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Qin A, Chen C, Bao B, Xin T, Xu L. Estimating the impact of different types hearing loss on cognitive decline and the joint effect of hearing loss and depression on cognitive decline among older adults in China. J Affect Disord 2024; 351:58-65. [PMID: 38286235 DOI: 10.1016/j.jad.2024.01.203] [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: 11/01/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Current research lacks examination of the relationship between different subtypes of hearing loss (HL) and cognitive decline (CD). Additionally, the co-effects of HL and depression on CD remain unexplored. This study aims to investigate the relationship between HL, various types of HL, and CD, as well as the combined impact of HL and depression on CD. METHODS Data from a total of 5218 older adults who participated in the most recent three waves of Chinese Longitudinal Healthy Longevity Survey (CLHLS) (2011-2012, 2014, and 2018) were included. HL was assessed through self-report and objective measures. CD was defined as a decrease in MMSE score of≥3 between any two survey periods for older adults. Cox proportional hazards model was applied to analyzed. RESULTS Among Chinese older adults, bilateral HL (HR = 1.202, 95%CI = 1.093-1.322, P < 0.001), onset of HL after the age of 40 (HR = 1.155, 95%CI = 1.056-1.264, P = 0.002), and chronic HL (HR = 1.143, 95%CI = 1.040-1.255, P = 0.005) posed a greater risk. HL (HR = 1.146, 95%CI = 1.048-1.254, P = 0.003) and depression (HR = 1.162, 95%CI = 1.038-1.301, P = 0.009) were independently or jointly associated with CD. Participants who were simultaneously exposed to both HL and depression experienced the highest risk of CD (HR = 1.314, 95%CI = 1.117-1.545, P = 0.001). LIMITATIONS Given the observational design, unidentified confounding variables may still be present, such as whether to wear a hearing aid. CONCLUSION This study emphasizes the high risk of specific types of HL for CD and the importance of implementing health interventions that address both physiological and psychological aspects to enhance cognitive function and prevent CD in older adults.
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Affiliation(s)
- Afei Qin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong 250012, China; Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong 250012, China
| | - Chiqi Chen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong 250012, China; Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong 250012, China
| | - Binghong Bao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong 250012, China; Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong 250012, China
| | - Tianjiao Xin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong 250012, China; Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong 250012, China
| | - Lingzhong Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong 250012, China; Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong 250012, China.
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Desai P, Beck T, Krueger KR, Wilson RS, Evans DA, Rajan KB. Neuroticism, physical activity, and cognitive functioning in a population-based cohort of older adults. BMC Geriatr 2023; 23:717. [PMID: 37926833 PMCID: PMC10626783 DOI: 10.1186/s12877-023-04399-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/10/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Little is known about how physical activity influences the relationship between neuroticism and cognitive function and cognitive decline. METHODS Data from the Chicago Health and Aging Project (CHAP) was utilized to conduct this study. CHAP is a population-based cohort study of chronic conditions in older adults. Participants completed in-home interviews cycles of three years from 1993-2012. Mixed effects regression models were conducted to test the associations between physical activity, neuroticism, and the interaction between neuroticism and physical activity on outcomes: global cognitive function, global cognitive decline, episodic memory, decline in episodic memory, perceptual speed, and decline in perceptual speed. Stratified mixed effects regression models by physical activity level were conducted to test the associations between neuroticism and global cognitive function and global cognitive decline. RESULTS A total of 7,685 participants were eligible for this study. Participants were 62% female and 64% African American. We found statistically significant associations for the interaction of high physical activity and neuroticism on baseline global cognitive function (β = 0.017 (SE = 0.007), p = .010) and on the interaction of neuroticism and high physical activity on baseline episodic memory (β = 0.020 (SE = .009), p = .021) and on decline in episodic memory over time (β = -0.003 (SE = .001), p = .039). CONCLUSION Higher physical activity lessened the association between higher neuroticism and poor cognitive outcomes.
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Affiliation(s)
- Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Triangle Office Building, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, USA.
| | - Todd Beck
- Rush Institute for Healthy Aging, Rush University Medical Center, Triangle Office Building, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, USA
| | - Kristin R Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Triangle Office Building, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, USA
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Triangle Office Building, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, USA
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Triangle Office Building, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, USA
- Department of Neurology, University of California at Davis, Davis, CA, USA
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Yuan J, Wang Y, Liu Z. Temporal relationship between depression and cognitive decline in the elderly: a two-wave cross-lagged study in a Chinese sample. Aging Ment Health 2023; 27:2179-2186. [PMID: 37339082 DOI: 10.1080/13607863.2023.2225432] [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: 09/06/2022] [Accepted: 06/04/2023] [Indexed: 06/22/2023]
Abstract
Objectives: Less information is available about the temporal relationship between depression in the elderly and cognitive decline. In the current study, we (1) evaluated the temporal association between depression and cognitive decline in older adults over a 4-year period; (2) indicated which cognitive domains have a strong temporal relationship with depression.Methods: Using data from China Family Panel Studies, we examined the relationship between depression and cognition among adults aged 65 and older with a cross-lagged design.Results: The results showed that initial depression affected subsequent cognitive function, especially immediate and delayed recall, but that cognition decline did not predict depression over time.Conclusion: The findings suggest that depression precedes cognitive decline in older adults, which is of great significance for the future research of mild cognitive impairment and dementia in the elderly.
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Affiliation(s)
- Jing Yuan
- School of Nursing, Hebei University, Baoding, China
| | - Yan Wang
- School of Nursing, Hebei University, Baoding, China
| | - Zejun Liu
- Department of Psychology, Educational College, Shanghai Normal University, Shanghai, China
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Yuan M, Tang R, Rong M, Han Y, Fang Y. The association of spousal depressive symptoms and cognitive function among older adults: mediation and moderated mediation analyses. Aging Ment Health 2023; 27:2162-2169. [PMID: 37212625 DOI: 10.1080/13607863.2023.2213665] [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: 11/01/2022] [Accepted: 05/06/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES To test whether contagious depressive symptoms mediate the association between spousal depressive symptoms (spousal-DS) and the other spouse's cognitive function, and test the moderated mediation of social activities engagement and sleep quality. STUDY DESIGN A total of 3,230 adults aged ≥60 and one of his/her close relatives were interviewed in 2016 in Xiamen, China. METHODS Cognitive function and depressive symptoms were measured by MoCA and GDS-15/CES-D-10, respectively. Social activities engagement and sleep quality were self-reported. Mediation and moderated mediation were tested by PROCESS macro with 5000 bootstrapping re-samples. RESULT Among all, 1,193 pairs were husband-wife with complete information and were included. The mean ages of older adults and their spouses were 68.35 ± 6.53 and 66.53 ± 7.91 years, respectively. The mean MoCA and GDS-15 scores for older adults were 22.21 ± 5.45 and 1.73 ± 2.17, respectively. The average score of CES-D-10 for spouses was 14.18 ± 4.77. Spousal-DS were associated with cognitive functions of older adults via the contagious depressive symptoms (indirect effect: -0.048, 95% confidence interval (CI): (-0.075, -0.028)). Such mediation can be buffered by attending social activities (interaction: -0.062, 95% CI: (-0.111, -0.013)) and improving sleep quality (interaction: -0.034, 95% CI: (-0.057, -0.012)). CONCLUSION Cognitive function of older adults was associated with his/her spouse's depressive symptoms, and the association was mediated by contagious depressive symptoms and moderated by social activities as well as sleep quality.
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Affiliation(s)
- Manqiong Yuan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Rui Tang
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Meng Rong
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Yaofeng Han
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
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Hong JW, Nam YJ, Hong S, Roh HW. Mediating effect of depressive symptoms on the relationship between digital literacy and cognitive function in older adults. Front Psychiatry 2023; 14:1248347. [PMID: 37810594 PMCID: PMC10551625 DOI: 10.3389/fpsyt.2023.1248347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/28/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Although several studies have examined the individual relationships among digital literacy, cognitive function, and depressive symptoms, few have integrated all three factors into a single model. This study aimed to address this gap by investigating the mediating effect of depressive symptoms on the relationship between digital literacy and cognition. In doing so, we hoped to contribute to a more comprehensive understanding of the complex interplay among these variables and their implications for mental health and well-being. Methods Participants were 7,988 older adults (65 years or older) who participated in the Living Profiles of Older People Survey 2020. The main type of exposure was digital literacy (communication, information, media, and online transaction literacy). The main outcomes were depressive symptoms measured using the Short Geriatric Depression Scale of Korean version and cognitive function measured using the Mini-Mental State Examination score. Multiple linear regression and mediation analyses were also performed. Results After adjusting for covariates, our analysis found a significant association between digital literacy and both depressive symptoms and cognitive function (β of four types of digital literacy and depressive symptoms = -0.123, -0.172, -0.702, and - 0.639, respectively; β of four types of digital literacy and cognitive function = 2.102, 2.217, 1.711, and 1.436, respectively). Moreover, our study showed that depressive symptoms play a mediating role in the relationship between media and online transaction literacy and cognitive function (95% CI of indirect effects = 0.0647-0.1212 and 0.0639-0.1277, respectively), implying an indirect pathway (digital literacy, depressive symptoms, and cognitive function). Discussion This study sheds light on the relationship between digital literacy, depressive symptoms, and cognitive function in older adults. We found that depressive symptoms mediated the association between specific aspects of digital literacy (online transaction and media literacy) and cognitive function. Our results indicate that community-based digital literacy programs could be effective in reducing depression and preserving or improving cognitive function in older adults.
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Affiliation(s)
- Jae Woo Hong
- Department of Medicine, Gachon University School of Medicine, Incheon, Republic of Korea
| | - You Jin Nam
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sunhwa Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Hyun Woong Roh
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
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Mehta K, Mohebbi M, Pasco JA, Williams LJ, Sui SX, Walder K, Ng BL, Gupta VB. A plasma protein signature associated with cognitive function in men without severe cognitive impairment. Alzheimers Res Ther 2023; 15:148. [PMID: 37658429 PMCID: PMC10472730 DOI: 10.1186/s13195-023-01294-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/21/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND A minimally invasive blood-based assessment of cognitive function could be a promising screening strategy to identify high-risk groups for the incidence of Alzheimer's disease. METHODS The study included 448 cognitively unimpaired men (mean age 64.1 years) drawn from the Geelong Osteoporosis Study. A targeted mass spectrometry-based proteomic assay was performed to measure the abundance levels of 269 plasma proteins followed by linear regression analyses adjusted for age and APOE ε4 carrier status to identify the biomarkers related to overall cognitive function. Furthermore, two-way interactions were conducted to see whether Alzheimer's disease-linked genetic variants or health conditions modify the association between biomarkers and cognitive function. RESULTS Ten plasma proteins showed an association with overall cognitive function. This association was modified by allelic variants in genes ABCA7, CLU, BDNF and MS4A6A that have been previously linked to Alzheimer's disease. Modifiable health conditions such as mood disorders and poor bone health, which are postulated to be risk factors for Alzheimer's disease, also impacted the relationship observed between protein marker levels and cognition. In addition to the univariate analyses, an 11-feature multianalyte model was created using the least absolute shrinkage and selection operator regression that identified 10 protein features and age associated with cognitive function. CONCLUSIONS Overall, the present study revealed plasma protein candidates that may contribute to the development of a blood-based screening test for identifying early cognitive changes. This study also highlights the importance of considering other risk factors in elucidating the relationship between biomarkers and cognition, an area that remains largely unexplored.
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Affiliation(s)
- Kanika Mehta
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3216, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Mohammadreza Mohebbi
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3216, Australia
- Biostatistics Unit, Faculty of Health, Deakin University, Burwood, VIC, Australia
| | - Julie A Pasco
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3216, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Prahran, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
| | - Lana J Williams
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3216, Australia
- Barwon Health, Geelong, VIC, Australia
| | - Sophia X Sui
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3216, Australia
| | - Ken Walder
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3216, Australia
| | - Boon Lung Ng
- Department of Geriatric Medicine, Barwon Health, Geelong, VIC, Australia
| | - Veer Bala Gupta
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3216, Australia.
