Structural changes and cognitive deficits in depression and their clinical correlates

Functional and cognitive impairment in the first episode of depression: A systematic review

OBJECTIVES

To describe the cognitive and functional impairment in individuals with the first episode of major depressive disorder (MDD) as compared to controls and individuals with recurrent MDD. Also to describe the functional and cognitive trajectory after the first episode of MDD.

METHODS

A total of 52 studies were included in our systematic review. 32 studies compared the cognitive performance between first episode of depression (FED) and controls, 11 studies compared the cognitive performance between recurrent depression (RD) and FED, 10 compared global functioning between RD and FED, four studies assessed cognition in FED over time, and two studies assessed global functioning in FED over time.

RESULTS

The majority of studies (n = 22/32, 68.8%) found that FED subjects performed significantly worse than controls on cognitive tests, with processing speed (n = 12) and executive/working memory (n = 11) being the most commonly impaired domains. Seven out of 11 studies (63.6%) found that RD performed significantly worse than FED, with verbal learning and memory being the most commonly impaired domain (n = 4). Most studies (n = 7/10, 70%) did not find a significant difference in global functioning between RD and FED. In three of four longitudinal studies assessing cognition, subgroup analyses were used instead of directly assessing cognition in FED over time while the remaining study found significant cognitive declines over time in FED when compared to controls. The two longitudinal studies assessing functional trajectory found that functioning significantly improved over time, possibly due to the improvement of depressive symptoms.

CONCLUSION

There is strong evidence that cognitive impairment is present during the first episode of depression, and individuals with multiple episodes display greater cognitive impairment than individuals with a single episode. Future studies aimed at identifying predictors of cognitive and functional impairment after the first episode of depression are needed to describe the functional and cognitive trajectory of individuals with the first episode of MDD over time.

Cognitive symptoms domain in major depressive disorder-revisited

Cognitive dysfunction in MDD is more of an endophenotype rather than an epiphenomenon. This sorely remains un face cachee of MDD and largely unimpacted by currently available pharmacological and non-pharmacological interventions. These deficits have been considerably tied to symptoms residua, increased risk of relapse, functional impairment, and, reduced quality of life. Accordingly, targeting cognitive symptoms domain in MDD is unmet clinical desideratum in the journey to functional recovery.

Consumption of fruits and vegetables: improved physical health, mental health, physical functioning and cognitive health in older adults from 11 European countries

Objective: Regular consumption of fruits and vegetables has been found to contribute to physical health and physical functioning. However, health is not limited to the absence of physical diseases but also encompasses mental health and cognition. Thus, we wanted to examine how the consumption of fruit and vegetables is associated with overall health, including mental health and cognitive health of older European adults.Design: We used multilevel regression analysis (participants nested within countries) to examine the effects of nutrition on overall health. Participants were asked in 2011 about their health behaviour including nutritional habits. Several health outcomes were measured longitudinally in 2013: Self-rated health, grip strength, instrumental activities of daily living (IADL), activities of daily living (ADL), mobility, depression, quality of life, short-term memory, and long-term memory.Setting: We used the 2011 and 2013 waves of the Survey of Health, Ageing and Retirement in Europe (SHARE), a multi-national population survey of older adults.Subjects:N = 22,635 older adults were sampled from 11 European countries.Results: Frequent consumption of fruits and vegetables is associated with improved health outcomes, including cognitive and mental health.Conclusions: Frequent consumption of fruits and vegetables contributes to slower disablement processes and might be an easily implementable way to improve the overall health of older adults. Future studies should examine the cross-national differences in the observed effects.

Fruit and vegetable consumption is associated with improved mental and cognitive health in older adults from non-Western developing countries

OBJECTIVES

Consumption of fruits and vegetables has been shown to contribute to mental and cognitive health in older adults from Western industrialized countries. However, it is unclear whether this effect replicates in older adults from non-Western developing countries. Thus, the present study examined the contribution of fruit and vegetable consumption to mental and cognitive health in older persons from China, India, Mexico, Russia, South Africa and Ghana.

DESIGN

Representative cross-sectional and cross-national study.Setting/SubjectsWe used data from the WHO Study on Global Ageing and Adult Health (SAGE), sampled in 2007 to 2010. Our final sample size included 28 078 participants.

RESULTS

Fruit and vegetable consumption predicted an increased cognitive performance in older adults including improved verbal recall, improved delayed verbal recall, improved digit span test performance and improved verbal fluency; the effect of fruit consumption was much stronger than the effect of vegetable consumption. Regarding mental health, fruit consumption was significantly associated with better subjective quality of life and less depressive symptoms; vegetable consumption, however, did not significantly relate to mental health.

CONCLUSIONS

Consumption of fruits is associated with both improved cognitive and mental health in older adults from non-Western developing countries, and consumption of vegetables is associated with improved cognitive health only. Increasing fruit and vegetable consumption might be one easy and cost-effective way to improve the overall health and quality of life of older adults in non-Western developing countries.