Hamilton Depression Scale in dementia.

INTRODUCTION: Wide variations in frequency of depression in primary degenerative dementia (PDD) and in vascular dementia (VD) have been reported. This may perhaps be due to inadequacy of common diagnostic tools in detecting depression in the face of cognitive decline. We evaluated here the Hamilton Depression Rating Scale (HDRS) in demented patients with PDD and VD. METHODS: We examined 50 consecutive patients with PDD and 50 consecutive patients with VD. All patients underwent neurological examination and their depression was evaluated using DSM-III-R criteria and the HDRS. The data obtained were analysed for distribution of depression and pattern of responses obtained in the HDRS. Sensitivity, specificity and Youden's J-indices for different cut-off scores of the HDRS in its ability to detect depression in this population were calculated. RESULTS: Dementia was associated with depression in 38% of the patients (DSM-III-R criteria). HDRS scores were higher in depressed patients (z= -5.7, P < 0.0001) with an HDRS cut-off score of 10 being indicative of depression in demented patients. Symptoms related to 'affective' components of the HDRS (such as depressive mood and anxiety) were strongly associated with the diagnosis of depression (Mann-Whitney tests, P < 0.0001). CONCLUSION: Depression is frequent in demented patients. The HDRS has good criterion validity in the evaluation of depression in demented patients. (Int J Psych Clin Pract 2002; 6: 91-94).

Genetic analysis of growth curve parameters of body weight, height and head circumference.

A sample of 681 Israeli boys and girls, including 355 regular siblings (SB), 112 pairs of dizygotic (DZ) and 51 pairs of monozygotic (MZ) twins, was measured for body weight (WT), length (HT) and head circumference (HC) at birth and during the first year of life. The Count model with three parameters was chosen as the best fitting and most parsimonious function to approximate growth of the studied traits. The curves' fitting parameters were estimated for WT, HT and HC for each individual. To test the assumption that there is a genetic source influencing the pattern of growth for each trait, familial correlations between parameter estimates were computed for MZ, DZ twins and SB. In all instances MZ twins showed the highest within-pair correlation in parameters of growth (from 0.58 to 0.86), while SB showed the lowest ones (from 0.10 to 0.70). Variance decomposition analysis was used to simultaneously assess the contribution of gender, gestational age, additive genetic factor, common sibs and common intrauterine environmental effects on total variance of each studied trait separately. All these sources of variation were statistically significant, though the effect of intrauterine environment played a substantial role in early stages of child physical development, explaining from 18.1% to 70.6% of the total variance of the growth curve parameters. Further analyses are needed to clarify how this environment affects child growth and for how long.

Genetic analysis of motor milestones attainment in early childhood.

The age of attainment for four motor developmental traits, such as turning over, sitting up without support, pulling up to a standing position and walking without support, was examined in 822 children, including 626 siblings from families with 2 to 6 children, 68 pairs of dizygotic twins and 30 pairs of monozygotic twins. Correlation analysis, carried out separately for each type of sibship, showed the highest pairwise correlations in monozygotic twins and the lowest correlation in non-twin siblings for all motor milestones. Variance component analysis was used to decompose the different independent components forming the variation of the studied trait, such as genetic effect, common twin environment, common sib environment and residual factors. The results revealed that the major proportion of the total variance after adjustment for gestation age for the attainment of each motor skill, except pulling up to standing position, is explained by the common twin environment (50.5 to 66.6%), whilst a moderate proportion is explained by additive genetic factors (22.2 to 33.5%). Gestational age was found to be an important predictor of appearance of all motor milestones, affecting delay of 4.5 to 8.6 days for the attainment of the motor abilities for each week of earlier gestation. The age of attainment of the standing position was affected only by shared sibs environment (33.3% of the total variance) and showed no influence of either genetic or common twin environment. Phenotypic between trait correlations were high and significant for all studied traits (range between 0.40 and 0.67, P < 0.01 in all instances). Genetic cross correlations, however, were not easily interpreted and did not show clear variance trends among the different groups of children.

Major locus influencing plasma APO-A1 levels also controls plasma HDL3-C concentrations.

