The Use of Antidepressant Medication before and after the Diagnosis of Amyotrophic Lateral Sclerosis: A Population-Based Cohort Study

2015 ◽  
Vol 44 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Federica Edith Pisa ◽  
Giancarlo Logroscino ◽  
Anica Casetta ◽  
Laura Cecotti ◽  
Lorenzo Verriello ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Cohort Study ◽  
Repeated Measures ◽  
Cox Regression ◽  
Antidepressant Medication ◽  
Population Based ◽  
Multiple Sources ◽  
Cross Sectional ◽  
Multivariate Proportional Hazard ◽  
Lateral Sclerosis

Background: The prevalent use of antidepressants (ATDs) in patients with Amyotrophic Lateral Sclerosis (ALS) varies across cross-sectional and clinic-based published studies. This population-based cohort study assesses the real-world prevalence of the use of ATDs, its trajectory and the association of incident use with clinical characteristics. Methods: All patients with incident ALS in the Friuli Venezia Giulia region, Italy, from 2002 to 2009, were identified through multiple sources including health databases. Diagnosis was validated through clinical documentation review. ATDs prescriptions from 2000 to 2011 were obtained from regional database. The trajectory was estimated through generalized estimating equations for repeated measures logistic regression and the Hazard ratio (HR) of initiating ATDs through multivariate proportional hazard Cox regression. Results: In this cohort of 261 ALS cases, age-, sex-adjusted prevalence of the use of ATDs was 37.3%, higher than in general population. The trajectory increased by 16% in 1-year period across diagnosis. Age ≤67 years at diagnosis (HR 1.28, 95% CI 0.84-1.95) and bulbar onset (1.43, 95% CI 0.90-2.26) were positively associated with initiating ATDs after diagnosis. Conclusions: More than one-third of patients used ATDs. Depression may occur more frequently than previously reported. Depression may precede motor alterations and be related to both ALS diagnosis and progression.

scholarly journals Informal care and the impact on depression and anxiety among Swedish adults: a population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marlene Stratmann ◽  
Yvonne Forsell ◽  
Jette Möller ◽  
Yajun Liang
Keyword(s):  
Cohort Study ◽  
Informal Care ◽  
Cox Regression ◽  
Informal Caregiving ◽  
Population Based ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Short And Long Term ◽  
The Impact

Abstract Background As the population is ageing, the need for informal caregivers increases, and thus we need to know more about the effects on caregivers. This study aims to determine both cross-sectional and longitudinal associations between perceived limitation of informal caregiving and mental health of caregivers. Methods This population-based cohort study was based on the Swedish Psykisk hälsa, Arbete och RelaTioner (PART) study, and 9346 individuals aged 18–65 were included. Data were collected through questionnaires, interviews and Swedish registers. Informal care was defined as care given to a family member. Self-reported and diagnosed depression and anxiety were included as outcomes. Covariates included sex, age, social support and socio-economic position. Ordinal logistic regression and Cox regression were performed to determine the associations between caregiving and anxiety or depression. Results Self-reported depression and anxiety was only increased among those experiencing limitations (adjusted odds ratios [aOR] 2.00, 95% confidence intervals [CI] 1.63–2.47 for depression; aOR 2.07, 95% CI 1.57–2.74 for anxiety) compared to those not giving care, respectively. The adjusted hazard ratio (aHR) were increased for diagnosed depression (aHR 1.97, 95% CI 1.27–3.05) and for diagnosed anxiety (aHR 1.86, 95% CI 1.06–3.25) among those giving care and experiencing limitations, compared to those not giving care. No significant associations were found in caregivers without limitations. Conclusion Caregivers experiencing limitations showed a significant association with short- and long-term anxiety and depression. This study implies the importance of exploring the degree to which informal caregiving can be provided without adding burden to caregivers.

scholarly journals Progression of Oropharyngeal Dysphagia in Amyotrophic Lateral Sclerosis: A Retrospective Cohort Study

Dysphagia ◽  
2021 ◽  
Author(s):  
Laura Mariani ◽  
Giovanni Ruoppolo ◽  
Armando Cilfone ◽  
Chiara Cocchi ◽  
Jacopo Preziosi Standoli ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Oropharyngeal Dysphagia ◽  
Incidence Rates ◽  
Increased Risk ◽  
Als Patients ◽  
Lateral Sclerosis