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Teixeira IA, Coutinho ESF, Marinho V, Castro-Costa E, Deslandes AC. Prevalence of dynapenia and overlap with disability, depression, and executive dysfunction. Rev Saude Publica 2023; 57:43. [PMID: 37556665 PMCID: PMC10355316 DOI: 10.11606/s1518-8787.2023057004580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 09/27/2022] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE This study aims to investigate handgrip strength and dynapenia prevalence among older adults stratified by Brazilian macroregions. Additionally, we aim to evaluate the overlap between dynapenia and Instrumental Activities of Daily Living (IADL) disability, depression, and executive dysfunction on a national basis and by each Brazilian macroregion. METHODS This cross-sectional analysis was based on data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil). A multistage cluster sample design was used, with a representative population-based study of non-institutionalized community-dwelling Brazilians aged ≥ 50 years from 70 municipalities across all five macroregions of the country. The outcome variable was dynapenia. Covariables were IADL disability, depression, and executive dysfunction. The Brazilian macroregions were used for stratification. In addition, the following additional variables were included: age group, gender, education level, macroregions (North, Northeast, Southeast, South, and Midwest), self-reported health, multimorbidity, and falls. RESULTS A total of 8,849 (94%) of the sample provided complete information for the handgrip strength assessment and were included in this analysis. Dynapenia prevalence was higher in North and Northeast regions (28.5% and 35.1%, respectively). We identified statistically significant differences between different macroregions for dynapenia, IADL disability, and verbal fluency, with worse values in the North and Northeast regions. In the North and Northeast macroregions, nearly half of the subjects that presented executive dysfunction and IADL disability also had dynapenia. There was a more significant overlap in the prevalence of all four conditions in the North and Northeast regions (4.8% and 5.5%, respectively), whereas the overlap was smaller in the South (2.3%). There was also a smaller overlap in the prevalence of dynapenia and depression in the South (5.8%) compared with other macroregions. CONCLUSIONS Macroregions in Brazil exhibit marked differences in the prevalence of dynapenia and in its overlap with IADL disability, depression, and executive dysfunction.
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Affiliation(s)
- Ivan Abdalla Teixeira
- Universidade Federal do Rio de JaneiroInstituto de PsiquiatriaRio de JaneiroRJBrasil Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria. Rio de Janeiro, RJ, Brasil
| | - Evandro Silva Freire Coutinho
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro, Instituto de Medicina Social. Rio de Janeiro, RJ, Brasil
| | - Valeska Marinho
- Universidade Federal do Rio de JaneiroInstituto de PsiquiatriaRio de JaneiroRJBrasil Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria. Rio de Janeiro, RJ, Brasil
| | - Erico Castro-Costa
- Fundação Oswaldo CruzInstituto René RachouBelo HorizonteMGBrasilFundação Oswaldo Cruz. Instituto René Rachou. Belo Horizonte, MG, Brasil.
| | - Andrea Camaz Deslandes
- Universidade Federal do Rio de JaneiroInstituto de PsiquiatriaRio de JaneiroRJBrasil Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria. Rio de Janeiro, RJ, Brasil
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Desai P, Beck T, Krueger K, Wilson R, Evans D, Rajan K. Neuroticism, Physical Activity, and Cognitive Functioning in a Population-Based Cohort of Older Adults. RESEARCH SQUARE 2023:rs.3.rs-2874085. [PMID: 37292956 PMCID: PMC10246268 DOI: 10.21203/rs.3.rs-2874085/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background Little is known about how physical activity influences the relationship between neuroticism and cognitive function and cognitive decline. Methods Data from the Chicago Health and Aging Project (CHAP) was utilized to conduct this study. CHAP is a population-based cohort study of chronic conditions in older adults. Participants completed in-home interviews cycles of three years from 1993-2012. Mixed effects regression models were conducted to test the associations between physical activity, neuroticism, and the interaction between neuroticism and global cognitive function and global cognitive decline. Stratified mixed effects regression models by physical activity level were conducted to test the associations between neuroticism and global cognitive function and global cognitive decline. Results A total of 7,685 participants were eligible for this study. Participants were 62% female and 64% African American. We found statistically significant associations for the interaction of medium physical and neuroticism (β = 0.014 (SE = 0.007), p = .037) and the interaction of high physical activity and neuroticism (β = 0.021 (SE = 0.007), p = .003) on global cognitive function at baseline but not for decline over time. Stratified analysis showed that among participants with high physical activity levels, the association between neuroticism and global cognitive decline was statistically significant (β=-0.002 (SE = 0.001), p = .023). Conclusion Increasing physical activity level benefits the cognitive functioning of individuals with high neuroticism. Interventions should incorporate health behavior change approaches which aim to reduce characteristics of neuroticism.
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Křenek P, Hořínková J, Bartečků E. Peripheral Inflammatory Markers in Subtypes and Core Features of Depression: A Systematized Review. Psychopathology 2023; 56:403-416. [PMID: 36812905 PMCID: PMC10568602 DOI: 10.1159/000528907] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 12/28/2022] [Indexed: 02/24/2023]
Abstract
INTRODUCTION The aim of this work was to summarize relationships between two subtypes of major depressive disorder (melancholic and atypical) and four core features of depression that reflect the domains identified consistently in previous studies of major depressive disorder endophenotypes (exaggerated reactivity to negative information, altered reward processing, cognitive control deficits, and somatic symptoms) on the one hand and selected peripheral inflammatory markers (C-reactive protein [CRP], cytokines, and adipokines) on the other. METHODS A systematized review was conducted. The database used for searching articles was PubMed (MEDLINE). RESULTS According to our search, most peripheral immunological markers associated with major depressive disorder are not specific to a single depressive symptom group. The most evident examples are CRP, IL-6, and TNF-α. The strongest evidence supports the connection of peripheral inflammatory markers with somatic symptoms; weaker evidence indicates a role of immune changes in altered reward processing. The least amount of evidence was found for the role of peripheral inflammatory markers in exaggerated reactivity to negative information and cognitive control deficits. Regarding the depression subtypes, a tendency for higher CRP and adipokines was observed in atypical depression; increased IL-6 was found in melancholic depression. CONCLUSION Somatic symptoms of depression could be a manifestation of a specific immunological endophenotype of depressive disorder. Melancholic and atypical depression may be characterized by different profiles of immunological markers.
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Affiliation(s)
- Pavel Křenek
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia,
| | - Jana Hořínková
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia
| | - Elis Bartečků
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia
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Johar H, Schaefer A, Su TT. Depressive symptoms mediate the longitudinal association between diabetes and subjective cognitive decline. Findings from a semirural multi-ethnic older population in Malaysia. Prev Med 2023; 167:107390. [PMID: 36528114 DOI: 10.1016/j.ypmed.2022.107390] [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: 08/11/2022] [Revised: 11/15/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022]
Abstract
The potential role of psychological distress as the pathway linking diabetes and subjective cognitive decline (SCD) is still unclear. This study aims to investigate whether depressive symptoms mediate the relationship between diabetes and SCD in older adults. Baseline data from 3428 adults (55-94 years) of the South East Asia Community Observatory (SEACO), Malaysia were utilized. Subjective cognitive complaints (SCC) were recorded at baseline and five years later. Mediation analyses with non-parametric bootstrapping methods were employed. A proportion of 20% of participants without SCC at baseline reported a decline in SCC after 5 years of follow-up. Known diabetes (β = -0.13, SE = 0.05, p = 0.02) and depressive symptoms (ß = -0.18, SE = 0.05, p = 0.001) were independently associated with SCD. Previously diagnosed diabetes was associated with depressive symptoms at baseline (ß = 0.04, SE = 0.02, p = 0.01), and greater SCD at follow-up (β = -0.19, SE = 0.06, p = 0.001). Mediation analyses revealed that 9% of the association between diabetes and SCD was attributable to an indirect effect through depressive symptoms (ß = -0.01, 95% CI 0.02-0.001, p < 0.0001). This study provides further evidence of the detrimental effects of diabetes and depression on subjective cognitive decline. Our findings also suggest that depression is an important pathway linking previously diagnosed diabetes with subjective cognitive decline in older adulthood.
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Affiliation(s)
- Hamimatunnisa Johar
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor, Malaysia; Department of Psychosomatic Medicine and Psychotherapy, University of Giessen and Marburg, Giessen, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, München, Germany.
| | - Alexandre Schaefer
- School of Medical and Life Sciences, Department of Psychology, Sunway University, Malaysia; Ageing, Health and Well-being Research Centre, Sunway University, Malaysia
| | - Tin Tin Su
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor, Malaysia; South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor, Malaysia
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Mehta K, Mohebbi M, Pasco JA, Williams LJ, Walder K, Ng BL, Gupta VB. Impact of Mood Disorder History and Bone Health on Cognitive Function Among Men Without Dementia. J Alzheimers Dis 2023; 96:381-393. [PMID: 37781798 DOI: 10.3233/jad-230140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
BACKGROUND Poor cognitive function, a major disabling condition of older age, is often considered a prodromal feature of dementia. High mortality and the lack of a cure for dementia have necessitated a focus on the identification of potentially modifiable risk factors. Mental and physical health conditions such as mood disorders and bone loss have been previously linked with poor cognition individually although their combined effect remains largely unknown. OBJECTIVE Considering the multifactorial nature of dementia pathology, we investigated whether mood disorders, bone health and their interaction are associated with cognitive function in a population-based sample of men. METHODS Four hundred and forty-two male participants were drawn from the Geelong Osteoporosis Study. Cognitive function was assessed using the CogState Brief Battery, which measured cognitive performance across four domains and was used to compute overall cognitive function. Mood disorders and hip bone mineral density (BMD) were determined using a semi-structured clinical interview and dual-energy X-ray absorptiometry, respectively. RESULTS Hip BMD (Bcoeff = 0.56, 95% CI: [0.07, 1.05], p = 0.025) but not mood disorder (Bcoeff = -0.50, 95% CI: [-0.20, 0.10], p = 0.529) was associated with overall cognitive function after accounting for potential confounders. Interaction effects were observed between the two exposures (Bcoeff = -1.37, 95% CI: [-2.49, -0.26], p = 0.016) suggesting that individuals without a mood disorder displayed better cognitive performance with increasing BMD, while those with a lifetime history of mood disorder displayed poorer cognitive function with increasing BMD. CONCLUSIONS These findings highlight the importance of exploring interactions among potentially modifiable health conditions associated with cognitive function.
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Affiliation(s)
- Kanika Mehta
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Mohammadreza Mohebbi
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia
- Biostatistics Unit, Faculty of Health, Deakin University, Burwood, VIC, Australia
| | - Julie A Pasco
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Prahran, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
| | - Lana J Williams
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
| | - Ken Walder
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia
| | - Boon Lung Ng
- Department of Geriatric Medicine, Barwon Health, Geelong, VIC, Australia
| | - Veer Bala Gupta
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia
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12
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Gender differences in the association between adverse events in childhood or adolescence and the risk of premature mortality. Sci Rep 2022; 12:19118. [PMID: 36352182 PMCID: PMC9646814 DOI: 10.1038/s41598-022-23443-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
Abstract
To examine, by gender, the relationship between adverse events in childhood or adolescence and the increased risk of early mortality (before 80 years). The study sample included 941 participants of the English Longitudinal Study of Aging who died between 2007 and 2018. Data on socioeconomic status, infectious diseases, and parental stress in childhood or adolescence were collected at baseline (2006). Logistic regression models were adjusted by socioeconomic, behavioral and clinical variables. Having lived with only one parent (OR 3.79; p = 0.01), overprotection from the father (OR 1.12; p = 0.04) and having had an infectious disease in childhood or adolescence (OR 2.05; p = 0.01) were risk factors for mortality before the age of 80 in men. In women, overprotection from the father (OR 1.22; p < 0.01) was the only risk factor for mortality before the age of 80, whereas a low occupation of the head of the family (OR 0.58; p = 0.04) and greater care from the mother in childhood or adolescence (OR 0.86; p = 0.03) were protective factors. Independently of one's current characteristics, having worse socioeconomic status and health in childhood or adolescence increased the risk of early mortality in men. Parental overprotection increased the risk of early mortality in both sexes, whereas maternal care favored longevity in women.
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13
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Koutsonida M, Markozannes G, Bouras E, Aretouli E, Tsilidis KK. Metabolic syndrome and cognition: A systematic review across cognitive domains and a bibliometric analysis. Front Psychol 2022; 13:981379. [PMID: 36438337 PMCID: PMC9682181 DOI: 10.3389/fpsyg.2022.981379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/19/2022] [Indexed: 11/11/2022] Open
Abstract
The aim of this review is to investigate the association between metabolic syndrome (MetS) and cognitive decline in distinct cognitive domains, and to perform a complementary study description through the bibliometric analysis. PubMed and Scopus databases were searched from inception to 15 December 2021 to identify longitudinal studies that examined the association of MetS with incident decline, in order to prevent reverse causality. The Preferred Reporting Items for Systematic Review and Meta-Analysis checklist was used to conduct the present systematic review. Thirty studies were included and results were analyzed across the cognitive domains of global cognition, memory, executive functions, attention, visuoconstructive abilities, and language. The majority of the studies reviewed did not report statistically significant results for most cognitive domains investigated, and decline in specific cognitive domains was not consistently associated with the presence of MetS. Meta-analyses were not conducted due to the high degree of between-study heterogeneity regarding the MetS definitions, the cognitive domains examined, the specific tests used for each cognitive domain and the different measures of association used. Bibliometric analysis revealed that most studies are conducted by research teams from USA and China, and that cognitive tasks that reflect real-life abilities are rarely examined. Future studies should employ larger sample sizes, longer follow-up periods, a global consensus for MetS definition and standardized tests of the above mentioned cognitive domains as well as problem-solving tasks with high sensitivity and specificity to clarify the impact of MetS on cognition and its underlying mechanisms.
