing.

    Objective To estimate reductions in life expectancy associated with cardiometabolic multimorbidity.

    Design, Setting, and Participants Age- and sex-adjusted mortality rates and hazard ratios (HRs) were calculated using individual participant data from the Emerging Risk Factors Collaboration (689 300 participants; 91 cohorts; years of baseline surveys: 1960-2007; latest mortality follow-up: April 2013; 128 843 deaths). The HRs from the Emerging Risk Factors Collaboration were compared with those from the UK Biobank (499 808 participants; years of baseline surveys: 2006-2010; latest mortality follow-up: November 2013; 7995 deaths). Cumulative survival was estimated by applying calculated age-specific HRs for mortality to contemporary US age-specific death rates.

    Exposures A history of 2 or more of the following: diabetes mellitus, stroke, myocardial infarction (MI).

    Main Outcomes and Measures All-cause mortality and estimated reductions in life expectancy.
    Results In participants in the Emerging Risk Factors Collaboration without a history of diabetes, stroke, or MI at baseline (reference group), the all-cause mortality rate adjusted to the age of 60 years was 6.8 per 1000 person-years. Mortality rates per 1000 person-years were 15.6 in participants with a history of diabetes, 16.1 in those with stroke, 16.8 in those with MI, 32.0 in those with both diabetes and MI, 32.5 in those with both diabetes and stroke, 32.8 in those with both stroke and MI, and 59.5 in those with diabetes, stroke, and MI. Compared with the reference group, the HRs for all-cause mortality were 1.9 (95% CI, 1.8-2.0) in participants with a history of diabetes, 2.1 (95% CI, 2.0-2.2) in those with stroke, 2.0 (95% CI, 1.9-2.2) in those with MI, 3.7 (95% CI, 3.3-4.1) in those with both diabetes and MI, 3.8 (95% CI, 3.5-4.2) in those with both diabetes and stroke, 3.5 (95% CI, 3.1-4.0) in those with both stroke and MI, and 6.9 (95% CI, 5.7-8.3) in those with diabetes, stroke, and MI. The HRs from the Emerging Risk Factors Collaboration were similar to those from the more recently recruited UK Biobank. The HRs were little changed after further adjustment for markers of established intermediate pathways (eg, levels of lipids and blood pressure) and lifestyle factors (eg, smoking, diet). At the age of 60 years, a history of any 2 of these conditions was associated with 12 years of reduced life expectancy and a history of all 3 of these conditions was associated with 15 years of reduced life expectancy.

    Conclusions and Relevance Mortality associated with a history of diabetes, stroke, or MI was similar for each condition. Because any combination of these conditions was associated with multiplicative mortality risk, life expectancy was substantially lower in people with multimorbidity.
    Low Respiratory Function Increases the Risk of Depressive Symptoms in Later Life in Men
    Giltay, E.J. ; Nissinen, A. ; Giampaoli, S. ; Zitman, F.G. ; Kromhout, D. - \ 2010
    Psychosomatic Medicine 72 (2010)1. - ISSN 0033-3174 - p. 53 - 60.
    obstructive pulmonary-disease - geriatric medical patients - quality-of-life - lung-function - suicidal ideation - follow-up - chronic-bronchitis - cigarette-smoking - united-states - disorders
    Objective: To assess the risk of depressive symptoms with respect to respiratory function in middle-aged men. Chronic lung diseases are associated with a high prevalence of depression, but the association of poor respiratory function with depressive symptoms has not been established in prospective population-based cohort studies. Methods: In a prospective, population-based cohort study with up to 30 years of follow-up, we included 1205 men aged 50 to 69 years from Finland (n = 663) and Italy (n = 542). Forced vital capacity (FVC) and forced expiratory flow in 0.75 sec (FEV0.75) in 1970 were analyzed in relationship to depressive symptoms (by Zung self-rating depression scale [SDS]) in 1985, 1990, 1995, and 2000, using multilevel regression models. Subsequent analyses were done separately in the strata with (n = 501) and without (n = 704) chronic diseases in 1970 (i.e., chronic lung diseases, cardiovascular diseases, or diabetes mellitus). Results: Poor respiratory function was associated independently with steeper increases in depressive symptoms over time, both for FVC (p <.001) and FEV0.75 (p = .004). In participants without chronic diseases, a standard deviation (SD) increase in FVC was associated with a 1.1-point decrease (standard error [SE] = 0.4) in Zung SDS (p = .01) and a 1.5-point decrease (SE = 0.4) (p <.001) in participants with chronic diseases (p = .27 for interaction). Low FEV0.75 was associated with more depressive symptoms in participants with chronic diseases (1.7 SE 0.4 decrease per SD; p <.001), but not in participants without chronic diseases (0.6 SE 0.4 decrease per SD; p = .16; p = .008 for interaction). Conclusions: Small lung volumes were associated with an increased risk of subsequent depressive symptoms at old age, especially in persons with chronic lung diseases, cardiovascular diseases, or diabetes mellitus at baseline
    Apolipoprotein E Genotype Modifies the Association between Midlife Lung Function and Cognitive Function in Old Age
    Giltay, E.J. ; Nissinen, A. ; Giampaoli, S. ; Kromhout, D. - \ 2009
    Dementia and Geriatric Cognitive Disorders 28 (2009)5. - ISSN 1420-8008 - p. 433 - 441.