AbstractLittle is known regarding the optimal timing of dysphagia assessment and PEG indication in amyotrophic lateral sclerosis (ALS). The study aims to investigate the progression of dysphagia in a cohort of ALS patients and to analyse whether there are variables linked to a faster progression of dysphagia and faster indication of PEG placement. A retrospective cohort study in 108 individuals with ALS. Fiberoptic endoscopic evaluation of swallowing was performed 6 monthly until PEG indication or death. Dysphagia severity and PEG indication were assessed using Penetration Aspiration Scale. Progression Index (PI) analysed the risk of disease progression (fast/slow) in relation to dysphagia onset and PEG indication. Patients were grouped based on ALS onset and PI. Person-time incidence rates were computed considering dysphagia onset and PEG indication from ALS symptoms during the entire observation period and have been reported as monthly and 6-month rates. Cox regression survival analysis assessed dysphagia and PEG risk factors depending on onset. Person-time incidence rates of dysphagia progression and PEG risk were increased based on type of ALS onset and PI. Patients with a fast progressing disease and with bulbar onset (BO) show statistically significant increased risk of dysphagia (BO 178.10% hazard ratio (HR) = 2.781 P < 0.01; fast 181.10% HR 2.811 P < 0.01). Regarding PEG risk, fast patients and patients with BO had a statistically significant increased risk (fast 147.40% HR 2.474 P < 0.01, BO 165.40% HR 2.654 P < 0.01). Fast PI predicts the likelihood of faster progression of dysphagia and PEG indication and should be included in multidisciplinary assessments and considered in the design of future guidelines regarding dysphagia management in ALS patients.Level of Evidence Level IV.

scholarly journals Determining the incidence of familiality in ALS

2018 ◽  
Vol 4 (3) ◽  
pp. e239 ◽  
Author(s):  
Marie Ryan ◽  
Mark Heverin ◽  
Mark A. Doherty ◽  
Nicola Davis ◽  
Emma M. Corr ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Incidence Rate ◽  
Temporal Trends ◽  
Population Based ◽  
Incidence Rates ◽  
True Rate ◽  
Cross Sectional ◽  
Sporadic Als ◽  
The Mean ◽  
Lateral Sclerosis

ObjectiveTo assess temporal trends in familial amyotrophic lateral sclerosis (FALS) incidence rates in an Irish population and to determine factors influencing FALS ascertainment.MethodsPopulation-based data collected over 23 years, using the Irish amyotrophic lateral sclerosis (ALS) register and DNA biobank, were analyzed and age-standardized rates of FALS and associated familial neuropsychiatric endophenotypes were identified.ResultsBetween 1994 and 2016, 269 patients with a family history of ALS from 197 unique families were included on the register. Using stringent diagnostic criteria for FALS, the mean age-standardized FALS incidence rate for the study period was 11.1% (95% confidence interval [CI], 8.8–13.4). The FALS incidence rate increased steadily from 5.2% in 1994 to 19.1% in 2016, an annual increase of 0.7% (95% CI, 0.5–0.9, p < 0.0001). Inclusion of the presence of neuropsychiatric endophenotypes within kindreds increased the FALS incidence rate to 30%. The incidence of FALS in newly diagnosed individuals from known families increased significantly with time, accounting for 50% of all FALS diagnoses by 2016. The mean annual rate of recategorization from “sporadic ALS” to “FALS” was 3% (95% CI, 2.6–3.8).ConclusionsThe true population-based rate of FALS is at least 20%. Inclusion of extended endophenotypes within kindreds increases the rate of FALS to 30%. Cross-sectional analysis of clinic-based cohorts and stringent definitions of FALS underestimate the true rate of familial disease. This has implications for genetic counseling and in the recognition of presymptomatic stages of ALS.

scholarly journals Risk of Amyotrophic Lateral Sclerosis in Patients With Diabetes: A Nationwide Population-Based Cohort Study

2015 ◽  
Vol 25 (6) ◽  
pp. 445-451 ◽  
Author(s):  
Yu Sun ◽  
Chien-Jung Lu ◽  
Rong-Chi Chen ◽  
Wen-Hsuan Hou ◽  
Chung-Yi Li
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Cohort Study ◽  
Population Based ◽  
Patients With Diabetes ◽  
Lateral Sclerosis
Sign in / Sign up

Export Citation Format

Share Document