1
|
Persaud UD, Manning KJ, Wu R, Springate BA, Steffens DC. The Role of State Versus Trait Anxiety on Cognition in Older Adults With Major Depressive Disorder. Am J Geriatr Psychiatry 2024; 32:1130-1140. [PMID: 38677962 DOI: 10.1016/j.jagp.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE Anxiety superimposed on late life depression (LLD) results in greater changes to prefrontal and medial temporal brain regions compared to depression alone. Yet, the combined impact of anxiety and depression on cognition in LLD has not been thoroughly investigated. The current study investigated whether annual changes in state and trait anxiety were associated with cognitive changes in older adults with major depression. We hypothesized that the presence of anxiety among older depressed adults would be associated with worse cognitive performance in the domains of memory and executive functioning over time. DESIGN Three-year longitudinal observational study of older adults with LLD who were offered antidepressant treatment. SETTING Academic Health Center. METHODS Participants included 124 adults aged 60+ who met criteria for major depression at baseline. The association between anxiety and cognition was examined with separate multilevel linear models that addressed both between-subject and within-person effects of state and trait anxiety on cognitive functioning tests. RESULTS Individuals who experienced annual increases in anxiety above his/her personal average also experienced cognitive decline. Increases in state anxiety were associated with declines in memory and global cognition. By contrast, increases in trait anxiety were associated with declines in mental flexibility and memory. These findings remained significant even when controlling for changes in depression over time. CONCLUSION In LLD, individual increases in state and trait anxiety were associated with cognitive declines in different domains.
Collapse
Affiliation(s)
- Usha D Persaud
- Rusk Rehabilitation at NYU Langone Health, Department of Psychology, New York, NY
| | - Kevin J Manning
- Department of Psychiatry, University of Connecticut, School of Medicine (KJM, BAS, DCS), Farmington, CT.
| | - Rong Wu
- Biostatistics Center, The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut (RW), Farmington, CT
| | - Beth A Springate
- Department of Psychiatry, University of Connecticut, School of Medicine (KJM, BAS, DCS), Farmington, CT
| | - David C Steffens
- Department of Psychiatry, University of Connecticut, School of Medicine (KJM, BAS, DCS), Farmington, CT
| |
Collapse
|
2
|
Manning KJ, Wu R, McQuoid DR, Steffens DC, Potter GG. Reliable Cognitive Decline in Late-Life Major Depression. Arch Clin Neuropsychol 2023; 38:247-257. [PMID: 36302229 PMCID: PMC9940117 DOI: 10.1093/arclin/acac083] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Major depression in older adults increases the statistical likelihood of dementia. It is challenging to translate statistical evidence of cognitive decline at the group level into knowledge of individual cognitive outcomes. The objective of the current study is to investigate 2-year reliable cognitive change in late-life depression (LLD), which will enhance understanding of cognitive changes in LLD and provide a means to assess individual change. METHODS In a sample of non-depressed cognitively normal older adults or NDCN (n = 113), we used linear regression to predict tests of global cognition, processing speed-executive functioning, and memory administered 1 and 2 years later. Stepwise regression was used to select covariates among demographics and raw test scores (either baseline or year 1) and we cross-validated the final models using the predicted residual error sum of squares (PRESS). We then derived a z-change score from the difference between actual and predicted follow-up scores and investigated the proportion of LLD patients (n = 199) and NDCN adults who experienced reliable "decline" (a z-score < -1.645), "stability" (z-scores between + - 1.645), and "improvement" (z scores > +1.645). RESULTS A greater proportion LLD compared with NDCN experienced cognitive decline in processing speed/executive functioning and global cognition over 2 years. When compared to NDCN, a greater proportion of LLD also significantly improved on one test of processing speed over 2 years. CONCLUSIONS Older adults with LLD are at risk of meaningful cognitive decline over a relatively short period, particularly in the domain of executive functioning and processing speed. This study provides a series of reliable change equations for common neuropsychological tests that can be applied clinically.