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Affiliation(s)
- Myrto Koutsonida
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Georgios Markozannes
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Emmanouil Bouras
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Aretouli
- Department of Psychology, School of Social Sciences, University of Ioannina, Ioannina, Greece
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Eleni Aretouli,
| | - Konstantinos K. Tsilidis
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- *Correspondence: Konstantinos K. Tsilidis,
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14
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Baiden P, Cassidy J, Panisch LS, LaBrenz CA, Onyeaka HK. Association of adverse childhood experiences with subjective cognitive decline in adulthood: Findings from a population-based study. Aging Ment Health 2022; 26:2214-2222. [PMID: 34957876 DOI: 10.1080/13607863.2021.2017848] [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] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Adverse childhood experiences have been found to be associated with negative outcomes during adulthood. Emerging research indicates that adverse childhood experiences may elevate the risk for Alzheimer's disease. Yet, few studies have investigated the association between adverse childhood experiences and subjective cognitive decline among middle-aged and older adults in the United States. The objective of this study was to investigate the association between adverse childhood experiences and subjective cognitive decline among middle-aged and older adults in the United States. METHODS Data for this study were obtained from the 2019 Behavioral Risk Factor Surveillance Survey. An analytic sample of 50,277 adults aged 45 to 79 years (53.3% female) from 15 states was analyzed using binary logistic regression. The outcome variable investigated in this study was subjective cognitive decline, and the main explanatory variable was adverse childhood experiences. RESULTS Of the 50,277 respondents, 10.3% reported experiencing subjective cognitive decline during the past year, and 14.5% had four or more adverse childhood experiences. We found a dose-response association between adverse childhood experiences and subjective cognitive decline. Respondents who had four or more adverse childhood experiences had 2.98 times higher odds of having subjective cognitive decline when compared to respondents with no adverse childhood experiences (aOR = 2.98, 95% CI = 2.56-3.48). Other factors associated with subjective cognitive decline have been identified and discussed. CONCLUSION The findings of this study provide evidence indicating that early life factors may be linked with cognitive decline in later adulthood. The findings of this study are discussed with implications for practice and research.
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Affiliation(s)
- Philip Baiden
- School of Social Work, The University of Texas at Arlington, Arlington, Texas, USA
| | - Jessica Cassidy
- School of Social Work, The University of Texas at Arlington, Arlington, Texas, USA
| | - Lisa S Panisch
- School of Social Work, Wayne State University, Detroit, Michigan, USA
| | - Catherine A LaBrenz
- School of Social Work, The University of Texas at Arlington, Arlington, Texas, USA
| | - Henry K Onyeaka
- Harvard Medical School, Department of Psychiatry, Massachusetts General Hospital/McLean Hospital, Boston, Massachusetts, USA
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15
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Zainal NH, Newman MG. Elevated Anxious and Depressed Mood Relates to Future Executive Dysfunction in Older Adults: A Longitudinal Network Analysis of Psychopathology and Cognitive Functioning. Clin Psychol Sci 2022; 11:218-238. [PMID: 36993876 PMCID: PMC10046395 DOI: 10.1177/21677026221114076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Vulnerability models posit that executive-functioning (EF) problems centrally affect future common (vs. rare) psychopathology symptoms. Conversely, scar theory postulates that depression/anxiety (vs. other psychopathology) symptoms centrally influence reduced EF. However, most studies so far have been cross-sectional. We used cross-lagged panel network analysis to determine temporal and component-to-component relations on this topic. Community older adults participated across four time points. Cognitive tests and the caregiver-rated Neuropsychiatric Inventory assessed nine psychopathology and eight cognitive-functioning nodes. Nodes with the highest bridge expected influence cross-sectionally were agitation and episodic memory. Episodic memory had the strongest inverse relation with age. Agitation had the strongest negative association with global cognition. EF nodes tended to be centrally affected by prior depressed and anxious moods rather than influential on any future nodes. Heightened anxious and depressed mood (vs. other nodes) centrally predicted future decreased EF-related (vs. non-EF-related) nodes in older adults, supporting scar (vs. vulnerability) theory.
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Affiliation(s)
- Nur Hani Zainal
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School
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16
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Jindra C, Li C, Tsang RSM, Bauermeister S, Gallacher J. Depression and memory function - evidence from cross-lagged panel models with unit fixed effects in ELSA and HRS. Psychol Med 2022; 52:1428-1436. [PMID: 32914740 DOI: 10.1017/s0033291720003037] [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: 11/07/2022]
Abstract
BACKGROUND Individuals with depression are often found to perform worse on cognitive tests and to have an increased risk of dementia. The causes and the direction of these associations are however not well understood. We looked at two specific hypotheses, the aetiological risk factor hypothesis and the reverse causality hypothesis. METHOD We analysed observational data from two cohorts, English Longitudinal Study of Ageing (ELSA) and Health and Retirement Study (HRS), using cross-lagged panel models with unit fixed effects. Each model was run once with depression and repeated with cognition as the dependent variable and the other variable as the main explanatory variable. All models were estimated separately for contemporaneous effects and lagged effects up to 8 years in the past. We contrasted the results with models making the random effects assumption. RESULTS Evidence from the fixed effects models is mixed. We find no evidence for the reverse causality hypothesis in ELSA and HRS. While there is no evidence for the aetiological risk factors hypothesis in ELSA, results from HRS indicate some effects. CONCLUSION Our findings suggest that current levels of cognitive function do not influence future levels of depression. Results in HRS provide some evidence that current levels of depressive symptoms influence future cognition.
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Affiliation(s)
- Christoph Jindra
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, United Kingdom
| | - Chenlu Li
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, United Kingdom
| | - Ruby S M Tsang
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, United Kingdom
| | - Sarah Bauermeister
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, United Kingdom
| | - John Gallacher
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, United Kingdom
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17
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Depression and bone loss as risk factors for cognitive decline: A systematic review and meta-analysis. Ageing Res Rev 2022; 76:101575. [PMID: 35093615 DOI: 10.1016/j.arr.2022.101575] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 01/24/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Depression is linked to Alzheimer's disease (AD) but it is unclear whether depression is also associated with cognitive decline in the preclinical phase and mild cognitive impairment (MCI). Previous meta-analyses have only investigated AD as an outcome without accounting for individuals showing cognitive decline that does not meet the diagnostic criteria for AD. Other potentially modifiable risk factors such as bone loss have also been less explored and there remains uncertainty around their temporal relationship with cognitive decline. AIMS To conduct a systematic review and meta-analysis investigating depression and bone loss as risk factors for subsequent cognitive decline. METHODS A comprehensive search strategy was developed and applied using four databases; MEDLINE Complete, Embase, PsycINFO and CINAHL Complete. The pooled summary effects were estimated as odds ratios with 95% confidence intervals using a random-effects model. The study protocol was registered with PROSPERO (ID: CRD42020159369). RESULTS A total of 75 longitudinal cohort studies were identified for meta-analysis, of which 70 examined the impact of depression on cognitive decline and five examined the impact of bone loss. Prior exposure to depression was found to be associated with cognitive score reduction (OR 1.33 95% CI 1.17, 1.51), MCI incidence (OR 1.52 95% CI 1.28, 1.79) and AD incidence (OR 1.79 95% CI 1.46, 2.2). Bone loss was also associated with the incidence of AD (OR=1.81 95% CI 1.28, 2.55). CONCLUSIONS Overall, the results support the hypothesis that depression is associated with subsequent cognitive decline. Bone loss was also found to be associated with AD incidence; however, due to the small number of studies, the results should be viewed with caution.
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18
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Brett BL, Kerr ZY, Walton SR, Chandran A, Defreese JD, Mannix R, Echemendia RJ, Meehan WP, Guskiewicz KM, McCrea M. Longitudinal trajectory of depression symptom severity and the influence of concussion history and physical function over a 19-year period among former National Football League (NFL) players: an NFL-LONG Study. J Neurol Neurosurg Psychiatry 2022; 93:272-279. [PMID: 34663623 PMCID: PMC8854336 DOI: 10.1136/jnnp-2021-326602] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 10/03/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study investigated the longitudinal course of depressive symptom severity over 19 years in former American football players and the influence of concussion history, contact sport participation and physical function on observed trajectories. METHODS Former American football players completed a general health questionnaire involving demographic information, medical/psychiatric history, concussion/football history and validated measures of depression and physical function at three time points (2001, 2010 and 2019). Parallel process latent growth curve modelling tested associations between concussion history, years of football participation, and overall and change in physical function on the overall level and trajectory of depressive symptoms. RESULTS Among the 333 participants (mean(SD) age, 48.95 (9.37) at enrolment), there was a statistically significant, but small increase in depressive symptom severity from 2001 (48.34 (7.75)) to 2019 (49.77 (9.52)), slope=0.079 (SE=0.11), p=0.007. Those with greater concussion history endorsed greater overall depressive symptom severity, B=1.38 (SE=0.33), p<0.001. Concussion history, B<0.001 (SE=0.02), p=0.997 and years of participation, B<0.001 (SE=0.01), p=0.980, were not associated with rate of change (slope factor) over 19 years. Greater decline in physical function, B=-0.71 (SE=0.16), p<0.001, was predictive of a faster growth rate (ie, steeper increase) of depression symptom endorsement over time. CONCLUSIONS Concussion history, not years of participation, was associated with greater depressive symptom severity. Neither factor was predictive of changes over a 19-year period. Decline in physical function was a significant predictor of a steeper trajectory of increased depressive symptoms, independent of concussion effects. This represents one viable target for preventative intervention to mitigate long-term neuropsychiatric difficulties associated with concussion across subsequent decades of life.
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Affiliation(s)
- Benjamin L Brett
- Department of Neurosurgery, Medical College of Wisconsin, Wauwatosa, WI, USA
- Department of Neurology, Medical College of Wisconsin, Wauwatosa, WI, USA
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Samuel R Walton
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, indianapolis, IN, USA
| | - J D Defreese
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Ruben J Echemendia
- Psychological and Neurobehavioral Associates, Inc, State College, Pennsylvania, USA
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, USA
| | - William P Meehan
- Sports Medicine Division, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics and Orthopedics, Harvard Medical School, Boston, MA, USA
| | - Kevin M Guskiewicz
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Michael McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Wauwatosa, WI, USA
- Department of Neurology, Medical College of Wisconsin, Wauwatosa, WI, USA
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19
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Du Preez A, Lefèvre-Arbogast S, González-Domínguez R, Houghton V, de Lucia C, Low DY, Helmer C, Féart C, Delcourt C, Proust-Lima C, Pallàs M, Sánchez-Pla A, Urpi-Sardà M, Ruigrok SR, Altendorfer B, Aigner L, Lucassen PJ, Korosi A, Manach C, Andres-Lacueva C, Samieri C, Thuret S. Impaired hippocampal neurogenesis in vitro is modulated by dietary-related endogenous factors and associated with depression in a longitudinal ageing cohort study. Mol Psychiatry 2022; 27:3425-3440. [PMID: 35794184 PMCID: PMC7613865 DOI: 10.1038/s41380-022-01644-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 05/09/2022] [Accepted: 05/23/2022] [Indexed: 12/20/2022]
Abstract
Environmental factors like diet have been linked to depression and/or relapse risk in later life. This could be partially driven by the food metabolome, which communicates with the brain via the circulatory system and interacts with hippocampal neurogenesis (HN), a form of brain plasticity implicated in depression aetiology. Despite the associations between HN, diet and depression, human data further substantiating this hypothesis are largely missing. Here, we used an in vitro model of HN to test the effects of serum samples from a longitudinal ageing cohort of 373 participants, with or without depressive symptomology. 1% participant serum was applied to human fetal hippocampal progenitor cells, and changes in HN markers were related to the occurrence of depressive symptoms across a 12-year period. Key nutritional, metabolomic and lipidomic biomarkers (extracted from participant plasma and serum) were subsequently tested for their ability to modulate HN. In our assay, we found that reduced cell death and increased neuronal differentiation were associated with later life depressive symptomatology. Additionally, we found impairments in neuronal cell morphology in cells treated with serum from participants experiencing recurrent depressive symptoms across the 12-year period. Interestingly, we found that increased neuronal differentiation was modulated by increased serum levels of metabolite butyrylcarnitine and decreased glycerophospholipid, PC35:1(16:0/19:1), levels - both of which are closely linked to diet - all in the context of depressive symptomology. These findings potentially suggest that diet and altered HN could subsequently shape the trajectory of late-life depressive symptomology.
