Can social support and physical activity buffer cognitive impairment in individuals with depressive symptoms? Results from a representative sample of young to older adults

Functional social isolation mediates the association between depression and executive function in older women: findings from the Canadian Longitudinal Study on Aging Comprehensive cohort

Depression and social isolation increase risk for executive function declines and are among the top five modifiable risk factors for dementia. However, the interrelationships between depression, social isolation and executive function are not well established. Further evidence is needed to inform strategies to promote executive function and independence in older age. We examined whether social isolation mediated the association between depression and executive function in community-dwelling middle-aged and older adults and whether this association was modified by age and sex. Adults aged 45 to 85 years from the Canadian Longitudinal Study on Aging (CLSA) Comprehensive cohort were followed over three years (complete case analysis, n = 14,133). Baseline depressive symptoms, a history of clinical depression, and functional social isolation (perceived lack of social support) were self-reported. Executive function at follow-up was a composite measure of five cognitive tests. Conditional process analysis assessed the mediating effects of functional social isolation across age group and sex, adjusted for sociodemographic and health covariates. Functional social isolation significantly mediated the association of depressive symptoms (proportion mediated [PM] = 8.0%) or clinical depression (PM = 17.5%) with executive function only among women aged 75+ years. Functional social isolation explains a proportion of the total effect of depressive symptoms or clinical depression on executive function in women aged 75 and older. Although reverse causation cannot be ruled out, our findings suggest that interventions that reduce functional social isolation or depression in older women may promote executive function.

Investigating pathways from anxiety sensitivity to impairment in a treatment-seeking sample

BACKGROUND

Previous research suggests that high anxiety sensitivity (AS) - a fear of arousal-related body sensations - may have implications not only for mental health symptoms but also for functional impairment. The aim of the present study was to examine whether elevated AS is associated with functional impairment by way of heightened anxiety symptoms and resultant depressive symptoms or unhealthy coping behaviours (i.e., alcohol use, exercise avoidance, sleep problems) in a chained mediation model.

METHOD

Participants were 128 treatment-seeking individuals with high AS who qualified for an anxiety, depression, or posttraumatic stress disorder diagnosis. They completed self-report measures of AS, anxiety, depression, and unhealthy coping behaviours as part of a pre-treatment assessment battery for a larger study examining the efficacy of a cognitive behavioural intervention for AS. Data were analyzed using path analysis.

RESULTS

Results revealed a direct association between AS and functional impairment that was partially mediated through a chained indirect pathway from AS to anxiety symptoms to depression symptoms to functional impairment. Unhealthy coping behaviours did not serve as mediators.

LIMITATIONS

Results are limited by the cross-sectional nature of the data.

CONCLUSIONS

The present findings have clinical implications insofar as supporting the relevance of reducing AS and focusing on depressive symptoms when seeking to improve clients' functioning.

Breakdown of the blood-brain barrier: A mediator of increased Alzheimer's risk in patients with metabolic disorders?

Metabolic disorders (MDs), including type 1 and 2 diabetes and chronic obesity, are among the faster growing diseases globally and are a primary risk factor for Alzheimer's disease (AD). The term "type-3 diabetes" has been proposed for AD due to the interrelated cellular, metabolic, and immune features shared by diabetes, insulin resistance (IR), and the cognitive impairment and neurodegeneration found in AD. Patients with MDs and/or AD commonly exhibit altered glucose homeostasis and IR; systemic chronic inflammation encompassing all of the periphery, blood-brain barrier (BBB), and central nervous system; pathological vascular remodeling; and increased BBB permeability that allows transfusion of neurotoxic molecules from the blood to the brain. This review summarizes the components of the BBB, mechanisms through which MDs alter BBB permeability via immune and metabolic pathways, the contribution of BBB dysfunction to the manifestation and progression of AD, and current avenues of therapeutic research that address BBB permeability. In addition, issues with the translational applicability of current animal models of AD regarding BBB dysfunction and proposals for future directions of research that address the relationship between MDs, BBB dysfunction, and AD are discussed.