Collapse
Affiliation(s)
- Kevin J Manning
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - Rong Wu
- Biostatistics Center, University of Connecticut Health Center, Farmington, CT, USA
| | - Douglas R McQuoid
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - David C Steffens
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - Guy G Potter
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| |
Collapse
|
3
|
Dotson VM, Gradone AM, Bogoian HR, Minto LR, Taiwo Z, Salling ZN. Be Fit, Be Sharp, Be Well: The Case for Exercise as a Treatment for Cognitive Impairment in Late-life Depression. J Int Neuropsychol Soc 2021; 27:776-789. [PMID: 34154693 PMCID: PMC10436256 DOI: 10.1017/s1355617721000710] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To lay out the argument that exercise impacts neurobiological targets common to both mood and cognitive functioning, and thus more research should be conducted on its use as an alternative or adjunctive treatment for cognitive impairment in late-life depression (LLD). METHOD This narrative review summarizes the literature on cognitive impairment in LLD, describes the structural and functional brain changes and neurochemical changes that are linked to both cognitive impairment and mood disruption, and explains how exercise targets these same neurobiological changes and can thus provide an alternative or adjunctive treatment for cognitive impairment in LLD. RESULTS Cognitive impairment is common in LLD and predicts recurrence of depression, poor response to antidepressant treatment, and overall disability. Traditional depression treatment with medication, psychotherapy, or both, is not effective in fully reversing cognitive impairment for most depressed older adults. Physical exercise is an ideal treatment candidate based on evidence that it 1) is an effective treatment for depression, 2) enhances cognitive functioning in normal aging and in other patient populations, and 3) targets many of the neurobiological mechanisms that underlie mood and cognitive functioning. Results of the limited existing clinical trials of exercise for cognitive impairment in depression are mixed but overall support this contention. CONCLUSIONS Although limited, existing evidence suggests exercise may be a viable alternative or adjunctive treatment to address cognitive impairment in LLD, and thus more research in this area is warranted. Moving forward, additional research is needed in large, diverse samples to translate the growing research findings into clinical practice.
Collapse
Affiliation(s)
- Vonetta M. Dotson
- Department of Psychology, Georgia State University
- Gerontology Institute, Georgia State University
| | | | | | - Lex R. Minto
- Department of Psychology, Georgia State University
| | - Zinat Taiwo
- Department of Psychology, Georgia State University
| | | |
Collapse
|
4
|
Crosstalk between Depression and Dementia with Resting-State fMRI Studies and Its Relationship with Cognitive Functioning. Biomedicines 2021; 9:biomedicines9010082. [PMID: 33467174 PMCID: PMC7830949 DOI: 10.3390/biomedicines9010082] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 12/11/2022] Open
Abstract
Alzheimer’s disease (AD) is the most common type of dementia, and depression is a risk factor for developing AD. Epidemiological studies provide a clinical correlation between late-life depression (LLD) and AD. Depression patients generally remit with no residual symptoms, but LLD patients demonstrate residual cognitive impairment. Due to the lack of effective treatments, understanding how risk factors affect the course of AD is essential to manage AD. Advances in neuroimaging, including resting-state functional MRI (fMRI), have been used to address neural systems that contribute to clinical symptoms and functional changes across various psychiatric disorders. Resting-state fMRI studies have contributed to understanding each of the two diseases, but the link between LLD and AD has not been fully elucidated. This review focuses on three crucial and well-established networks in AD and LLD and discusses the impacts on cognitive decline, clinical symptoms, and prognosis. Three networks are the (1) default mode network, (2) executive control network, and (3) salience network. The multiple properties emphasized here, relevant for the hypothesis of the linkage between LLD and AD, will be further developed by ongoing future studies.
Collapse
|
5
|
Kim YK, Han KM. Neural substrates for late-life depression: A selective review of structural neuroimaging studies. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110010. [PMID: 32544600 DOI: 10.1016/j.pnpbp.2020.110010] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 12/15/2022]
Abstract
Recent neuroimaging studies have characterized the pathophysiology of late-life depression (LLD) as a dysfunction of the brain networks involved in the regulation of emotion, motivational behavior, cognitive control, executive function, and self-referential thinking. In this article, we reviewed LLD-associated structural neuroimaging markers such as white matter hyperintensity (WMH), white matter integrity measured by diffusion tensor imaging, cortical and subcortical volumes, and cortical thickness, which may provide a structural basis for brain network dysfunction in LLD. LLD was associated with greater severity or volumes of deep, periventricular, or overall WMH and with decreased white matter integrity in the brain regions belonging to the fronto-striatal-limbic circuits and reduced white matter tract integrity which connects these circuits, such as the cingulum, corpus callosum, or uncinate fasciculus. Decreased volumes or cortical thickness in the prefrontal cortex, orbitofrontal cortex, anterior and posterior cingulate cortex, several temporal and parietal regions, hippocampus, amygdala, striatum, thalamus, and the insula were associated with LLD. These structural neuroimaging findings were also associated with cognitive dysfunction, which is a prominent clinical feature in LLD. Several structural neuroimaging markers including the WMH burden, white matter integrity, and cortical and subcortical volumes predicted antidepressant response in LLD. These structural neuroimaging findings support the hypothesis that disruption of the brain networks involved in emotion regulation and cognitive processing by impaired structural connectivity is strongly associated with the pathophysiology of LLD.