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Affiliation(s)
- Andrea Du Preez
- grid.13097.3c0000 0001 2322 6764Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 9NU UK
| | - Sophie Lefèvre-Arbogast
- grid.508062.90000 0004 8511 8605University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France
| | - Raúl González-Domínguez
- grid.5841.80000 0004 1937 0247Nutrition, Food Science and Gastronomy Department, Faculty of Pharmacy and Food Science, University of Barcelona, 08028 Barcelona, Spain ,grid.413448.e0000 0000 9314 1427CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 0828 Barcelona, Spain
| | - Vikki Houghton
- grid.13097.3c0000 0001 2322 6764Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 9NU UK
| | - Chiara de Lucia
- grid.13097.3c0000 0001 2322 6764Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 9NU UK
| | - Dorrain Y. Low
- Université Clermont Auvergne, INRA, UMR1019, Human Nutrition Unit, F-63000 Clermont Ferrand, France
| | - Catherine Helmer
- grid.508062.90000 0004 8511 8605University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France
| | - Catherine Féart
- grid.508062.90000 0004 8511 8605University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France
| | - Cécile Delcourt
- grid.508062.90000 0004 8511 8605University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France
| | - Cécile Proust-Lima
- grid.508062.90000 0004 8511 8605University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France
| | - Mercè Pallàs
- grid.5841.80000 0004 1937 0247Pharmacology Section, Department of Pharmacology, Toxicology and Medicinal Chemistry, Faculty of Pharmacy and Food Sciences, and Institute of Neurosciences, University of Barcelona, Av. Joan XXIII, 27-31, E-08028 Barcelona, Spain
| | - Alex Sánchez-Pla
- grid.5841.80000 0004 1937 0247Nutrition, Food Science and Gastronomy Department, Faculty of Pharmacy and Food Science, University of Barcelona, 08028 Barcelona, Spain ,grid.413448.e0000 0000 9314 1427CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 0828 Barcelona, Spain
| | - Mireia Urpi-Sardà
- grid.5841.80000 0004 1937 0247Nutrition, Food Science and Gastronomy Department, Faculty of Pharmacy and Food Science, University of Barcelona, 08028 Barcelona, Spain ,grid.413448.e0000 0000 9314 1427CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 0828 Barcelona, Spain
| | - Silvie R. Ruigrok
- grid.7177.60000000084992262Brain Plasticity Group, Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, 1098 XH Amsterdam, The Netherlands
| | - Barbara Altendorfer
- grid.21604.310000 0004 0523 5263Institute of Molecular Regenerative Medicine, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, Salzburg, 5020 Austria
| | - Ludwig Aigner
- grid.21604.310000 0004 0523 5263Institute of Molecular Regenerative Medicine, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, Salzburg, 5020 Austria
| | - Paul J. Lucassen
- grid.7177.60000000084992262Brain Plasticity Group, Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, 1098 XH Amsterdam, The Netherlands
| | - Aniko Korosi
- grid.7177.60000000084992262Brain Plasticity Group, Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, 1098 XH Amsterdam, The Netherlands
| | - Claudine Manach
- Université Clermont Auvergne, INRA, UMR1019, Human Nutrition Unit, F-63000 Clermont Ferrand, France
| | - Cristina Andres-Lacueva
- grid.5841.80000 0004 1937 0247Nutrition, Food Science and Gastronomy Department, Faculty of Pharmacy and Food Science, University of Barcelona, 08028 Barcelona, Spain ,grid.413448.e0000 0000 9314 1427CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 0828 Barcelona, Spain
| | - Cécilia Samieri
- grid.508062.90000 0004 8511 8605University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France
| | - Sandrine Thuret
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9NU, UK. .,Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307, Dresden, Germany.
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20
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Pathways linking abdominal obesity to poor memory function: Explore the mediating role of hypertension and depressive symptoms. J Affect Disord 2021; 295:492-497. [PMID: 34509063 DOI: 10.1016/j.jad.2021.08.092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/26/2021] [Accepted: 08/30/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The negative effect of abdominal obesity on cognitive function has been widely reported, especially on memory function, however, it is unclear how the effect is mediated. We aim to investigate the mediating role of hypertension and depressive symptoms. METHODS Data were collected from wave 6 (2012-2013) of the English Longitudinal Study of Ageing (ELSA). Abdominal obesity was defined as a waist circumference (WC) ≥88cm for women and ≥102cm for men. Hypertension was determined on the basis of objective blood pressure measurement and previous physician diagnosis. Depressive symptoms were assessed with the 8-item version of the Center for Epidemiologic Studies (CESD) scale. Memory function was measured with the 10-word immediate and delayed recall tests. Baron and Kenny's causal steps and Karlson/Holm/Breen (KHB) method were used to examine the mediating effect. RESULTS A total of 7,448 participants aged ≥50 years were included in this study. We found a negative effect of abdominal obesity on memory function (β=-0.047, p=0.031). KHB method identified significant mediating effect of hypertension and depressive symptoms on the relationship between abdominal obesity and memory function, they explained 16.92 and 6.32% of the total effect of abdominal obesity on memory function, respectively. LIMITATIONS This study was limited by its cross-sectional design and possibility of residual confounding. CONCLUSIONS Hypertension and depressive symptoms might be possible pathways linking abdominal obesity and poor memory function, suggesting that collaborative interventions of abdominal obesity, hypertension and depressive symptoms are beneficial in maintaining memory function.
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Shea TB. Improvement of cognitive performance by a nutraceutical formulation: Underlying mechanisms revealed by laboratory studies. Free Radic Biol Med 2021; 174:281-304. [PMID: 34352370 DOI: 10.1016/j.freeradbiomed.2021.07.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 12/28/2022]
Abstract
Cognitive decline, decrease in neuronal function and neuronal loss that accompany normal aging and dementia are the result of multiple mechanisms, many of which involve oxidative stress. Herein, we review these various mechanisms and identify pharmacological and non-pharmacological approaches, including modification of diet, that may reduce the risk and progression of cognitive decline. The optimal degree of neuronal protection is derived by combinations of, rather than individual, compounds. Compounds that provide antioxidant protection are particularly effective at delaying or improving cognitive performance in the early stages of Mild Cognitive Impairment and Alzheimer's disease. Laboratory studies confirm alleviation of oxidative damage in brain tissue. Lifestyle modifications show a degree of efficacy and may augment pharmacological approaches. Unfortunately, oxidative damage and resultant accumulation of biomarkers of neuronal damage can precede cognitive decline by years to decades. This underscores the importance of optimization of dietary enrichment, antioxidant supplementation and other lifestyle modifications during aging even for individuals who are cognitively intact.
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Affiliation(s)
- Thomas B Shea
- Laboratory for Neuroscience, Department of Biological Sciences, University of Massachusetts Lowell, Lowell, MA, 01854, USA.
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22
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Koyama S, Saito M, Cable N, Ikeda T, Tsuji T, Noguchi T, Abbas H, Miyashiro I, Osaka K, Kondo K, Watt RG, Aida J. Examining the associations between oral health and social isolation: A cross-national comparative study between Japan and England. Soc Sci Med 2021; 277:113895. [PMID: 33882441 DOI: 10.1016/j.socscimed.2021.113895] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/23/2021] [Accepted: 03/31/2021] [Indexed: 12/12/2022]
Abstract
In Western countries, the most important part of the face in communication is the mouth, whereas it is the eyes in Asian countries; thus oral health could be more important in social interactions in Western countries. Our aim was to examine differences in the association between oral health status and social isolation among older people by comparing Japan and England. We used cross-sectional information obtained from adults aged 65+ in two ongoing prospective cohort studies: The Japan Gerontological Evaluation Study (JAGES, N = 120,195) and the English Longitudinal Study of Ageing (ELSA, N = 3,958). The dependent variable, social isolation score (SIS) was calculated from five factors (marital status, social support from children, social support from family, social support from friends, and social participation). The independent variables were self-reported number of remaining teeth (0, 1-9, 10-19, ≥20) and denture use (≥20 teeth, 10-19 teeth with denture, 10-19 teeth without denture, 0-9 teeth with denture, 0-9 teeth without denture), while the covariates in the model were: sex, age, educational attainment, self-rated health, number of comorbidities, household annual equivalized income, mental health status, daily living activities, and smoking status. We examined associations between oral health status and SIS by applying an ordered logit model by country. Compared to England, more Japanese participants were socially isolated (1.4% vs. 5.8%), but fewer were edentulous (13.1% vs. 7.7%). In both countries, poorer oral health further increased the odds of being socially isolated. Pooled analysis of the ordered logit model with an interaction term showed that the association of number of remaining teeth with SIS was stronger in edentulous participants and in England (odds ratio = 1.50, 95% Confidence interval:1.26-1.80). In both countries, oral health was associated with social isolation; this association could be stronger in England than in Japan.
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Affiliation(s)
- Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Ohtemae, Chuo Ward, Osaka, 541-8567, Japan.
| | - Masashige Saito
- Department of Social Welfare, Nihon Fukushi University, Okuda, Mihama-cho, Chita-gun, Aichi, 470-3295, Japan.
| | - Noriko Cable
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom.
| | - Takaaki Ikeda
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan; Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba Ward, Sendai City, Miyagi 980-8574, Japan.
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, 3-29-1 Otsuka, Tokyo, 112-0012, Japan.
| | - Taiji Noguchi
- Department of Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi, 474-8511, Japan.
| | - Hazem Abbas
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba Ward, Sendai City, Miyagi 980-8574, Japan.
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Ohtemae, Chuo Ward, Osaka, 541-8567, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba Ward, Sendai City, Miyagi 980-8574, Japan.
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo Ward, Chiba, 260-8670, Japan.
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom.
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8510, Japan; Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-machi, Aoba Ward, Sendai City, Miyagi, 980-8574, Japan.
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Noguchi T, Saito M, Aida J, Cable N, Tsuji T, Koyama S, Ikeda T, Osaka K, Kondo K. Association between social isolation and depression onset among older adults: a cross-national longitudinal study in England and Japan. BMJ Open 2021; 11:e045834. [PMID: 33737442 PMCID: PMC7978252 DOI: 10.1136/bmjopen-2020-045834] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Social isolation is a risk factor for depression in older age. However, little is known regarding whether its impact varies depending on country-specific cultural contexts regarding social relationships. The present study examined the association of social isolation with depression onset among older adults in England, which has taken advanced measures against social isolation, and Japan, a super-aged society with a rapidly increasing number of socially isolated people. DESIGN Prospective longitudinal study. SETTING We used data from two ongoing studies: the English Longitudinal Study of Ageing (ELSA) and the Japan Gerontological Evaluation Study (JAGES). PARTICIPANTS Older adults aged ≥65 years without depression at baseline were followed up regarding depression onset for 2 years (2010/2011-2012/2013) for the ELSA and 2.5 years (2010/2011-2013) for the JAGES. PRIMARY OUTCOME MEASURE Depression was assessed with eight items from the Centre for Epidemiologic Studies Depression Scale for the ELSA and Geriatric Depression Scale for the JAGES. Multivariable logistic regression analysis was performed to evaluate social isolation using multiple parameters (marital status; interaction with children, relatives and friends; and social participation). RESULTS The data of 3331 respondents from the ELSA and 33 127 from the JAGES were analysed. Multivariable logistic regression analysis demonstrated that social isolation was significantly associated with depression onset in both countries. In the ELSA, poor interaction with children was marginally associated with depression onset, while in the JAGES, poor interaction with children and no social participation significantly affected depression onset. CONCLUSIONS Despite variations in cultural background, social isolation was associated with depression onset in both England and Japan. Addressing social isolation to safeguard older adults' mental health must be globally prioritised.
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Affiliation(s)
- Taiji Noguchi
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Bunkyo-ku, Japan
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University, Sendai, Japan
| | - Noriko Cable
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Takaaki Ikeda
- Department of Health Policy Science, Yamagata University Faculty of Medicine Graduate School of Medical Science, Yamagata, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry School of Dentistry, Sendai, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry School of Dentistry, Sendai, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
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Cumulative Burden of Depression and Neurocognitive Decline Among Persons With HIV: A Longitudinal Study. J Acquir Immune Defic Syndr 2021; 84:304-312. [PMID: 32195746 DOI: 10.1097/qai.0000000000002346] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Higher cumulative burden of depression among people with HIV (PWH) is associated with poorer health outcomes; however, longitudinal relationships with neurocognition are unclear. This study examined hypotheses that among PWH, (1) higher cumulative burden of depression would relate to steeper declines in neurocognition, and (2) visit-to-visit depression severity would relate to fluctuations in neurocognition within persons. SETTING Data were collected at a university-based research center from 2002 to 2016. METHODS Participants included 448 PWH followed longitudinally. All participants had >1 visit (M = 4.97; SD = 3.53) capturing depression severity (Beck Depression Inventory-II) and neurocognition (comprehensive test battery). Cumulative burden of depression was calculated using an established method that derives weighted depression severity scores by time between visits and total time on study. Participants were categorized into low (67%), medium (15%), and high (18%) depression burden. Multilevel modeling examined between- and within-person associations between cumulative depression burden and neurocognition over time. RESULTS The high depression burden group demonstrated steeper global neurocognitive decline compared with the low depression burden group (b = -0.100, P = 0.001); this was driven by declines in executive functioning, delayed recall, and verbal fluency. Within-person results showed that compared with visits when participants reported minimal depressive symptoms, their neurocognition was worse when they reported mild (b = -0.12, P = 0.04) or moderate-to-severe (b = -0.15, P = 0.03) symptoms; this was driven by worsened motor skills and processing speed. CONCLUSIONS High cumulative burden of depression is associated with worsening neurocognition among PWH, which may relate to poor HIV-related treatment outcomes. Intensive interventions among severely depressed PWH may benefit physical, mental, and cognitive health.