    alzheimers-disease - pulmonary-function - risk-factors - atherosclerosis risk - respiratory-function - life expectancy - apoe epsilon-4 - birth cohort - dementia - health
    Background/Aims: Because poor lung function may be a risk factor for cognitive decline, we aimed to test the association of respiratory function with cognitive function and dementia later in life, as well as potential effect modification by APOE 4 carrier status. Methods: In a prospective population-based cohort study, forced vital capacity and forced expiratory flow were measured around 1965 in 857 men aged 45-64 years (394 from Finland, 208 from The Netherlands, and 255 from Italy). The Mini-Mental State Examination scores around 1990, 1995 and 2000 were analyzed using multilevel regression models and the Clinical Dementia Rating score around 1990 using multinomial logistic regression analyses. Results: Midlife lung function was positively associated with cognitive function in old age in APOE 4 non-carriers, but not in carriers (p <0.05 for interaction). In Finland and Italy, 18.6% had questionable to mild dementia and 2.8% moderate to severe dementia after 25 years of follow-up. Dementia was inversely related to midlife lung function in APOE 4 non-carriers, but not in carriers (p <0.05 for interaction). Conclusions: Small lung volumes were prospectively associated with an increased risk for poor cognitive function and dementia in non-carriers of the APOE 4 gene.
    Serum cholesterol, apolipoprotein E genotype and depressive symptoms in elderly European men: The FINE study
    Giltay, E.J. ; Dortland, A.K.B.V.R. ; Nissinen, A. ; Giampaoli, S. ; Veen, T. ; Zitman, F.G. ; Bots, S. ; Kromhout, D. - \ 2009
    Journal of Affective Disorders 115 (2009)3. - ISSN 0165-0327 - p. 471 - 477.
    late-life depression - late-onset depression - e polymorphism - alzheimers-disease - risk-factors - e-epsilon-4 frequency - cardiovascular risk - lipoprotein changes - e epsilon-4 - association
    Background Cohort and case-control studies found that lower serum total cholesterol is associated with depression. It is, however, unclear whether low cholesterol or its lipoprotein fractions are causally related to depression. Using a Mendelian randomization design, the potential association between apolipoprotein E (APOE) genotype (affecting lifetime cholesterol levels) and depressive symptoms was studied. Methods In the longitudinal Finland, Italy, the Netherlands Elderly (FINE) Study 1089 men were included in 1985. The 435 men from Finland, 418 men from The Netherlands, and 236 men from Italy (aged 65–84 years) were free of myocardial infarction, stroke, diabetes mellitus and cancer at all time points. They were prospectively studied around 1985 (n = 658), 1990 (n = 668), 1995 (n = 327), and 2000 (n = 82). Associations between serum cholesterol, lipoprotein fractions and APOE genotype, with depressive symptoms (by Zung self-rating depression scale [SDS]) were analyzed using multilevel regression models. Results Serum total cholesterol was inversely associated with the Zung SDS (- 0.61 points per 1 mmol/L increase in cholesterol; 95% confidence interval: - 1.05 to - 0.17; P = 0.007), after adjustment for country, age, body mass index, smoking, and alcohol intake. However, none of the cholesterol lipoprotein fractions were associated with the Zung SDS. The APOE genotypes e4/4, e4/3; e3/3; e4/2, and e3/2 or e2/2 were associated with decreasing levels of serum total and LDL cholesterol (Ps <0.001), but not with increasing depressive symptoms (P = 0.67). Limitations APOE genotype was assessed through protein isoforms and not actual DNA-based typing. Conclusions There was a modest inverse relationship between depression scores and serum total cholesterol in elderly men, but no associations with lipoprotein fractions or with the APOE genotype
    The association of depression with cardiovascular mortality is partly explained by health status. The FINE Study
    Kamphuis, M.H. ; Geerlings, M.I. ; Giampaoli, S. ; Nissinen, A. ; Grobbee, D.E. ; Kromhout, D. - \ 2009
    Journal of Affective Disorders 114 (2009)1-3. - ISSN 0165-0327 - p. 184 - 192.