Collapse
Affiliation(s)
- Yong-Ku Kim
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kyu-Man Han
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea.
| |
Collapse
|
6
|
Fernández-Niño JA, Bonilla-Tinoco LJ, Manrique-Espinoza BS, Salinas-Rodríguez A, Santos-Luna R, Román-Pérez S, Morales-Carmona E, Duncan DT. Neighborhood features and depression in Mexican older adults: A longitudinal analysis based on the study on global AGEing and adult health (SAGE), waves 1 and 2 (2009-2014). PLoS One 2019; 14:e0219540. [PMID: 31291353 PMCID: PMC6619793 DOI: 10.1371/journal.pone.0219540] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 06/26/2019] [Indexed: 11/21/2022] Open
Abstract
A growing body of literature shows that neighborhood characteristics influence older adults' mental health. Therefore, the aim of this study was to examine the association between structural and social characteristics of the neighborhood, and depression in Mexican older adults. A longitudinal study was conducted based on waves 1 (2009-2010) and 2 (2014) of the Mexican sample from the Study on global AGEing and adult health (SAGE). A street-network buffer around each participant's household was used to define neighborhood, so that built environment and social characteristics were assessed within it. Depression was ascertained by using an algorithm based on the Composite International Diagnostic Interview. In the analysis, multilevel logistic regression models were constructed separately for each built and social environments measurement, adjusted for socioeconomic, demographic and health-related covariates, and stratified by area of residence (urban versus rural). The results showed that a length of space between 15-45 meters restricted to vehicles was significantly associated with a lower risk of depression in older adults from the urban area (OR: 0.44; IC 95% 0.23-0.83) and the protective association appeared to be larger with increasing space with this restriction, although it lacked significance. Contrarily, the built environment measures were not predictive of depression in the rural setting. On the other hand, none of the variables from the social environment had a significant association, although safety appeared to behave as a risk factor in the overall (OR: 1.48; CI 95% 0.96-2.30; p = 0.08) and rural (OR: 3.44; CI 95% 0.95-12.45; p = 0.06) samples, as it reached marginal significance. Research about neighborhood effects on older adults' mental health is an emergent field that has shown that depression might be treated not only from the individual-level, but also from the neighborhood-level. Additionally, further research is needed, especially in low- and middle-income countries, to help guide neighborhood policies.
Collapse
Affiliation(s)
| | | | | | | | - René Santos-Luna
- Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | | | | | - Dustin T. Duncan
- Spatial Epidemiology Lab, New York University School of Health, New York, New York, United States of America
| |
Collapse
|
7
|
Jamieson A, Goodwill AM, Termine M, Campbell S, Szoeke C. Depression related cerebral pathology and its relationship with cognitive functioning: A systematic review. J Affect Disord 2019; 250:410-418. [PMID: 30878653 DOI: 10.1016/j.jad.2019.03.042] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/26/2019] [Accepted: 03/04/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND Depression's relationship with cerebral abnormalities and cognitive decline is temporally dynamic. Despite clear clinical utility, understanding depression's effect on cerebral structures, cognitive impairment and the interaction between these symptoms has had limited consideration. METHODS This review summarised studies examining a clinical depression diagnosis or validated scales measuring depressive symptoms, data concerning amyloid-beta (Aβ) levels, brain structure and function focusing on hippocampal alterations, or white matter hyperintensities (WMH), and at least one validated neuropsychological test. Online database searches of: PsycINFO, EMBASE, MEDLINE, and Scopus were conducted to identify potential articles. RESULTS While depression was consistently associated with cross-sectionally cognitive decline across multiple domains, the neuropathological basis of this dysfunction remained unclear. Hippocampal, frontal, and limbic dysfunction as well as cortical thinning, WMH, and Aβ burden all provide inconsistent findings, likely due to depression subtypes. The consistency of these findings additionally decreases when examining this relationship longitudinally, as these results are further confounded by pre-dementia states. The therapeutic interventions examined were more efficacious in the younger compared with the older samples, who were characterised by greater WMH and Aβ burden. LIMITATIONS The limited number of longitudinal and interventional studies in addition to the heterogeneity of the samples restricts their generalisability. CONCLUSIONS Symptomatological differences between early-onset and late-onset depression (EOD and LOD) appear crucial in understanding whether late-life depression is the primary or secondary source of cerebral pathology. Though severe cognitive impairments and clearer neuropathological underpinnings are more characteristic of LOD than EOD, the inconsistency of valid biomarkers remains problematic.
