A practical approach to assess depression risk and to guide risk reduction strategies in later life

Background: Many factors have been associated with the onset and maintenance of depressive symptoms in later life, although this knowledge is yet to be translated into significant health gains for the population. This study gathered information about common modifiable and non-modifiable risk factors for depression with the aim of developing a practical probabilistic model of depression that can be used to guide risk reduction strategies. \Methods: A cross-sectional study was undertaken of 20,677 community-dwelling Australians aged 60 years or over in contact with their general practitioner during the preceding 12 months. Prevalent depression (minor or major) according to the Patient Health Questionnaire (PHQ-9) assessment was the main outcome of interest. Other measured exposures included self-reported age, gender, education, loss of mother or father before age 15 years, physical or sexual abuse before age 15 years, marital status, financial stress, social support, smoking and alcohol use, physical activity, obesity, diabetes, hypertension, and prevalent cardiovascular diseases, chronic respiratory diseases and cancer. Results: The mean age of participants was 71.7 +/- 7.6 years and 57.9% were women. Depression was present in 1665 (8.0%) of our subjects. Multivariate logistic regression showed depression was independently associated with age older than 75 years, childhood adverse experiences, adverse lifestyle practices (smoking, risk alcohol use, physical inactivity), intermediate health hazards (obesity, diabetes and hypertension), comorbid medical conditions (clinical history of coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, emphysema or cancers), and social or financial strain. We stratified the exposures to build a matrix that showed that the probability of depression increased progressively with the accumulation of risk factors, from less than 3% for those with no adverse factors to more than 80% for people reporting the maximum number of risk factors. Conclusions: Our probabilistic matrix can be used to estimate depression risk and to guide the introduction of risk reduction strategies. Future studies should now aim to clarify whether interventions designed to mitigate the impact of risk factors can change the prevalence and incidence of depression in later life.

Global properties of `ordinary` early-type galaxies: photometry and spectroscopy of stars and globular clusters in NGC 4494

We present a comprehensive analysis of the spatial, kinematic and chemical properties of stars and globular clusters (GCs) in the `ordinary` elliptical galaxy NGC 4494 using data from the Keck and Subaru telescopes. We derive galaxy surface brightness and colour profiles out to large galactocentric radii. We compare the latter to metallicities derived using the near-infrared Calcium Triplet. We obtain stellar kinematics out to similar to 3.5 effective radii. The latter appear flattened or elongated beyond similar to 1.8 effective radii in contrast to the relatively round photometric isophotes. In fact, NGC 4494 may be a flattened galaxy, possibly even an S0, seen at an inclination of similar to 45 degrees. We publish a catalogue of 431 GC candidates brighter than i(0) = 24 based on the photometry, of which 109 are confirmed spectroscopically and 54 have measured spectroscopic metallicities. We also report the discovery of three spectroscopically confirmed ultra-compact dwarfs around NGC 4494 with measured metallicities of -0.4 less than or similar to [Fe/H] less than or similar to -0.3. Based on their properties, we conclude that they are simply bright GCs. The metal-poor GCs are found to be rotating with similar amplitude as the galaxy stars, while the metal-rich GCs show marginal rotation. We supplement our analysis with available literature data and results. Using model predictions of galaxy formation, and a suite of merger simulations, we find that many of the observational properties of NGC 4494 may be explained by formation in a relatively recent gas-rich major merger. Complete studies of individual galaxies incorporating a range of observational avenues and methods such as the one presented here will be an invaluable tool for constraining the fine details of galaxy formation models, especially at large galactocentric radii.