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Barker MS, Cosentino SA, Fremont R, Devanand DP, Huey ED. Towards Defining the Neuroanatomical Basis of Late-Onset Psychiatric Symptoms. J Geriatr Psychiatry Neurol 2022; 35:751-762. [PMID: 35380884 PMCID: PMC11270909 DOI: 10.1177/08919887221090213] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Psychiatric symptoms, including changes in emotional processing, are a common feature of many neurodegenerative disorders, such as Alzheimer's disease, dementia with Lewy Bodies, frontotemporal dementia, and Huntington's disease. However, the neuroanatomical basis of emotional symptoms is not well defined; this stands in contrast to the relatively well-understood neuroanatomical correlates of cognitive and motor symptoms in neurodegenerative disorders. Furthermore, psychiatric diagnostic categories, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Statistical Classification of Diseases and Related Health Problems (ICD), may have limited applicability in patients with late-onset psychiatric symptoms in the context of neurodegenerative disorders. In this clinical review, we suggest that early-onset and late-onset psychiatric symptoms have distinct etiologies, and that late-onset changes in emotional processing are likely underpinned by neurodegenerative disease. Furthermore, we suggest that an improved understanding of the neuroanatomical correlates of emotional changes in neurodegenerative disease may facilitate diagnosis and future treatment development. Finally, we propose a novel clinical approach, in a preliminary attempt to incorporate late-onset emotional symptoms alongside cognitive and motor symptoms into a clinical "algorithm," with a focus on the neuroanatomy implicated when particular combinations of emotional, cognitive, and motor features are present. We anticipate that this clinical approach will assist with the diagnosis of neurodegenerative disorders, and our proposed schema represents a move towards integrating neurologic and psychiatric classification systems.
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Affiliation(s)
- Megan S. Barker
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, USA
| | - Stephanie A. Cosentino
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Rachel Fremont
- Division of Geriatric Psychiatry, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Davangere P. Devanand
- Division of Geriatric Psychiatry, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Edward D. Huey
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Division of Geriatric Psychiatry, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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Natsume S, Baba H, Maeshima H, Saida T, Yoshinari N, Shimizu K, Suzuki T. Clinical course and serum amyloid β levels in elderly patients with major depressive disorder. J Affect Disord 2022; 315:156-161. [PMID: 35932935 DOI: 10.1016/j.jad.2022.07.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/26/2022] [Accepted: 07/30/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Depression is known to be a risk factor for Alzheimer's disease (AD). Changes in amyloid β protein (Aβ) metabolism have been speculated as a factor contributing to the transition from depression to AD. The aim of this study is to reveal the time course and state-dependency of Aβ metabolism. METHODS Serum Aβ levels in 277 elderly (≥60 years) patients with depression (both early- and late-onset) were measured at admission, immediately after remission, and 1 year after remission, and compared them with 178 healthy subjects. RESULTS The analysis revealed decreased Aβ42 levels and increased Aβ42/40 ratios in elderly patients with depression at admission compared with healthy subjects. These changes in the acute phase of depression were not normalized immediately after remission; however, they recovered to healthy levels 1 year after remission. LIMITATIONS There is a possibility that the results may be influenced by antidepressants. CONCLUSIONS These results suggest that altered Aβ metabolism caused by depression may ameliorate, although after a lengthy period of time after remission. Our findings also suggest that the AD-related pathological changes caused or increased by depression can be reduced by maintaining remission for an extended period of time.
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Affiliation(s)
- Shuntaro Natsume
- Department of Psychiatry & Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hajime Baba
- Department of Psychiatry & Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Psychiatry, Juntendo Koshigaya Hospital, Juntendo University Faculty of Medicine, Saitama, Japan.
| | - Hitoshi Maeshima
- Department of Psychiatry & Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Psychiatry, Juntendo Koshigaya Hospital, Juntendo University Faculty of Medicine, Saitama, Japan
| | - Takao Saida
- Department of Psychiatry & Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Naoto Yoshinari
- Department of Psychiatry & Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Psychiatry, Juntendo Koshigaya Hospital, Juntendo University Faculty of Medicine, Saitama, Japan
| | - Kentaro Shimizu
- Department of Psychiatry & Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toshihito Suzuki
- Department of Psychiatry & Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Psychiatry, Juntendo Koshigaya Hospital, Juntendo University Faculty of Medicine, Saitama, Japan
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103
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Miniawi SE, Orgeta V, Stafford J. Non-affective psychotic disorders and risk of dementia: a systematic review and meta-analysis. Psychol Med 2022; 52:1-13. [PMID: 36200264 PMCID: PMC9772917 DOI: 10.1017/s0033291722002781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 12/30/2022]
Abstract
Non-affective psychotic disorders have been associated with an increased risk of developing dementia. However, research in this area remains limited, highlighting the need for an up-to-date systematic review and meta-analysis of the evidence. We aimed to systematically review and quantify the risk of dementia associated with psychotic disorders. We searched four electronic databases for longitudinal studies investigating non-affective psychotic disorders and subsequent dementia. We used random-effects meta-analyses to pool estimates across studies and assessed risk of bias for each study. Non-affective psychotic disorders were associated with increased risk of all-cause dementia; pooled risk ratio (RR) = 2.52, 95% confidence interval (CI) (1.67-3.80), I2 = 99.7%, n = 12,997,101; 11 studies, with high heterogeneity between studies. Subgroup analyses indicated stronger associations in studies with shorter follow-up periods, conducted in non-European countries, published after 2020, and where ≥60% of the sample were female. The risk was higher in people aged <60 years at baseline, in typical and late-onset psychotic disorders versus very late-onset psychosis, in broader psychotic disorders vs schizophrenia, and in prospective vs retrospective studies. Associations remained after excluding low quality studies (pooled RR = 2.50, 95% CI (1.71-3.68), I2 = 99.0%). Our review finds a substantial association between psychotic disorders and subsequent dementia. Our findings indicate that psychotic disorders are a potentially modifiable risk factor for dementia and suggest that individuals with psychotic disorders need to be closely monitored for cognitive decline in later life. Further research is needed to investigate the mechanisms underlying the association between psychotic disorders and dementia.
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Affiliation(s)
- Sara El Miniawi
- Division of Psychiatry, University College London (UCL), London, UK
| | - Vasiliki Orgeta
- Division of Psychiatry, University College London (UCL), London, UK
| | - Jean Stafford
- MRC Unit for Lifelong Health and Ageing, UCL, London, UK
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Jia F, Wang J, Wei N, Sun D, Cao F. Depression, cognitive reserve markers, and dementia risk in the general population. Aging Ment Health 2022; 26:2006-2013. [PMID: 34514889 DOI: 10.1080/13607863.2021.1972932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES We investigated depression, cognitive reserve, and their interaction as risk factors for incident dementia among community-dwelling older adults. METHODS In total, 2099 participants, aged ≥65 years with no dementia during baseline assessment, who completed the follow-up two years later were included from the Cognitive Function and Ageing Study Wales. Baseline depression and dementia and dementia at follow-up were evaluated using the Geriatric Mental State Examination and the Automated Geriatric Examination for Computer Assisted Taxonomy. Cognitive reserve was measured by combining overall education, mid-life occupational complexity, and later-life social and cognitive activities. Risk of dementia in relation to depression and cognitive reserve was estimated using penalized maximum likelihood logistic regression. Interactions between cognitive reserve and depression were assessed using both multiplicative and additive scales. RESULTS Baseline depression and low cognitive reserve significantly increased the risk of subsequent dementia at follow-up. No multiplicative interaction between cognitive reserve and depression existed. We observed an additive interaction between case-level depression and cognitive reserve. A significant association between depression and dementia was only found among people with low cognitive-reserve levels. CONCLUSIONS Greater cognitive reserve attenuated the depression-associated risk of developing dementia. This suggests the need to emphasize prodromal dementia detection among older adults with lower cognitive reserve and depression.
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Affiliation(s)
- Feifei Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Juan Wang
- Department of Nursing Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ning Wei
- Department of Obstetric, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Dawei Sun
- Department of Neurology, Pingdu Second People's Hospital, Qingdao, China
| | - Fenglin Cao
- Department of Nursing Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
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105
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Development and internal validation of a prognostic model for 15-year risk of Alzheimer dementia in primary care patients. Neurol Sci 2022; 43:5899-5908. [DOI: 10.1007/s10072-022-06258-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/05/2022] [Indexed: 10/17/2022]
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106
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Kim D, Kiss A, Bronskill SE, Lanctôt KL, Herrmann N, Gallagher D. Association between depression, gender and Alzheimer's neuropathology in older adults without dementia. Int J Geriatr Psychiatry 2022; 37. [PMID: 36047339 DOI: 10.1002/gps.5809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 08/22/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Previous studies regarding the relationship between depression and Alzheimer's neuropathology in older adults without dementia have reported conflicting findings. This study examined whether depression is associated with Alzheimer's neuropathology and whether sex moderates these relationships. METHODS This is a cross-sectional study of older adults without dementia (normal cognition or mild cognitive impairment, age 50+; CDR ≤ 0.5) who had autopsy within 1 year of their last clinic visit in the National Alzheimer's Coordinating Center database (2005-2020). Logistic regression models were fitted to determine if a recent or remote history of depression was associated with amyloid spread beyond the neocortex measured by modified Thal phase score, density of amyloid plaques measured by CERAD score or tau neuropathology measured by modified Braak score. A moderator analysis was performed to determine if any of these associations were moderated by sex. RESULTS This study included 407 participants (96 Thal, 405 Braak, and 406 CERAD). Those who had recently active depression (within previous 2 years) but not remote depression only were more likely to have higher Thal phase score compared to those without a history of depression (OR = 3.74; 95% CI, 1.15-12.17; p = 0.028). Sex did not moderate this association. No significant associations between recent depression and Braak or CERAD scores were observed. CONCLUSION Our findings indicate that the association between late life depression and Alzheimer's neuropathology is associated with spread of amyloid pathology beyond the neocortex to include allocortical and subcortical regions critical for regulation of mood and motivated behavior.
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Affiliation(s)
- Doyoung Kim
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Alex Kiss
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Susan E Bronskill
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Krista L Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Ochi S, Mori T, Iga JI, Ueno SI. Prevalence of Comorbid Dementia in Late-life Depression and Bipolar Disorder: A Retrospective Inpatient Study. J Alzheimers Dis Rep 2022; 6:589-598. [PMID: 36275416 PMCID: PMC9535605 DOI: 10.3233/adr-220052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/31/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Dementia in patients with late-life mood disorders is clinically important. Objective: We aimed to investigate the prevalence of dementia in patients with late-life major depressive disorder (MDD) or bipolar disorder (BD) and to clarify the clinical characteristics associated with the diagnosis of dementia. Methods: The prevalence of dementia at hospital discharge and the clinical characteristics at hospitalization who are diagnosed with MDD or BD over 65 years of age, from the medical records of 684 patients who had been admitted from 2015 to 2020 were investigated. Results: A total of 66 patients with MDD (n = 50) and BD (n = 16) were analyzed. The prevalence of dementia was significantly higher in MDD than in BD (24.0% versus 0%; p = 0.026). The mean age at onset of MDD was significantly older in the MDD with dementia group than in the MDD without (76.9±6.3 years versus 62.2±14.0 years; p < 0.001). The rate of first depressive episode at this admission was significantly higher in the MDD with dementia group (91.7% versus 30.3%; p < 0.001). The diagnosis of dementia was significantly associated with lower scores for “insomnia early” (p = 0.019) and higher scores for “insight” (p = 0.049) on the 17-item Hamilton Depression Rating (HAMD-17) subscales and lower scores for “recall” (p = 0.003) on the MMSE subscales. Conclusion: The older age of first onset of depression, “insomnia early”, “insight” and “recall” may be useful indicators for a diagnosis of dementia in late-life depression.
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Affiliation(s)
- Shinichiro Ochi
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Takaaki Mori
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Jun-ichi Iga
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Shu-ichi Ueno
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
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108
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Liu J, Qiang F, Dang J, Chen QY. Quantifying the parallel mediation influence of body mass index and depression on physical activity and cognitive function among 3,611 Chinese older adults. Front Aging Neurosci 2022; 14:977321. [PMID: 36158538 PMCID: PMC9490416 DOI: 10.3389/fnagi.2022.977321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/11/2022] [Indexed: 12/02/2022] Open
Abstract
Background Engagement in physically active lifestyles brings multidimensional health benefits including better cognitive function. While prior studies examined the link between physical activity and cognitive function, a remaining unanswered question is what modifiable factors channel such effects. Objective This study investigates the extent to which subject’s body mass index (BMI) and depression mediate the link between physical activity and cognitive function among older adults in China. Methods This study builds a parallel structural equation model utilizing the 2013–2018 China Health and Retirement Longitudinal Study (CHARLS) dataset. We screened a total of 14,724 subjects, among which 3,611 subjects met the inclusion criteria. Physical activity, depression, and cognitive function are measured using the International Physical Activity Questionnaire (IPAQ), Center for Epidemiological Research Depression Scale (CES-D), and Mini-Mental State Examination (MMSE) instruments. Results Parallel mediation analyses indicate that depression significantly mediates the link between physical activity and cognitive function (std. β = 0.023, p-value = 0.010), while no significant mediation was observed via BMI (std. β = 0.005, p-value = 0.155). Findings also show that physical activity is positively associated with cognitive function (std. β = 0.104, p-value = 0.004), whereas physical activity is inversely associated with BMI (std. β = –0.072, p-value = 0.045). Both BMI (std. β = –0.071, p-value = 0.042) and depression (std. β = –0.199, p-value = 0.001) are negatively associated with cognitive function. Conclusion This study quantifies the positive association between physical activity and cognitive function in older Chinese adults, and uncovers a significant mediation channel occurring through depression. From a clinical perspective, physical behavioral modifications can lead to linked improvements in both mental and cognitive wellbeing for older adults.