Collapse
Affiliation(s)
- Alec Jamieson
- Centre for Medical Research, Royal Melbourne Hospital, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Alicia M Goodwill
- Centre for Medical Research, Royal Melbourne Hospital, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia; Healthy Brain Initiative, Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mario Termine
- Centre for Medical Research, Royal Melbourne Hospital, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Stephen Campbell
- Australian Healthy Ageing Organisation (AHAO), Parkville, Victoria, Australia
| | - Cassandra Szoeke
- Centre for Medical Research, Royal Melbourne Hospital, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia; Healthy Brain Initiative, Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia; Australian Healthy Ageing Organisation (AHAO), Parkville, Victoria, Australia.
| |
Collapse
|
8
|
Rajapakshe OBW, Sivayogan S, Kulatunga PM. Prevalence and correlates of depression among older urban community-dwelling adults in Sri Lanka. Psychogeriatrics 2019; 19:202-211. [PMID: 30467924 DOI: 10.1111/psyg.12389] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 08/21/2018] [Accepted: 09/23/2018] [Indexed: 12/30/2022]
Abstract
AIM As the population ages, mental health issues among the elderly are becoming a major concern worldwide, including in Sri Lanka. With rapid globalization, the coping and adapting skills of elderly individuals are tested, potentially revealing predisposition to psychological disturbances. Previous studies have indicated a higher risk of depression among the elderly. The current study attempts to quantify the prevalence and associated factors of depression in a highly urbanized setting within Sri Lanka. METHODS A community-based, cross-sectional analytical study was carried out in the urban areas of Colombo District. The subjects were young elders (60-74 years) who permanently reside in the area. Depression was assessed by the item Geriatric Depression Scale Sinhalese version (cut-off score ≥8) among 1283 subjects. Logistic regression analysis was used to assess the association of depression with sociodemographic and health-related variables. RESULTS The prevalence of depression in the sample was 13.9% (mild depression: 11.2%; moderate to severe depression: 2.7%). Among the sociodemographic predictors, female sex (odds ratio (OR) = 10.60), being 60-64 years old (OR = 1.61), being unmarried, separated, divorced, or widowed (OR = 3.73), income ≤20 000 Sri Lankan rupees (OR = 2.27), and perceived financial burden (OR = 3.15) were significantly associated with clinically significant depression. Among the health-related variables, smoking (OR = 2.18), alcohol use (OR = 7.58), presence of chronic disease (OR = 1.51), limitation in performing one or more instrumental activities of daily living (OR = 1.73), unsatisfactory partner relationship (OR = 2.94), perceived inadequate social support (OR = 2.47), experiencing abuse (OR = 3.90), and experiencing major life events (OR = 2.11) were significantly related with depression. CONCLUSION Depression is an important issue among the elderly living in an urbanized environment in Sri Lanka.
Collapse
Affiliation(s)
| | - Sivagurunadan Sivayogan
- Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Prasadi M Kulatunga
- Department of Psychiatry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| |
Collapse
|
9
|
Stopping Cognitive Decline in Patients With Late-Life Depression: A New Front in the Fight Against Dementia. Am J Geriatr Psychiatry 2018; 26:828-834. [PMID: 30049598 PMCID: PMC6633901 DOI: 10.1016/j.jagp.2018.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 05/30/2018] [Indexed: 01/11/2023]
|
10
|
Clinical and radiological determinants of transient symptoms associated with infarction (TSI). J Neurol Sci 2018; 390:195-199. [DOI: 10.1016/j.jns.2018.04.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 03/29/2018] [Accepted: 04/22/2018] [Indexed: 11/21/2022]
|
11
|
Mekli K, Phillips DF, Arpawong TE, Vanhoutte B, Tampubolon G, Nazroo JY, Lee J, Prescott CA, Stevens A, Pendleton N. Genome-wide scan of depressive symptomatology in two representative cohorts in the United States and the United Kingdom. J Psychiatr Res 2018; 100:63-70. [PMID: 29486404 PMCID: PMC6882010 DOI: 10.1016/j.jpsychires.2018.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 01/29/2018] [Accepted: 01/31/2018] [Indexed: 01/21/2023]
Abstract
Unlike the diagnosed Major Depressive Disorder, depressive symptomatology in the general population has received less attention in genome-wide association scan (GWAS) studies. Here we report a GWAS study on depressive symptomatology using a discovery-replication design and the following approaches: To improve the robustness of the phenotypic measure, we used longitudinal data and calculated mean scores for at least 3 observations for each individual. To maximize replicability, we used nearly identical genotyping platforms and identically constructed phenotypic measures in both the Discovery and Replication samples. We report one genome-wide significant hit; rs58682566 in the EPG5 gene was associated (p = 3.25E-08) with the mean of the depression symptom in the Discovery sample, without confirmation in the Replication sample. We also report 4 hits exceeding the genome-wide suggestive significance level with nominal replications. Rs11774887, rs4147527 and rs1379328, close to the SAMD12 gene, were associated with the mean depression symptom score (P-values in Discovery sample: 4.58E-06, 7.65E-06 and 7.66E-06; Replication sample: 0.049, 0.029 and 0.030, respectively). Rs13250896, located in an intergenic region, was associated with the mean score of the three somatic items of the depression symptoms score (p = 3.31E-07 and 0.042 for the Discovery and Replication samples). These results were not supported by evidence in the literature. We conclude that despite the strengths of our approach, using robust phenotypic measures and samples that maximize replicability potential, this study does not provide compelling evidence of a single genetic variant's significant role in depressive symptomatology.
