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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    Biological control of potato soft rot caused by Dickeya solani and the survival of bacterial antagonists under cold storage conditions
    Hadizadeh, I. ; Peivastegan, B. ; Hannukkala, A. ; Wolf, J.M. van der; Nissinen, R. ; Pirhonen, M. - \ 2018
    Plant Pathology 68 (2018)2. - ISSN 0032-0862 - p. 297 - 311.
    Dickeya and Pectobacterium are responsible for causing blackleg of plants and soft rot of tubers in storage and in the field, giving rise to losses in seed potato production. In an attempt to improve potato health, biocontrol activity of known and putative antagonists was screened using in vitro and in planta assays, followed by analysis of their persistence at various storage temperatures. Most antagonists had low survival on potato tuber surfaces at 4 °C. The population dynamics of the best low‐temperature tolerant strain and also the most efficient antagonist, Serratia plymuthica A30, along with Dickeya solani as target pathogen, was studied with TaqMan real‐time PCR throughout the storage period. Tubers of three potato cultivars were treated in the autumn with the antagonist and then inoculated with D. solani. Although the cell densities of both strains decreased during the storage period in inoculated tubers, the pathogen population was always lower in the presence of the antagonist. The treated tubers were planted in the field the following growing season to evaluate the efficiency of the bacterial antagonist for controlling disease incidence. The potato endophyte S. plymuthica A30 protected potato plants by reducing blackleg development on average by 58.5% and transmission to tuber progeny as latent infection by 47–75%. These results suggest that treatment of potato tubers with biocontrol agents after harvest can reduce the severity of soft rot disease during storage and affect the transmission of soft rot bacteria from mother tubers to progeny tubers during field cultivation.
    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
    Respiratory function and other biological risk factors for completed suicide: 40 years of follow-up of European cohorts of the Seven Countries Study
    Giltay, E.J. ; Zitman, F.G. ; Menotti, A. ; Nissinen, A. ; Jacobs, D.R. ; Adachi, H. ; Kafatos, A. ; Kromhout, D. - \ 2010
    Journal of Affective Disorders 120 (2010)1-3. - ISSN 0165-0327 - p. 249 - 253.
    body-mass index - serum-cholesterol - united-states - lung-function - men - association - mortality - height - death - ideation
    Background - Prospective cohort studies on biological risk factors of completed suicide are scarce. We aimed to test which biological risk factors independently identify subjects at increased risk of suicidal death. Methods - In the prospective cohort of the Seven Countries Study, 5,321 middle-aged men from Finland, Serbia, Italy, and Greece were included. Completed suicide (ICD-8 codes E950-959) was assessed during 40 years of follow-up. Biological cardiovascular risk factors (including forced vital capacity [FVC] and height) were tested for their role as predictors in multivariable Cox models stratified by country. Results - There were 4518 deaths during follow-up, with 64 from suicide (1.4%). In univariable models, only FVC and height were strongly inversely related with suicide. Socio-economic status and being unmarried were potential confounders. In multivariable models taking these confounders into account, both a low FVC (0.30 for top vs. lowest quartile; 95% CI: 0.12–0.76; P = 0.006 for trend) and a low FVC/height ratio (0.37 for top vs. lowest quartile; 95% CI: 0.17–0.82; P = 0.004 for trend) were strongly inversely related with completed suicide. Limitations - Information on proximal causes, such as prior suicidal ideation, emotional distress and depression, was lacking at baseline. Conclusions - Poor respiratory function in middle-aged men was an independent risk factor for completed suicide
    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
    Cardiovascular risk factors and dementia mortality: 40 years of follow-up in the Seven Countries Study
    Alonso, A. ; Jacobs, D.R. ; Menotti, A. ; Nissinen, A. ; Dontas, A. ; Kafatos, A. ; Kromhout, D. - \ 2009
    Journal of the Neurological Sciences 280 (2009)1-2. - ISSN 0022-510X - p. 79 - 83.