    self-rated health - coronary-heart-disease - elderly-men - myocardial-infarction - older persons - risk-factors - symptoms - scale - community - events
    Background Depression is associated with an increased risk of cardiovascular diseases (CVD) and cardiovascular mortality. We investigated to what extent subjective health status explained the apparent association between depressive symptoms and cardiovascular mortality in older European men. Methods Data were used from the population-based prospective Finland, Italy and the Netherlands Elderly (FINE) Study. Depressive symptoms were measured with the Zung Self-rating Depression Scale in 909 men, aged 70¿90 years, free of CVD and diabetes in 1990. Subjective health status was estimated with a single question on self-rated health and with a standardized questionnaire about activities of daily living. Cardiovascular mortality was determined during ten years of follow-up. Results At baseline, poor self-rated health and more disability in activities of daily living were both associated with more depressive symptoms using multiple linear regression analysis. Prospectively men who reported to be unhealthy or with moderate to severe disability had an approximately 2.5 times higher risk of cardiovascular mortality using Cox regression analysis. An increase in depressive symptoms by one standard deviation was associated with an increased risk of cardiovascular mortality (HR 1.37; 95% CI 1.21¿1.56). A substantial part of this association was explained by self-rated health and disability (proportion explained 0.32; 95% CI 0.09¿0.55). However, a significant risk of depressive symptoms on cardiovascular mortality remained (HR 1.25; 95% CI 1.09¿1.43) after adjustment for subjective health status. Limitations Health status is based on subjective measures. Conclusions In older men, subjective health status explains a considerable part of the association between depression and risk of cardiovascular mortality
    Lifestyle- and diet-related factors in late-life depression - a 5-year follow-up of elderly European men: the FINE study
    Bots, S. ; Tijhuis, M.J. ; Giampaoli, S. ; Kromhout, D. ; Nissinen, A. - \ 2008
    International Journal of Geriatric Psychiatry 23 (2008)5. - ISSN 0885-6230 - p. 478 - 484.
    physical-activity - older-adults - alcohol-consumption - general-population - total cholesterol - fish consumption - global burden - symptoms - exercise - risk
    Objective Late-life depression is one of the main health problems among elderly populations and a key element of healthy ageing. Causal relationships of lifestyle- and diet-related factors in late-life depression are unclear. This study investigates prospective associations of lifestyle- and diet-related factors with development of categorically defined late-life depression in a well-documented population of elderly European men. Subjects and methods Altogether 526 not-demented and not-depressed European men aged 70-89 at baseline were included in the analyses. The association of lifestyle-related and dietary factors with development of categorically defined depression (> = 48/80 on the Zung Self-rating Depression Scale) was assessed in a follow-up of 5 years. Results Eleven percent (n = 59) of the men developed depression during follow-up. An independent association with development of depression was found for baseline depressive status [Odds Ratio (OR) 1.19, 95% Confidence Interval (CI): 1.10-1.28, p <0.001], a decline in serum total cholesterol level between study years (OR 1.76, 95%CI: 1.01-3.04, p = 0.045), physical activity (OR 0.97, 95%CI: 0.94-1.00, p = 0.022) and moderate alcohol intake (OR 0.35, 95%CI: 0.14-0.87, p = 0.023) but not for dietary factors. Conclusions This study of a well-documented population of elderly European men confirms that physical activity and moderate alcohol consumption may protect against depression in the old-old. Our results are the first to suggest that a decline in serum cholesterol level may predict development of late-life depression. As the effects of age, medication and incipient cognitive decline could not be entirely ruled out; this finding must be interpreted with care
    Physical inactivity, depression, and risk of cardiovascular mortality
    Kamphuis, M.H. ; Geerlings, M.I. ; Tijhuis, M.A.R. ; Giampaoli, S. ; Nissinen, A. ; Grobbee, D.E. ; Kromhout, D. - \ 2007
    Medicine and Science in Sports and Exercise 39 (2007)10. - ISSN 0195-9131 - p. 1693 - 1699.