Collapse
Affiliation(s)
- Krisztina Mekli
- Cathie Marsh Institute for Social Research, The University of Manchester, Manchester, United Kingdom.
| | - Drystan F. Phillips
- Dornsife Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA,RAND Corporation, Santa Monica, CA, USA
| | - Thalida E. Arpawong
- Department of Psychology, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, USA
| | - Bram Vanhoutte
- Cathie Marsh Institute for Social Research, The University of Manchester, Manchester, United Kingdom.
| | - Gindo Tampubolon
- Institute for Social Change, The University of Manchester, Manchester, United Kingdom.
| | - James Y. Nazroo
- Cathie Marsh Institute for Social Research, The University of Manchester, Manchester, United Kingdom
| | - Jinkook Lee
- Dornsife Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA; RAND Corporation, Santa Monica, CA, USA.
| | - Carol A. Prescott
- Department of Psychology, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, USA,Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Adam Stevens
- Division of Developmental Biology and Medicine, The University of Manchester, Manchester, United Kingdom.
| | - Neil Pendleton
- Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, United Kingdom.
| |
Collapse
|
12
|
Abbott CC, Khafaja M. Editorial Comment: Stress and Late-Life Depression. Am J Geriatr Psychiatry 2017; 25:978-979. [PMID: 28602383 PMCID: PMC8344408 DOI: 10.1016/j.jagp.2017.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 05/11/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Christopher C Abbott
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM.
| | - Mohamad Khafaja
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM
| |
Collapse
|
13
|
Schaakxs R, Comijs HC, van der Mast RC, Schoevers RA, Beekman ATF, Penninx BWJH. Risk Factors for Depression: Differential Across Age? Am J Geriatr Psychiatry 2017; 25:966-977. [PMID: 28529007 DOI: 10.1016/j.jagp.2017.04.004] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/15/2017] [Accepted: 04/03/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The occurrence of well-established risk factors for depression differs across the lifespan. Risk factors may be more strongly associated with depression at ages when occurrence, and therefore expectance, is relatively low ("on-time off-time" hypothesis). This large-scale study examined absolute and relative risks of established risk factors for depression across the lifespan. METHODS Participants were 2,215 currently or never depressed adults aged 18 to 93 years from two cohort studies: NESDA and NESDO. The occurrence of 19 established risk factors (absolute risk) was examined in different age groups. In addition, the relative risk of these risk factors for depression was compared across age groups by examining risk factor × age interaction. RESULTS The occurrence of all risk factors differed significantly across age groups. Although most risk factors had significant associations with depression across the lifespan, for five risk factors the strength of the association was age-dependent. Stronger associations with depression in younger age were found for childhood abuse, pain, higher body mass index (BMI) and number of chronic diseases, whereas low income imposed a stronger risk in older age. Associations with depression were strongest in age groups where occurrence was lowest. CONCLUSIONS Although the exposure to risk factors changes across the lifespan, the relative risk associating them to depression remains similar for most risk factors. Some specific risk factors (low income, and health factors pain, BMI, and number of chronic diseases), however, seem more strongly associated with depression in ages in which occurrence is lowest and least expected.
Collapse
Affiliation(s)
- Roxanne Schaakxs
- Amsterdam Public Health Research Institute, Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
| | - Hannie C Comijs
- Amsterdam Public Health Research Institute, Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Roos C van der Mast
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; the Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Robert A Schoevers
- University Medical Center Groningen, Department of Psychiatry and Interdisciplinary Center for Psychopathology and Emotion Regulation, University of Groningen, Groningen, The Netherlands
| | - Aartjan T F Beekman
- Amsterdam Public Health Research Institute, Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Amsterdam Public Health Research Institute, Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
14
|
Phillips C. Physical Activity Modulates Common Neuroplasticity Substrates in Major Depressive and Bipolar Disorder. Neural Plast 2017; 2017:7014146. [PMID: 28529805 PMCID: PMC5424494 DOI: 10.1155/2017/7014146] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/10/2017] [Accepted: 03/16/2017] [Indexed: 12/13/2022] Open
Abstract
Mood disorders (MDs) are chronic, recurrent mental diseases that affect millions of individuals worldwide. Although the biogenic amine model has provided some clinical utility, a need remains to better understand the interrelated mechanisms that contribute to neuroplasticity deficits in MDs and the means by which various therapeutics mitigate them. Of those therapeutics being investigated, physical activity (PA) has shown clear and consistent promise. Accordingly, the aims of this review are to (1) explicate key modulators, processes, and interactions that impinge upon multiple susceptibility points to effectuate neuroplasticity deficits in MDs; (2) explore the putative mechanisms by which PA mitigates these features; (3) review protocols used to induce the positive effects of PA in MDs; and (4) highlight implications for clinicians and researchers.
