Depression Clinical Trial
Official title:
Gerontology Research Programme: Biological, Clinical, Psychosocial and Behavioural Predictors of Health Status in Prospectively Followed-up Cohorts of Elderly Persons
The Gerontology Research Programme (GRP) in the National University Singapore's Department of Psychological Medicine, was formed to coordinate and facilitate the conduct of multi-disciplinary research on in a wide range of research on ageing and health. The establishment of the Singapore Longitudinal Aging Cohort will provide a large community-based cohort of elderly subjects for observational studies with useful clinical applications. Research synergy is achieved in terms of pooling multi-disciplinary expertise, and combining genetic, biological, environmental, behavioural, social, clinical, and health services approaches to gerontological research.
The SLAS is the principal longitudinal cohort study in GRP. The SLAS is a community-based
longitudinal epidemiologic study that aims to increase the understanding of ageing and
health, and the factors that influence the ageing process. SLAS seeks to identify the
cognitive, biomedical, lifestyle and behavioral, as well as psychosocial risk and protective
factors that affect the transition from healthy ageing to functional impairment, illness and
death.
Participants recruited into SLAS are community-dwelling seniors, aged 55 and above, from
various areas in Singapore. Participants are approached door-to-door, are provided detailed
information regarding their participation, and are required to provide informed consent
before enrollment into the study. The study procedure includes a baseline survey upon
enrollment, and participants are revisited on a 3-yearly basis thereafter.
Enrolled subjects provide baseline data through structured interviews, physician assessments,
laboratory testing, and self-reports of conditions, symptoms, and risk behaviors. Data in the
study is collected by trained research staff and nurses. The information to be collected
include:
Outcomes:
Primary Outcomes
4 Main Primary Outcomes
1. Mild cognitive impairment and cognitive functioning
2. Frailty
3. Depression, anxiety (Mood disorder I)
4. Successful and healthy ageing
Basic screening followed by diagnostic tests.
Cognitive domain functioning. Particpants are screened fro cogntve impairment using global
cognitive tests (MMSE and MOCA). An exhaustive neuropsychological assessment battery is also
conducted to assess specific cognitive domain functioning of participants. Selected
participants that meet screening criteria, thus indicating the presence of possible cognitive
impairment, undergo further testing to determine their cognitive functioning status
(cognitively normal, mild cognitive impairment, cognitive decline, or dementia), as diagnosed
by a panel of geriatricians, in accordance with the DSM-IV-TR criteria for dementia (1), and
the MCI Working Group of the European Consortium on Alzheimer's disease criteria (2).
Frailty assessment. A battery of measures, including self-report, physical assessments and
anthropometric measures, is administered to measure the frailty status of the individuals, in
accordance with the Fried et al.'s phenotype criteria (3).
Psychiatric assessment. Several self-reported questionnaires are administered to measure the
symptomatology of common psychiatric disorders such as depression, among others. Selected
participants that meet screening criteria, thus indicating the presence of possible
psychiatric disorders, would undergo further testing to determine their mental health state,
in accordance with the DSM-IV-TR criteria (1).
Successful and healthy ageing. Successful and healthy ageing is determined by a number of
self-reported and objective measurements of health which aim to reflect the overall and
physical health, cognitive, emotional and social well-functioning (inclusive of life
engagement and life satisfaction) of the individual.
Secondary Outcomes
Physical domain functioning. Self-reported measures as well as physical assessments would be
conducted to measure physical functioning, disability and independence in activities of daily
living among participants.
Health, health services utilization. Data regarding the history of chronic medical conditions
and falls, medication use, use of hospital and primary care services and self-rated health.
Quality of Life. Self-reported measures would be conducted to measure the quality of life
amongst the participants.
Mortality. The date of death of participants would be recorded, as well as assessing the
Singapore National Registry of Diseases Office (NRDO).
Respiratory functioning. Data regarding respiratory functioning would be collected via a
spirometry test.
Risk and protective factors:
Socioeconomic and demographic variables. Information regarding the age, gender, educational
status and household income would be collected from the participants via self-report.
Medical history. Information regarding the history of selected medical and mental disorders
would be collected from the participants via self-report.
Biological determinants. Biological specimens (blood and urine) will be analyzed for
constituents of interest (e.g. micronutrients, lipid and glucose levels, among others).
Pharmacological determinants. The use of pharmacological agents such as anti-inflammatory,
cholesterol-lowering and other drugs will be recorded via a self-report measure.
Nutrition. Participants would be assessed on their nutritional status and dietary consumption
(NSI screening, MNA screening, food frequency, 2-day food diary). The dietary records are
analyzed for nutrients of interest and phytochemicals such as B12, B6, folate, curcumin, and
other nutritional supplements.
Lifestyle and health risk behaviors. Lifestyle behaviors measured would include physical,
leisure and social activities engagement duration and frequency. Health risk behaviors
measured include the body mass index and other anthropometric measures, smoking, customary
physical activity, social and productive activities and alcohol use among participants.
Psycho-social data. Self-reported questionnaires are administered to measure life
satisfaction, personality, religiosity, social support and asocial network connections for
select participants.
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