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25
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Innes KE, Sambamoorthi U. The Potential Contribution of Chronic Pain and Common Chronic Pain Conditions to Subsequent Cognitive Decline, New Onset Cognitive Impairment, and Incident Dementia: A Systematic Review and Conceptual Model for Future Research. J Alzheimers Dis 2020; 78:1177-1195. [PMID: 33252087 DOI: 10.3233/jad-200960] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Growing evidence suggests that chronic pain and certain chronic pain conditions may increase risk for cognitive decline and dementia. OBJECTIVE In this systematic review, we critically evaluate available evidence regarding the association of chronic pain and specific common chronic pain conditions to subsequent decline in cognitive function, new onset cognitive impairment (CI), and incident Alzheimer's disease and related dementias (ADRD); outline major gaps in the literature; and provide a preliminary conceptual model illustrating potential pathways linking pain to cognitive change. METHODS To identify qualifying studies, we searched seven scientific databases and scanned bibliographies of identified articles and relevant review papers. Sixteen studies met our inclusion criteria (2 matched case-control, 10 retrospective cohort, 2 prospective cohort), including 11 regarding the association of osteoarthritis (N = 4), fibromyalgia (N = 1), or headache/migraine (N = 6) to incident ADRD (N = 10) and/or its subtypes (N = 6), and 5 investigating the relation of chronic pain symptoms to subsequent cognitive decline (N = 2), CI (N = 1), and/or ADRD (N = 3). RESULTS Studies yielded consistent evidence for a positive association of osteoarthritis and migraines/headaches to incident ADRD; however, findings regarding dementia subtypes were mixed. Emerging evidence also suggests chronic pain symptoms may accelerate cognitive decline and increase risk for memory impairment and ADRD, although findings and measures varied considerably across studies. CONCLUSION While existing studies support a link between chronic pain and ADRD risk, conclusions are limited by substantial study heterogeneity, limited investigation of certain pain conditions, and methodological and other concerns characterizing most investigations to date. Additional rigorous, long-term prospective studies are needed to elucidate the effects of chronic pain and specific chronic pain conditions on cognitive decline and conversion to ADRD, and to clarify the influence of potential confounding and mediating factors.
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Affiliation(s)
- Kim E Innes
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV, USA
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, USA
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26
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Cochar-Soares N, de Carvalho DHT, de Andrade FB, Castro-Costa E, de Oliveira C, Lima-Costa MF, Alexandre TDS. Does undiagnosed diabetes mitigate the association between diabetes and cognitive impairment? Findings from the ELSI-Brazil study. J Diabetes 2020; 12:834-843. [PMID: 32478972 DOI: 10.1111/1753-0407.13074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 05/04/2020] [Accepted: 05/25/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment. However, most of the evidence has been based on self-reported T2DM, and undiagnosed diabetes has not been considered as a separate category. We aimed to examine the extent to which undiagnosed diabetes modifies the association between diabetes and cognitive impairment in a representative sample of Brazilian adults aged 50 years and older. METHODS We analyzed baseline data from 1944 participants of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) conducted from 2015 to 2016. Diabetes was evaluated based on self-reported doctor diagnosis and glycosylated hemoglobin levels. Participants were classified as diabetics (D), undiagnosed diabetics (UDD), or nondiabetics (ND). Cognitive function was assessed by word list learning and verbal fluency tests. Three multiple logistic regression models were used to evaluate the changes in the strength of the associations. RESULTS Participants with diabetes had 49% greater odds of exhibiting impaired memory than nondiabetics (odds ratio [OR] = 1.49; 95% CI: 1.01-2.20). By combining UDD and ND, the association between diabetes and impaired memory was attenuated by 2.0%, losing its statistical significance (OR = 1.46; 95% CI: 0.98-2.17). By combining UDD and D, the association was attenuated by 7.4% (OR = 1.38; 95% CI: 1.01-1.90). No significant association was found between T2DM and impaired verbal fluency. CONCLUSION This study found an association between T2DM and impaired memory but not with impaired verbal fluency. When UDD individuals are considered diabetics, this association is attenuated; when UDD individuals are considered as ND, this association is attenuated to the extent that it loses its statistical significance, affecting thus the clinical interpretation.
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Affiliation(s)
- Natália Cochar-Soares
- Department of Gerontology, Graduate Program in Gerontology, Federal University of Sao Carlos, Brazil
| | - Danilo H T de Carvalho
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Sao Carlos, Brazil
| | | | - Erico Castro-Costa
- René Rachou Research Center, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Maria F Lima-Costa
- René Rachou Research Center, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Tiago da S Alexandre
- Department of Gerontology, Graduate Program in Gerontology, Federal University of Sao Carlos, Brazil
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Sao Carlos, Brazil
- Department of Epidemiology and Public Health, University College London, London, UK
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27
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Kuiper JS, Smidt N, Zuidema SU, Comijs HC, Oude Voshaar RC, Zuidersma M. A longitudinal study of the impact of social network size and loneliness on cognitive performance in depressed older adults. Aging Ment Health 2020; 24:889-897. [PMID: 30729792 DOI: 10.1080/13607863.2019.1571012] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objectives: To examine the association of social network size and loneliness with cognitive performance and -decline in depressed older adults.Method: A sample of 378 older adults [70.7 (7.4) years] with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of current depressive disorder were recruited from primary care and specialized mental health care. Cognitive performance was assessed at baseline and 2 years follow-up with the Stroop colored-word test, a modified version of the Auditory Verbal Learning Task and the Digit Span subtest from the Wechsler Adult Intelligence Scale, encompassing four cognitive domains; processing speed, interference control, memory, and working memory. Social network size was assessed with the Close Person Inventory and loneliness with the de Jong Gierveld Loneliness Scale at baseline.Results: After adjusting for baseline working memory performance, loneliness was associated with impaired working memory after 2 years [B = -0.08 (-0.17 to 0.00)]. This association was no longer significant after adjusting for age, sex, education level, physical activity, alcohol use and depressive symptom severity [B = -0.07 (-0.16 to 0.03)]. A backward elimination procedure revealed education level to be the only covariable to explain this association. Loneliness was not associated with impairments or decline in other cognitive domains. Social network size was not associated with cognitive impairments or decline.Conclusion: Social network size and loneliness do not predict cognitive decline in depressed older adults.
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Affiliation(s)
- Jisca S Kuiper
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Geriatrics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sytse U Zuidema
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hannie C Comijs
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Richard C Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marij Zuidersma
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Hudon C, Escudier F, De Roy J, Croteau J, Cross N, Dang-Vu TT, Zomahoun HTV, Grenier S, Gagnon JF, Parent A, Bruneau MA, Belleville S. Behavioral and Psychological Symptoms that Predict Cognitive Decline or Impairment in Cognitively Normal Middle-Aged or Older Adults: a Meta-Analysis. Neuropsychol Rev 2020; 30:558-579. [PMID: 32394109 DOI: 10.1007/s11065-020-09437-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/30/2020] [Indexed: 12/12/2022]
Abstract
Epidemiological studies have revealed that behavioral and psychological (or non-cognitive) symptoms are risk factors for cognitive decline in older adults. This study aimed to systematically review the literature and determine which behavioral and psychological symptoms are most predictive of future cognitive decline among individuals with no pre-existing cognitive impairments. The selected studies included middle-aged or older adults without cognitive impairments. The predictors were assessed using behavioral and psychological questionnaires, or diagnostic interviews, to identify non-cognitive symptoms or psychiatric clinical conditions. The follow-up period was at least one year, and the design of the selected studies was either retrospective or prospective. This study compared individuals with and without non-cognitive manifestations and resulted in one of three outcomes: (a) a score change on a cognitive measure, (b) a diagnosis of mild cognitive impairment, or (c) a diagnosis of Alzheimer's disease or dementia. Four online databases were searched for eligible studies from the database inception to January 17, 2017: MEDLINE (PubMed), Embase (OVID), PsycINFO, and Web of Science. Pooled effect sizes were estimated using a random-effect model. Higgins I2, the Q statistic, and tau-squared were used to quantify the observed heterogeneity between the studies. Results indicate that depression and sleep duration (long and short) were the most consistent associations between behavioral or psychological symptoms and cognitive decline. This meta-analysis supports the need to assess behavioral and psychological symptoms in cognitively intact older adults to identify those who are at risk for cognitive decline.
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Affiliation(s)
- Carol Hudon
- École de psychologie, Université Laval, 2601, ch. de la Canardière (F-2400), Québec, QC, G1J 2G3, Canada. .,CERVO Brain Research Centre, Québec, QC, Canada.
| | - Frédérique Escudier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Jessie De Roy
- Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada.,Centre de recherche, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NÎM, Montréal, QC, Canada
| | - Jordie Croteau
- Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit, Université Laval, Québec, QC, Canada.,Population Health and Practice-Changing Research Group, Research Centre of CHU de Québec-Université Laval, Québec, QC, Canada
| | - Nathan Cross
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Department of Health, Kinesiology and Applied Physiology, Concordia University, Montréal, QC, Canada
| | - Thien Thanh Dang-Vu
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Department of Health, Kinesiology and Applied Physiology, Concordia University, Montréal, QC, Canada
| | - Hervé Tchala Vignon Zomahoun
- Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit, Université Laval, Québec, QC, Canada.,Population Health and Practice-Changing Research Group, Research Centre of CHU de Québec-Université Laval, Québec, QC, Canada
| | - Sébastien Grenier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université de Montréal, Montréal, QC, Canada
| | - Jean-François Gagnon
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada.,Centre de recherche, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NÎM, Montréal, QC, Canada
| | | | - Marie-Andrée Bruneau
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychiatrie, Université de Montréal, Montréal, QC, Canada
| | - Sylvie Belleville
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université de Montréal, Montréal, QC, Canada
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de Carvalho DHT, Scholes S, Santos JLF, de Oliveira C, Alexandre TDS. Does Abdominal Obesity Accelerate Muscle Strength Decline in Older Adults? Evidence From the English Longitudinal Study of Ageing. J Gerontol A Biol Sci Med Sci 2020; 74:1105-1111. [PMID: 30107482 PMCID: PMC6580692 DOI: 10.1093/gerona/gly178] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Indexed: 12/25/2022] Open
Abstract
Background Cross-sectional evidence has shown an association between abdominal obesity and lower muscle strength in older adults. However, no longitudinal findings have confirmed this association. In addition, the impact of abdominal fat on the reduction in muscle strength is not yet fully understood. Methods We investigated the longitudinal associations between abdominal obesity and handgrip strength in 5,181 older adults from the English Longitudinal Study of Ageing over 8 years of follow-up. Muscular strength was measured using a manual dynamometer. Abdominal obesity was defined as a waist circumference >102 cm for men and >88 cm for women. Generalized linear mixed models were adjusted by measures of socioeconomic status, health conditions, lifestyle, cognition, depressive symptoms, biomarkers, and disability. Results At baseline, the mean age of participants was 65.8 years and their mean waist circumference and body mass index (BMI) were 95 cm and 27.7 kg/m2, respectively. Fully adjusted models showed that abdominal obese men and women had stronger muscle strength at baseline. The decline over time in muscle strength was accelerated in abdominal obese men (−0.12 kg/year, 95% confidence interval: −0.24 to −0.01) compared with nonabdominal obese. This association was not found in women. Comparative analyses showed that overweight men according to their BMI were not at greater risk of muscle strength decline. However, these men were at risk based on their waist circumference. Conclusions Abdominal obesity is associated with accelerated muscle strength decline in men.