Collapse
|
15
|
Schaakxs R, Comijs HC, Lamers F, Beekman ATF, Penninx BWJH. Age-related variability in the presentation of symptoms of major depressive disorder. Psychol Med 2017; 47:543-552. [PMID: 27786143 DOI: 10.1017/s0033291716002579] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND The heterogeneous aetiology of major depressive disorder (MDD) might affect the presentation of depressive symptoms across the lifespan. We examined to what extent a range of mood, cognitive, and somatic/vegetative depressive symptoms were differentially present depending on patient's age. METHOD Data came from 1404 participants with current MDD (aged 18-88 years) from two cohort studies: the Netherlands Study of Depression and Anxiety (NESDA) and the Netherlands Study of Depression in Older Persons (NESDO). Associations between age (per 10 years) and 30 depressive symptoms as well as three symptom clusters (mood, cognitive, somatic/vegetative) were assessed using logistic and linear regression analyses. RESULTS Depression severity was found to be stable with increasing age. Nevertheless, 20 (67%) out of 30 symptoms were associated with age. Most clearly, with ageing there was more often early morning awakening [odds ratio (OR) 1.47, 95% confidence interval (CI) 1.36-1.60], reduced interest in sex (OR 1.42, 95% CI 1.31-1.53), and problems sleeping during the night (OR 1.33, 95% CI 1.24-1.43), whereas symptoms most strongly associated with younger age were interpersonal sensitivity (OR 0.72, 95% CI 0.66-0.79), feeling irritable (OR 0.73, 95% CI 0.67-0.79), and sleeping too much (OR 0.75, 95% CI 0.68-0.83). The sum score of somatic/vegetative symptoms was associated with older age (B = 0.23, p < 0.001), whereas the mood and cognitive sum scores were associated with younger age (B = -0.20, p < 0.001; B = -0.04, p = 0.004). CONCLUSIONS Depression severity was found to be stable across the lifespan, yet depressive symptoms tend to shift with age from being predominantly mood-related to being more somatic/vegetative. Due to the increasing somatic presentation of depression with age, diagnoses may be missed.
Collapse
Affiliation(s)
- R Schaakxs
- Department of Psychiatry and EMGO Institute for Health and Care Research,VU University Medical Centre,Amsterdam,The Netherlands
| | - H C Comijs
- Department of Psychiatry and EMGO Institute for Health and Care Research,VU University Medical Centre,Amsterdam,The Netherlands
| | - F Lamers
- Department of Psychiatry and EMGO Institute for Health and Care Research,VU University Medical Centre,Amsterdam,The Netherlands
| | - A T F Beekman
- Department of Psychiatry and EMGO Institute for Health and Care Research,VU University Medical Centre,Amsterdam,The Netherlands
| | - B W J H Penninx
- Department of Psychiatry and EMGO Institute for Health and Care Research,VU University Medical Centre,Amsterdam,The Netherlands
| |
Collapse
|
16
|
Rafalo-Ulinska A, Piotrowska J, Kryczyk A, Opoka W, Sowa-Kucma M, Misztak P, Rajkowska G, Stockmeier CA, Datka W, Nowak G, Szewczyk B. Zinc transporters protein level in postmortem brain of depressed subjects and suicide victims. J Psychiatr Res 2016; 83:220-229. [PMID: 27661418 PMCID: PMC5107146 DOI: 10.1016/j.jpsychires.2016.09.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/31/2016] [Accepted: 09/08/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a serious psychiatric illness, associated with an increasing rate of suicide. The pathogenesis of depression may be associated with the disruption of zinc (Zn) homeostasis. In the brain, several proteins that regulate Zn homeostasis are present, including Zn transporters (ZnTs) which remove Zn from the cytosol. The present study was designed to investigate whether depression and suicide are associated with alterations in the expression of the ZnTs protein. METHODS Protein levels of ZnT1, ZnT3, ZnT4, ZnT5 and ZnT6 were measured in postmortem brain tissue from two different cohorts. Cohort A contained 10 subjects diagnosed with MDD (7 were suicide victims) and 10 psychiatrically-normal control subjects and cohort B contained 11 non-diagnosed suicide victims and 8 sudden-death control subjects. Moreover, in cohort A we measured protein level of NMDA (GluN2A subunit), AMPA (GluA1 subunit) and 5-HT1A receptors and PSD-95. Proteins were measured in the prefrontal cortex (PFC) using Western blotting. In addition, Zn concentration was measured using a voltammetric method. RESULTS There was a significant increase in protein levels of ZnT1, ZnT4, ZnT5 in the PFC in MDD, relative to control subjects, while ZnT3 protein level was decreased in MDD. There was no significant difference in the Zn concentration in the PFC between control and MDD subjects. Similarly, in the PFC of suicide victims (non-diagnosed), an increase in protein levels of ZnT1, ZnT4, ZnT5 and ZnT6 was observed. Conversely, protein levels of ZnT3 were decreased in both suicide victims and subjects with MDD, in comparison with control subjects. There was also a significant decrease in the protein level of GluA1, GluN2A, PSD-95 and 5-HT1A in MDD. CONCLUSIONS Our studies suggest that alterations in Zn transport proteins are associated with the pathophysiology of MDD and suicide.