    coronary-heart-disease - elderly-men - myocardial-infarction - postmenopausal women - symptoms - exercise - scale - zung - netherlands - finland
    Purpose: Studies indicate that depression may increase risk of cardiovascular disease (CVD) in addition to classical risk factors. One of the hypotheses to explain this relation is that depressed subjects become physically inactive. We set out to determine the role of physical inactivity in the relation between depressive symptoms and cardiovascular mortality. Methods: Data were used from the population-based prospective Finland, Italy, and the Netherlands Elderly (FINE) Study. Depressive symptoms were measured with the Zung Self-Rating Depression Scale in 909 elderly men, aged 70-90 yr, free of CVD and diabetes at baseline in 1990. Physical activity was assessed with a questionnaire for retired men. Hazard ratios (HR) for 10-yr cardiovascular mortality were calculated, adjusting for demographics and cardiovascular risk factors. Results: At baseline, men with more depressive symptoms were less physically active (722 min.wk(-1); 95% confidence interval (CI), 642-802) than men with few depressive symptoms (919 min.wk(-1); 95% CI, 823-1015). During 10 yr of follow-up, 256 (28%) men died from CVD. The adjusted HR of cardiovascular mortality for a decrease of 30 min.d(-1) in physical activity was 1.09 (95% CI, 1.04-1.14). An increase in depressive symptoms with one standard deviation was associated with a higher cardiovascular mortality risk (HR = 1.42; 95% CI, 1.26-1.60). After additional adjustment for physical activity the risk decreased (9%), but an independent risk remained (HR = 1.37; 95% CI, 1.21-1.56). The excess risk on cardiovascular mortality attributable to the combined effect of depressive symptoms with inactivity was 1.47 (95% CI, -0.17 to 3.11). Conclusions: In the present study, the increased risk of depressive symptoms on cardiovascular mortality could not be explained by physical inactivity. However, our results suggest that depressive symptoms and physical inactivity may interact to increase cardiovascular mortality risk.
    Autonomic dysfunction: a link between depression and cardiovascular mortality? The FINE Study
    Kamphuis, M.H. ; Geerlings, M.I. ; Dekker, J.M. ; Giampaoli, S. ; Nissinen, A. ; Grobbee, D.E. ; Kromhout, D. - \ 2007
    European Journal of Cardiovascular Prevention and Rehabilitation 14 (2007)6. - ISSN 1741-8267 - p. 796 - 802.
    heart-rate-variability - coronary-artery-disease - elderly-men - myocardial-infarction - nervous-system - qt-interval - plasma norepinephrine - psychosocial factors - major depression - symptoms
    Background: Depression is associated with an increased risk of cardiovascular diseases (CVD) in vascular patients as well as in the general population. We investigated whether autonomic dysfunction could explain this relationship. Design: The Finland, Italy and The Netherlands Elderly (FINE) Study is a prospective cohort study. Methods: Depressive symptoms were measured with the Zung Self-rating Depression Scale in 870 men, aged 70-90 years, free of CVD and diabetes in 1990. Resting heart rate was determined from a 15-30-s resting electrocardiogram in The Netherlands and Italy and as pulse rate in Finland. In addition, in The Netherlands, heart-rate variability (HRV) and QTc interval were determined. Results: At baseline, depressive symptoms were associated with an increase in resting heart rate, and nonsignificantly with low HRV and prolonged QTc interval. After 10 years of follow-up, 233 (27%) men died from CVD. Prospectively, an increase in resting heart rate with 1 SD was associated with an increased risk of cardiovascular mortality [hazard ratio (HR), 1.22; 95% confidence interval (CI), 1.08-1.38]. In addition, low HRV (HR, 0.78; 95% CI, 0.61-1.01) and prolonged QTc interval (HR, 1.28; 95% CI, 1.06-1.53) per SD were associated with cardiovascular mortality. The increased risk of depressive symptoms for cardiovascular mortality (HR, 1.38; 95% CI, 1.21-1.58) did not change after adjustments for several indicators of autonomic dysfunction. Conclusion: This study suggests that mild depressive symptoms are associated with autonomic dysfunction in elderly men. The increased risk of cardiovascular mortality with increasing magnitude of depressive symptoms could, however, not be explained by autonomic dysfunction.