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Affiliation(s)
| | - Shaun Scholes
- Department of Epidemiology and Public Health, University College London, UK
| | | | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, UK
| | - Tiago da Silva Alexandre
- Department of Physical Therapy, Federal University of Sao Carlos, Brazil.,Department of Gerontology, Federal University of Sao Carlos, Brazil
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Bell G, John A, Gaysina D. Affective symptoms across the life course and resilience in cognitive function. Ann Hum Biol 2020; 47:116-124. [DOI: 10.1080/03014460.2020.1745886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Georgia Bell
- School of Psychology, University of Sussex, Brighton, UK
| | - Amber John
- School of Psychology, University of Sussex, Brighton, UK
| | - Darya Gaysina
- School of Psychology, University of Sussex, Brighton, UK
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Wu CR, Chen PY, Hsieh SH, Huang HC, Chen YT, Chen TJ, Chiu HY. Sleep Mediates the Relationship Between Depression and Cognitive Impairment in Older Men. Am J Mens Health 2019; 13:1557988319825765. [PMID: 30819067 PMCID: PMC6440061 DOI: 10.1177/1557988319825765] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Sleep and depression are strongly associated with cognitive impairment. The role of sleep disturbances in the adverse effect of depression on cognitive dysfunction in older adults remains unclear. This study explored the mediating effect of self-reported sleep disturbances on the relationship between depression and cognitive impairment in older adults according to sex differences. This study derived data from the 2009 Taiwan National Health Interview Survey and included 2,175 community-dwelling adults aged 65 years and older (men = 991; women = 1,184). Sleep disturbances were measured using self-reported survey questions. The Center for Epidemiological Studies Depression scale was used to assess depression. The Mini-Mental State Examination was used to evaluate cognitive impairment. A higher proportion of female older persons had cognitive impairment and depression than male older persons (cognition: 24.4% vs. 11.5%; depression: 17.0% vs. 10.8%). The meditating effect of sleep was detected in only men. Difficulty in initiating sleep was a complete mediator of the adverse effect of depression on cognitive impairment (Sobel test: p = .03). In summary, difficultly in initiating sleep may be a crucial, treatable mediator of the adverse effect of depression on cognitive impairment in older men.
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Affiliation(s)
- Chia-Rung Wu
- 1 Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,2 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Pin-Yuan Chen
- 3 Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung, Taiwan.,4 School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shu-Hua Hsieh
- 1 Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Hui-Chuan Huang
- 2 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yu-Ting Chen
- 5 School of Nursing, Chang Gung University, Taoyuan, Taiwan
| | - Ting-Jhen Chen
- 2 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Yean Chiu
- 2 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,6 Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Zuidersma M, Sjöberg L, Pantzar A, Fratiglioni L, Wang HX. A bi-factor model of the Montgomery Åsberg depression rating scale and future cognitive impairments in older adults: A 6-year follow-up study. J Psychiatr Res 2019; 109:1-9. [PMID: 30453181 DOI: 10.1016/j.jpsychires.2018.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 10/15/2018] [Accepted: 11/09/2018] [Indexed: 11/15/2022]
Abstract
Depression has been found to be associated with cognitive decline. This study evaluated the association of general depressive symptoms and motivational-related symptoms with cognitive impairment 6 years later and to explore the role of potential underlying mechanisms. In 2690 cognitively healthy persons aged ≥60 from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) depressive symptoms were derived from the Montgomery Åsberg Depression Rating Scale (MADRS). Cognitive performance was assessed at baseline and 6 years later in 1810 persons with the Mini Mental State Examination (global cognition), Digit Span Forward (short-term memory), Digit Span Backward (working memory), Clock-test (visuospatial construction), and the 5-item test (immediate and delayed recall). Bi-factor analysis on the MADRS yielded a General Depression factor and an unrelated Motivational factor. After adjusting for demographics, the General Depression factor was only associated with 6-year impairment in delayed recall (OR (95% CI): 1.18 (1.04-1.34)). This association was no longer significant after adjusting for demographics, cardiovascular risk, lifestyle factors and medication use. The Motivational factor was not significantly associated with future cognitive impairments after adjusting for demographics. Concluding, almost all associations of general depressive symptoms and motivational-related symptoms with future cognitive impairments appeared to be confounded by demographics. Only the association of general depressive symptoms with future memory impairments appeared to be explained by a combination of demographics, cardiovascular risk, lifestyle and medication use.
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Affiliation(s)
- Marij Zuidersma
- University Center of Psychiatry & Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Linnea Sjöberg
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | | | - Laura Fratiglioni
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Hui-Xin Wang
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stress Research Institute, Stockholm University, Sweden.
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Choi EY, Kim YS, Lee HY, Shin HR, Park S, Cho SE. The moderating effect of subjective age on the association between depressive symptoms and cognitive functioning in Korean older adults. Aging Ment Health 2019; 23:38-45. [PMID: 29052424 DOI: 10.1080/13607863.2017.1390733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Depressive symptoms are greatly associated with cognitive impairment in older adults. Recent growing body of literature has reported that the subjective perception of one's own age (subjective age) predicts both cognitive performance and mental well-being in old age. This study aims to examine whether subjective age moderates the association between depressive symptoms and cognitive functioning in a representative sample of Korean older adults. To address this research question, we employed the Stereotype-Embodiment Theory as a theoretical guide. METHOD Data are from the 2016 Dementia Literacy Survey collected by Kyung Hee University, and 526 community-dwelling Korean older adults (ages 60-79) completed the questionnaire about depressive symptoms, cognitive functioning, and subjective age. RESULTS According to the hierarchical regression analysis, both higher levels of depressive symptoms and older subjective age were associated with poorer cognitive functioning. Further analyses showed that subjective age attenuated the effect of depressive symptoms on cognitive functioning: when older adults have a higher level of depression, those with younger subjective age reported a higher level of cognitive functioning than those with older subjective age. CONCLUSION Based on the findings from this study, both theoretical and practical implications were discussed.
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Affiliation(s)
- Eun Young Choi
- a Graduate School of East-West Medical Science , Kyung Hee University , Yongin-si , Republic of Korea
| | - Young Sun Kim
- a Graduate School of East-West Medical Science , Kyung Hee University , Yongin-si , Republic of Korea
| | - Hee Yun Lee
- b School of Social Work , University of Minnesota , St. Paul , MN , USA
| | - Hye Ri Shin
- a Graduate School of East-West Medical Science , Kyung Hee University , Yongin-si , Republic of Korea
| | - SeolWoo Park
- a Graduate School of East-West Medical Science , Kyung Hee University , Yongin-si , Republic of Korea
| | - Sung Eun Cho
- a Graduate School of East-West Medical Science , Kyung Hee University , Yongin-si , Republic of Korea
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James SN, Davis D, O'Hare C, Sharma N, John A, Gaysina D, Hardy R, Kuh D, Richards M. Lifetime affective problems and later-life cognitive state: Over 50 years of follow-up in a British birth cohort study. J Affect Disord 2018; 241:348-355. [PMID: 30144717 PMCID: PMC6137547 DOI: 10.1016/j.jad.2018.07.078] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/27/2018] [Accepted: 07/27/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Affective problems increase the risk of dementia and cognitive impairment, yet the life course dimension of this association is not clearly understood. We aimed to investigate how affective problems across the life course relate to later-life cognitive state. METHODS Data from 1269 participants from the Medical Research Council National Survey of Health and Development (NSHD, the British 1946 birth cohort) were used. Prospectively-assessed measures of affective symptoms spanning ages 13-69 and categorised into case-level thresholds. Outcomes consisted of a comprehensive measure of cognitive state (Addenbrooke's Cognitive Examination (ACE-III)), verbal memory, and letter search speed and accuracy at age 69. RESULTS Complementary life course models demonstrated that having 2 or more case-level problems across the life course was most strongly associated with poorer cognitive outcomes, before and after adjusting for sex, childhood cognition, childhood and midlife occupational position and education. LIMITATIONS A disproportionate loss to follow-up of those who had lower childhood cognitive scores may have led to underestimation of the strength of associations. DISCUSSION Using a population-based prospective study we provide evidence that recurrent lifetime affective problems predicts poorer later-life cognitive state, and this risk can be already manifest in early old age (age 69). Our findings raise the possibility that effective management to minimise affective problems reoccurring across the life course may reduce the associated risk of cognitive impairment and decline.
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Affiliation(s)
- Sarah-Naomi James
- MRC Unit for Lifelong Health and Aging at UCL, 33 Bedford Place, WC1B 5JU, London, United Kingdom
| | - Daniel Davis
- MRC Unit for Lifelong Health and Aging at UCL, 33 Bedford Place, WC1B 5JU, London, United Kingdom
| | - Celia O'Hare
- MRC Unit for Lifelong Health and Aging at UCL, 33 Bedford Place, WC1B 5JU, London, United Kingdom
| | - Nikhil Sharma
- MRC Unit for Lifelong Health and Aging at UCL, 33 Bedford Place, WC1B 5JU, London, United Kingdom
| | - Amber John
- EDGE Lab, School of Psychology, University of Sussex, BN1 9RH, Brighton, United Kingdom
| | - Darya Gaysina
- EDGE Lab, School of Psychology, University of Sussex, BN1 9RH, Brighton, United Kingdom
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Aging at UCL, 33 Bedford Place, WC1B 5JU, London, United Kingdom
| | - Diana Kuh
- MRC Unit for Lifelong Health and Aging at UCL, 33 Bedford Place, WC1B 5JU, London, United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Aging at UCL, 33 Bedford Place, WC1B 5JU, London, United Kingdom.
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Gallagher D, Kiss A, Lanctot KL, Herrmann N. Toward Prevention of Mild Cognitive Impairment in Older Adults With Depression: An Observational Study of Potentially Modifiable Risk Factors. J Clin Psychiatry 2018; 80:18m12331. [PMID: 30549490 PMCID: PMC6296258 DOI: 10.4088/jcp.18m12331] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/29/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Late-life depression has been associated with increased risk of mild cognitive impairment (MCI) and dementia. Predictors of increased risk are incompletely understood. Identification of potentially modifiable risk factors could facilitate prevention of MCI and dementia. This study aimed to determine which clinical characteristics are associated with increased risk of MCI among older adults with depression and normal cognition at baseline. METHODS Data from the National Alzheimer's Coordinating Center dataset were used. Study participants who attended a participating Alzheimer's Disease Center from September 2005 through September 2017 with normal cognition and a history of clinically defined depression (broadly based on DSM criteria) were followed until first diagnosis of MCI (or dementia when MCI was not diagnosed). RESULTS A total of 2,655 study participants were followed for a median duration of 41.8 months. Of these, 586 (22.1%) developed either MCI (n = 509, 19.2%) or dementia (n = 77, 2.9%). In survival analyses, cognitive decline was associated with age, sex, education, baseline cognition, and several potentially modifiable risk factors including vascular risk factors, hearing impairment, vitamin B₁₂ deficiency, active depression within the last 2 years, and increased severity of depression. In an adjusted survival analysis, the only variables that remained significantly associated with development of MCI or dementia were female sex (HR = 0.72; 95% CI, 0.59-0.88), higher education (HR = 0.96; 95% CI, 0.93-0.99), and higher baseline cognition (HR = 0.87; 95% CI, 0.82-0.93), which were associated with reduced risk, and older age (HR = 1.07; 95% CI, 1.05-1.08), active depression within the last 2 years (HR = 1.41; 95% CI, 1.15-1.74), and increased severity of depression (HR = 1.05; 95% CI, 1.02-1.09), which were associated with increased risk. CONCLUSIONS Development of MCI is associated with several potentially modifiable risk factors in older adults with depression. Future studies should determine whether active management of risk factors could reduce incidence of MCI in this vulnerable population.
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Affiliation(s)
- Damien Gallagher
- Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, Ontario M4N 3M5. .,Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada
| | - Alex Kiss
- Sunnybrook Research Institute and Department of Health Policy, Management and Evaluation, University of Toronto
| | - Krista L Lanctot
- Sunnybrook Research Institute and Departments of Psychiatry, Pharmacology and Toxicology, University of Toronto
| | - Nathan Herrmann
- Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre & University of Toronto
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Portellano-Ortiz C, Garre-Olmo J, Calvó-Perxas L, Conde-Sala JL. Factor structure of depressive symptoms using the EURO-D scale in the over-50s in Europe. Findings from the SHARE project. Aging Ment Health 2018; 22:1477-1485. [PMID: 28856915 DOI: 10.1080/13607863.2017.1370688] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aims of this study are: to analyze the factor structure of the EURO-D depression scale; to explore the variables associated with depressive symptoms in the total sample and in the EURO-D factors; and to compare the presence of depressive symptoms and the factor distribution in 15 European countries. METHOD 62,182 participants in Wave 5 (2013) of the Survey of Health, Aging and Retirement in Europe (SHARE) were included. INSTRUMENTS The SHARE study and the EURO-D scale. Factor, bivariate and multilevel analyses were performed. RESULTS Higher levels of depressive symptoms were associated with a poorer self-perception of physical health (η2 = 0.22) and economic difficulties (η2 = 0.07). Factor analysis of the EURO-D identified two factors: Suffering and Motivation. Higher levels of depressive symptoms were associated with female gender and younger age (≤60) in the Suffering factor, and with less activity and exercise, older age (≥71), widowhood and lower educational level in the Motivation factor. Poorer self-perception of physical health and economic difficulties were associated with higher depressive symptomatology in both factors. CONCLUSIONS Poorer self-perception of physical health, female gender, economic difficulties, widowhood, lower levels of activity and exercise and lower educational level were associated with higher depressive symptomatology. In the countries of southern Europe, the Motivation factor predominated.