Collapse
Affiliation(s)
- Anna Rafalo-Ulinska
- Institute of Pharmacology, Polish Academy of Sciences, Smetna 12, 31-343 Krakow, Poland,Institute of Zoology, Jagiellonian University, Gronostajowa 9, 30-387 Krakow, Poland
| | - Joanna Piotrowska
- Department of Inorganic and Analytical Chemistry, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland
| | - Agata Kryczyk
- Department of Inorganic and Analytical Chemistry, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland
| | - Włodzimierz Opoka
- Department of Inorganic and Analytical Chemistry, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland
| | - Magdalena Sowa-Kucma
- Institute of Pharmacology, Polish Academy of Sciences, Smetna 12, 31-343 Krakow, Poland
| | - Paulina Misztak
- Institute of Pharmacology, Polish Academy of Sciences, Smetna 12, 31-343 Krakow, Poland,Department of Pharmacobiology, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland
| | - Grazyna Rajkowska
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA
| | - Craig A Stockmeier
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA,Department of Psychiatry, Case Western Reserve University, 10524 Euclid Avenue, Cleveland, OH 44106, USA
| | - Wojciech Datka
- Department of Affective Disorders, Jagiellonian University Medical College, Kopernika 21a, 31-501 Kraków, Poland
| | - Gabriel Nowak
- Institute of Pharmacology, Polish Academy of Sciences, Smetna 12, 31-343 Krakow, Poland,Department of Pharmacobiology, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland
| | - Bernadeta Szewczyk
- Institute of Pharmacology, Polish Academy of Sciences, Smetna 12, 31-343 Krakow, Poland.
| |
Collapse
|
17
|
Byun MS, Choe YM, Sohn BK, Yi D, Han JY, Park J, Choi HJ, Baek H, Lee JH, Kim HJ, Kim YK, Yoon EJ, Sohn CH, Woo JI, Lee DY. Association of Cerebral Amyloidosis, Blood Pressure, and Neuronal Injury with Late-Life Onset Depression. Front Aging Neurosci 2016; 8:236. [PMID: 27790137 PMCID: PMC5061734 DOI: 10.3389/fnagi.2016.00236] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/23/2016] [Indexed: 01/14/2023] Open
Abstract
Previous literature suggests that Alzheimer's disease (AD) process may contribute to late-life onset depression (LLOD). Therefore, we investigated the association of LLOD with cerebral amyloidosis and neuronal injury, the two key brain changes in AD, along with vascular risks. Twenty nine non-demented individuals who first experienced major depressive disorder (MDD) after age of 60 years were included as LLOD subjects, and 27 non-demented elderly individuals without lifetime experience of MDD were included as normal controls (NC). Comorbid mild cognitive impairment (MCI) was diagnosed in 48% of LLOD subjects and in 0% of NC. LLOD, irrespective of comorbid MCI diagnosis, was associated with prominent prefrontal cortical atrophy. Compared to NC, LLOD subjects with comorbid MCI (LLODMCI) showed increased cerebral 11C-Pittsburg compound B (PiB) retention and plasma beta-amyloid 1–40 and 1–42 peptides, as measures of cerebral amyloidosis; and, such relationship was not observed in overall LLOD or LLOD without MCI (LLODwoMCI). LLOD subjects, particularly the LLODwoMCI, had higher systolic blood pressure (SBP) than NC. When analyzed in the same multiple logistic regression model that included prefrontal gray matter (GM) density, cerebral amyloidosis, and SBP as independent variables, only prefrontal GM density showed a significant independent association with LLOD regardless of MCI comorbidity status. Our findings suggest AD process might be related to LLOD via prefrontal neuronal injury in the MCI stage, whereas vascular processes—SBP elevation, in particular—are associated with LLOD via prefrontal neuronal injury even in cognitively intact or less impaired individuals.