    Decline in Cognitive Functioning Is Associated with a Higher Mortality Risk
    Gelder, B.M. van; Tijhuis, M.A.R. ; Kalmijn, S. ; Giampaoli, S. ; Kromhout, D. - \ 2007
    Neuroepidemiology 28 (2007)2. - ISSN 0251-5350 - p. 93 - 100.
    mini-mental-state - alzheimers-disease - elderly-men - terminal decline - dementia - survival - population - death - netherlands - impairment
    Objective: This study investigates the association between 5-year change in cognitive functioning and subsequent mortality. Methods:Four hundred and ninety-three Dutch and Italian men from the Finland, Italy, and the Netherlands Elderly (FINE) Study, born between 1900 and 1920, participated in the present study between 1990 and 2000. Cognitive functioning was measured with the Mini-Mental State Examination in 1990 and 1995, and mortality data were obtained until the year 2000. A proportional hazard analysis was used to investigate the association between 5-year change in cognitive functioning and subsequent 5-year mortality. Adjustments were made for age, education, country, lifestyle factors, prevalence of chronic diseases and, additionally, for baseline cognitive functioning. Results:Men whose cognition decreased (more than 1 standard deviation) between 1990 and 1995 had a 2-fold higher risk of dying in the following 5 years compared with men whose cognition was stable (adjusted hazard ratio = 1.9; 95% confidence interval 1.3-2.7). Mortality risk of men whose cognition improved between 1995 and 2000 was not different from men whose cognition was stable (adjusted hazard ratio = 1.1, 95% confidence interval 0.7-1.9). Conclusion:A decline in cognitive functioning is associated with a higher mortality risk.
    Coffee consumption is inversely associated with cognitive decline in elderly European men: the FINE Study
    Gelder, B.M. van; Buijsse, B. ; Tijhuis, M.J. ; Kalmijn, S. ; Giampaoli, S. ; Nissinen, A. ; Kromhout, D. - \ 2007
    European Journal of Clinical Nutrition 61 (2007)2. - ISSN 0954-3007 - p. 226 - 232.
    risk-factors - alzheimers-disease - state-examination - caffeine - humans - netherlands - performance - adenosine - finland - age
    Objective: To investigate whether coffee consumption is associated with 10-year cognitive decline in elderly men, as results of previous studies obtained hitherto have been controversial and prospective information on this association has been lacking. Design, subjects and setting: Six hundred and seventy six healthy men born between 1900 and 1920 from Finland, Italy and the Netherlands participated in a 10-year prospective cohort study. Cognitive functioning was assessed using the Mini-Mental State Examination (0¿30 points, with a higher score indicating better cognitive performance). Coffee consumption was estimated in cups per day. A mixed longitudinal model was used to investigate the association between baseline coffee consumption and 10-year cognitive decline. Multiple adjustments were made. Results: Men who consumed coffee had a 10-year cognitive decline of 1.2 points (4%). Non-consumers had an additional decline of 1.4 points (P
    Marital status and living situation during a 5-year period are associated with a subsequent 10-year cognitive decline in older men: The FINE study
    Gelder, B.M. van; Tijhuis, M. ; Kalmijn, S. ; Giampaoli, S. ; Nissinen, A. ; Kromhout, D. - \ 2006
    Journals of Gerontology. Series B: Psychological Sciences & Social Sciences 61 (2006)4. - ISSN 1079-5014 - p. P213 - P219.
    social integration - risk-factors - elderly-men - alzheimers-disease - leisure activities - physical-activity - dementia - health - performance - prevalence
    We investigate the association between marital status and living situation (over 5 years) on 10-year subsequent cognitive decline. The study population consisted of 1,042 men aged 70-89 years in 1990, who participated in the longitudinal Finland, Italy, the Netherlands Elderly (known as FINE) Study. We measured cognition by using the Mini-Mental State Examination, and we assessed marital status (married vs unmarried) and living situation (living with others vs living alone) with a standardized questionnaire. We performed repeated measurement analyses and made adjustments for age, education, country, smoking, alcohol, chronic diseases, marital status or living situation, and baseline cognition. Men who lost a partner, who were unmarried, who started to live alone, or who lived alone during the 5-year period had at least a two times stronger subsequent cognitive decline compared with men who were married or who lived with someone in those years.