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Affiliation(s)
- Ji Liu
- Faculty of Education, Shaanxi Normal University, Xi’an, China
| | - Faying Qiang
- Faculty of Education, Shaanxi Normal University, Xi’an, China
| | - Jingxia Dang
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qiao Yi Chen
- School of Basic Medical Sciences, Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Qiao Yi Chen,
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109
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Wu T, Li C, Zhu Y, Ma Y, Hua R, Zhong B, Xie W. The trajectories of depressive symptoms and subsequent incident dementia, coronary heart diseases, stroke and all-cause mortality. J Affect Disord 2022; 312:9-16. [PMID: 35690126 DOI: 10.1016/j.jad.2022.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/23/2022] [Accepted: 06/06/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Evidence suggests the occurrence of depressive symptoms in mid- to late-life inflates the risk for ageing-related morbidity compared to people without depressive symptoms. The eventual association between depressive symptoms in mid- to late-life and long-term (over 10-year) risks for incident dementia, coronary heart disease (CHD), stroke, and morbidity is to be established. METHODS This longitudinal cohort study utilized Health and Retirement Study (HRS) of U.S residents aged ≥ 50 years who were interviewed every 2-year during follow-up (average follow-up: 11.6 ± 2.85 years). Trajectories of depressive symptoms were assessed by the Center for Epidemiologic Studies Depression (CES-D) scale from 1994 to 2000 at baseline. Incident dementia, CHD, stroke and all-cause mortality were determined from 2000 to 2018. RESULTS Among 7810 individuals who were free from dementia, CHD and stroke, five trajectories of depressive symptoms were identified: non-depressed (36.7 %), mild (48.8 %), worsening (7.8 %), improving (4.1 %) and persistent (2.7 %). Compared with those in the non-depressed group, participants with mild, worsening and persistent depressive symptoms had significantly greater hazards of incident dementia (multivariable adjusted hazard ratios and 95 % confidence intervals: 1.32 [1.17-1.48], 1.58 [1.30-1.93], 2.82 [2.17-3.67], respectively), CHD (1.13 [1.03-1.24], 1.47 [1.25-1.73], 1.34 [1.03-1.74], respectively), stroke (1.30 [1.12-1.52], 1.58 [1.23-2.04], 1.71 [1.16-2.53], respectively) and all-cause mortality (1.17 [1.07-1.27], 1.46 [1.27-1.68], 1.66 [1.35-2.06], respectively). The hazards of incident events, except for CHD, were not significantly greater in individuals with improving depressive symptoms. CONCLUSIONS The present findings suggest even sub-clinical threshold depressive symptoms were associated with the hazards of ageing related diseases while such associations were not significant with managed depressive symptoms.
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Affiliation(s)
- Tao Wu
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Chenglong Li
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Yidan Zhu
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Yanjun Ma
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Rong Hua
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Baoliang Zhong
- Department of Geriatric Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Wuxiang Xie
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China.
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110
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Reply to dos Santos Ferreira and Velly. Pain 2022; 163:e968. [PMID: 35838654 DOI: 10.1097/j.pain.0000000000002665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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111
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Scott MJ, Robbins PA, Conde E, Bentley-Edwards KL. Depression in the African American Christian Community: Examining Denominational and Gender Differences. JOURNAL OF RELIGION AND HEALTH 2022; 61:2838-2854. [PMID: 35290555 DOI: 10.1007/s10943-022-01528-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 06/14/2023]
Abstract
Depression among African American adults can diminish their daily functioning and quality of life. African American communities commonly uses religion and spirituality (R/S) to cope with life stressors; however, it is unclear whether R/S contribute to mental health risk or resilience. Since men and women differ in their R/S participation and Christian denominations have varying gender roles and expectations, it is critical to determine if they experience similar mental health effects. This study examines whether self-reported denominational affiliation predicts dissimilar odds of reporting elevated depressive symptoms among African American young adults and if these effects are different for women and men, using the National Longitudinal Study of Adolescent to Adult Health (Add Health). Results indicate that the odds of having elevated depressive symptoms are three times higher for Catholic women compared to Baptist women, but no denominational differences were found among men. This study highlights how unique denominational and gender subcultures within African American Christian communities may predict depression outcomes. Healthcare professionals and church-based outreach programs should consider the role of denomination and gender when designing and participating in efforts to support mental health equity.
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Affiliation(s)
- Melissa J Scott
- The Samuel DuBois Cook Center On Social Equity, Duke University, 411 West Chapel Hill St, Box 104407, Durham, NC, 27701, USA.
| | - Paul A Robbins
- The Samuel DuBois Cook Center On Social Equity, Duke University, 411 West Chapel Hill St, Box 104407, Durham, NC, 27701, USA
| | - Eugenia Conde
- The Samuel DuBois Cook Center On Social Equity, Duke University, 411 West Chapel Hill St, Box 104407, Durham, NC, 27701, USA
| | - Keisha L Bentley-Edwards
- The Samuel DuBois Cook Center On Social Equity, Duke University, 411 West Chapel Hill St, Box 104407, Durham, NC, 27701, USA
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Xu Q, Zou K, Deng Z, Zhou J, Dang X, Zhu S, Liu L, Fang C. A Study of Dementia Prediction Models Based on Machine Learning with Survey Data of Community-Dwelling Elderly People in China. J Alzheimers Dis 2022; 89:669-679. [PMID: 35912742 DOI: 10.3233/jad-220316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND For community-dwelling elderly individuals without enough clinical data, it is important to develop a method to predict their dementia risk and identify risk factors for the formulation of reasonable public health policies to prevent dementia. OBJECTIVE A community elderly survey data was used to establish machine learning prediction models for dementia and analyze the risk factors. METHODS In a cluster-sample community survey of 9,387 elderly people in 5 subdistricts of Wuxi City, data on sociodemographics and neuropsychological self-rating scales for depression, anxiety, and cognition evaluation were collected. Machine learning models were developed to predict their dementia risk and identify risk factors. RESULTS The random forest model (AUC = 0.686) had slightly better dementia prediction performance than logistic regression model (AUC = 0.677) and neural network model (AUC = 0.664). The sociodemographic data and psychological evaluation revealed that depression (OR = 3.933, 95% CI = 2.995-5.166); anxiety (OR = 2.352, 95% CI = 1.577-3.509); multiple physical diseases (OR = 2.486, 95% CI = 1.882-3.284 for three or above); "disability, poverty or no family member" (OR = 1.859, 95% CI = 1.337-2.585) and "empty nester" (OR = 1.339, 95% CI = 1.125-1.595) in special family status; "no spouse now" (OR = 1.567, 95% CI = 1.118-2.197); age older than 80 years (OR = 1.645, 95% CI = 1.335-2.026); and female (OR = 1.214, 95% CI = 1.048-1.405) were risk factors for suspected dementia, while a higher education level (OR = 0.365, 95% CI = 0.245-0.546 for college or above) was a protective factor. CONCLUSION The machine learning models using sociodemographic and psychological evaluation data from community surveys can be used as references for the prevention and control of dementia in large-scale community populations and the formulation of public health policies.
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Affiliation(s)
- Qing Xu
- Department of Geriatric Psychiatry, Wuxi MentalHealth Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Kai Zou
- Department of Geriatric Psychiatry, Wuxi MentalHealth Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Zhao'an Deng
- Department of Geriatric Psychiatry, Wuxi MentalHealth Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Jianbang Zhou
- Department of Psychiatry, Haidong First People'sHospital, Haidong, Qinghai, China
| | - Xinghong Dang
- Department of Psychiatry, Haidong First People'sHospital, Haidong, Qinghai, China
| | - Shenglong Zhu
- Department of Psychiatry, Haidong First People'sHospital, Haidong, Qinghai, China
| | - Liang Liu
- Department of Geriatric Psychiatry, Wuxi MentalHealth Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Chunxia Fang
- Combined TCM &Western Medicine Department, Wuxi Mental Health Center, NanjingMedical University, Wuxi, Jiangsu, China
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de Almeida Faria ACR, Dall'Agnol JF, Gouveia AM, de Paiva CI, Segalla VC, Baena CP. Risk factors for cognitive decline in type 2 diabetes mellitus patients in Brazil: a prospective observational study. Diabetol Metab Syndr 2022; 14:105. [PMID: 35897033 PMCID: PMC9327152 DOI: 10.1186/s13098-022-00872-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 07/04/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Type 2 Diabetes Mellitus (T2DM) patients are twice as likely to develop dementia. The study's goal was to evaluate cognitive performance and risk factors for cognitive decline in this population. METHODS Prospective observational study was conducted with 400 T2DM adults, of whom, during routine baseline and follow-up appointments, had socio-demographic, clinical, and laboratory data collected, and underwent physical examination, screening for depression symptoms (Patient Health Questionaire-9-PHQ-9), and cognitive tests: Mini-Mental State Examination (MMSE), Semantic Verbal Fluency Test, Trail Making Test A/B, and Word Memory Tests. Each cognitive test score was converted to a z-score and its average resulted in a new variable called Global Cognitive z-Score [GCS(z)]. Averages of the cognitive test scores and GCS(z) at both moments were compared by the Student's T-Test for paired samples. Multivariate binary logistic regression models were built to assess the association of GCS(z) < zero with risk factors for cognitive decline at the baseline and follow-up. RESULTS After exclusions, 251 patients were eligible, being 56.6% female, mean age of 61.1 (± 9.8) years, 12.6 (± 8.9) years of DM duration, and 7.6 (± 4.2) years of school education. Follow-up had 134 patients reevaluated and took place after a mean of 18.4(± 5.0) months. Eleven (14%) patients with a GCS(z) ≥ 0 at baseline turned into a GCS(z) < 0 at follow-up. There were no significant differences between the means of cognitive test scores and GCS(z) at the two evaluation moments. At the baseline, the multivariate logistic regression model identified five risk factors associated with GCS(z) < zero: age ≥ 65 years, schooling ≤ 6 years, arterial hypertension, depression symptoms, and diabetic retinopathy (DR), with odds ratio (OR) and 95% confidence interval (CI95%) respectively: 5.46 (2.42-12.34); 12.19 (5.62-26.46); 2.55 (0.88-7.39); 3.53 (1.55-8.07) e 2.50 (1.18-5.34). At follow-up, the risk factors for GCS(z) < zero were: schooling ≤ 6 years, DM duration ≥ 10 years, depression symptoms, arterial hypertension, and cardiovascular disease (CVD), OR and CI95% respectively: 10.15 (3.68-28.01); 2.68 (0.96-7.48); 4.92 (1.77-13.70); 7.21 (1.38-35.71) e 5.76 (1.93-17.18). CONCLUSIONS Based on our results, cognitive evaluation and follow-up should be incorporated on the routine of T2DM patients, especially for those with advanced age, low education level, prolonged DM duration, arterial hypertension, depression symptoms, CVD, and DR.
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Affiliation(s)
- Ana Cristina Ravazzani de Almeida Faria
- Postgraduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), Rua Imaculada Conceição, 1155, Curitiba, 80215-901, Brazil
- School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Paraná, Brazil
| | - Joceline Franco Dall'Agnol
- Postgraduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), Rua Imaculada Conceição, 1155, Curitiba, 80215-901, Brazil
| | - Aline Maciel Gouveia
- School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Paraná, Brazil
| | - Clara Inácio de Paiva
- School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Paraná, Brazil
| | | | - Cristina Pellegrino Baena
- Postgraduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), Rua Imaculada Conceição, 1155, Curitiba, 80215-901, Brazil.
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Du Y, Yan F, Zhao L, Fang Y, Qiu Q, Wei W, Wang J, Tang Y, Lin X, Li X. Depression symptoms moderate the relationship between gray matter volumes and cognitive function in patients with mild cognitive impairment. J Psychiatr Res 2022; 151:516-522. [PMID: 35636026 DOI: 10.1016/j.jpsychires.2022.05.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/22/2022] [Accepted: 05/19/2022] [Indexed: 10/18/2022]
Abstract
Previous studies have demonstrated that decreased gray matter volume (GMV) correlates with cognitive function in elderly patients with mild cognitive impairment (MCI). However, it is unclear whether those correlations are present in MCI patients with depressive symptoms (MCID). This study investigated the association among depressive symptoms, GMV and cognitive function. We included 210 participants, namely, 70 elderly MCID patients, 70 MCI patients without depressive symptoms (MCIND) and 70 healthy controls (HCs). Voxel-based morphometry (VBM) was used to investigate the structural disruptions among the patients in the three groups, and correlation analysis was performed between the GMV of regions showing group differences and cognitive function. Moderation analyses were conducted to verify the conditional effect of depressive symptoms on the relationship between structural changes and cognitive function. We found decreased GMV in the bilateral fusiform gyrus, inferior temporal gyrus, parahippocampal gyrus, and hippocampus in the MCIND group compared to the HC group. Moreover, we identified decreased GMV in the bilateral fusiform gyrus in the elderly MCID patients compared with the elderly MCIND patients, which provides further insights into the neural mechanisms of depressive symptoms in patients with MCID. Most importantly, the severity of depressive symptoms moderated the positive correlation between the GMV of abnormal brain regions and cognitive function. Furthermore, this study is the first report of the moderating effect of depressive symptoms on the GMV of abnormal brain areas and cognitive function in patients with MCID, indicating the significance of clinical intervention in elderly MCI patients with depressive symptoms.