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Affiliation(s)
- Cristina Portellano-Ortiz
- a Department of Cognition, Development and Educational Psychology, Faculty of Psychology , University of Barcelona , Barcelona , Spain
| | - Josep Garre-Olmo
- b Research Unit , Girona Biomedical Research Institute (IDIBGI) , Institut d'Assistència Sanitària , Salt , Spain.,c Department of Medical Sciences , University of Girona , Girona , Spain
| | - Laia Calvó-Perxas
- b Research Unit , Girona Biomedical Research Institute (IDIBGI) , Institut d'Assistència Sanitària , Salt , Spain
| | - Josep Lluís Conde-Sala
- a Department of Cognition, Development and Educational Psychology, Faculty of Psychology , University of Barcelona , Barcelona , Spain.,b Research Unit , Girona Biomedical Research Institute (IDIBGI) , Institut d'Assistència Sanitària , Salt , Spain
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Gallagher D, Kiss A, Lanctot K, Herrmann N. Depression and Risk of Alzheimer Dementia: A Longitudinal Analysis to Determine Predictors of Increased Risk among Older Adults with Depression. Am J Geriatr Psychiatry 2018; 26:819-827. [PMID: 29960668 PMCID: PMC6101977 DOI: 10.1016/j.jagp.2018.05.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/02/2018] [Accepted: 05/02/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Older adults with depression are at increased risk of Alzheimer dementia, but predictors of increased risk remain incompletely understood. We aim to identify characteristics of older adults with depression most at risk of progressing to Alzheimer dementia. Identification of high-risk subgroups could facilitate future interventional strategies to reduce risk of Alzheimer dementia in older adults with depression. METHODS Using data from the National Alzheimer's Coordinating Center, 1,965 participants with clinically defined depression and mild cognitive impairment at baseline were followed until development of Alzheimer dementia or loss to follow-up. RESULTS Seven hundred and eighty (39.7%) developed Alzheimer dementia over a median follow-up duration of 27 months. In survival analyses, age (hazard ratio [HR] 1.04, 95% 1.03-1.05), baseline Mini-Mental State Exam (HR 0.85, 95% confidence interval 0.83-0.87), amnestic subtype of mild cognitive impairment (HR 1.66, 95% 1.30-2.12), presence of APOE4 allele (HR 1.99, 1.69-2.36), and presence of active depression within the last two years (HR 1.44, 95% confidence interval 1.16-1.79) were all independently associated with increased risk of Alzheimer dementia. Six hundred and fifty-six (41.7%) participants with mild cognitive impairment and active depression within the last two years developed Alzheimer dementia compared to 120 (31.6%) of those with a more remote history of depression. CONCLUSION Older adults with depression and mild cognitive impairment demonstrated a high rate of progression to Alzheimer dementia over a relatively short duration of follow-up. Individuals with a combination of mild cognitive impairment and recently active depression are a particularly high-risk subgroup.
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Affiliation(s)
- Damien Gallagher
- Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada.
| | - Alex Kiss
- Sunnybrook Research Institute and Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Krista Lanctot
- Sunnybrook Research Institute and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Research Institute and Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Research Institute and Department of Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada
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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]
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Ou R, Wei Q, Hou Y, Yuan X, Song W, Cao B, Liu H, Zhang L, Chen Y, Shang H. Vascular risk factors and depression in Parkinson's disease. Eur J Neurol 2018; 25:637-643. [PMID: 29271534 DOI: 10.1111/ene.13551] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 12/18/2017] [Indexed: 02/05/2023]
Affiliation(s)
- R. Ou
- Department of Neurology; West China Hospital; Sichuan University; Chengdu Sichuan China
| | - Q. Wei
- Department of Neurology; West China Hospital; Sichuan University; Chengdu Sichuan China
| | - Y. Hou
- Department of Neurology; West China Hospital; Sichuan University; Chengdu Sichuan China
| | - X. Yuan
- Department of Neurology; West China Hospital; Sichuan University; Chengdu Sichuan China
| | - W. Song
- Department of Neurology; West China Hospital; Sichuan University; Chengdu Sichuan China
| | - B. Cao
- Department of Neurology; West China Hospital; Sichuan University; Chengdu Sichuan China
| | - H. Liu
- Department of Neurology; West China Hospital; Sichuan University; Chengdu Sichuan China
| | - L. Zhang
- Department of Neurology; West China Hospital; Sichuan University; Chengdu Sichuan China
| | - Y. Chen
- Department of Neurology; West China Hospital; Sichuan University; Chengdu Sichuan China
| | - H. Shang
- Department of Neurology; West China Hospital; Sichuan University; Chengdu Sichuan China
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Doiron M, Langlois M, Dupré N, Simard M. The influence of vascular risk factors on cognitive function in early Parkinson's disease. Int J Geriatr Psychiatry 2018; 33:288-297. [PMID: 28509343 DOI: 10.1002/gps.4735] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 04/10/2017] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Hypertension, dyslipidemia, diabetes, and obesity are well-established risk factors for cognitive impairment and dementia in older adults. In contrast, previous studies that have assessed the impact of vascular risk factors (VRFs) on cognition in Parkinson's disease (PD) have had methodological limitations and reported conflicting findings. We address this question in a large well-characterized cohort of de novo PD patients. METHODS A total of 367 untreated and non-demented patients aged 50 years and older with early PD (H&Y = 1.0-2.0) underwent a comprehensive clinical and neuropsychological assessment at baseline and 24 months later. A series of linear mixed models were used to determine the effects of VRFs on cognition while controlling for patient and disease characteristics. The outcomes included norm-referenced Z-scores of global cognition, visuospatial skills, verbal episodic memory, semantic verbal fluency, attention, and working memory tests. RESULTS A longer history of hypertension and a higher pulse pressure were significant predictors of lower Z-scores on immediate and delayed free recall, recognition, and verbal fluency tests. On average, every 10 mmHg increase in pulse pressure was associated with a 0.08 reduction on the cognitive Z-scores. The effects were independent of age, education, disease duration, motor impairment, medication, and depressive symptoms. Other VRFs were not associated with cognitive outcomes. CONCLUSIONS Our results are consistent with previous studies suggesting that hypertension exerts a detrimental effect on memory and verbal fluency in early PD. Management of blood pressure and cardiovascular health may be important to reduce risk of cognitive decline in PD. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Maxime Doiron
- School of Psychology, Laval University, Quebec City, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Quebec City, Canada.,Faculty of Medicine, Laval University, Quebec City, Canada
| | - Mélanie Langlois
- Faculty of Medicine, Laval University, Quebec City, Canada.,Department of Neurological Sciences, CHU de Québec (Enfant-Jésus), Quebec City, Canada
| | - Nicolas Dupré
- Faculty of Medicine, Laval University, Quebec City, Canada.,Department of Neurological Sciences, CHU de Québec (Enfant-Jésus), Quebec City, Canada
| | - Martine Simard
- School of Psychology, Laval University, Quebec City, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Quebec City, Canada
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Sun M, Lanctot K, Herrmann N, Gallagher D. Exercise for Cognitive Symptoms in Depression: A Systematic Review of Interventional Studies. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:115-128. [PMID: 29186973 PMCID: PMC5788135 DOI: 10.1177/0706743717738493] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To explore the effect of exercise on cognition in depression as well as the impact of potential moderators and intervention type. METHOD Controlled and uncontrolled interventional studies that described an exercise intervention and cognitive outcomes in participants with major depressive disorder (MDD) were included following a search of Pubmed, Ovid Medline, PsycInfo and Embase from inception to January 2017. Meta-analyses were conducted to calculate Hedges' g using a random-effects model. Meta-regression explored the relationships among age, baseline cognition, frequency and duration of exercise, and cognitive outcomes. Subgroup analyses were also conducted according to type and intensity of exercise interventions. RESULTS Of 12 controlled studies and 3 uncontrolled studies that met inclusion criteria, 9 (642 patients) were included in the meta-analysis. No significant effect of exercise was found on global cognition (Hedges' g = 0.08, P = 0.33, I2 = 0%) or on individual cognitive domains. Meta-regression analyses failed to find significant relationships among participant age, baseline cognition, number of exercise sessions per wk, duration of exercise per wk, total duration of exercise during the intervention, or improvement in global cognition. Interventions combining physical with cognitive activity significantly improved global cognition ( P = 0.048), whereas low-intensity interventions were also positive ( P = 0.048). CONCLUSIONS No impact of physical exercise was found on cognition in MDD overall. However, we found that interventions combining physical and cognitive activities had a positive impact, and that lower-intensity interventions, where adherence was improved, also impacted positively. There remains a lack of high-quality data in this population.
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Affiliation(s)
- Meng Sun
- Department of Psychiatry, The Second Xianga Hospital, Central South University, Changsha, Hunan, China
- China National Clinical Research Center on Mental Health Disorders (Xiangya), Changsha, Hunan, China
- China National Technology Institute on Mental Disorders, Changsha, Hunan, China
- Hunan Technology Institute of Psychiatry, Changsha, Hunan, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
- Mental Health Institute of Central South University, Changsha, Hunan, China
- Division of Geriatric Psychiatry, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Krista Lanctot
- Medical Outcome and Research in Economics Group (MORE), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry and Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Damien Gallagher
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Shea TB, Remington R. Apparent Cognitive Decline as Revealed by an Executive Function Test within a Cohort of Elderly Individuals Self-Reporting Normal Cognitive Performance. J Alzheimers Dis 2018; 61:913-915. [PMID: 29332053 DOI: 10.3233/jad-170794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Alzheimer's disease (AD) can be preceded by subtle memory decline that can last a decade or more before progressing to what would be diagnosed as the mild cognitive impairment stage. During this early stage of decline, individuals and even their caregivers can fail to perceive any serious difficulty or need to consult a physician. Herein, we present evidence in support of these concerns, and demonstrate how this can interfere not only with clinical trials of AD but also those involving cognitive performance of elderly individuals without intentional reference to AD.
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Affiliation(s)
- Thomas B Shea
- Department of Biological Sciences, UMass Lowell, Lowell, MA, USA
| | - Ruth Remington
- Department of Nursing, Framingham State University, Framingham, MA, USA
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Su X, Huang X, Jin Y, Wan S, Han Z. The relationship of individual social activity and cognitive function of community Chinese elderly: a cross-sectional study. Neuropsychiatr Dis Treat 2018; 14:2149-2157. [PMID: 30197518 PMCID: PMC6113942 DOI: 10.2147/ndt.s160036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The prevention of cognitive impairment is a crucial public health issue, and leisure activities have been studied as the strategy of the cognitive preservation. The aim of the study was to explore the possible relationship between social activity and cognitive function among community-dwelling Chinese elderly in two big cities of Southern China. PARTICIPANTS AND METHODS Altogether, 557 nondemented older adults aged 60 years and older (73.4±6.5 years) were recruited in the social centers in Hong Kong and Guangzhou. A leisure activity questionnaire was used to measure the social activity participation. Cognitive function was examined using a neuropsychological battery. The association between social activity and cognitive function was analyzed using the multiple linear regression analysis. RESULTS Social activities had a weak relationship with cognitive performance when measured in terms of overall participation. Attending an interest class had significant association with the Cantonese version of Mini Mental State Examination, the word list learning test, the delayed recall test, and the trail making test. Religious activity showed significant association with the word list learning test and the digit vigilance test. Singing had significant association with the Category Verbal Fluency Test (CVFT) and the trail making test. CONCLUSION Some individual social activity items may be associated with better cognitive function among the community Chinese elderly independently of other factors.