    alzheimers-disease - vascular dementia - cognitive decline - blood-pressure - midlife - smoking - cholesterol - life - atherosclerosis - metaanalysis
    Previous research shows that cardiovascular risk factors in mid-adulthood could increase the risk of dementia later in life, but studies with very long follow-up are still scarce. We assessed whether cardiovascular risk factors measured in midlife were associated with dementia mortality during a 40-year follow-up. 10,211 men, aged 40-59 at baseline, from 13 cohorts of the Seven Countries Study were followed for 40 years. Information on cardiovascular risk factors was obtained at baseline from questionnaires and a physical examination. Dementia death was assigned if there was any mention of dementia on the death certificate. Associations between cardiovascular risk factors and death from dementia were estimated through Cox proportional hazards models. We identified 160 dementia deaths during the follow-up. Smoking, hypercholesterolemia, high blood pressure, low forced vital capacity and previous history of cardiovascular disease at baseline were associated with a higher risk of death from dementia in the follow-up. The hazard ratio (HR) of dementia death among heavy smokers was 1.58 (95% confidence interval (CI) 1.03, 2.43) compared to non-smokers. Similarly, the HR (95% CI) among those with systolic BP -> 160 or diastolic BP -> 95 mm Hg compared to normotensives (<140/90) was 1.55 (1.02, 2.35). Individuals with the largest forced vital capacity had a lower risk of dying of dementia (HR 0.54, 95% CI 0.30, 0.98). Finally, total serum cholesterol was directly associated with higher risk of dementia mortality (p for trend = 0.03). In men, cardiovascular risk factors in midlife are associated with increased risk of dementia death later in life
    Homogeneity in the relationship of serum cholesterol to coronary deaths across different cultures: 40-year follow-up of the Seven Countries Study
    Menotti, A. ; Lanti, M. ; Kromhout, D. ; Blackburn, H. ; Jacobs, D. ; Nissinen, A. ; Dontas, A. ; Kafatos, A. ; Nedeljkovic, S. ; Adachi, H. - \ 2008
    European Journal of Cardiovascular Prevention and Rehabilitation 15 (2008)6. - ISSN 1741-8267 - p. 719 - 725.
    heart-disease - europe - risk - prediction - mortality - project - score
    Background: The aim was to investigate whether multivariate coefficients of serum cholesterol in the prediction of coronary heart disease (CHD) deaths were similar across different cultures in a long-term follow-up. Design: Thirteen cohorts for a total of 10 157 men aged 40¿59 years at entry, enrolled in seven countries (USA, Finland, the Netherlands, Italy, Serbia, Greece, Japan) were repeatedly examined and followed up for 40 years. Methods: Serum cholesterol measured at baseline, and then on repeated occasions, was studied, using multivariate models, in relation with the occurrence of CHD deaths during a 40-year follow-up. Results: Homogeneity of multivariate serum cholesterol coefficients was found considering cholesterol levels at baseline, as average of up to three measurements during the first 10 years, as average of up to six measurements in 35 years, using the time-dependent technique with up to three measurements in 10 years, and with up to six measurement in 35 years. Conclusion: The strength of the association between serum cholesterol and CHD death seems homogeneous across different cultures characterized by different levels of serum cholesterol and different absolute risk of CHD death.
    Effects of Past and Recent Blood Pressure and Cholesterol Level on Coronary Heart Disease and Stroke Mortality, Accounting for Measurement Error - Reply ( letter to the editor
    Boshuizen, H.C. ; Lanti, M. ; Menotti, A. ; Moschandreas, J. ; Tolonen, H. ; Nissinen, A. ; Nedeljkovic, S. ; Kafatos, A. ; Kromhout, D. - \ 2008
    American Journal of Epidemiology 167 (2008)4. - ISSN 0002-9262 - p. 503 - 504.
    The authors aimed to quantify the effects of current systolic blood pressure (SBP) and serum total cholesterol on the risk of mortality in comparison with SBP or serum cholesterol 25 years previously, taking measurement error into account. The authors reanalyzed 35-year follow-up data on mortality due to coronary heart disease and stroke among subjects aged 65 years or more from nine cohorts of the Seven Countries Study. The two-step method of Tsiatis et al. (J Am Stat Assoc 1995;90:27-37) was used to adjust for regression dilution bias, and results were compared with those obtained using more commonly applied methods of adjustment for regression dilution bias. It was found that the commonly used univariate adjustment for regression dilution bias overestimates the effects of both SBP and cholesterol compared with multivariate methods. Also, the two-step method makes better use of the information available, resulting in smaller confidence intervals. Results comparing recent and past exposure indicated that past SBP is more important than recent SBP in terms of its effect on coronary heart disease mortality, while both recent and past values seem to be important for effects of cholesterol on coronary heart disease mortality and effects of SBP on stroke mortality. Associations between serum cholesterol concentration and risk of stroke mortality are weak.
    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.
    Forty-year coronary mortality trends and changes in major risk factors in the first 10 years of follow-up in the seven countries study
    Menotti, A. ; Lanti, M. ; Kromhout, D. ; Blackburn, H. ; Nissinen, A. ; Dontas, A. ; Kafatos, A. ; Nedeljkovic, S. ; Adachi, H. - \ 2007
    European Journal of Epidemiology 22 (2007)11. - ISSN 0393-2990 - p. 747 - 754.