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Affiliation(s)
- Yang Du
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Yan
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Lu Zhao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Yuan Fang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Qi Qiu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Wenjing Wei
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Jinghua Wang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiang Lin
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
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The longitudinal association between loneliness and depressive symptoms in the elderly: a systematic review. Int Psychogeriatr 2022; 34:657-669. [PMID: 33849675 DOI: 10.1017/s1041610221000399] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Loneliness and the onset of depression in old age are growing problems related to the greater life expectancy nowadays. This review investigated the longitudinal association between loneliness and depressive symptoms in the elderly. DESIGN A comprehensive search was conducted using three databases (Scopus, PsycInfo, and PubMed) combing for empirical studies published up until July 2020. A total of 4.549 abstracts and 221 full-text articles were assessed. Three authors independently reviewed titles and abstracts; disagreements were resolved by consensus. RESULTS Ten studies were included in the final review. We identified two categories of studies based on the outcome considered in each article: 1) the longitudinal effect of loneliness on depressive symptoms and 2) the clinical course of depression and its association with loneliness. All the articles reported a significant and positive association between loneliness and depressive symptoms in their longitudinal design research, ranging from an odds ratio of 0.41 to 17.76. The heterogeneity regarding the effect size in the analyses can be explained by the multifactorial design implemented by most of the studies included. CONCLUSIONS Future research should investigate the moderators' role and how it may influence the longitudinal association between loneliness and depression over the years.
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Korhonen K, Tarkiainen L, Leinonen T, Einiö E, Martikainen P. Association between a history of clinical depression and dementia, and the role of sociodemographic factors: population-based cohort study. Br J Psychiatry 2022; 221:410-416. [PMID: 35043777 DOI: 10.1192/bjp.2021.217] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Depression is associated with an increased dementia risk, but the nature of the association in the long-term remains unresolved, and the role of sociodemographic factors mainly unexplored. AIMS To assess whether a history of clinical depression is associated with dementia in later life, controlling for observed sociodemographic factors and unobserved factors shared by siblings, and to test whether gender, educational level and marital status modify the association. METHOD We conducted a national cohort study of 1 616 321 individuals aged 65 years or older between 2001 and 2018 using administrative healthcare data. A history of depression was ascertained from the national hospital register in the period 15-30 years prior to dementia follow-up. We used conventional and sibling fixed-effects Cox regression models to analyse the association between a history of depression, sociodemographic factors and dementia. RESULTS A history of depression was related to an adjusted hazard ratio of 1.27 (95% CI 1.23-1.31) for dementia in the conventional Cox model and of 1.55 (95% CI 1.09-2.20) in the sibling fixed-effects model. Depression was related to an elevated dementia risk similarly across all levels of education (test for interaction, P = 0.84), but the association was weaker for the widowed than for the married (P = 0.003), and stronger for men than women (P = 0.006). The excess risk among men attenuated following covariate adjustment (P = 0.10). DISCUSSION This study shows that a history of depression is consistently associated with later-life dementia risk. The results support the hypothesis that depression is an aetiological risk factor for dementia.
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Affiliation(s)
- Kaarina Korhonen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Finland
| | - Lasse Tarkiainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Finland and Helsinki Institute of Urban and Regional Studies (URBARIA), University of Helsinki, Finland
| | | | - Elina Einiö
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Finland
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Finland; Department of Public Health Sciences, Stockholm University, Sweden; and Laboratory of Population Health, Max Planck Institute for Demographic Research, Germany
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Loreto F, Fitzgerald A, Golemme M, Gunning S, Win Z, Patel N, Carswell C, Perry R, Kennedy A, Edison P, Malhotra P. Prevalence of Depressive Symptoms in a Memory Clinic Cohort: A Retrospective Study. J Alzheimers Dis 2022; 88:1179-1187. [PMID: 35754270 DOI: 10.3233/jad-220170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Depression has been suggested to be a cause of reversible cognitive impairment but also a risk factor for neurodegenerative disease. Studies suggest that depression prevalence may be high in early onset dementia, particularly Alzheimer's disease, but this has not been systematically assessed in a biomarker-validated clinical dementia cohort to date. OBJECTIVE To examine the prevalence, features, and association with amyloid pathology of lifetime depressive symptoms in a memory clinic cohort meeting appropriate use criteria for amyloid PET imaging. METHODS We included 300 patients from a single-center memory clinic cohort that received diagnostic biomarker evaluation with amyloid PET imaging according to appropriate use criteria. History of lifetime depressive symptoms was retrospectively assessed through structured review of clinical correspondence. RESULTS One hundred forty-two (47%) patients had a history of significant depressive symptoms ('D+'). Of these, 89% had ongoing symptoms and 60% were on antidepressants at the time of presentation to our Clinic. Depressive symptoms were equally highly prevalent in the amyloid-positive and the heterogeneous group of amyloid-negative patients. CONCLUSION Approximately half of patients who meet appropriate use criteria for amyloid PET had a history of depressive symptoms. We suggest that depression is an important feature of both neurodegenerative and non-neurodegenerative cognitive impairment and may contribute to the diagnostic uncertainty behind referral to amyloid PET.
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Affiliation(s)
- Flavia Loreto
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Anna Fitzgerald
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Mara Golemme
- Department of Neurology, Imperial College Healthcare NHS Trust, London, UK.,UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, UK
| | - Stephen Gunning
- Department of Neuropsychology, Imperial College Healthcare NHS Trust, London, UK
| | - Zarni Win
- Department of Nuclear Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Neva Patel
- Department of Nuclear Medicine, Imperial College Healthcare NHS Trust, London, UK
| | | | - Richard Perry
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK.,Department of Neurology, Imperial College Healthcare NHS Trust, London, UK
| | - Angus Kennedy
- Department of Neurology, Imperial College Healthcare NHS Trust, London, UK
| | - Paul Edison
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Paresh Malhotra
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK.,Department of Neurology, Imperial College Healthcare NHS Trust, London, UK.,UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, UK
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118
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Baba H, Kito S, Nukariya K, Takeshima M, Fujise N, Iga J, Oshibuchi H, Kawano M, Kimura M, Mizukami K, Mimura M. Guidelines for diagnosis and treatment of depression in older adults: A report from the Japanese Society of mood disorders. Psychiatry Clin Neurosci 2022; 76:222-234. [PMID: 35274788 DOI: 10.1111/pcn.13349] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 11/30/2022]
Abstract
The Committee for Treatment Guidelines of Mood Disorders, Japanese Society of Mood Disorders, published a Japanese guideline for the treatment of late-life depression in 2020. Based on that guideline, the present guideline was developed and revised to incorporate the suggestions of global experts and the latest published evidence. In the diagnosis of late-life depression, it is important to carefully differentiate it from bipolar disorders, depressive states caused by physical and organic brain disease, drug effects, and dementia, and to determine the comorbidity between late-life depression and dementia. It is necessary to fully understand the clinical characteristics and psychosocial background of late-life depression, evaluate the patient's condition, and provide basic interventions based on these factors. Problem-solving therapy, reminiscence therapy/life review therapy, and behavioral activation therapy, and other forms of psychotherapy can reduce depressive symptoms. In terms of pharmacotherapy, newer antidepressants or non-tricyclic antidepressants are recommended for late-life depression, and it is recommended that the efficacy of least the minimal effective dosage should first be determined. Switching antidepressants and aripiprazole augmentation can be used to treatment-resistant therapy. Electroconvulsive therapy and repetitive transcranial magnetic stimulation have demonstrated usefulness for late-life depression. Exercise therapy, high-intensity light therapy, and diet therapy also show some effectiveness and are useful for late-life depression. Continuation therapy should be maintained for at least 1 year after remission.
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Affiliation(s)
- Hajime Baba
- Department of Psychiatry, Juntendo University Koshigaya Hospital, Saitama, Japan.,Department of Psychiatry & Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shinsuke Kito
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan
| | - Kazutaka Nukariya
- Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan.,Department of Psychiatry, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
| | - Minoru Takeshima
- Department of Psychiatry, Meishin-kai Shibata Hospital, Toyama, Japan.,Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Noboru Fujise
- Health Care Center, Kumamoto University, Kumamoto, Japan
| | - Junichi Iga
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Hidehiro Oshibuchi
- Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan.,Department of Child Psychiatry, Kanagawa Children's Medical Center, Kanagawa, Japan
| | | | - Mahiko Kimura
- Department of Neuropsychiatry, Nippon Medical School, Chiba Hokusoh Hospital, Chiba, Japan
| | - Katsuyoshi Mizukami
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Ba’yah Abdul Kadir N, Griffiths MD. Psychosocial Risk Factors for Depression Among Married Muslim Mothers in Malaysia. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-020-00452-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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120
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Rodriguez-Loureiro L, Gadeyne S, Bauwelinck M, Lefebvre W, Vanpoucke C, Casas L. Long-term exposure to residential greenness and neurodegenerative disease mortality among older adults: a 13-year follow-up cohort study. Environ Health 2022; 21:49. [PMID: 35525977 PMCID: PMC9077872 DOI: 10.1186/s12940-022-00863-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/29/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND Living in greener areas is associated with slower cognitive decline and reduced dementia risk among older adults, but the evidence with neurodegenerative disease mortality is scarce. We studied the association between residential surrounding greenness and neurodegenerative disease mortality in older adults. METHODS We used data from the 2001 Belgian census linked to mortality register data during 2001-2014. We included individuals aged 60 years or older and residing in the five largest Belgian urban areas at baseline (2001). Exposure to residential surrounding greenness was assessed using the 2006 Normalized Difference Vegetation Index (NDVI) within 500-m from residence. We considered all neurodegenerative diseases and four specific outcomes: Alzheimer's disease, vascular dementia, unspecified dementia, and Parkinson's disease. We fitted Cox proportional hazard models to obtain hazard ratios (HR) and 95% confidence intervals (CI) of the associations between one interquartile range (IQR) increment in surrounding greenness and neurodegenerative disease mortality outcomes, adjusted for census-based covariates. Furthermore, we evaluated the potential role of 2010 air pollution (PM2.5 and NO2) concentrations, and we explored effect modification by sociodemographic characteristics. RESULTS From 1,134,502 individuals included at baseline, 6.1% died from neurodegenerative diseases during follow-up. After full adjustment, one IQR (0.22) increment of surrounding greenness was associated with a 4-5% reduction in premature mortality from all neurodegenerative diseases, Alzheimer's disease, vascular and unspecified dementia [e.g., for Alzheimer's disease mortality: HR 0.95 (95%CI: 0.93, 0.98)]. No association was found with Parkinson's disease mortality. Main associations remained for all neurodegenerative disease mortality when accounting for air pollution, but not for the majority of specific mortality outcomes. Associations were strongest in the lower educated and residents from most deprived neighbourhoods. CONCLUSIONS Living near greener spaces may reduce the risk of neurodegenerative disease mortality among older adults, potentially independent from air pollution. Socioeconomically disadvantaged groups may experience the greatest beneficial effect.
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Affiliation(s)
| | - Sylvie Gadeyne
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Wouter Lefebvre
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | | | - Lidia Casas
- Department of Family Medicine and Population Health, Social Epidemiology and Health Policy, University of Antwerp, Wilrijk, Belgium
- Institute for Environment and Sustainable Development (IMDO), University of Antwerp, Antwerp, Belgium
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121
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Alastalo A, Tolppanen A, Nietola M, Haapea M, Miettunen J, Hartikainen S, Jääskeläinen E. Prevalence and characteristics of psychiatric morbidity treated in specialized health care in a nationwide cohort of people with newly diagnosed Alzheimer's disease. Acta Psychiatr Scand 2022; 145:507-516. [PMID: 35266140 PMCID: PMC9311732 DOI: 10.1111/acps.13423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Psychiatric disorders have been implied as both risk factors and prodromal symptoms of Alzheimer's disease (AD). A better understanding of the history of psychiatric morbidity in people with AD may aid with understanding this relationship and highlight challenges in diagnosing AD in people with concomitant psychiatric disorders. METHODS Medication use and Alzheimer's disease (MEDALZ) study is a nationwide register-based cohort of people (n = 70,718) who received a clinically verified AD diagnosis in Finland in 2005-2011 and were community-dwelling at the time of diagnosis. The study population was divided into four groups based on psychiatric morbidity treated in specialized health care. We characterized the groups using data of psychiatric and somatic illnesses, psychotropic drug use, and socioeconomic factors and investigated factors associated with prodromal AD. RESULTS Altogether, 4.3% of cohort members had a psychiatric diagnosis at least five years before AD diagnosis, 3.1% had a psychiatric diagnosis only up to five years before AD diagnosis, and 1.1% had a psychiatric diagnosis both less and more than 5 years before AD. Belonging to the Prodromal group (psychiatric diagnosis within 5 years before AD diagnosis) was most strongly associated with substance abuse (RR 65.06, 95%CI 55.54-76.22). Other associated factors with the Prodromal group were female gender, use of psychotropics, stroke, and asthma/COPD. CONCLUSION Substance abuse and psychotropic drug use are common five years before AD diagnosis. These can be potential markers of possible prodromal symptoms of AD and should be acknowledged in clinical work.