Collapse
Affiliation(s)
- Min Soo Byun
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University Seoul, South Korea
| | - Young Min Choe
- Department of Neuropsychiatry, Ulsan University Hospital Ulsan, South Korea
| | - Bo Kyung Sohn
- Department of Neuropsychiatry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center Seoul, South Korea
| | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University Seoul, South Korea
| | - Ji Young Han
- Department of Neuropsychiatry, Seoul National University Hospital Seoul, South Korea
| | - Jinsick Park
- Department of Biomedical Engineering, Hanyang University Seoul, South Korea
| | - Hyo Jung Choi
- Department of Neuropsychiatry, Seoul National University Hospital Seoul, South Korea
| | - Hyewon Baek
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly Yongin, South Korea
| | - Jun Ho Lee
- Department of Neuropsychiatry, Seoul National University Hospital Seoul, South Korea
| | - Hyun Jung Kim
- Department of Neuropsychiatry, Changsan Convalescent Hospital Changwon, South Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center Seoul, South Korea
| | - Eun Jin Yoon
- Department of Nuclear Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center Seoul, South Korea
| | - Chul-Ho Sohn
- Department of Radiology, Seoul National University Hospital Seoul, South Korea
| | - Jong Inn Woo
- Department of Psychiatry, Seoul National University College of Medicine Seoul, South Korea
| | - Dong Young Lee
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National UniversitySeoul, South Korea; Department of Neuropsychiatry, Seoul National University HospitalSeoul, South Korea; Department of Psychiatry, Seoul National University College of MedicineSeoul, South Korea
| |
Collapse
|
18
|
Rosenbaum D, Hagen K, Deppermann S, Kroczek AM, Haeussinger FB, Heinzel S, Berg D, Fallgatter AJ, Metzger FG, Ehlis AC. State-dependent altered connectivity in late-life depression: a functional near-infrared spectroscopy study. Neurobiol Aging 2016; 39:57-68. [DOI: 10.1016/j.neurobiolaging.2015.11.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 11/04/2015] [Accepted: 11/27/2015] [Indexed: 01/08/2023]
|
19
|
Moukaddam N, Bejjani C, Shah AA. Treatment Approaches to Neurocognitive Disorders. Psychiatr Ann 2016. [DOI: 10.3928/00485713-20160105-01] [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: 11/20/2022]
|
20
|
Depressionen im höheren Lebensalter, Teil 1. Z Gerontol Geriatr 2016; 49:335-48. [DOI: 10.1007/s00391-015-1019-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 11/11/2015] [Accepted: 12/22/2015] [Indexed: 12/29/2022]
|
21
|
Opdebeeck C, Quinn C, Nelis SM, Clare L. Is cognitive lifestyle associated with depressive thoughts and self-reported depressive symptoms in later life? Eur J Ageing 2015; 13:63-73. [PMID: 27034645 PMCID: PMC4769311 DOI: 10.1007/s10433-015-0359-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Key components of cognitive lifestyle are educational attainment, occupational complexity and engagement in cognitively stimulating leisure activities. Each of these factors is associated with experiencing fewer depressive symptoms in later life, but no study to date has examined the relationship between overall cognitive lifestyle and depressive symptoms. This task is made more complex because relatively few older participants in cross-sectional studies will be currently experiencing depression. However, many more will show evidence of a depressive thinking style that predisposes them towards depression. This study aimed to investigate the extent to which cognitive lifestyle and its individual components are associated with depressive thoughts and symptoms. Two hundred and six community-dwelling participants aged 65+ completed the depressive cognitions scale, the geriatric depression scale and the lifetime of experiences questionnaire, which assesses cognitive lifestyle. Correlational analysis indicated that each of the individual lifestyle factors—education, occupational complexity and activities in young adulthood, mid-life and later life—and the combined cognitive lifestyle score was positively associated with each other and negatively with depressive symptoms, while all except education were negatively associated with depressive thoughts. Depressive thoughts and symptoms were strongly correlated. Cognitive lifestyle score explained 4.6 % of the variance in depressive thoughts and 10.2 % of the variance in depressive symptoms. The association of greater participation in cognitive activities, especially in later life, with fewer depressive symptoms and thoughts suggests that preventive interventions aimed at increasing participation in cognitively stimulating leisure activity could be beneficial in decreasing the risk of experiencing depressive thoughts and symptoms in later life.
Collapse
Affiliation(s)
- Carol Opdebeeck
- Research in Ageing and Cognitive Health (REACH), School of Psychology, Bangor University, Bangor, Gwynedd LL572AS UK
| | - Catherine Quinn
- REACH: The Centre for Research in Ageing and Cognitive Health, School of Psychology, University of Exeter, Exeter, EX44QG UK
| | - Sharon M Nelis
- REACH: The Centre for Research in Ageing and Cognitive Health, School of Psychology, University of Exeter, Exeter, EX44QG UK
| | - Linda Clare
- Research in Ageing and Cognitive Health (REACH), School of Psychology, Bangor University, Bangor, Gwynedd LL572AS UK ; REACH: The Centre for Research in Ageing and Cognitive Health, School of Psychology, University of Exeter, Exeter, EX44QG UK
| |
Collapse
|