    Hierarchy levels, sum score, and worsening of disabitity are related to depressive symptoms in elderly men from three European countries
    Brink, C.L. van den; Bos, G.A.M. van den; Tijhuis, M.A.R. ; Aijanseppa, S. ; Nissinen, A. ; Giampaoli, S. ; Kromhout, D. - \ 2006
    Journal of Aging and Health 18 (2006)1. - ISSN 0898-2643 - p. 125 - 141.
    gospel oak project - quality-of-life - physical health - older-adults - functional impairment - geriatric depression - sex-differences - risk-factors - association - population
    The objectives were to investigate the predictive value of hierarchy levels and sum score of disability and change in disability on depressive symptoms. Method: Longitudinal data of 723 men age 70 and older from the Finland, Italy, and the Netherlands Elderly Study were collected in 1990 and 1995. Self-reported disability was based on three disability domains (instrumental activities, mobility, and basic activities) and depressive symptoms on the Zung questionnaire. Results: Severity levels of disability were positively associated with depressive symptoms. Men with no disability scored 5 to 17 points lower (p <.01) on depressive symptoms than did those with disability in all domains. Among men with mild disability, those who had worsening of disability status in the preceding 5 years scored 5 points higher (p = .004) on depressive symptoms than did men who improved. Discussion: Hierarchic severity levels, sum score of disability, and preceding changes in disability status are risk factors for depressive symptoms
    Depressive symptoms as risk factor of cardiovascular mortality in older European men: the Finland, Italy and Netherlands elderly (FINE) study
    Kamphuis, M.H. ; Kalmijn, S. ; Tijhuis, M.A.R. ; Geerlings, M.I. ; Giampaoli, S. ; Nissinen, A. ; Grobbee, D.E. ; Kromhout, D. - \ 2006
    European Journal of Cardiovascular Prevention and Rehabilitation 13 (2006)2. - ISSN 1741-8267 - p. 199 - 206.
    coronary-heart-disease - plasma norepinephrine - myocardial-infarction - major depression - scale - events - zung - age - metaanalysis - association
    BACKGROUND: Depressive symptoms have been suggested to increase the risk of cardiovascular diseases, but this may reflect reversed causality. We investigated to what extent depressive symptoms are a true risk factor for cardiovascular mortality in elderly men. DESIGN: The Finland, Italy and Netherlands Elderly (FINE) study is a prospective cohort study conducted in Finland, Italy and The Netherlands. METHODS: Depressive symptoms were measured with the Zung self-rating Depression Scale in 799 elderly men, aged 70-90 years, free from cardiovascular diseases. Using Cox models, hazard ratios (HRs) were calculated for specific cardiovascular mortality endpoints. The analyses were adjusted for potential confounders, stratified on country and repeated after exclusion of men who died from cardiovascular diseases up to 5 years after baseline. RESULTS: During 10-years of follow-up 224 (28%) men died from cardiovascular diseases. The adjusted hazard for a five-point increase in depressive symptoms was 1.15 [95% confidence interval (CI) 1.08-1.23] for cardiovascular mortality. This risk was stronger for mortality from stroke (HR 1.35; 95% CI 1.19-1.53) and heart failure (HR 1.16; 95% CI 1.00-1.35) in comparison with mortality from coronary heart disease (HR 1.08; 95% CI 0.97-1.20) and other degenerative heart diseases (HR 1.06; 95% CI 0.91-1.23). Exclusion of men who died from cardiovascular diseases within 5 years after baseline did not change the strength of the associations. There were no significant differences in HRs between northern and southern Europe. CONCLUSIONS: This study provides further and more convincing prospective evidence for depressive symptoms as a risk factor for cardiovascular mortality in elderly men.
    The contribution of self-rated health and depressive symptoms to disability severity as a predictor of 10-year mortality in European elderly men
    Brink, C.L. van den; Tijhuis, M. ; Bos, G.A.M. van den; Giampaoli, S. ; Nissinen, A. ; Kromhout, D. - \ 2005
    American Journal of Public Health 95 (2005)11. - ISSN 0090-0036 - p. 2029 - 2034.
    functional status - risk-factors - physical-activity - older-adults - community - association - gender - performance - survival - women
    Objectives. To investigate the effect of disability severity and the contribution of self-rated health and depressive symptoms to 10-year mortality. Methods. Longitudinal data were collected from 1141 men aged 70 to 89 years from the Finland, Italy, and the Netherlands Elderly Study from 1990 to 2000. Disability severity was classified into 4 categories: no disability, instrumental activities, mobility, and basic activities of daily living. Self-rated health and depressive symptoms were classified into 2 and 3 categories, respectively. Multivariate Cox proportional hazard models were used to calculate mortality risks. Results. Men with severe disability had a risk of mortality that was more than 2-fold higher (hazard ratio [HR] = 2.41; 95% confidence interval [CI] = 1.84, 3.16) than that of men without disability. Men who had severe disability and did not feel healthy had the highest mortality risk (HR = 3.30; 95% CI = 2.52, 4.33). This risk was lower at lower levels of disability and higher levels of self-rated health. The same trend was observed for depressive symptoms. Conclusions. For adequate prognoses on mortality or for developing intervention strategies, not only physical aspects of health but also other health outcomes should be taken into account.