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Affiliation(s)
- Aleksi Alastalo
- Center for Life Course Health ResearchUniversity of OuluOuluFinland,Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
| | | | - Miika Nietola
- Department of PsychiatryUniversity of Turku and Turku University HospitalTurkuFinland
| | - Marianne Haapea
- Center for Life Course Health ResearchUniversity of OuluOuluFinland,Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland,Department of PsychiatryOulu University HospitalOuluFinland
| | - Jouko Miettunen
- Center for Life Course Health ResearchUniversity of OuluOuluFinland,Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
| | | | - Erika Jääskeläinen
- Center for Life Course Health ResearchUniversity of OuluOuluFinland,Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland,Department of PsychiatryOulu University HospitalOuluFinland
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Stafford J, Chung WT, Sommerlad A, Kirkbride JB, Howard R. Psychiatric disorders and risk of subsequent dementia: Systematic review and meta-analysis of longitudinal studies. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5711. [PMID: 35460299 PMCID: PMC9325434 DOI: 10.1002/gps.5711] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Although psychiatric disorders have been found to be associated with increased risk of dementia, previous findings are mixed, and the nature of these relationships remains poorly understood. We examined longitudinal associations between depression, anxiety, post-traumatic stress disorders (PTSD), bipolar disorder (BPD), psychotic disorders and subsequent dementia. METHODS We searched three databases for longitudinal, population-based studies investigating associations between psychiatric disorders and dementia (PROSPERO registration: CRD42020209638). We conducted narrative synthesis, and random-effects meta-analyses to obtain pooled estimates. We used meta-regression and stratified analyses to examine variation by sex, age-at-onset and follow-up time. RESULTS Fifty-seven citations met eligibility criteria. Most studies focussed on depression (n = 33), which was associated with subsequent all-cause dementia (pooled relative risk [RR]: 1.96, 95% confidence interval [CI]: 1.59-2.43; I2 = 96.5%), Alzheimer's Disease (pooled RR: 1.9, 95% CI: 1.52-2.38; I2 = 85.5%), and Vascular Dementia (pooled RR: 2.71, 95% CI: 2.48-2.97; I2 = 0). Associations were stronger in studies with shorter follow-up periods and for severe and late-onset depression. Findings regarding anxiety were mixed, and we did not find evidence of an overall association (pooled RR: 1.18, 95% CI: 0.96-1.45; I2 = 52.2%, n = 5). Despite sparse evidence, psychotic disorders (pooled RR: 2.19, 95% CI: 1.44-3.31; I2 = 99%), PTSD and BPD were associated with subsequent dementia. CONCLUSIONS People with psychiatric disorders represent high-risk groups for dementia, highlighting the importance of ongoing symptom monitoring in these groups. Findings regarding temporality and age-at-onset indicate that depression symptoms could reflect prodromal dementia for some individuals. Further longitudinal research is required to determine whether psychiatric disorders represent causal risk factors or early markers of dementia neuropathology.
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Affiliation(s)
- Jean Stafford
- MRC Unit for Lifelong Health and AgeingUniversity College London (UCL)LondonUK
| | - Wing Tung Chung
- Division of PsychiatryUniversity College London (UCL)LondonUK
| | | | | | - Robert Howard
- Division of PsychiatryUniversity College London (UCL)LondonUK
- Camden and Islington NHS Foundation TrustLondonUK
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123
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Late-onset depression: A risk factor for major neurocognitive disorder? CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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124
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Gender differences in the association of depression trajectories with executive and memory functions: Evidence from the longitudinal study of the Survey of Health, Ageing and Retirement in Europe (2004-2017). J Psychiatr Res 2022; 149:177-184. [PMID: 35278782 DOI: 10.1016/j.jpsychires.2022.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/25/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2022]
Abstract
Gender differences in depression trajectories and their effects on cognitive function are poorly understood. This article aims to identify depression trajectories in both genders and further explore the association of depression trajectories with executive and memory functions by gender. A total 3990 participants aged 50 years or older with repeated measurements from waves 1 to 7 (wave 3 excluded) of the Study of the Survey of Health, Ageing and Retirement in Europe (SHARE) were included. Group-based trajectory modeling (GBTM) was conducted to identify the optimal number of depression trajectories. Generalized estimating equation (GEE) models were used to examine the relation of depression trajectories to cognitive function after stratification by gender. Three distinct depression trajectories were identified in both genders, but the patterns of trajectories among genders were nonidentical. The trajectories of depression in males were characterized by non-low, moderate, persistent-depressive symptoms but with an unstable trend, while in females, they were characterized by non-low, moderate, persistent-depressive symptoms and with a worsening trend. The prevalence of persistent high depression in women (20.08%) was higher than that in men (3.13%). Moderate and persistent high depression trajectories were negatively associated with episodic memory (β = -0.53 and -0.72, respectively, p < 0.001) and verbal fluency in females (β = -0.96 and -1.47, p=0.01 and < 0.001, respectively). Older women had a greater frequency of developing depression than older men. Gender differences in depression trajectories existed. Moderate and persistent high depression trajectories exerted a negative effect on some domains of cognitive impairment only in females.
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125
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Kilpatrick LA, Krause-Sorio B, Siddarth P, Narr KL, Lavretsky H. Default mode network connectivity and treatment response in geriatric depression. Brain Behav 2022; 12:e2475. [PMID: 35233974 PMCID: PMC9015007 DOI: 10.1002/brb3.2475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 11/09/2021] [Accepted: 12/08/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Default mode network (DMN) connectivity is altered in depression. We evaluated the relationship between changes in within-network DMN connectivity and improvement in depression in a subsample of our parent clinical trial comparing escitalopram/memantine (ESC/MEM) to escitalopram/placebo (ESC/PBO) in older depressed adults (NCT01902004). METHODS Twenty-six participants with major depression (age > 60 years) and subjective memory complaints underwent treatment with ESC/MEM (n = 13) or ESC/PBO (n = 13), and completed baseline and 3-month follow-up resting state magnetic resonance imaging scans. Multi-block partial least squares correlation analysis was used to evaluate the impact of treatment on within-network DMN connectivity changes and their relationship with symptom improvement at 3 months (controlling for age and sex). RESULTS A significant latent variable was identified, reflecting within-network DMN connectivity changes correlated with symptom improvement (p = .01). Specifically, although overall group differences in within-network DMN connectivity changes failed to reach significance, increased within-network connectivity of posterior/lateral DMN regions (precuneus, angular gyrus, superior/middle temporal cortex) was more strongly and positively correlated with symptom improvement in the ESC/MEM group (r = 0.97, 95% confidence interval: 0.86-0.98) than in the ESC/PBO group (r = 0.36, 95% confidence interval: 0.13-0.72). CONCLUSIONS Increased within-network connectivity of core DMN nodes was more strongly correlated with depressive symptom improvement with ESC/MEM than with ESC/PBO, supporting an improved engagement of brain circuitry implicated in the amelioration of depressive symptoms with combined ESC/MEM treatment in older adults with depression and subjective memory complaints.
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Affiliation(s)
- Lisa A Kilpatrick
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Beatrix Krause-Sorio
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Prabha Siddarth
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Katherine L Narr
- Brain Mapping Center, Departments of Neurology, and Psychiatry and Biobehavioral Sciences, Los Angeles, California, USA
| | - Helen Lavretsky
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
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126
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van Gennip ACE, Sedaghat S, Carnethon MR, Allen NB, Klein BEK, Cotch MF, Chirinos DA, Stehouwer CDA, van Sloten TT. Retinal Microvascular Caliber and Incident Depressive Symptoms: The Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 2022; 191:843-855. [PMID: 34652423 PMCID: PMC9071571 DOI: 10.1093/aje/kwab255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/05/2021] [Accepted: 10/12/2021] [Indexed: 11/15/2022] Open
Abstract
Cerebral microvascular dysfunction may contribute to depression via disruption of brain structures involved in mood regulation, but evidence is limited. The retina allows for visualization of a microvascular bed that shares similarities with the cerebral microvasculature. We investigated the associations between baseline retinal arteriolar and venular calibers (central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE), respectively) and incident depressive symptoms in the Multi-Ethnic Study of Atherosclerosis (MESA). We used longitudinal data on 4,366 participants (mean age = 63.2 years; 48.5% women, 28.4% Black) without baseline depressive symptoms. Depressive symptoms, defined as Center for Epidemiologic Studies Depression Scale score ≥16 and/or use of antidepressant medication, were determined between 2002 and 2004 (baseline; MESA visit 2) and at 3 follow-up examinations conducted every 1.5–2 years thereafter. Fundus photography was performed at baseline. After a mean follow-up period of 6.1 years, 21.9%
(n = 958) had incident depressive symptoms. After adjustment for sociodemographic, lifestyle, and cardiovascular factors, a 1–standard-deviation larger baseline CRVE was associated with a higher risk of depressive symptoms (hazard ratio = 1.10, 95% confidence interval: 1.02, 1.17), and a 1–standard-deviation larger baseline CRAE was not statistically significantly associated with incident
depressive symptoms (hazard ratio = 1.04, 95% confidence interval: 0.97, 1.11). In this study, larger baseline CRVE, but not CRAE, was associated with a higher incidence of depressive symptoms.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Thomas T van Sloten
- Correspondence to Dr. Thomas T. van Sloten, Department of Internal Medicine, School for Cardiovascular Diseases (CARIM), Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands (e-mail: )
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Freudenberg-Hua Y, Makhnevich A, Li W, Liu Y, Qiu M, Marziliano A, Carney M, Greenwald B, Kane JM, Diefenbach M, Burns E, Koppel J, Sinvani L. Psychotropic Medication Use Is Associated With Greater 1-Year Incidence of Dementia After COVID-19 Hospitalization. Front Med (Lausanne) 2022; 9:841326. [PMID: 35372430 PMCID: PMC8972194 DOI: 10.3389/fmed.2022.841326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/15/2022] [Indexed: 12/15/2022] Open
Abstract
Background COVID-19 has been associated with an increased risk of incident dementia (post-COVID dementia). Establishing additional risk markers may help identify at-risk individuals and guide clinical decision-making. Methods We investigated pre-COVID psychotropic medication use (exposure) and 1-year incidence of dementia (outcome) in 1,755 patients (≥65 years) hospitalized with COVID-19. Logistic regression models were used to examine the association, adjusting for demographic and clinical variables. For further confirmation, we applied the Least Absolute Shrinkage and Selection Operator (LASSO) regression and a machine learning (Random Forest) algorithm. Results One-year incidence rate of post-COVID dementia was 12.7% (N = 223). Pre-COVID psychotropic medications (OR = 2.7, 95% CI: 1.8-4.0, P < 0.001) and delirium (OR = 3.0, 95% CI: 1.9-4.6, P < 0.001) were significantly associated with greater 1-year incidence of post-COVID dementia. The association between psychotropic medications and incident dementia remained robust when the analysis was restricted to the 423 patients with at least one documented neurological or psychiatric diagnosis at the time of COVID-19 admission (OR = 3.09, 95% CI: 1.5-6.6, P = 0.002). Across different drug classes, antipsychotics (OR = 2.8, 95% CI: 1.7-4.4, P < 0.001) and mood stabilizers/anticonvulsants (OR = 2.4, 95% CI: 1.39-4.02, P = 0.001) displayed the greatest association with post-COVID dementia. The association of psychotropic medication with dementia was further confirmed with Random Forest and LASSO analysis. Conclusion Confirming prior studies we observed a high dementia incidence in older patients after COVID-19 hospitalization. Pre-COVID psychotropic medications were associated with higher risk of incident dementia. Psychotropic medications may be risk markers that signify neuropsychiatric symptoms during prodromal dementia, and not mutually exclusive, contribute to post-COVID dementia.
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Affiliation(s)
- Yun Freudenberg-Hua
- Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Alexander Makhnevich
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, United States
| | - Wentian Li
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Yan Liu
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Michael Qiu
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Allison Marziliano
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, United States
| | - Maria Carney
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, United States
| | - Blaine Greenwald
- Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - John M. Kane
- Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Michael Diefenbach
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, United States
| | - Edith Burns
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, United States
| | - Jeremy Koppel
- Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Liron Sinvani
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, United States
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Babulal GM, Chen L, Doherty JM, Murphy SA, Johnson AM, Roe CM. Longitudinal Changes in Anger, Anxiety, and Fatigue Are Associated with Cerebrospinal Fluid Biomarkers of Alzheimer’s Disease. J Alzheimers Dis 2022; 87:141-148. [DOI: 10.3233/jad-215708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Alzheimer’s disease (AD) studies in cognitively normal (CN) older adults aged≥65 suggest depression is associated with molecular biomarkers (imaging and cerebrospinal fluid [CSF]). This study used linear mixed models (covariance pattern model) to assess whether baseline CSF biomarkers (Aβ 42/Aβ 40, t-Tau/Aβ 42, p-Tau/Aβ 42) predicted changes in non-depressed mood states in CN older adults (N = 248), with an average of three follow-up years. Participants with higher levels of CSF biomarkers developed more anger, anxiety, and fatigue over time compared to those with more normal levels. Non-depressed mood states in preclinical AD may be a prodrome for neuropsychiatric symptoms in symptomatic AD.
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Affiliation(s)
- Ganesh M. Babulal
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
- Institute of Public Health, Washington University in St. Louis, St. Louis, MO, USA
- Department of Psychology, Faculty of Humanities, University of Johannesburg, South Africa
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Ling Chen
- Division of Biostatistics, Washington University in St. Louis, St. Louis, MO, USA
| | - Jason M. Doherty
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Samantha A. Murphy
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Ann M. Johnson
- Center for Clinical Studies, Washington University in St. Louis, St. Louis, MO, USA
| | - Catherine M. Roe
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
- Roe Research LLC, St. Louis, MO, USA
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129
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Cremers G, Taylor E, Hodge L, Quigley A. Effectiveness and Acceptability of Low-intensity Psychological Interventions on the Well-being of Older Adults: A Systematic Review. Clin Gerontol 2022; 45:214-234. [PMID: 31507251 DOI: 10.1080/07317115.2019.1662867] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Growth in the older adult population and healthcare inequities mean there is a global need to increase access to early intervention in mental healthcare for older adults. This systematic review synthesized the evidence for the efficacy and acceptability of low-intensity psychological interventions (self-help, psychoeducation, bibliotherapy, internet cognitive-behavioral therapy: iCBT) for older adults with mild-to-moderate mental health problems.Methods: Ovid, EBSCOhost and ProQuest were searched for articles describing low-intensity psychological interventions. Pre and post outcome measures and a mean age of at least 50 (age range ≥40) were required for inclusion.Results: 26 articles (23 studies) described various interventions. Most studies were good quality and reported improvements in participant's mental health scores post intervention. Participants were more likely to be female, aged 60-70 and to be highly educated. Eight studies reported obtaining participant satisfaction ratings. Three studies included participants from rural areas.Conclusions: Low-intensity psychological interventions can be effective for older adults with mild-to-moderate mental health problems, but generalizability is constrained.Clinical Implications: Guided iCBT and bibliotherapy may be beneficial for adults in their 60s and 70s experiencing mild-to-moderate levels of depression. CBT may also be beneficial for reducing symptoms of mild-to-moderate anxiety. Providing the option of low-intensity psychological intervention, particularly iCBT, may help increase engagement with treatment.