Elevated plasma levels of apolipoprotein A1 (APO-A1) and high-density lipoprotein cholesterol (HDL-C) are important protective factors for atherosclerosis and coronary heart disease. Using the data on plasma concentrations of APO-A1, and HDL-C particles HDL2-C and HDL3-C in 970 Israeli individuals belonging to 228 pedigrees, we tested the hypothesis that a major locus influencing interindividual variation in APO-A1 levels also controls interindividual variation in HDL3-C and HDL2-C levels. Univariate and bivariate complex segregation analyses, as implemented in two statistical packages (MAN-3 and PAP-4.0) were applied to test the hypothesis. The results of the analysis clearly indicated the possibility of major gene involvement in the determination of plasma concentration variation of each of the 3 study variables. The results provide strong evidence in support of our hypothesis that HDL3-C genetic variation fully depends on the APO-A1 major locus. In particular, environmental and sporadic models were strongly rejected (P < 0.001) in bivariate analysis. The hypothesis of no pleiotropic effect of the putative APO-A1 locus on HDL3-C transmission was also unequivocally rejected (P < 0.001), while the bivariate Mendelian model was accepted (P > 0.05). The results of bivariate analysis of APO-A1 effect on HDL2-C were not clear. They indicated the possibility of the existence of slight genetic covariation between the two variables, and as yet we were unable to decipher the mode of covariation with the applied models.

Tel-Aviv-Heidelberg Three Generation Offspring Study: Genetic and environmental sources of variation and covariation among plasma lipids, lipoproteins, and apoliproteins.

Multivariate genetic analysis, implemented in the statistical package for pedigree analysis, FISHER, was carried out on a large sample of Israeli pedigrees to evaluate heritability and genetic correlations among an array of plasma lipids: total cholesterol (TCHL), triglycerides (TRIG), HDL-C and HDL2-C, HDL3-C, LDL-C and HDL-C%, apolipoproteins A and B (APO-A1 and APO-B), lipoprotein LP(a) and fibrinogen (FIBR). Multiple regression analysis showed that although sex, age, smoking and other study environmental factors, have a significant contribution to the variation of each plasma lipid, they exert little effect on covariation in lipids. Genes, however, are important factors of the variation and covariation in lipids. Thus, variance component analysis showed that the genetic component of the study variables, adjusted on age, sex and environmental factors, ranged between 31% for logarithm-transformed TRIG and 77% for plasma concentrations of LP(a). Coefficients of multiple genetic determination of the genetic variation of each variable attributable to all of the other variables, ranged from low values (<30%) for TRIG, LP(a) and FIBR, to moderate (64%) for HDL2-C. The genetic variation of each of the remaining variables was completely explained by variation in other lipids. The results of a factor analyses of phenotypic, genetic and environmental correlation matrices were similar and clearly identified several clusters of variables. The first included APO-A1, HDL-C, HDL2-C and HDL3-C, and the second-APO-B, LDL-C and THCL. Further analysis showed that it was probable the genetic component of variation of HDL3-C plasma concentration that fully depended on APO-A1, while those of LDL-C and TCHL fully depended on APO-B. The degree of correlation between TRIG, LP(a), FIBR and other variables, if any, was considerably lower. Am. J. Hum. Biol. 9:357-370, 1997. © 1997 Wiley-Liss, Inc.

Relationship between genetic anomalies of different levels and deviations in dermatoglyphic traits. Part 2: Dermatoglyphic peculiarities of females with Turner's syndrome.

The present study is carried out to evaluate the effect of chromosomal morbidity (45x/46xx or 45x/47xxx or 45x) in the females with Turner syndrome, based on dermatoglyphic traits and indices of diversity and asymmetry. The main objectives of the present study is to find dermatoglyphic traits and fluctuating asymmetry indices which could be "marker traits" and could indicate the degree of developmental instability of the organism. The sample of Turner females (N = 57) was collected in the Genetic Institute of Sheba Hospital, Tel Aviv, Israel, by Professor Bat-Miriam Katznelson during 20 years, between 1968-1988. All patients were checked by chromosomal examination and finger and palm prints were collected with the aid of pads manufactured by Lamedco Inc. Knoxville, Tennessee, U.S.A. Interpretation of the prints was according to Cummins & Midlo (1961) and Penrose (1968) and included identification of patterns, ridge counts and the measurements of distances and angles in the palms. 79 dermatoglyphic variables for every patient: 28 continuous traits, 9 discrete traits, 11 indices of intraindividual diversity, 15 indices of directional asymmetry and 16 indices of fluctuating asymmetry were estimated. The problem of asymmetry, fluctuating and directional and of intraindividual diversity of quantitative dermatoglyphic traits is here reviewed as well as illustrated by data obtained on a sample of healthy control group of Jews from Israel.