    Duration and intensity of physical activity and disability among European elderly men
    Brink, C.L. van den; Picavet, H.S.J. ; Bos, G.A.M. van den; Giampaoli, S. ; Nissinen, A. ; Kromhout, D. - \ 2005
    Disability & Rehabilitation 27 (2005)6. - ISSN 0963-8288 - p. 341 - 347.
    body-mass index - risk-factors - cardiovascular-diseases - functional decline - late-life - older - zutphen - associations - performance - population
    PURPOSE: To investigate the relationship between duration and intensity of physical activity and disability 10 years later, and to investigate the possible effect of selective mortality. METHOD: Longitudinal data of 560 men aged 70?-?89 years, without disability at baseline from the Finland, Italy and The Netherlands Elderly (FINE) Study was used. Physical activity in 1990 was based on activities like walking, bicycling and gardening. Disability severity (three categories) in 1990 and 2000 was based on instrumental activities, mobility and basic activities of daily living. RESULTS: Men in the highest tertile of total physical activity had a lower risk of disability than men in the lowest tertile (odds ratio (OR) 0.46; 95% confidence interval (CI): 0.26-0.84). This was due to duration of physical activity (OR highest tertile 0.42; 95% CI: 0.23-0.78 compared to the lowest tertile). Intensity of physical activity was not associated with disability. Addition of deceased men as fourth category leaded to weaker associations between physical activity and disability (OR highest tertile 0.67; 95% CI: 0.44-1.02). CONCLUSIONS: Even in old age among relatively healthy men, a physically active lifestyle was inversely related to disability. To prevent disability duration of physical activity seems to be more important than intensity.
    Effect of widowhood on disability onset in elderly men from three european countries
    Brink, C.L. van den; Tijhuis, M.A.R. ; Bos, G.A.M. van den; Giampaoli, S. ; Kivinen, P. ; Nissinen, A.M. ; Kromhout, D. - \ 2004
    Journal of the American Geriatrics Society 52 (2004)3. - ISSN 0002-8614 - p. 353 - 358.
    self-rated health - marital-status - life events - mortality differences - depressive symptoms - older adults - netherlands - performance - gender
    OBJECTIVES: To investigate in different countries the effects of becoming widowed, duration of widowhood, and household composition of widowed men on disability onset in different disability domains. DESIGN: Longitudinal data from a cohort study collected around 1990, 1995, and 2000. SETTING: Three cohorts from Finland, The Netherlands, and Italy. PARTICIPANTS: Seven hundred thirty-six men, aged 70 and older at baseline. MEASUREMENTS: Disability was measured using standardized questionnaire on activities of daily living (ADLs). Three domains were assessed: instrumental ADLs (IADLs), mobility, and basic ADLs (BADLs). Duration of widowhood was divided into less than 5 years and 5 or more years and household composition into living alone and living with family or in an institution. RESULTS: Men who became widowed developed more IADL disabilities (odds ratio (OR)=2.15; 95% confidence interval (CI)=1.22-3.81) and mobility (OR=1.84; 95% CI=1.15-2.96) than men who were still married. Men who had been widowed for less than 5 years developed more IADL disabilities than those who had been widowed for 5 years or more (OR=2.27; 95% CI=1.14-4.54). Widowed men living alone showed fewer disabilities in mobility (OR=0.25; 95% CI=0.09-0.73) and BADLs (OR=0.02; 95% CI=0.001-0.33) than those living with others. The effects on disability onset did not differ between countries. CONCLUSION: Widowhood in elderly men is a risk factor for dependency in IADLs and mobility. The growth in the number of widowers may lead to higher demands on family care and professional care
    Moderate coffee consumption is associated with a less rapid cognitive decline in elderly men: the FINE study
    Gelder, B.M. van; Buijsse, G.M. ; Kalmijn, S. ; Tijhuis, M.J. ; Giampaoli, S. ; Nissinen, A. ; Kromhout, D. - \ 2004
    Neurobiology of aging 25 (2004)S2. - ISSN 0197-4580 - p. S481 - S481.