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Affiliation(s)
- Xiufang Su
- Department of Psychiatry, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Xingbing Huang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, People's Republic of China
| | - Yu Jin
- Faculty of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Shouwen Wan
- Guangzhou Dr Su Health Industry (Group) Co., Ltd, Guangzhou, People's Republic of China
| | - Zili Han
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China,
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Veronese N, Solmi M, Maggi S, Noale M, Sergi G, Manzato E, Prina AM, Fornaro M, Carvalho AF, Stubbs B. Frailty and incident depression in community-dwelling older people: results from the ELSA study. Int J Geriatr Psychiatry 2017; 32:e141-e149. [PMID: 28195361 DOI: 10.1002/gps.4673] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 01/10/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Frailty and pre-frailty are two common conditions in the older people, but whether these conditions could predict depression is still limited to a few longitudinal studies. In this paper, we aimed to investigate whether frailty and pre-frailty are associated with an increased risk of depression in a prospective cohort of community-dwelling older people. METHODS Four thousand seventy-seven community-dwelling men and women over 60 years without depression at baseline were included from the English Longitudinal Study of Ageing. Frailty status was defined according to modified Fried's criteria (weakness, weight loss, slow gait speed, low physical activity and exhaustion) and categorized as frailty (≥3 criteria), pre-frailty (1-2 criteria) or robustness (0 criterion). Depression was diagnosed as ≥4 out of 8 points of Center for Epidemiologic Studies Depression Scale, after 2 years of follow-up. RESULTS Over a 2-year follow-up, 360 individuals developed depression. In a logistic regression analysis, adjusted for 18 potential baseline confounders, pre-frailty (odds ratio (OR) = 0.89; 95% confidence interval (CI), 0.54-1.46; p = 0.64) and frailty (OR = 1.22; 95% CI, 0.90-1.64; p = 0.21) did not predict the onset of depression at follow-up. Among the criteria included in the frailty definition, only slow gait speed (OR = 1.82; 95% CI, 1.00-3.32; p = 0.05) appeared to predict a higher risk of depression. CONCLUSIONS Among older community dwellers, frailty and pre-frailty did not predict the onset of depression during 2 years of follow-up, when accounting for potential confounders, whilst slow gait speed considered alone may predict depression in the older people. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Nicola Veronese
- Department of Medicine DIMED, Geriatrics Division, University of Padua, Padua, Italy.,Institute of Clinical Research and Education in Medicine (IREM), Padua, Italy.,National Research Council, Neuroscience Institute, Padua, Italy
| | - Marco Solmi
- Institute of Clinical Research and Education in Medicine (IREM), Padua, Italy.,Department of Neuroscience, University of Padua, Padua, Italy
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Padua, Italy
| | - Marianna Noale
- National Research Council, Neuroscience Institute, Padua, Italy
| | - Giuseppe Sergi
- Department of Medicine DIMED, Geriatrics Division, University of Padua, Padua, Italy
| | - Enzo Manzato
- Department of Medicine DIMED, Geriatrics Division, University of Padua, Padua, Italy.,National Research Council, Neuroscience Institute, Padua, Italy
| | - A Matthew Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Michele Fornaro
- New York Psychiatric Institute, Columbia University, New York, NY, USA
| | - André F Carvalho
- Translational Psychiatry Research Group, Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Brendon Stubbs
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
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Gallagher D, Kiss A, Lanctot K, Herrmann N. Depression with inflammation: longitudinal analysis of a proposed depressive subtype in community dwelling older adults. Int J Geriatr Psychiatry 2017; 32:e18-e24. [PMID: 27911015 DOI: 10.1002/gps.4645] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 11/09/2016] [Accepted: 11/16/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE It has been proposed that inflammation may be causally related to depression. If this is the case, it may be possible to distinguish an inflammatory depressive subtype according to illness course, pattern of co-morbidity and symptom profile. METHODS Eight hundred and eleven community dwelling older adults with depression (8 item Center for Epidemiologic Studies scale ≥ 4) from the English Longitudinal study of Ageing (ELSA) were followed for a median of 47 months. Participants with depression and inflammation (C Reactive Protein > 3 mg/l) were compared to those with depression alone. RESULTS In a longitudinal analysis, depression with associated inflammation was more likely to persist over time. This association was independent of baseline depression severity and medical co-morbidity (OR 1.47 95% CI 1.03 - 2.10, p = 0.034) but was no longer significant following further adjustment for body mass index (OR 1.37 95% CI 0.94 - 2.01, p = 0.106). Inflammation either partially or completely mediated the association between medical co-morbidity, body mass index and depression at follow-up. Depression with inflammation was associated with more amotivation, less sadness, greater medical co-morbidity and higher body mass index. CONCLUSIONS Our findings provide some support for an inflammatory contribution to depression. This subgroup has a worse prognosis and may benefit from interventions targeting co-morbidity, body mass index and associated inflammation. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Damien Gallagher
- Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada
| | - Alex Kiss
- Sunnybrook Research Institute and Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Krista Lanctot
- Sunnybrook Research Institute and Departments of Psychiatry, Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada
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Tanji F, Sugawara Y, Tomata Y, Watanabe T, Sugiyama K, Kaiho Y, Tomita H, Tsuji I. Psychological distress and the incident risk of functional disability in elderly survivors after the Great East Japan Earthquake. J Affect Disord 2017. [PMID: 28646710 DOI: 10.1016/j.jad.2017.06.030] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND We conducted a prospective cohort study to investigate whether psychological distress would have increased the incident risk of functional disability after the 2011 Great East Japan Earthquake. METHODS First phase data pertaining to psychological distress and other lifestyle factors were collected from 1037 subjects aged ≥ 65 years, from June to December 2011, in four affected areas of Miyagi prefecture in Japan. Psychological distress was measured by the Kessler 6-item psychological distress scale (K6), and classified into three categories (K6 score ≤ 9, 10-12, ≥ 13). Outcome data on functional disability were collected from the public Long-term Care Insurance database. Participants were followed up for about 2.6 years. The Cox model was used to calculate the multivariate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS During the follow-up period, 118 participants were certified as incident disability (43.8 disability events per 1000 person-years). Compared with the lowest category (K6 score ≤ 9), participants in the highest category (K6 score ≥ 13) had a significantly higher risk of functional disability (HR = 2.65, 95% CI = 1.35-5.18, p = 0.002). In order to consider reverse causality, we conducted analysis excluding all incidents and deaths that occurred within the first year of follow-up, but our findings remained unchanged. LIMITATIONS We did not consider all potential confounders and use of appropriate medication. CONCLUSIONS The present study has demonstrated that psychological distress was associated with an increased risk of functional disability among elderly survivors of a natural disaster.
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Affiliation(s)
- Fumiya Tanji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan.
| | - Yumi Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Yasutake Tomata
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Takashi Watanabe
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Kemmyo Sugiyama
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Yu Kaiho
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Tomita
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
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Gallagher D, Fischer CE, Iaboni A. Neuropsychiatric Symptoms in Mild Cognitive Impairment. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2017; 62:161-169. [PMID: 28212495 PMCID: PMC5317015 DOI: 10.1177/0706743716648296] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Neuropsychiatric symptoms (NPS) may be the first manifestation of an underlying neurocognitive disorder. We undertook a review to provide an update on the epidemiology and etiological mechanisms of NPS that occur in mild cognitive impairment (MCI) and just before the onset of MCI. We discuss common clinical presentations and the implications for diagnosis and care. METHOD The authors conducted a selective review of the literature regarding the emergence of NPS in late life, before and after the onset of MCI. We discuss recent publications that explore the epidemiology and etiological mechanisms of NPS in the earliest clinical stages of these disorders. RESULTS NPS have been reported in 35% to 85% of adults with MCI and also occur in advance of cognitive decline. The occurrence of NPS for the first time in later life should increase suspicion for an underlying neurocognitive disorder. The presenting symptom may provide a clue regarding the etiology of the underlying disorder, and the co-occurrence of NPS may herald a more accelerated cognitive decline. CONCLUSIONS NPS are prevalent in the early clinical stages of neurocognitive disorders and can serve as both useful diagnostic and prognostic indicators. Recognition of NPS as early manifestations of neurocognitive disorders will become increasingly important as we move towards preventative strategies and disease-modifying treatments that may be most effective when deployed in the earliest stages of disease.
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Affiliation(s)
- Damien Gallagher
- 1 Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, Ontario.,2 Department of Psychiatry, University of Toronto, Toronto, Ontario
| | - Corinne E Fischer
- 2 Department of Psychiatry, University of Toronto, Toronto, Ontario.,3 Keenan Research Centre for Biomedical Research, The Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario.,4 Institute of Medical Sciences, University of Toronto, Toronto, Ontario
| | - Andrea Iaboni
- 2 Department of Psychiatry, University of Toronto, Toronto, Ontario.,5 Toronto Rehabilitation Institute and the Centre for Mental Health, University Health Network, Toronto, Ontario
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Moore K, O'Shea M, Hughes CF, Hoey L, Ward M, McNulty H. Current evidence linking nutrition with brain health in ageing. NUTR BULL 2017. [DOI: 10.1111/nbu.12250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- K. Moore
- Northern Ireland Centre for Food and Health; Ulster University Coleraine; Coleraine UK
| | - M. O'Shea
- Northern Ireland Centre for Food and Health; Ulster University Coleraine; Coleraine UK
| | - C. F. Hughes
- Northern Ireland Centre for Food and Health; Ulster University Coleraine; Coleraine UK
| | - L. Hoey
- Northern Ireland Centre for Food and Health; Ulster University Coleraine; Coleraine UK
| | - M. Ward
- Northern Ireland Centre for Food and Health; Ulster University Coleraine; Coleraine UK
| | - H. McNulty
- Northern Ireland Centre for Food and Health; Ulster University Coleraine; Coleraine UK
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Brunner EJ, Welch CA, Shipley MJ, Ahmadi-Abhari S, Singh-Manoux A, Kivimäki M. Midlife Risk Factors for Impaired Physical and Cognitive Functioning at Older Ages: A Cohort Study. J Gerontol A Biol Sci Med Sci 2017; 72:237-242. [PMID: 27271050 PMCID: PMC5233910 DOI: 10.1093/gerona/glw092] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 04/28/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Previous studies examined midlife risk factors separately for old-age impaired physical and cognitive functioning. We determined the overlap of risk factors for both domains of functioning within the same setting. METHODS Biological and behavioral risk factors at age 50 years and cognitive and physical functioning were assessed 18 (SD = 5) years later in the Whitehall II study (N = 6,316). Impaired physical functioning was defined as ≥1 limitation on the activities of daily living scale. Impaired cognitive functioning was defined as Mini-Mental State Examination score <27. Two statistical analyses were employed: minimally adjusted analysis (for age, sex, and ethnicity) and mutually adjusted analysis (including all risk factors). Missing data on risk factors were imputed. RESULTS After confounder adjustment, impaired physical and cognitive functioning at older ages were predicted by hypertension (odds ratios [ORs] 1.80 95% confidence interval [CI] 1.39-2.33 and 1.57 95% CI 1.07-2.31, respectively), poor lung function (1.51 95% CI 1.28-1.78 and 1.31 95% CI 1.08-1.59), and physical inactivity, marginally in the case of cognitive function (1.50 95% CI 1.19-1.90 and 1.27 95% CI 0.99-1.62) at age 50 years. Impaired physical functioning but not cognitive functioning was additionally predicted by depression and higher body mass index (1.72 95% CI 1.46-2.03 and 1.29 95% CI 1.16-1.44, respectively). CONCLUSIONS Several midlife risk factors are associated with impaired physical and cognitive functioning in old age, supporting a unified prevention policy. Analysis of 12 risk factors at age 50 suggests that strategies targeting physical inactivity, hypertension, and poor lung function will reduce impairments in both cognitive and physical functioning in old age.
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Affiliation(s)
- Eric J Brunner
- Research Department of Epidemiology and Public Health, University College London, UK.
| | - Catherine A Welch
- Research Department of Epidemiology and Public Health, University College London, UK
| | - Martin J Shipley
- Research Department of Epidemiology and Public Health, University College London, UK
| | - Sara Ahmadi-Abhari
- Research Department of Epidemiology and Public Health, University College London, UK
| | - Archana Singh-Manoux
- Research Department of Epidemiology and Public Health, University College London, UK
- INSERM U1018, Center for Research in Epidemiology and Population Health, Paul Brousse Hospital, Villejuif, France
| | - Mika Kivimäki
- Research Department of Epidemiology and Public Health, University College London, UK
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50
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Lee SH, Kim YB. Which type of social activities may reduce cognitive decline in the elderly?: a longitudinal population-based study. BMC Geriatr 2016; 16:165. [PMID: 27677321 PMCID: PMC5039914 DOI: 10.1186/s12877-016-0343-x] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 09/19/2016] [Indexed: 01/24/2023] Open
Abstract
Background Previous studies have found that social activities are beneficial for the reduction of cognitive decline (CD) in the elderly. However, knowledge regarding the types of social activities that reduce CD in later life is limited. The aim of this study is to examine which type of social activities reduce CD 4 years later among young-old (Y-O) and old-old (O-O) adults. Methods We conducted a secondary analysis using data from cognitively intact adults 65 years of age or older who participated in the Korean Longitudinal Study of Aging (KLoSA). Cognitive function was assessed using the Korean version of the Mini-Mental State Examination (MMSE). We computed CD between 2008 and 2012 by subtracting the Wave 4 MMSE score from the Wave 2 MMSE score. Multivariate linear regression analysis was conducted regarding the effects of social activities on CD after adjusting for age, sex, education, income, marital status, activities of daily living (ADL), instrumental activities of daily living (IADL), chronic diseases, quality of life, depressive symptom, change in depressive symptom, and cognitive functioning at baseline. Results Subjects who participated in senior citizen clubs or senior centers at baseline had a lower risk of CD 4 years later than those who did not in Y-O adults. Frequent contact with offspring by phone or letters was associated with reduced CD in O-O adults. Frequent face-to-face contact with offspring was positively associated with CD in O-O adults. Participating in two or more formal social activities was associated with reduced CD compared with nonparticipation in O-O adults. Conclusion Encouraging older adults to participate in senior citizen clubs or to have frequent contacts with adult children by phone or letters may help reduce CD in later life among older adults. Participation in a variety of formal social activities may also have a beneficial effect on preventing CD in older adults. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0343-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Seung Hee Lee
- Department of Nursing, University of Ulsan, Ulsan, Republic of Korea
| | - Young Bum Kim
- Hallym University Institute of Aging, Chuncheon, Republic of Korea.
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