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Affiliation(s)
- Gwendolyn Cremers
- Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK.,Psychological Services, NHS Borders, Melrose, UK
| | - Emily Taylor
- Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Lorna Hodge
- Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
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Holtback C, Welin C, Fu M, Thunström E, Rosengren A, Lappas G, Hansson P. Mid-life extrapyramidal symptoms predict cognitive impairment 23 years later. Acta Neurol Scand 2022; 145:305-313. [PMID: 34791639 DOI: 10.1111/ane.13557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The prevalence of dementia is growing rapidly worldwide. The early identification and treatment of cognitive decline could reduce the burden on the health care system. Our objective was to investigate whether factors measured at an examination at age 50 predict cognitive impairment (CI) 23 years later. MATERIALS & METHODS In 1993 we enrolled a randomly selected sample of 798 men, 50 years of age, from the general population. They all underwent a physical examination, provided blood samples and filled out questionnaires addressing lifestyle and psychosocial factors. Cognitive testing was offered to all participants still alive in 2016, at age 73. RESULTS A total of 333 men participated in the cognitive study, of which 80 (24.0%) performed at a level corresponding to mild cognitive impairment, and four (1.2%) at a level consistent with severe cognitive impairment. After the first step in the multivariable analysis, hypertension, heavy smoking, high intake of alcohol, financial stress, difficulty falling asleep, and cogwheel rigidity were associated with cognitive impairment. After further adjustment, only wide waist circumference measured in cm (OR 1.04, 95% CI 1.00-1.08, p = .04), leg pendulousness (OR 41.97, 95% CI 3.27-538.62, p = .004) and self-assessed hidden irritability (OR 2.18, 95% CI 1.10-4.32, p = .03) at baseline, remained as being associated with cognitive impairment 23 years later. CONCLUSIONS Extrapyramidal symptoms such as leg pendulousness, at the age of 50, may be an indicator for very early identification of future cognitive decline.
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Affiliation(s)
- Charlotte Holtback
- Department of Molecular and Clinical Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Catharina Welin
- Department of Molecular and Clinical Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Michael Fu
- Department of Molecular and Clinical Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Medicine Geriatrics and Emergency Medicine Sahlgrenska University Hospital Region Västra Götaland Gothenburg Sweden
| | - Erik Thunström
- Department of Molecular and Clinical Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Medicine Geriatrics and Emergency Medicine Sahlgrenska University Hospital Region Västra Götaland Gothenburg Sweden
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Medicine Geriatrics and Emergency Medicine Sahlgrenska University Hospital Region Västra Götaland Gothenburg Sweden
| | - Georgios Lappas
- Department of Molecular and Clinical Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Per‐Olof Hansson
- Department of Molecular and Clinical Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Medicine Geriatrics and Emergency Medicine Sahlgrenska University Hospital Region Västra Götaland Gothenburg Sweden
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131
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Nedelec T, Couvy-Duchesne B, Monnet F, Daly T, Ansart M, Gantzer L, Lekens B, Epelbaum S, Dufouil C, Durrleman S. Identifying health conditions associated with Alzheimer's disease up to 15 years before diagnosis: an agnostic study of French and British health records. THE LANCET DIGITAL HEALTH 2022; 4:e169-e178. [DOI: 10.1016/s2589-7500(21)00275-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/06/2021] [Accepted: 11/25/2021] [Indexed: 12/30/2022]
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132
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Loessner L, Matthes C, Haussmann R, Brandt MD, Sauer C, Espin M, Noppes F, Werner A, Linn J, Hummel T, Haehner A, Donix M. Predictors of subjective cognitive deficits in patients with mild cognitive impairment. Psychogeriatrics 2022; 22:210-217. [PMID: 34939254 DOI: 10.1111/psyg.12802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/12/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Detailed examination of cognitive deficits in patients with mild cognitive impairment (MCI) yields substantial diagnostic and prognostic value, specifically with respect to memory. Magnitude and characteristics of subjective cognitive deficits, however, often receive less attention in this population at risk for developing dementia. METHODS We investigated predictors of subjective cognitive deficits in patients with MCI, using a detailed assessment for such impairments associated with different cognitive domains, as well as demographic and clinical variables including magnetic resonance imaging data. RESULTS The strongest predictor for subjective memory deficits was depressed mood, whereas subjective performance issues associated with attention or executive functions also corresponded to measurable impairments in the respective cognitive domains. Reduced hippocampal thickness and hemispheric entorhinal cortex thickness asymmetry were associated with objective memory impairment but not with subjective deficits or symptoms of depression. CONCLUSIONS Whereas low objective memory performance and reduced cortical thickness within medial temporal lobe subregions could be associated with neurodegeneration, greater subjective memory deficits in patients with MCI may indicate psychological burden.
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Affiliation(s)
- Lorenz Loessner
- Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Claudia Matthes
- Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Robert Haussmann
- Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Moritz D Brandt
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Cathrin Sauer
- Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Melanie Espin
- Department of Otorhinolaryngology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Felix Noppes
- Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Annett Werner
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany.,Department of Neuroradiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Jennifer Linn
- Department of Neuroradiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Markus Donix
- Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
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Emsell L, Vanhaute H, Vansteelandt K, De Winter FL, Christiaens D, Van den Stock J, Vandenberghe R, Van Laere K, Sunaert S, Bouckaert F, Vandenbulcke M. An optimized MRI and PET based clinical protocol for improving the differential diagnosis of geriatric depression and Alzheimer's disease. Psychiatry Res Neuroimaging 2022; 320:111443. [PMID: 35091333 DOI: 10.1016/j.pscychresns.2022.111443] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/28/2021] [Accepted: 01/12/2022] [Indexed: 11/16/2022]
Abstract
Amyloid positron emission tomography (PET) and hippocampal volume derived from magnetic resonance imaging may be useful clinical biomarkers for differentiating between geriatric depression and Alzheimer's disease (AD). Here we investigated the incremental value of using hippocampal volume and 18F-flutemetmol amyloid PET measures in tandem and sequentially to improve discrimination in unclassified participants. Two approaches were compared in 41 participants with geriatric depression and 27 participants with probable AD: (1) amyloid and hippocampal volume combined in one model and (2) classification based on hippocampal volume first and then subsequent stratification using standardized uptake value ratio (SUVR)-determined amyloid positivity. Hippocampal volume and amyloid SUVR were significant diagnostic predictors of depression (sensitivity: 95%, specificity: 89%). 51% of participants were correctly classified according to clinical diagnosis based on hippocampal volume alone, increasing to 87% when adding amyloid data (sensitivity: 94%, specificity: 78%). Our results suggest that hippocampal volume may be a useful gatekeeper for identifying depressed individuals at risk for AD who would benefit from additional amyloid biomarkers when available.
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Affiliation(s)
- Louise Emsell
- Geriatric Psychiatry, UPC KU Leuven, Leuven, Belgium; Department of Neurosciences, Neuropsychiatry, KU Leuven, Leuven, Belgium; Department of Imaging & Pathology, Translational MRI, Medical Imaging Research Center, KU Leuven, UZ Leuven (Gasthuisberg), Leuven 3000, Belgium.
| | - Heleen Vanhaute
- Geriatric Psychiatry, UPC KU Leuven, Leuven, Belgium; Department of Imaging & Pathology, Nuclear Medicine and Molecular Imaging, KU Leuven, Leuven, Belgium; Nuclear Medicine, University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium
| | - Kristof Vansteelandt
- Geriatric Psychiatry, UPC KU Leuven, Leuven, Belgium; Department of Neurosciences, Neuropsychiatry, KU Leuven, Leuven, Belgium.
| | - François-Laurent De Winter
- Geriatric Psychiatry, UPC KU Leuven, Leuven, Belgium; Department of Neurosciences, Neuropsychiatry, KU Leuven, Leuven, Belgium.
| | - Danny Christiaens
- Department of Neurosciences, Neuropsychiatry, KU Leuven, Leuven, Belgium
| | - Jan Van den Stock
- Geriatric Psychiatry, UPC KU Leuven, Leuven, Belgium; Department of Neurosciences, Neuropsychiatry, KU Leuven, Leuven, Belgium.
| | - Rik Vandenberghe
- Department of Neurosciences, Laboratory for Cognitive Neurology, KU Leuven, Leuven, Belgium.
| | - Koen Van Laere
- Department of Imaging & Pathology, Nuclear Medicine and Molecular Imaging, KU Leuven, Leuven, Belgium; Nuclear Medicine, University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium.
| | - Stefan Sunaert
- Department of Imaging & Pathology, Translational MRI, Medical Imaging Research Center, KU Leuven, UZ Leuven (Gasthuisberg), Leuven 3000, Belgium; Department of Radiology, University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium.
| | - Filip Bouckaert
- Geriatric Psychiatry, UPC KU Leuven, Leuven, Belgium; Department of Neurosciences, Neuropsychiatry, KU Leuven, Leuven, Belgium.
| | - Mathieu Vandenbulcke
- Geriatric Psychiatry, UPC KU Leuven, Leuven, Belgium; Department of Neurosciences, Neuropsychiatry, KU Leuven, Leuven, Belgium.
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El-Tallawy HN, Saadeldin HM, Ezzeldin AM, Tohamy AM, Eltellawy S, Bathalath AM, Shehab MM. Genetic, clinical, and biochemical aspects of patients with Alzheimer disease. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00455-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Abstract
Background
The most common form of dementia is Alzheimer’s disease (AD). The clinical manifestations of AD are loss of memory that is progressive and deterioration in cognitive function. The objective of this study is to find patterns of AD among patients regarding clinical aspects, psychological aspects, and laboratory aspects, as well as to determine the role of some genes (APOE1, APOE2, and TMEM106B) in the pathogenesis of AD. In this case–control study, 40 patients with AD were recruited from the inpatient neurology departments and outpatient neurology clinics of the university hospitals in the period of January 1 to December 31, 2017. Furthermore, 40 cross-matched control patients underwent a complete history taking, neurological examination, brain MRI or CT, psychometric tests, thyroid function, and lipid profile measurements. Extracted DNA was quantified using a nanodrop analyzer (ND-1OOO) spectrophotometer for TMEM106B (rs1990622), APOE2 (rs429358), and APOE1 (rs7412).
Results
All subtypes of lipid profiles were significantly higher in patients with AD than the controls. There was a significant difference between the two groups regarding TMEM106B. There was an insignificant difference regarding thyroid hormones T3, T4, and TSH between patients and controls. There was no significant difference between AD patients and the control group regarding APOE-1 and APOE-2. Patients were worse than controls in tests of cognition, such as The Cognitive Abilities Screening Instrument (CASI) and auditory number and letter span test. In addition, AD patients had more depression than controls.
Conclusion
There may be a significant role of a high lipid profile and TMEM106B expression in the pathogenesis of AD.
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Ben Hassen C, Fayosse A, Landré B, Raggi M, Bloomberg M, Sabia S, Singh-Manoux A. Association between age at onset of multimorbidity and incidence of dementia: 30 year follow-up in Whitehall II prospective cohort study. BMJ 2022; 376:e068005. [PMID: 35110302 PMCID: PMC9086721 DOI: 10.1136/bmj-2021-068005] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To examine the association of midlife and late life multimorbidity, including severity of multimorbidity, with incident dementia. DESIGN Prospective cohort study. SETTING Civil service departments in London (Whitehall II study, study inception in 1985-88). PARTICIPANTS 10 095 participants, aged 35 to 55 at baseline. MAIN OUTCOME MEASURE Incident dementia at follow-up between 1985 and 2019. Cause specific Cox proportional hazards regression was used to examine the association of multimorbidity overall and at age 55, 60, 65, and 70 with subsequent dementia, taking into account the competing risk of death. RESULTS The prevalence of multimorbidity (≥2 chronic diseases) was 6.6% (655/9937) at age 55 and 31.7% (2464/7783) at age 70; 639 cases of incident dementia occurred over a median follow-up of 31.7 years. After adjustment for sociodemographic factors and health behaviours, multimorbidity at age 55 was associated with subsequent risk of dementia (difference in incidence rate per 1000 person years 1.56, 95% confidence interval 0.62 to 2.77; hazard ratio 2.44, 95% confidence interval 1.82 to 3.26). The association weakened progressively with older age at onset of multimorbidity. At age 65, onset of multimorbidity before age 55 was associated with 3.86 (1.80 to 6.52) per 1000 person years higher incidence of dementia (hazard ratio 2.46, 1.80 to 2.26) and onset between 60 and 65 was associated with 1.85 (0.64 to 3.39) per 1000 person years higher incidence (1.51, 1.16 to 1.97). Severity of multimorbidity (≥3 chronic diseases) at age 55 was associated with a 5.22 (1.14 to 11.95) per 1000 person years higher incidence of dementia (hazard ratio 4.96, 2.54 to 9.67); the same analyses at age 70 showed 4.49 (2.33 to 7.19) per 1000 person years higher incidence (1.65, 1.25 to 2.18). CONCLUSION Multimorbidity, particularly when onset is in midlife rather than late life, has a robust association with subsequent dementia. The increasingly younger age at onset of multimorbidity makes prevention of multimorbidity in people with a first chronic disease important.