    Coffee is a daily consumed drink in most Western countries and is the primary source of caffeine. Caffeine intake seems to be beneficial for cognitive function on the short term, however results are controversial and longitudinal information on this association is lacking. Objective(s): This study investigated whether coffee consumption is associated with 10- year age-related cognitive decline in elderly men. Methods: Seven hundred and seven healthy men born between 1900 and 1920 of Finland, Italy and the Netherlands participated in this longitudinal study between 1990 and 2000. Cognitive functioning was assessed using the Mini Mental State Examination (MMSE). The maximum score on the MMSE is 30 points, with a higher score indicating better cognitive performance. Coffee consumption was estimated in cups per day. A mixed longitudinal random coefficient model was used to determine the association between baseline coffee consumption and 10-year cognitive decline. Adjustments were made for the potential confounding factors age, education, alcohol consumption, smoking status, serum cholesterol, cohort, anti-hypertensive drug use, anticoagulant use, body mass index, physical activity and baseline cognitive functioning (if applicable). Results: Cognitive functioning did not differ between coffee consumers and non-consumers in 1990. However, men who did not drink coffee had a 10 year cognitive decline of 2.5 points (8.3%), which is stronger (p <0.05) than the cognitive decline of men who did drink one to four cups of coffee a day. Men who consumed three cups of coffee a day had the least cogllitive decline of 0.6 points (2.0%), which was 4.2 times less rapid than men who did not drink coffee (p <0.001). The cognitive decline of men who consumed more than four cups of coffee per day did not differ from men who did not drink coffee. Conclusions: Our findings suggest that drinking 1-4 cups of coffee a day may reduce cognitive decline in elderly men. However, confirmation by other longitudinal studies is necessary.
    Coffee consumption is associated with a less rapid cognitive decline in elderly men. The FINE study
    Gelder, B.M. van; Buijsse, G.M. ; Tijhuis, M.J. ; Kalmijn, S. ; Giampaoli, S. ; Nissinen, A. ; Kromhout, D. - \ 2004
    Journal of Nutrition, Health and Aging 8 (2004)6. - ISSN 1279-7707 - p. 457 - 457.
    Self-reported disability and its association with performance-based limitation in elderly men: A comparison of three European countries
    Brink, C.L. van den; Tijhuis, M. ; Kalmijn, S. ; Klazinga, N.S. ; Nissinen, A. ; Giampaoli, S. ; Kivinen, P. ; Kromhout, D. ; Bos, G.A.M. van den - \ 2003
    Journal of the American Geriatrics Society 51 (2003)6. - ISSN 0002-8614 - p. 782 - 788.
    functional status - physical function - rated health
    OBJECTIVES:To compare self-reported disability and performance-based limitation and their association in elderly men from three European countries. DESIGN:Cross-sectional data from a cohort study collected around 1990. SETTING:Three cohorts from Finland, the Netherlands, and Italy. PARTICIPANTS:One thousand one hundred sixty-one men aged 70 and older. MEASUREMENTS:Disability and functional limitation were measured in a standardized way in three countries. Self-reported disability was estimated by questionnaire, assessing three domains of activities of daily living: instrumental activities of daily living, mobility, and activities of daily living (score 0¿3). Functional limitation was measured by performance tests (score 0¿16), with 0 indicated the healthiest score. RESULTS:Self-reported disability and performance-based limitation scores differed between countries. Mean self-reported disability score was worse in Italy (0.72) and the Netherlands (0.70) than in Finland (0.54). Italian men scored worst on the performance-based tests (mean 4.80 vs 4.04 for Finland and 3.74 for the Netherlands). Differences in self-reported disability remained after adjusting for performance scores: Dutch men reported more disabilities (odds ratio (OR) = 1.66, 95% confidence interval (CI) = 1.23¿2.25) than men in Finland (reference group) and Italy (OR = 1.08, 95% CI = 0.77¿1.53). Self-reported disability was positively associated with performance-based score (OR = 1.28, 95% CI = 1.21¿1.35) and did not differ between countries. CONCLUSION:Cross-cultural variation was noted in self-reported disability adjusted for performance score. These differences may be due to sociocultural and physical environmental factors. Self-reported disability was consistently associated with performance-based limitation in Finland, the Netherlands, and Italy.
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