RESUMEN
INTRODUCTION: Overweight and obesity lead to numerous complications and their treatment. The associated costs represent a health and sociopolitical burden. Therefore, the development of overweight and obesity is of great importance for health policy. METHODS: The Gutenberg Health Study (GHS), a population-based observational study of individuals aged 35-74 years in the city of Mainz and the district of Mainz-Bingen, examined current data on the prevalence and development of overweight and obesity and their association with concomitant diseases and medication use. RESULTS: Among men, 48.1% were overweight and 26.3% had obesity. Among women, these proportions were 32.1% and 24.1%, respectively. Elevated body mass index (BMI) was associated with numerous complications, particularly insulin resistance and type 2 diabetes, arterial hypertension, elevated triglycerides and low HDL cholesterol, and cardiovascular disease. Accordingly, medications to treat these conditions were used significantly more often in individuals with elevated BMI. During the 10-year observation period, mean weight increased in the population. Both men and women had a moderate but significant increase in BMI compared to men and women of the same age at baseline. Individual weight changes over the 10-year observation period, on the other hand, were age-dependent. In the two younger age decades, weight gain was observed, while in the oldest age decade, mean body weight decreased. CONCLUSION: These current data confirm that overweight and obesity are associated with relevant complications and that these complications lead to significant use of appropriate medications. The study also suggests that there is a significant trend toward increased prevalence of obesity (BMI ≥30) over the 10-year period.
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Diabetes Mellitus Tipo 2 , Sobrepeso , Masculino , Humanos , Femenino , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Estudios de Seguimiento , Prevalencia , Obesidad/complicaciones , Obesidad/epidemiología , Índice de Masa Corporal , Factores de RiesgoRESUMEN
OBJECTIVES: The Tower of London (TOL) test has probably become the most often used task to assess planning ability in clinical and experimental settings. Since its implementation, efforts were made to provide a task version with adequate psychometric properties, but extensive normative data are not publicly available until now. The computerized TOL-Freiburg Version (TOL-F) was developed based on theory-grounded task analyses, and its psychometric adequacy has been repeatedly demonstrated in several studies but often with small and selective samples. METHOD: In the present study, we now report reliability estimates and normative data for the TOL-F stratified for age, sex, and education from a large population-representative sample collected in the Gutenberg Health Study in Mainz, Germany (n=7703; 40-80 years). RESULTS: The present data confirm previously reported adequate indices of reliability (>.70) of the TOL-F. We also provide normative data for the TOL-F stratified for age (5-year intervals), sex, and education (low vs. high education). CONCLUSIONS: Together, its adequate reliability and the representative age-, sex-, and education-fair normative data render the computerized TOL-F a suitable diagnostic instrument to assess planning ability. (JINS, 2019, 25, 520-529).
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Función Ejecutiva/fisiología , Desarrollo Humano/fisiología , Pruebas Neuropsicológicas/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Alemania , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Reproducibilidad de los ResultadosRESUMEN
BACKGROUND: Major depression and anxiety disorders are known to negatively influence cognitive performance. Moreover, there is evidence for greater cognitive decline in older adults with generalized anxiety disorder. Except for clinical studies, complex executive planning functions and subclinical levels of anxiety have not been examined in a population-based sample with a broad age range. METHODS: Planning performance was assessed using the Tower of London task in a population-based sample of 4240 participants aged 40-80 years from the Gutenberg Health Study (GHS) and related to self-reported anxiety and depression by means of multiple linear regression analysis. RESULTS: Higher anxiety ratings were associated with lower planning performance (ß = -0.20; p < 0.0001) independent of age (ß = 0.03; p = 0.47). When directly comparing the predictive value of depression and anxiety on cognition, only anxiety attained significance (ß = -0.19; p = 0.0047), whereas depression did not (ß = -0.01; p = 0.71). CONCLUSIONS: Subclinical levels of anxiety but not of depression showed negative associations with cognitive functioning independent of age. Our results demonstrate that associations observed in clinical groups might differ from those in population-based samples, also with regard to the trajectory across the life span. Further studies are needed to uncover causal interrelations of anxiety and cognition, which have been proposed in the literature, in order to develop interventions aimed at reducing this negative affective state and to improve executive functioning.
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Ansiedad/complicaciones , Ansiedad/psicología , Disfunción Cognitiva/fisiopatología , Pruebas Neuropsicológicas , Anciano , Cognición , Disfunción Cognitiva/etiología , Estudios Transversales , Depresión/psicología , Función Ejecutiva , Femenino , Alemania , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Solución de Problemas , Estudios Prospectivos , Desempeño PsicomotorRESUMEN
OBJECTIVE: Distressed ('Type D') personality is associated with adverse health outcomes in patients with cardiovascular disease (CVD). While personality traits from the Five-Factor Model are related to cognitive functioning, neither Type D personality nor its underlying traits negative affectivity (NA) and social inhibition (SI) have been investigated regarding cognition. We therefore compared the predictive value of Type D classification and its subcomponents NA and SI on planning performance in individuals with and without CVD. METHODS: Type D personality traits (DS14) were determined in a population-based sample of 4026 participants (including 549 with CVD) aged 40-80years from the Gutenberg Health Study (GHS) and related to planning performance as assessed with the Tower of London task. Current depression and anxiety were controlled as state variables. RESULTS: Type D personality status was negatively associated with planning performance in the CVD patient group only (p<0.001) but had no impact in the non-CVD group (p=0.40). In the overall sample, NA was negatively and SI positively associated with planning performance. No differential effect on planning between groups was found for depression and anxiety. CONCLUSION: While the subcomponents NA and SI in the population-based sample confirm and extend previous research on personality traits and cognition, Type D personality classification in combination with CVD emerged as a risk factor for decreased cognitive functioning, independent of depression and anxiety. These findings implicate the need to early focus on individual differences in cognitive functioning in patients with CVD.