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Affiliation(s)
- Céline Ben Hassen
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Aurore Fayosse
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Benjamin Landré
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Martina Raggi
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Mikaela Bloomberg
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Séverine Sabia
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Archana Singh-Manoux
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
- Department of Epidemiology and Public Health, University College London, London, UK
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Maxwell CJ, Maclagan LC, Harris DA, Wang X, Guan J, Marrie RA, Hogan DB, Austin PC, Vigod SN, Swartz RH, Bronskill SE. Incidence of neurological and psychiatric comorbidity over time: a population-based cohort study in Ontario, Canada. Age Ageing 2022; 51:6520504. [PMID: 35134841 DOI: 10.1093/ageing/afab277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/14/2021] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Comprehensive, population-based investigations of the extent and temporality of associations between common neurological and psychiatric disorders are scarce. METHODS This retrospective cohort study used linked health administrative data for Ontarians aged 40-85 years on 1 April 2002, to estimate the adjusted rate of incident dementia, Parkinson's disease (PD), stroke or mood/anxiety disorder (over 14 years) according to the presence and time since diagnosis of a prior disorder. Sex differences in the cumulative incidence of a later disorder were also examined. RESULTS The cohort included 5,283,546 Ontarians (mean age 56.2 ± 12.1 years, 52% female). The rate of dementia was significantly higher for those with prior PD (adjusted hazard ratio [adjHR] 4.05, 95% confidence interval [CI] 3.99-4.11); stroke (adjHR 2.49, CI 2.47-2.52) and psychiatric disorder (adjHR 1.79, CI 1.78-1.80). The rate of PD was significantly higher for those with prior dementia (adjHR 2.23, CI 2.17-2.30) and psychiatric disorder (adjHR 1.77, CI 1.74-1.81). The rate of stroke was significantly higher among those with prior dementia (adjHR 1.56, CI 1.53-1.58). Prior dementia (adjHR 2.36, CI 2.33-2.39), PD (adjHR 1.80, CI 1.75-1.85) and stroke (adjHR 1.47, CI 1.45-1.49) were associated with a higher rate of an incident psychiatric disorder. Generally, associations were strongest in the 6 months following a prior diagnosis and demonstrated a J-shape relationship over time. Significant sex differences were evident in the absolute risks for several disorders. CONCLUSIONS The observed nature of bidirectional associations between these neurological and psychiatric disorders indicates opportunities for earlier diagnosis and interventions to improve patient care.
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Affiliation(s)
- Colleen J Maxwell
- Schools of Pharmacy and Public Health, Sciences University of Waterloo, Waterloo, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | | | - Daniel A Harris
- ICES, Toronto, Ontario, Canada
- Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - David B Hogan
- Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Peter C Austin
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Simone N Vigod
- ICES, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Richard H Swartz
- ICES, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Susan E Bronskill
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
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137
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Gao L, Zhang Y, Sterling K, Song W. Brain-derived neurotrophic factor in Alzheimer's disease and its pharmaceutical potential. Transl Neurodegener 2022; 11:4. [PMID: 35090576 PMCID: PMC8796548 DOI: 10.1186/s40035-022-00279-0] [Citation(s) in RCA: 152] [Impact Index Per Article: 76.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/01/2022] [Indexed: 12/14/2022] Open
Abstract
Synaptic abnormalities are a cardinal feature of Alzheimer's disease (AD) that are known to arise as the disease progresses. A growing body of evidence suggests that pathological alterations to neuronal circuits and synapses may provide a mechanistic link between amyloid β (Aβ) and tau pathology and thus may serve as an obligatory relay of the cognitive impairment in AD. Brain-derived neurotrophic factors (BDNFs) play an important role in maintaining synaptic plasticity in learning and memory. Considering AD as a synaptic disorder, BDNF has attracted increasing attention as a potential diagnostic biomarker and a therapeutical molecule for AD. Although depletion of BDNF has been linked with Aβ accumulation, tau phosphorylation, neuroinflammation and neuronal apoptosis, the exact mechanisms underlying the effect of impaired BDNF signaling on AD are still unknown. Here, we present an overview of how BDNF genomic structure is connected to factors that regulate BDNF signaling. We then discuss the role of BDNF in AD and the potential of BDNF-targeting therapeutics for AD.
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Affiliation(s)
- Lina Gao
- Shandong Collaborative Innovation Center for Diagnosis, Treatment and Behavioral Interventions of Mental Disorders, Institute of Mental Health, College of Pharmacy, Jining Medical University, Jining, 272067, Shandong, China
- Townsend Family Laboratories, Department of Psychiatry, The University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Yun Zhang
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Keenan Sterling
- Townsend Family Laboratories, Department of Psychiatry, The University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Weihong Song
- Shandong Collaborative Innovation Center for Diagnosis, Treatment and Behavioral Interventions of Mental Disorders, Institute of Mental Health, College of Pharmacy, Jining Medical University, Jining, 272067, Shandong, China.
- Townsend Family Laboratories, Department of Psychiatry, The University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, School of Mental Health and The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou, 325001, Zhejiang, China.
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138
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de Crom TOE, Mooldijk SS, Ikram MK, Ikram MA, Voortman T. MIND diet and the risk of dementia: a population-based study. Alzheimers Res Ther 2022; 14:8. [PMID: 35022067 PMCID: PMC8756695 DOI: 10.1186/s13195-022-00957-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/30/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Adherence to the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet has been linked to a decreased risk of dementia, but reverse causality and residual confounding by lifestyle may partly account for this link. We aimed to address these issues by studying the associations over cumulative time periods, which may provide insight into possible reverse causality, and by using both historical and more contemporary dietary data as this could give insight into confounding since historical data may be less affected by lifestyle factors. METHODS In the population-based Rotterdam Study, dietary intake was assessed using validated food frequency questionnaires in 5375 participants between 1989 and 1993 (baseline I) and in a largely non-overlapping sample in 2861 participants between 2009 and 2013 (baseline II). We calculated the MIND diet score and studied its association with the risk of all-cause dementia, using Cox models. Incident all-cause dementia was recorded until 2018. RESULTS During a mean follow-up of 15.6 years from baseline I, 1188 participants developed dementia. A higher MIND diet score at baseline I was associated with a lower risk of dementia over the first 7 years of follow-up (hazard ratio (HR) [95% confidence interval (CI)] per standard deviation (SD) increase, 0.85 [0.74, 0.98]), but associations disappeared over longer follow-up intervals. The mean follow-up from baseline II was 5.9 years during which 248 participants developed dementia. A higher MIND diet score at baseline II was associated with a lower risk of dementia over every follow-up interval, but associations slightly attenuated over time (HR [95% CI] for 7 years follow-up per SD increase, 0.76 [0.66, 0.87]). The MIND diet score at baseline II was more strongly associated with the risk of dementia than the MIND diet score at baseline I. CONCLUSION Better adherence to the MIND diet is associated with a decreased risk of dementia within the first years of follow-up, but this may in part be explained by reverse causality and residual confounding by lifestyle. Further research is needed to unravel to which extent the MIND diet may affect the risk of dementia.
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Affiliation(s)
- Tosca O E de Crom
- Department of Epidemiology, Erasmus MC, University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
| | - Sanne S Mooldijk
- Department of Epidemiology, Erasmus MC, University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.,Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.,Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
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139
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Zhu Y, Li C, Xie W, Zhong B, Wu Y, Blumenthal JA. Trajectories of depressive symptoms and subsequent cognitive decline in older adults: a pooled analysis of two longitudinal cohorts. Age Ageing 2022; 51:6398536. [PMID: 34657957 DOI: 10.1093/ageing/afab191] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/30/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND the course of depression is variable, but it is unknown how this variability over time affects long-term cognitive decline. OBJECTIVE to examine the relationship of different trajectories of depressive symptoms on rates of subsequent cognitive decline in older adults. DESIGN population-based cohort study. SETTING communities in the USA and England. SUBJECTS 17,556 older adults from the Health and Retirement Study and the English Longitudinal Study of Ageing. METHODS depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, and trajectories were calculated using group-based trajectory modelling. Global cognitive function and three cognitive domains of memory, executive function and temporal orientation were assessed for up to 18 years. RESULTS five trajectories of depressive symptoms were identified. Compared with the 'non-depressed' trajectory, the 'worsening depressive symptoms' trajectory (pooled β = -0.016 standard deviation (SD)/year, 95% confidence interval (CI): -0.021 to -0.010), 'persistent depressive symptoms' trajectory (pooled β = -0.016 SD/year, 95% CI: -0.024 to -0.008), and 'mild depressive symptoms' trajectory (pooled β = -0.008 SD/year, 95% CI: -0.014 to -0.003) were associated with faster rates of cognitive decline, while no such association was found for the 'improving depressive symptoms' trajectory (pooled β = 0.001 SD/year, 95% CI: -0.010 to 0.012). CONCLUSIONS subthreshold depressive symptoms are associated with an increased rate of cognitive decline, while individuals who show improving depressive symptoms do not exhibit accelerated cognitive decline. These findings raise the possibility that maintaining depressive symptoms as low as possible and ignoring the clinical threshold, might mitigate cognitive decline in older adults.
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Affiliation(s)
- Yidan Zhu
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Chenglong Li
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Wuxiang Xie
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Baoliang Zhong
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Yangfeng Wu
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - James A Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
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Urban-Kowalczyk M, Kasjaniuk M, Śmigielski J, Kotlicka-Antczak M. Major Depression and Onset of Frontotemporal Dementia. Neuropsychiatr Dis Treat 2022; 18:2807-2812. [PMID: 36471745 PMCID: PMC9719411 DOI: 10.2147/ndt.s390385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/01/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Frontotemporal dementia (FTD) is still a clinical challenge with the highest rate of misdiagnosis and poor outcome. The pathogenetic relationship between depression and neurodegeneration remains unclear. This study evaluated depression prevalence before FTD diagnosis. PATIENTS AND METHODS The aim was to assess the prevalence and impact of depression on FTD diagnostic process. The clinical characteristics of 72 patients hospitalized in Department of Affective and Psychotic Disorders Medical University of Lodz between 2010 and 2020 with final diagnosis FTD were analyzed. The data referring to first psychiatric diagnosis, time from first psychopathological symptoms to clarification of FTD diagnosis were collected. The patients who did not undergo full neuropsychiatric verification were excluded from the analysis. RESULTS About 69% of patients had other concomitant diagnosis of mental disorders which was made prior to FTD diagnosis. Among this subsample, 71% revealed depression diagnosis with at least moderate severity. The patients whose first diagnosis was psychotic depression revealed the longest period from the appearance of the first psychopathological symptoms to the diagnosis of FTD in comparison to the subsample with other psychiatric diagnosis (p=0.034; mean 4.33±3.28 years vs mean 2.68±1.39 years). CONCLUSION The severe depressive symptoms in older age may reflect the development of neurodegeneration before full-blown frontotemporal dementia symptomatology. We hypothesized that psychotic depression is a predictor of FTD. Further investigations in this field are required.
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Affiliation(s)
| | | | - Janusz Śmigielski
- Department of Health Sciences, State University of Applied Sciences in Konin, Konin, Poland
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141
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Moulinet I, Landeau B, Touron E, De La Sayette V, Desgranges B, Vivien D, Marchant N, Poisnel G, Chételat G. Sex-specificities in anxiety and depressive symptoms across the lifespan and their links with multimodal neuroimaging. J Affect Disord 2022; 296:593-602. [PMID: 34637806 DOI: 10.1016/j.jad.2021.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/03/2021] [Accepted: 10/06/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Anxiety and depressive symptoms are associated with impaired well-being, higher risk of developing psychoaffective disorders and are risk factors for Alzheimer's disease (AD). To further understand their relevance and the mechanisms underlying their link with AD, our aims were to assess how anxiety and depressive symptoms changed with age and related to AD neuroimaging biomarkers across the adult lifespan, while also exploring sex specificities. METHODS 210 cognitively normal participants aged 19-86 years (101 men, 109 women) completed assessments of anxiety and depressive symptoms with the STAI-A and MADRS respectively, and neuroimaging measurements including structural MRI, FDG-PET and amyloid-PET. 167 of those were followed-up over 1.5-3 years. Multiple regressions were performed to assess the links between anxiety or depressive symptoms versus age, global cognition or each imaging modality, both cross-sectionally and longitudinally; and general linear models we used to test the interactive effect of sex on these associations. RESULTS Depressive symptoms decreased with age, while anxiety symptoms increased only among women. Higher anxiety symptoms were associated with lower grey matter (GM) volume and glucose metabolism, with an interaction of sex, this relationship being significant only in women. Longitudinally, only low baseline GM volume predicted an increase in anxiety symptoms with time. LIMITATIONS Only 43% of participants reported depressive symptoms. Despite additional analyses, the low variability in the measure might have prevented us from detecting subtle changes. CONCLUSIONS This study emphasizes the need to consider anxiety symptoms in assessments for dementia risk, particularly in women.
