General Practice

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The Discipline of General Practice is part of the School of Population Health and Clinical Practice

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Browsing General Practice by Author "Agustini, B."

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    Effects of aspirin on the long-term management of depression in older people: a double-blind randomised placebo-controlled trial
    (Springer, 2021) Berk, M.; Agustini, B.; Woods, R.L.; Nelson, M.R.; Shah, R.C.; Reid, C.M.; Storey, E.; Fitzgerald, S.M.; Lockery, J.E.; Wolfe, R.; Mohebbi, M.; Dodd, S.; Murray, A.M.; Stocks, N.; Fitzgerald, P.B.; Mazza, C.; McNeil, J.J.
    Late-life depression is common and often inadequately managed using existing therapies. Depression is also associated with increased markers of inflammation, suggesting a potential role for anti-inflammatory agents. ASPREE-D is a sub-study of ASPREE, a large multi-centre, population-based, double-blind, placebo-controlled trial of aspirin vs placebo in older Australian and American adults (median follow-up: 4.7 years) of whom 1879 were depressed at baseline. Participants were given 100 mg daily dose of aspirin or placebo. Depressive symptoms were assessed annually using the validated, self-rated short version of the Center for Epidemiological Studies Depression scale. There was a significant increase in depressive scores (0.6; 95% CI 0.2 to 0.9; χ2 (1)=10.37; p=0.001) and a decreased score in the mental health component of a quality of life scale (–0.7; 95% CI –1.4 to –0.1; χ2 (1)=4.74; p=0.029) in the aspirin group compared to the placebo group. These effects were greater in the first year of follow-up and persisted throughout the study, albeit with small to very small effect sizes. This study failed to demonstrate any benefit of aspirin in the long-term course of depression in this community-dwelling sample of older adults over a 5-year period, and identified an adverse effect of aspirin in the course of depression in those with pre-existing depressive symptoms.
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    The effect of depressive symptoms on disability-free survival in healthy older adults: a prospective cohort study
    (Wiley, 2022) Roebuck, G.; Lotfaliany, M.; Agustini, B.; Forbes, M.; Mohebbi, M.; McNeil, J.; Woods, R.L.; Reid, C.M.; Nelson, M.R.; Shah, R.C.; Ryan, J.; Newman, A.B.; Owen, A.; Freak-Poli, R.; Stocks, N.; Berk, M.; ASPREE Investigator Group,
    Background: Gerontology and ageing research are increasingly focussing on healthy life span (healthspan), the period of life lived free of serious disease and disability. Late-life depression (LLD) is believed to impact adversely on physical health. However, no studies have examined its effect on healthspan. This study investigated the effect of LLD and subthreshold depression on disability-free survival, a widely accepted measure of healthspan. Methods: This prospective cohort study used data from the ASPirin in Reducing Events in the Elderly study. Participants were aged ≥70 years (or ≥65 years for African-American and Hispanic participants) and free of dementia, physical disability and cardiovascular disease. Depressive symptoms were measured using the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10). LLD and subthreshold depression were defined as CES-D-10 scores ≥8 and 3–7, respectively. Disability-free survival was defined as survival free of dementia and persistent physical disability. Results: A total of 19,110 participants were followed up for a maximum of 7.3 years. In female participants, LLD was associated with lower disability-free survival adjusting for sociodemographic and lifestyle factors, medical comorbidities, polypharmacy, physical function and antidepressant use (HR, 1.50; 95% CI, 1.23–1.82). In male participants, LLD was associated with lower disability-free survival adjusting for sociodemographic and lifestyle factors (HR, 1.30; 95% CI, 1.03–1.64). Subthreshold depression was also associated with lower disability-free survival in both sexes. Conclusions: LLD may be a common and important risk factor for shortened healthspan.