Bilateral asymmetry in dental discrete traits in human isolates: south Sinai Bedouin tribes.

Data are presented on dental morphology as adjudged from dental casts of children (boys and girls) 6-13 years of age from four Bedouin tribes of Southern Sinai (Gebeliya, Muzeina, Hamada and Aliquat) and a mixed group designated as "other tribes", (Awlad Said, Gararsha, Sawalcha, Haweitat and Beni-Wassal). Alginate was the impression material used and the casts were made of artificial stone poured into the irreversible hydrocolloid impression. A total of 352 casts were available for study. In the maxilla, 29 dental discrete traits of permanent teeth and 2 traits of deciduous teeth were observed, and in the mandible, 24 traits of permanent teeth and 2 traits of deciduous teeth; in all, 57 traits were observed. Only clear traits were considered. From the studied 57 traits only 30 morphological traits were used for the estimation of the asymmetry. Total symmetry was observed in 2 mandibular teeth and traits: a) Lateral incisor-LI-slight inclination; b) Canine-Cn-no lingual cingulum and in 3 maxillary teeth and traits a) Central incisor-CI-slight convexity of labial profile curvature; b) First premolar-PM1-intercuspal distance more than 3 mm; and c) Second molar,-M2-pit groove pattern similar to the first molar. Low values of asymmetry (1-5.1%) were observed in traits describing outline form and shape, surface outline, and number of cusps in three maxillary and two mandibular teeth (nine discrete traits). High values of asymmetry (12.7-37.0%) were observed regarding traits describing styles on slopes, ridges, pits, grooves and lingual tubercles in three maxillary and one mandibular teeth (15 discrete traits). The high rate in molars was higher than that in the incisors. A higher rate of asymmetry occurred in the maxilla than in the mandible.

Obesity and the risk of toxaemia of pregnancy.

The purpose of the present study was to examine the relationship between severe pre-eclampsia/eclampsia (toxaemia) and obesity. We collected sociodemographic, anthropometric, medical and pregnancy outcome data from the hospital records of 248 Israeli women diagnosed with either pregnancy-induced or chronic hypertension, and compared these data to a control group of 236 women. Univariate analysis showed that while there exists a statistically significant positive association between obesity and hypertension (both pregnancy-induced and chronic) obesity presents no added risk to the development of toxaemia. Furthermore, we found a significant decrease in the rate of obesity among primigravid versus multigravid mothers with toxaemia superimposed on pregnancy-induced hypertension. On the other hand, primigravid mothers with PIH were at an increased risk of developing toxaemia as compared to multigravid women. These results suggest that obesity is not a significant factor in the development of toxaemia.

Population biology of human aging: ethnic and climatic variation of bone age scores.

Hand radiograms for osseographic assessment of bone-aging status were taken from more than 7500 individuals living in 32 different geographic localities and belonging to 20 ethnic groups. Multiple regression analysis was used to evaluate possible associations between bone-aging parameters and number of climatic factors. To determine whether population differences in bone-aging estimates were related to linguistic, ethnic, or genetic differences among the samples, we performed a matrix correspondence analysis. Euclidean distance matrices for parameters TM (average age at entering visual stage of bone aging) and B (the rate of bone aging per year) were tested against design matrices specifying linguistic or ethnic affiliation of the tested populations, yet no significant correlations were detected in this set of analyses. The matrix of joint genetic distances based on 10 genetic systems showed significant correlation (r = 0.48, p = 0.013) with the matrix of B differences. This suggests some genetic control in the rate of bone aging. TM and age-adjusted bone-aging scores (Z) yielded no evidence of correlation with genetic differences among the studied populations. Multiple regression analysis, however, uncovered that 37.5% of TM variation and 48% of Z variation could be explained by climate factors and their interactions.