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Affiliation(s)
- Inès Moulinet
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, Institute Blood and Brain @ Caen-Normandie (BB@C), GIP Cyceron, 4 Bvd Henri Becquerel, Caen 14000, France
| | - Brigitte Landeau
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, Institute Blood and Brain @ Caen-Normandie (BB@C), GIP Cyceron, 4 Bvd Henri Becquerel, Caen 14000, France
| | - Edelweiss Touron
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, Institute Blood and Brain @ Caen-Normandie (BB@C), GIP Cyceron, 4 Bvd Henri Becquerel, Caen 14000, France
| | - Vincent De La Sayette
- Normandie Univ, UNICAEN, EPHE, INSERM, U1077, PSL Recherche Universités, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, GIP Cyceron, Caen 14000, France; Service de Neurologie, CHU de Caen, Caen, France
| | - Béatrice Desgranges
- Normandie Univ, UNICAEN, EPHE, INSERM, U1077, PSL Recherche Universités, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, GIP Cyceron, Caen 14000, France
| | - Denis Vivien
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, Institute Blood and Brain @ Caen-Normandie (BB@C), GIP Cyceron, 4 Bvd Henri Becquerel, Caen 14000, France; Department of Clinical Research, Caen Normandy Hospital (CHU) de Caen, Caen 14000, France
| | - Natalie Marchant
- Division of Psychiatry, University College London, London, United Kingdom
| | - Géraldine Poisnel
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, Institute Blood and Brain @ Caen-Normandie (BB@C), GIP Cyceron, 4 Bvd Henri Becquerel, Caen 14000, France
| | - Gaël Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, Institute Blood and Brain @ Caen-Normandie (BB@C), GIP Cyceron, 4 Bvd Henri Becquerel, Caen 14000, France.
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Feasibility and acceptability of cognitive behavioural therapy in older Japanese people with cognitive decline: a single-arm intervention. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x22000514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Abstract
Studies have shown that cognitive behavioural therapy (CBT) for older people with cognitive decline and depression/anxiety improves negative moods. However, CBT research focusing on this population in Japan is limited. This study aimed to evaluate the feasibility of a cognitive behavioural program for people with cognitive decline. Sixteen Japanese patients with mild dementia (n = 3) and mild cognitive impairment (MCI, n = 13) participated in the study. A single-arm, pre–post study was implemented in two hospitals in Japan. The CBT program included eight bi-weekly sessions. The feasibility outcomes (satisfaction, understanding and usefulness) were measured immediately after completing the sessions, and depression, anxiety, quality of life (QOL), neuropsychiatric symptoms, and caregiver burden were measured at three time points (i.e. before, immediately after, and 3-month follow-up). Ten MCI participants attended all sessions and the mean patient satisfaction scores using the Client Satisfaction Questionnaire were 31.0±10.05 out of 32. Linear mixed model analyses demonstrated that the time effect was significant for depression (d = 1.62), anxiety (d = 1.39), and QOL (d = 1.00) for the patients, and significant for anxiety (d = 1.08) for their caregivers. The study found that this CBT program is feasible and acceptable for older Japanese people with cognitive decline. The program also improved patients’ QOL, anxiety and depressive symptoms, and decreased caregivers’ anxiety.
Key learning aims
(1)
Recently, studies have shown that CBT for older people living with dementia has been effective in treating their depression and anxiety. However, evidence for the efficacy of CBT and other curative or care options for people living with dementia is limited in Japan.
(2)
We studied a short-period CBT program and found that it was likely to be feasible and acceptable for use among older Japanese people with mild cognitive impairment, that it may improve negative mood among this group, and that it may lessen the care burden for caregivers.
(3)
Furthermore, we found that caregiver involvement in the implementation of CBT for older people may be effective in improving the mood of family members.
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Salminen LE, Tubi MA, Bright J, Thomopoulos SI, Wieand A, Thompson PM. Sex is a defining feature of neuroimaging phenotypes in major brain disorders. Hum Brain Mapp 2022; 43:500-542. [PMID: 33949018 PMCID: PMC8805690 DOI: 10.1002/hbm.25438] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 12/12/2022] Open
Abstract
Sex is a biological variable that contributes to individual variability in brain structure and behavior. Neuroimaging studies of population-based samples have identified normative differences in brain structure between males and females, many of which are exacerbated in psychiatric and neurological conditions. Still, sex differences in MRI outcomes are understudied, particularly in clinical samples with known sex differences in disease risk, prevalence, and expression of clinical symptoms. Here we review the existing literature on sex differences in adult brain structure in normative samples and in 14 distinct psychiatric and neurological disorders. We discuss commonalities and sources of variance in study designs, analysis procedures, disease subtype effects, and the impact of these factors on MRI interpretation. Lastly, we identify key problems in the neuroimaging literature on sex differences and offer potential recommendations to address current barriers and optimize rigor and reproducibility. In particular, we emphasize the importance of large-scale neuroimaging initiatives such as the Enhancing NeuroImaging Genetics through Meta-Analyses consortium, the UK Biobank, Human Connectome Project, and others to provide unprecedented power to evaluate sex-specific phenotypes in major brain diseases.
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Affiliation(s)
- Lauren E. Salminen
- Imaging Genetics CenterMark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USCMarina del ReyCaliforniaUSA
| | - Meral A. Tubi
- Imaging Genetics CenterMark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USCMarina del ReyCaliforniaUSA
| | - Joanna Bright
- Imaging Genetics CenterMark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USCMarina del ReyCaliforniaUSA
| | - Sophia I. Thomopoulos
- Imaging Genetics CenterMark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USCMarina del ReyCaliforniaUSA
| | - Alyssa Wieand
- Imaging Genetics CenterMark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USCMarina del ReyCaliforniaUSA
| | - Paul M. Thompson
- Imaging Genetics CenterMark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USCMarina del ReyCaliforniaUSA
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144
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Gerritsen L, Twait EL, Jonsson PV, Gudnason V, Launer LJ, Geerlings MI. Depression and Dementia: The Role of Cortisol and Vascular Brain Lesions. AGES-Reykjavik Study. J Alzheimers Dis 2022; 85:1677-1687. [PMID: 34958034 PMCID: PMC11044806 DOI: 10.3233/jad-215241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Late-life depression (LLD) is related to an increased risk of developing dementia; however, the biological mechanisms explaining this relationship remain unclear. OBJECTIVE To determine whether the relationship between LLD and dementia can be best explained by the glucocorticoid cascade or vascular hypothesis. METHODS Data are from 4,354 persons (mean age 76±5 years) without dementia at baseline from the AGES-Reykjavik Study. LLD was assessed with the MINI diagnostic interview (current and remitted major depressive disorder [MDD]) and the Geriatric Depression Scale-15. Morning and evening salivary cortisol were collected (glucocorticoid cascade hypothesis). White matter hyperintensities (WMH; vascular hypothesis) volume was assessed using 1.5T brain MRI. Using Cox proportional hazard models, we estimated the associations of LLD, cortisol levels, and WMH volume with incident all-cause dementia, AD, and non-AD dementia. RESULTS During 8.8±3.2 years of follow-up, 843 persons developed dementia, including 397 with AD. Current MDD was associated with an increased risk of developing all-cause dementia (HR = 2.17; 95% CI 1.66-2.67), with risks similar for AD and non-AD, while remitted MDD was not (HR = 1.02; 95% CI 0.55-1.49). Depressive symptoms were also associated with increased risk of dementia, in particular non-AD dementias. Higher levels of evening cortisol increased risk of dementia, but this was independent of MDD. WMH partially explained the relation between current MDD and dementia risk but remained increased (HR = 1.71; 95% CI 1.34-2.08). CONCLUSION The current study highlights the importance of LLD in developing dementia. However, neither the glucocorticoid cascade nor the vascular hypotheses fully explained the relation between depression and dementia.
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Affiliation(s)
- Lotte Gerritsen
- Department of Psychology, Utrecht University, Utrecht, the Netherlands
| | - Emma L. Twait
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Palmi V. Jonsson
- Department of Geriatrics, Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Vilmundur Gudnason
- Department of Psychology, Utrecht University, Utrecht, the Netherlands
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Lenore J. Launer
- National Institute on Aging, Laboratory for Epidemiology and Population Sciences, Baltimore, MD, USA
| | - Mirjam I. Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
- National Institute on Aging, Laboratory for Epidemiology and Population Sciences, Baltimore, MD, USA
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145
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Roberto N, Portella MJ, Marquié M, Alegret M, Hernández I, Mauleón A, Rosende-Roca M, Abdelnour C, Esteban de Antonio E, Tartari JP, Vargas L, López-Cuevas R, Bojaryn U, Espinosa A, Ortega G, Pérez-Cordón A, Sanabria Á, Orellana A, de Rojas I, Moreno-Grau S, Montrreal L, Alarcón-Martín E, Ruíz A, Tárraga L, Boada M, Valero S. Neuropsychiatric Profile as a Predictor of Cognitive Decline in Mild Cognitive Impairment. Front Aging Neurosci 2021; 13:718949. [PMID: 34955804 PMCID: PMC8693625 DOI: 10.3389/fnagi.2021.718949] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Mild cognitive impairment is often associated with affective and other neuropsychiatric symptoms (NPS). This co-occurrence might have a relevant impact on disease progression, from MCI to dementia. Objective: The aim of this study was to explore the trajectories of cognitive decline in an MCI sample from a memory clinic, taking into consideration a perspective of isolated cognitive functions and based on NPS clusters, accounting for the different comorbid symptoms collected at their baseline visit. Methods: A total of 2,137 MCI patients were monitored over a 2.4-year period. Four clusters of NPS (i.e., Irritability, Apathy, Anxiety/Depression and Asymptomatic) were used to run linear mixed models to explore the interaction of cluster with time on cognitive trajectories using a comprehensive neuropsychological battery (NBACE) administered at baseline and at the three subsequent follow-ups. Results: A significant interaction between cluster and time in cognitive decline was found when verbal learning and cued-recall were explored (p = 0.002 for both memory functions). For verbal learning, the Irritability cluster had the largest effect size (0.69), whereas the Asymptomatic cluster showed the smallest effect size (0.22). For cued-recall, the Irritability cluster had the largest effect size among groups (0.64), and Anxiety/Depression had the smallest effect size (0.21). Conclusions: In MCI patients, the Irritability and Apathy NPS clusters shared similar patterns of worsening in memory functioning, which could point to these NPS as risk factors of a faster cognitive decline, acting as early prognostic markers and helping in the diagnostic process.
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Affiliation(s)
- Natalia Roberto
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Maria J Portella
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,Department of Psychiatry, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Networking Research Center on Mental Health (CIBERSAM), Madrid, Spain
| | - Marta Marquié
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Montserrat Alegret
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Isabel Hernández
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Ana Mauleón
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Maitee Rosende-Roca
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Carla Abdelnour
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | | | - Juan P Tartari
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Liliana Vargas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Rogelio López-Cuevas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Urszula Bojaryn
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Ana Espinosa
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Gemma Ortega
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Alba Pérez-Cordón
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Ángela Sanabria
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Adelina Orellana
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Itziar de Rojas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Sonia Moreno-Grau
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Laura Montrreal
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Emilio Alarcón-Martín
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Agustín Ruíz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Lluís Tárraga
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Mercè Boada
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Sergi Valero
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
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146
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Lanuza F, Petermann-Rocha F, Celis-Morales C, Concha-Cisternas Y, Nazar G, Troncoso-Pantoja C, Lassere-Laso N, Martínez-Sanguinetti MA, Parra-Soto S, Zamora-Ros R, Andrés-Lacueva C, Meroño T. A healthy eating score is inversely associated with depression in older adults: results from the Chilean National Health Survey 2016-2017. Public Health Nutr 2021; 25:1-12. [PMID: 34895386 PMCID: PMC9991839 DOI: 10.1017/s1368980021004869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/01/2021] [Accepted: 12/09/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate the relationship of a healthy eating score with depression in Chilean older adults. DESIGN Cross-sectional study. SETTING Older adults from the Chilean National Health Survey 2016-2017. Associations were analysed using complex samples multivariable logistic regressions adjusted for age, sex, socio-demographic, lifestyles (physical activity, smoking, alcohol consumption and sleep duration), BMI and clinical conditions (hypertension, diabetes, hypercholesterolaemia and cardiovascular diseases). PARTICIPANTS The number of participants was 2031 (≥ 60 years). The Composite International Diagnostic Interview-Short Form was applied to establish the diagnosis of major depressive episode. Six healthy eating habits were considered to produce the healthy eating score (range: 0-12): consumption of seafood, whole grain, dairy, fruits, vegetables and legumes. Participants were categorised according to their final scores as healthy (≥ 9), average (5-8) and unhealthy (≤ 4). RESULTS Participants with a healthy score had a higher educational level, physical activity and regular sleep hours than participants with an average and unhealthiest healthy eating score. Participants classified in the healthiest healthy eating score had an inverse association with depression (OR: 0·28, (95 % CI 0·10, 0·74)). Food items that contributed the most to this association were legumes (15·2 %) and seafood (12·7 %). CONCLUSION Older adults classified in the healthiest healthy eating score, characterised by a high consumption of legumes and seafood, showed a lower risk for depression in a representative sample of Chilean population.
