Wednesday, November 10, 2010

A study in the November issue of the British Journal of Psychiatry reports that participating in regular leisure-time physical activities of any intensity can lead to a decrease in depression. In a study of more than 40,000 Norwegian residents, investigators found that those who were not active during their time away from work were almost twice as likely to have symptoms of depression that those who were regularly active.

The investigators note that social benefits associated with exercise, such as increased number of friends and social support, may be more important contributors to this association than biological changes. However, there was no association found between workplace exertion (such as walking or heavy lifting) and decreased symptoms of depression.

Although many past studies have found lower rates of depression for people who are more active, "almost all of the published research on this topic has focused exclusively on intense leisure-time activity such as organized sports, jogging, and fitness classes," write the study authors. They note that results have been mixed when studies have considered other types of activities.

These participants (50.9% female; mean age, 45.9 years) were asked how often they engaged in light or intense physical activity during their leisure time and how active they were in their workplace. Light activity was defined as any activity not leading to being sweaty or out of breath.

They also underwent a physical examination and completed the Hospital Anxiety and Depression Scale questionnaire regarding symptoms of depression and anxiety. Social factors were also collected, including age, sex, marital status, education, social class, cigarette or alcohol use, any mental illnesses in immediate relatives, any somatic diseases, and level of social support.

Results showed that 10.1% had case-level symptoms of depression, 15.2% had symptoms of anxiety, and 5.6% had comorbid depression and anxiety. Those who participated in both light and intense leisure-time activities had decreasing rates of both depression and comorbid depression and anxiety symptoms based on amount of time spent on the activities.

In other words, "there was an inverse relationship between the amount of leisure-time physical activity and case-level symptoms of depression," investigators write. Although those who participated in light leisure activity had a slightly lower prevalence of anxiety, there was no association found with intense leisure-time activity. There were also no associations found between workplace activity and decreasing symptoms of any of the disorders studied.

However, the take-home message is that "we know from different sets of data that, at least for depression, some level of physical activity is helpful as opposed to not having activity." There is a large proportion of people who think exercise is too hard or that they do not have time for it. "For that population clinicians should be thinking about recommending that they should at least be engaging in the amount of physical activity that they think they're capable of. So again, little is better than nothing — which is actually a very good message.

Sunday, November 7, 2010

A recent article in New York Times pointed out that one of the first signs of impending dementia is an inability to understand money and credit, contracts and agreements.

The Financial Industry Regulatory Authority, the largest nongovernmental regulator for securities firms doing business in the United States, recently met with individual financial services companies and the Alzheimer’s Association to formulate guidelines on how to deal with clients who have trouble remembering and reasoning, a problem that is not new but is increasing as the population ages.

The issue promises to become more complicated as doctors diagnose Alzheimer’s earlier and earlier. If tests indicate that a person is developing dementia, does that mean the patient should be watched, or that should limits be placed on his or her abilities to make financial or legal decisions?

Financial firms are in “a dicey situation” if they have to decide whether a client can make major decisions about finances or future plans, said John M. Gannon, senior vice president for investor education with the financial regulatory agency. And yet, according to research by Daniel C. Marson, a neuropsychologist at the University of Alabama, Birmingham, confusion over money and finances is perhaps the most important and most predictable early functional change as people descend into dementia.

This makes sense because managing finances requires long range planning, risk evaluation, a varying degrees of arithmetic skill, all of which are brain functions lost with the varying forms of dementia.