    monica project populations - heart-disease mortality - blood-pressure changes - all-cause mortality - cardiovascular-diseases - european cohorts - serbian cohorts - event rates - deaths - cholesterol
    Time trends in coronary heart disease (CHD) mortality during a 40-year follow-up were studied in the Seven Countries Study. Thirteen cohorts of men aged 40¿59 at entry were enrolled in seven countries (USA, Finland, the Netherlands, Italy, Serbia, Greece and Japan) for a total of 10,628 subjects. Cardiovascular risk factors were measured at entry and at the 10-year follow-up examination and coronary heart disease mortality data collected during 40 years. During the 40-year follow-up, the hazard rate of the Weibull parametric distribution (annual conditional risk of death) for CHD mortality tended to slightly decline in the US, Finnish, Dutch and Japanese cohorts, moderately increased in Italy and exponentially increased in cohorts of Serbia and Greece. A strong positive association was found between the shape of the hazard curve, describing the acceleration of the hazard, and a score of population mean risk factor changes (serum cholesterol, systolic blood pressure and smoking prevalence) observed during the first 10 years of follow-up, with a correlation coefficient of 0.91 between the two indicators. The countries with a relative decline in the annual hazard function were the same where, during the same historical period, large decreases in official death rate from CHD were recorded, and viceversa. The acceleration in mortality risk for CHD mortality in different countries, described by the shape of the Weibull distribution, is related to changes in mean levels of major coronary risk factors.
    Effects of Past and Recent Blood Pressure and Cholesterol Level on Coronary Heart Disease and Stroke Mortality, Accounting for Measurement Error
    Boshuizen, H.C. ; Lanti, M. ; Menotti, A. ; Moschandreas, J. ; Tolonen, H. ; Nissinen, A. ; Nedeljkovic, S. ; Kafatos, A. ; Kromhout, D. - \ 2007
    American Journal of Epidemiology 165 (2007)4. - ISSN 0002-9262 - p. 398 - 409.
    regression dilution bias - serum total cholesterol - all-cause mortality - cardiovascular-disease - follow-up - risk-factors - 7 countries - metaanalysis - age - underestimation
    The authors aimed to quantify the effects of current systolic blood pressure (SBP) and serum total cholesterol on the risk of mortality in comparison with SBP or serum cholesterol 25 years previously, taking measurement error into account. The authors reanalyzed 35-year follow-up data on mortality due to coronary heart disease and stroke among subjects aged 65 years or more from nine cohorts of the Seven Countries Study. The two-step method of Tsiatis et al. (J Am Stat Assoc 1995;90:27¿37) was used to adjust for regression dilution bias, and results were compared with those obtained using more commonly applied methods of adjustment for regression dilution bias. It was found that the commonly used univariate adjustment for regression dilution bias overestimates the effects of both SBP and cholesterol compared with multivariate methods. Also, the two-step method makes better use of the information available, resulting in smaller confidence intervals. Results comparing recent and past exposure indicated that past SBP is more important than recent SBP in terms of its effect on coronary heart disease mortality, while both recent and past values seem to be important for effects of cholesterol on coronary heart disease mortality and effects of SBP on stroke mortality. Associations between serum cholesterol concentration and risk of stroke mortality are weak.
    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 relationship of age, blood pressure, serum cholesterol and smoking habits with the risk of typical and atypical coronary heart disease death in the European cohorts of the Seven Countries Study
    Menotti, A. ; Lanti, M. ; Nedeljkovic, S. ; Nissinen, A. ; Kafatos, A. ; Kromhout, D. - \ 2006
    International Journal of Cardiology 106 (2006)2. - ISSN 0167-5273 - p. 157 - 163.
    7 countries - population - failure
    Objective: To explore whether "typical" coronary heart disease (CHD) such as fatal myocardial infarction and sudden death relate to major cardiovascular risk factors in the same way as the "atypical" CHD, such as fatal heart failure and chronic arrhythmias. Design and setting: Ten cohorts (6633 cardiovascular disease-free men, aged 40-59) in five European countries were examined, age and three major risk factors were measured (systolic blood pressure, serum cholesterol, and smoking habits) and 35-year mortality data were collected. Proportional hazard models were solved with typical and atypical CHD deaths treated separately. Results: Death rates from typical and atypical CHD were inversely related among the five countries. Mean age at death was significantly higher for atypical than typical (75.8 versus 71.6 years; p <0.001). In the multivariate analysis conducted on pools of 5 countries (adjusted for countries), the relationship of risk factors with typical CHD was direct and significant for age (hazard ratio-HR-for 5 years of age 1.44 (95% CI 1.36-1.52)), systolic blood pressure (HR for 20 mm Hg, 1.39 (95% CI 1.32-1.47)), serum cholesterol (HR for 1 mmol/l of 1.22 (95% CI 1.16-1.27)) and smoking habits (HR smokers versus non-smokers of 1.39 (95% CI 1.24-1.57)). For atypical CHD, age had a larger HR of 2.27 (95% CI 2.05-2.52), systolic blood pressure had a smaller HR of 1.28 (95% CI 1.16-1.41), serum cholesterol had an inverse non-significant HR of 0.90 (0.58-1.58) and smoking habits had a larger HR of 1.54 (95% CI 1.26-1.89). Conclusions: Age and serum cholesterol were differently related with typical and atypical CHD deaths, suggesting different etiologies for these coronary diseases
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