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Affiliation(s)
- Fabian Lanuza
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Food Technology Reference Net (XIA), Nutrition and Food Safety Research Institute (INSA), Faculty of Pharmacy and Food Sciences, University of Barcelona, Avinguda Joan XXIII, 27-31, Barcelona, 08028, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Spain
- Centro de Epidemiología Cardiovascular y Nutricional (EPICYN), Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Fanny Petermann-Rocha
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Carlos Celis-Morales
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Center for Exercise Physiology Research (CIFE), University Mayor, Santiago, Chile
- Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile
| | - Yeny Concha-Cisternas
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Chile
- Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, Chile
| | - Gabriela Nazar
- Departamento de Psicología, Universidad de Concepción, Concepción, Chile
- Centro de Vida Saludable, Universidad de Concepción, Concepción, Chile
| | - Claudia Troncoso-Pantoja
- Centro de Investigación en Educación y Desarrollo (CIEDE-UCSC), Departamento de Salud Pública, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Nicole Lassere-Laso
- Escuela de Nutrición y Dietética, Facultad de Salud, Universidad Santo Tomás, Chile
| | | | | | - Raul Zamora-Ros
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Food Technology Reference Net (XIA), Nutrition and Food Safety Research Institute (INSA), Faculty of Pharmacy and Food Sciences, University of Barcelona, Avinguda Joan XXIII, 27-31, Barcelona, 08028, Spain
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Cristina Andrés-Lacueva
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Food Technology Reference Net (XIA), Nutrition and Food Safety Research Institute (INSA), Faculty of Pharmacy and Food Sciences, University of Barcelona, Avinguda Joan XXIII, 27-31, Barcelona, 08028, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Spain
| | - Tomás Meroño
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Food Technology Reference Net (XIA), Nutrition and Food Safety Research Institute (INSA), Faculty of Pharmacy and Food Sciences, University of Barcelona, Avinguda Joan XXIII, 27-31, Barcelona, 08028, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Spain
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147
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Tetsuka S. Depression and Dementia in Older Adults: A Neuropsychological Review. Aging Dis 2021; 12:1920-1934. [PMID: 34881077 PMCID: PMC8612610 DOI: 10.14336/ad.2021.0526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/26/2021] [Indexed: 01/23/2023] Open
Abstract
Depression and dementia are the most common neuropsychiatric disorders in the older adult population. There are a certain number of depressed patients who visit outpatient clinics because they suspect dementia due to similarities in the clinical symptoms in both disorders. Depressive symptoms associated with dementia may be diagnosed with depression, and treatment with antidepressants is continued for a long time. Depression and dementia differ in their treatment approaches and subsequent courses, and it is necessary to carefully differentiate between the two in the clinical practice of dementia treatment. In this review, I describe the similarities between depression and dementia and how to differentiate depression in dementia treatment based on the differences and emphasize that there is a significant potential to cure depression, in contrast to dementia, for which there is currently no fundamental therapy. Therefore, it is important to recognize that depression and dementia may present with common symptoms and to appropriately differentiate depressed patients who are suspected of having dementia. Dementia is a disorder in which cognitive dysfunction is caused by a variety of causative diseases and conditions, resulting in impairment of activities of daily living. However, current medical science has had difficulty finding a cure for the causative disease. Based on clinical findings, it has also been shown that the degree of symptoms for preexisting psychiatric disorders is alleviated as the brain ages. In the presence of dementia, the speed of the alleviation will increase. The importance of focusing on the positive aspects of aging is also discussed.
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Affiliation(s)
- Syuichi Tetsuka
- Department of Neurology, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, 329-2763, Japan
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148
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Zhang C, Chen X, Wang S, Hu J, Wang C, Liu X. Using CatBoost algorithm to identify middle-aged and elderly depression, national health and nutrition examination survey 2011-2018. Psychiatry Res 2021; 306:114261. [PMID: 34781111 DOI: 10.1016/j.psychres.2021.114261] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/10/2021] [Accepted: 10/30/2021] [Indexed: 12/16/2022]
Abstract
Depression is one of the most common mental health problems in middle-aged and elderly people. The establishment of risk factor-based depression risk assessment model is conducive to early detection and early treatment of high-risk groups of depression. Five machine learning models (logistic regression (LR); back propagation (BP); random forest (RF); support vector machines (SVM); category boosting (CatBoost) were used to evaluate the depression among 8374 middle-aged people and 4636 elderly people in the NHANES database from 2011 to 2018. In the 2011-2018 cycle, the estimated prevalence of depression was 8.97% in the middle-aged participants and 8.02% in the elderly participants. Among the middle-aged and elderly participants, CatBoost was the best model to identify depression, and its area under the working characteristic curve (AUC) reaches the highest. The second is LR model and SVM model, while the performance of BP and RF model was slightly worse. The primary influencing factor of depression in middle-aged male is alanine aminotransferase. All five machine learning models can identify the occurrence of depression in the NHANES data set through social demographics, lifestyle, laboratory data and other data of middle-aged and elderly people, and among five models, the CatBoost model performed best.
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Affiliation(s)
- Chenyang Zhang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin 130021, China
| | - Xiaofei Chen
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin 130021, China
| | - Song Wang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin 130021, China
| | - Junjun Hu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin 130021, China
| | - Chunpeng Wang
- School of Mathematics and Statistics, Northeast Normal University, Changchun 130000, China.
| | - Xin Liu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin 130021, China.
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149
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Hafdi M, Hoevenaar-Blom MP, Richard E. Multi-domain interventions for the prevention of dementia and cognitive decline. Cochrane Database Syst Rev 2021; 11:CD013572. [PMID: 34748207 PMCID: PMC8574768 DOI: 10.1002/14651858.cd013572.pub2] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Dementia is a worldwide concern. Its global prevalence is increasing. Currently, no effective medical treatment exists to cure or to delay the onset of cognitive decline or dementia. Up to 40% of dementia is attributable to potentially modifiable risk factors, which has led to the notion that targeting these risk factors might reduce the incidence of cognitive decline and dementia. Since sporadic dementia is a multifactorial condition, thought to derive from multiple causes and risk factors, multi-domain interventions may be more effective for the prevention of dementia than those targeting single risk factors. OBJECTIVES To assess the effects of multi-domain interventions for the prevention of cognitive decline and dementia in older adults, including both unselected populations and populations at increased risk of cognitive decline and dementia. SEARCH METHODS We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group's register, MEDLINE (Ovid SP), Embase (Ovid SP), PsycINFO (Ovid SP), CINAHL (EBSCOhost), Web of Science Core Collection (ISI Web of Science), LILACS (BIREME), and ClinicalTrials.gov on 28 April 2021. We also reviewed citations of reference lists of included studies, landmark papers, and review papers to identify additional studies and assessed their suitability for inclusion in the review. SELECTION CRITERIA We defined a multi-domain intervention as an intervention with more than one component, pharmacological or non-pharmacological, but not consisting only of two or more drugs with the same therapeutic target. We included randomised controlled trials (RCTs) evaluating the effect of such an intervention on cognitive functioning and/or incident dementia. We accepted as control conditions any sham intervention or usual care, but not single-domain interventions intended to reduce dementia risk. We required studies to have a minimum of 400 participants and an intervention and follow-up duration of at least 12 months. DATA COLLECTION AND ANALYSIS We initially screened search results using a 'crowdsourcing' method in which members of Cochrane's citizen science platform identify RCTs. We screened the identified citations against inclusion criteria by two review authors working independently. At least two review authors also independently extracted data, assessed the risk of bias and applied the GRADE approach to assess the certainty of evidence. We defined high-certainty reviews as trials with a low risk of bias across all domains other than blinding of participants and personnel involved in administering the intervention (because lifestyle interventions are difficult to blind). Critical outcomes were incident dementia, incident mild cognitive impairment (MCI), cognitive decline measured with any validated measure, and mortality. Important outcomes included adverse events (e.g. cardiovascular events), quality of life, and activities of daily living (ADL). Where appropriate, we synthesised data in random-effects meta-analyses. We expressed treatment effects as risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). MAIN RESULTS We included nine RCTs (18.452 participants) in this review. Two studies reported incident dementia as an outcome; all nine studies reported a measure for cognitive functioning. Assessment of cognitive functioning was very heterogeneous across studies, ranging from complete neuropsychological assessments to short screening tests such as the mini-mental state examination (MMSE). The duration of the interventions varied from 12 months to 10 years. We compared multi-domain interventions against usual care or a sham intervention. Positive MDs and RRs <1 favour multi-domain interventions over control interventions. For incident dementia, there was no evidence of a difference between the multi-domain intervention group and the control group (RR 0.94, 95% CI 0.76 to 1.18; 2 studies; 7256 participants; high-certainty evidence). There was a small difference in composite Z-score for cognitive function measured with a neuropsychological test battery (NTB) (MD 0.03, 95% CI 0.01 to 0.06; 3 studies; 4617 participants; high-certainty evidence) and with the Montreal Cognitive Assessment (MoCA) scale (MD 0.76 point, 95% CI 0.05 to 1.46; 2 studies; 1554 participants), but the certainty of evidence for the MoCA was very low (due to serious risk of bias, inconsistency and indirectness) and there was no evidence of an effect on the MMSE (MD 0.02 point, 95% CI -0.06 to 0.09; 6 studies; 8697participants; moderate-certainty evidence). There was no evidence of an effect on mortality (RR 0.93, 95% CI 0.84 to 1.04; 4 studies; 11,487 participants; high-certainty evidence). There was high-certainty evidence for an interaction of the multi-domain intervention with ApoE4 status on the outcome of cognitive function measured with an NTB (carriers MD 0.14, 95% CI 0.04 to 0.25, noncarriers MD 0.04, 95% CI -0.02 to 0.10, P for interaction 0.09). There was no clear evidence for an interaction with baseline cognitive status (defined by MMSE-score) on cognitive function measured with an NTB (low baseline MMSE group MD 0.06, 95% CI 0.01 to 0.11, high baseline MMSE group MD 0.01, 95% CI -0.01 to 0.04, P for interaction 0.12), nor was there clear evidence for an effect in participants with a Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score > 6 points (MD 0.07, 95%CI -0.00 to 0.15). AUTHORS' CONCLUSIONS We found no evidence that multi-domain interventions can prevent incident dementia based on two trials. There was a small improvement in cognitive function assessed by a NTB in the group of participants receiving a multi-domain intervention, although this effect was strongest in trials offering cognitive training within the multi-domain intervention, making it difficult to rule out a potential learning effect. Interventions were diverse in terms of their components and intensity.
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Affiliation(s)
- Melanie Hafdi
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Marieke P Hoevenaar-Blom
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Edo Richard
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Neurology, Donders Institute for Brain, Behaviour and Cognition, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
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150
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van der Heide FCT, Steens ILM, Geraets AFJ, Foreman YD, Henry RMA, Kroon AA, van der Kallen CJH, van Sloten TT, Dagnelie PC, van Dongen MCJM, Eussen SJPM, Berendschot TTJM, Schouten JSAG, Webers CAB, van Greevenbroek MMJ, Wesselius A, Koster A, Schaper NC, Schram MT, Köhler S, Stehouwer CDA. Association of Retinal Nerve Fiber Layer Thickness, an Index of Neurodegeneration, With Depressive Symptoms Over Time. JAMA Netw Open 2021; 4:e2134753. [PMID: 34783825 PMCID: PMC8596200 DOI: 10.1001/jamanetworkopen.2021.34753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
IMPORTANCE Whether neurodegeneration contributes to the early pathobiology of late-life depression remains incompletely understood. OBJECTIVE To investigate whether lower retinal nerve fiber layer (RNFL) thickness, a marker of neurodegeneration, is associated with the incidence of clinically relevant depressive symptoms and depressive symptoms over time. DESIGN, SETTING, AND PARTICIPANTS This is a population-based cohort study from the Netherlands (The Maastricht Study) with baseline examination between 2010 and 2020 and median (IQR) follow-up of 5.0 (3.0-6.0) years. Participants were recruited from the general population. Individuals with type 2 diabetes were oversampled by design. Data analysis was performed from September 2020 to January 2021. EXPOSURES RNFL, an index of neurodegeneration, assessed with optical coherence tomography. MAIN OUTCOMES AND MEASURES Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ)-9 (continuous score, 0-27) at baseline and over time via annual assessments. The presence of clinically relevant depressive symptoms was defined as a PHQ-9 score of 10 or higher. RESULTS We used data from 4934 participants with depressive symptoms over time (mean [SD] age, 59.7 [8.4] years; 2159 women [50.8%]; 870 had type 2 diabetes [20.5%]). Lower RNFL thickness was associated with higher incidence of clinically relevant depressive symptoms (per 1 SD, hazard ratio 1.11; 95% CI, 1.01-1.23) and more depressive symptoms over time (per 1 SD, rate ratio, 1.04; 95% CI, 1.01-1.06), after adjustment for demographic, cardiovascular, and lifestyle factors. CONCLUSIONS AND RELEVANCE The findings of this study suggest that lower RNFL thickness is associated with higher incidence of clinically relevant depressive symptoms and more depressive symptoms over time. Hence, neurodegeneration may be associated with the early pathobiology of late-life depression.
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Affiliation(s)
- Frank C. T. van der Heide
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Indra L. M. Steens
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Anouk F. J. Geraets
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center+, Maastricht, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Yuri D. Foreman
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Ronald M. A. Henry
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Abraham A. Kroon
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Carla J. H. van der Kallen
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Thomas T. van Sloten
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Pieter C. Dagnelie
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Martien C. J. M. van Dongen
- Care and Public Health Research Institute, Maastricht University, the Netherlands
- Department of Epidemiology, Maastricht University, the Netherlands
| | - Simone J. P. M. Eussen
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Epidemiology, Maastricht University, the Netherlands
| | - Tos T. J. M. Berendschot
- University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Jan S. A. G. Schouten
- Department of Ophthalmology, Canisius-Wilhelmina Ziekenhuis Nijmegen, the Netherlands
| | - Carroll A. B. Webers
- University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Marleen M. J. van Greevenbroek
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Anke Wesselius
- Department of Complex Genetics and Epidemiology, School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- Care and Public Health Research Institute, Maastricht University, the Netherlands
| | - Nicolaas C. Schaper
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Miranda T. Schram
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Seb Köhler
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center+, Maastricht, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Coen D. A. Stehouwer
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
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