The interrelationship between social connectedness and social engagement and its relation with cognition: a study using SHARE data

Understanding how psychosocial factors can promote better cognition in mid- and later life is important for making recommendations regarding policies and intervention programmes. This study focuses on two psychosocial aspects (social connectedness and social engagement) in order to assess their independent contribution to explaining cognition, but also how their interrelationship acts on cognition. We hypothesised that each of the factors is positively associated with cognition, but also that a combination of both factors contributes more to cognition than each of the factors independently. Our sample comprises 66,504 individuals who participated in the Survey of Health, Ageing and Retirement in Europe (SHARE). Multilevel linear regression analyses were performed. The results show that higher levels of social engagement and social connectedness are associated with improved cognition. When studying the interaction of social engagement and social connectedness and its association with cognitive function, the analysis shows that better cognitive scores are found in individuals having high levels of both social engagement and social connectedness. Moreover, when one of these aspects is lacking, the other plays a role in cognition protection. This study indicates the importance of social connectedness and social engagement for preserving/developing cognition, which greatly contributes to the quality of life of middle-aged and older adults.

The association between health-related factors, physical and mental diseases, social activities, and cognitive function in elderly Koreans: a population-based cross-sectional study

AIM

The purpose of this study was to verify the association of cognitive function with health-related variables, diseases, and social activities.

METHODS

Data from the 2016 Korean Longitudinal Study of Aging were analyzed. The participants of that study were 5678 adults aged 60 years or older living in 17 major Korean regions nationwide.

RESULTS

Hierarchical multiple regression analyses indicated that gender, age, education, marital status, depressive symptoms, body mass index, regular exercise, activities of daily living, instrumental activities of daily living, hand grip strength, and social activities were all significantly associated with cognitive function in elderly Koreans. However, socioeconomic status, diabetes, smoking, alcohol consumption, attendance at school reunions, volunteer work, and participation in political or civic organizations had no impact on cognitive function. First, the results indicated that men had better cognitive function than women; likewise, married individuals and those with a higher level of education also had better cognitive function. As age increased, cognitive function declined. Second, higher body mass index was related to poorer cognitive function, whereas regular exercise was positively associated with better cognitive function. In addition, higher activities of daily living and instrumental activities of daily living scores were associated with poorer cognitive function. Third, depressive symptoms were negatively associated with cognitive function. Finally, religious activities, social activities, and participation in leisure activities, cultural events, and sports were associated with better cognitive functioning. The possibility of reverse association exists between some of the variables (e.g. religious activity and cognitive function), and it is necessary to verify this possibility through a longitudinal study. The biggest limitation is that this is a cross-sectional study, which made it unfeasible to investigate the causal pathways.

CONCLUSIONS

This study suggests that regularly exercising and attending social activities each help to improve cognitive function in the elderly.

The Association between Family Caregiver Burden and Subjective Well-Being and the Moderating Effect of Social Participation among Japanese Adults: A Cross-Sectional Study

We examined the association between family caregiver burden and subjective well-being with social participation’s moderating effect among Japanese adults. Data were obtained from a cross-sectional survey by the Japan Multi-Institutional Collaborative Cohort Study in the Okazaki area between 2013 and 2017. Study participants included 5321 adults who visited the Public Health Center for annual health check-ups and answered a questionnaire regarding health status and lifestyle. Subjective well-being was assessed by a single item, out of 10 points, and analyzed with multivariable linear regression analysis models by subjective family caregiver burden (“none”, “mild”, “severe”), stratified by gender. Ultimately, 2857 men and 2223 women were included. Mean participant age (standard deviation) in years was 64.7 (10.4) for men and 61.3 (10.0) for women. Multivariable analysis revealed that, among women, higher caregiver burden was inversely associated with subjective well-being (p for trend < 0.001), and the interaction of severe caregiver burden and social participation on subjective well-being was positive and significant (p for interaction < 0.05). High family caregiver burden was inversely associated with subjective well-being among Japanese women, but moderated by the caregiver’s social participation, suggesting the importance of community development that enables family caregivers’ social participation to protect their subjective well-being.