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Umucu E, Gooding DC, Granger T, Wyman M, Lambrou N, Summers M, Strong L, Martin W, Carter F, Bouges S, Johnson A, Gleason CE. Ethno-racial differences in depressive symptom endorsement: Evaluation of brief forms of the Geriatric Depression Scale in older adults. J Affect Disord 2024; 364:274-278. [PMID: 39147158 PMCID: PMC11457266 DOI: 10.1016/j.jad.2024.08.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 08/11/2024] [Accepted: 08/12/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Depression among older adults is a pressing public health concern, necessitating accurate assessment tools. The Geriatric Depression Scale (GDS) offers a brief and efficient means of screening depressive symptoms, yet its performance across ethno-racial groups remains understudied. This study aimed to compare the ability of various brief forms of the GDS to detect depressive symptoms and to assess potential ethno-racial differences in symptom endorsement among White, Black/African-American, and American Indian/Alaska Native older adults. METHODS Data were obtained from the Wisconsin Alzheimer's Disease Research Center (ADRC) clinical cohort, comprising 555 cognitively healthy individuals at risk for dementia. We used participants' baseline data for this cross-sectional analysis. Depressive symptoms were assessed using multiple brief forms of the GDS, derived from a systematic review and meta-analysis. We examined internal consistency and correlations with global Clinical Dementia Rating (CDR) scores. We conducted Kruskal-Wallis tests and post hoc pairwise comparisons to assess ethno-racial group differences in symptom endorsement. RESULTS Descriptive statistics revealed a predominance of female and White participants, with notable representation from Black and American Indian/Alaska Native groups. All GDS versions demonstrated moderate to high internal consistency. Significant positive correlations were observed between GDS scores and global CDR scores. Ethno-racial group differences in depressive symptom endorsement were evident, with Black participants consistently reporting higher levels of symptoms across most GDS versions. However, American Indian/Alaska Native participants endorsed significantly fewer symptoms than Black participants in one GDS version. CONCLUSION The study highlights the importance of considering ethno-racial differences in depressive symptomatology when assessing older adults. While the GDS demonstrates overall reliability, variations in symptom endorsement across different ethno-racial groups underscore the need for culturally sensitive assessment tools and interventions. Future research should further explore these group differences and develop tailored approaches to depression screening and treatment in diverse older adult populations.
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Affiliation(s)
- Emre Umucu
- Public Health Sciences, The University of Texas at El Paso, El Paso, TX, United States; South Texas Veterans Health Care System Audie L. Murphy Memorial Veterans Hospital Division 7400 Merton Minter Boulevard San Antonio, TX 78229; College of Health Sciences Research, Evaluation, and Academic Center on Health Disparities (CHS REACHED).
| | - Diane Carol Gooding
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States; Division of Geriatrics, Department of Medicine, The School of Medicine and Public Health (SMPH), University of Wisconsin-Madison, Madison, WI, United States; Department of Psychiatry, SMPH, UW-Madison, Madison, WI, USA; Geriatrics and Gerontology, Dept. of Medicine, SMPH, UW-Madison, Madison, WI, USA
| | - Teresa Granger
- The University of Alabama, Tuscaloosa, AL, United States
| | - Mary Wyman
- W. S. Middleton Memorial Veterans Hospital, Madison, WI, United States; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Nick Lambrou
- W. S. Middleton Memorial Veterans Hospital, Madison, WI, United States
| | - Marlene Summers
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, United States
| | - Lois Strong
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, United States
| | - Wes Martin
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, United States
| | - Fabu Carter
- W. S. Middleton Memorial Veterans Hospital, Madison, WI, United States
| | - Shenikqua Bouges
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Carey E Gleason
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, United States; Division of Geriatrics, Department of Medicine, The School of Medicine and Public Health (SMPH), University of Wisconsin-Madison, Madison, WI, United States; Geriatric Research, Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, United States
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Wang W, Lu K, Du Q, Li C, Wang J, Wei Y, Yao M, Li S, Li X, Tian X, Zhang T, Yin F, Ma Y. Association between depressive duration and cognitive decline in middle-aged and older adults: Evidence from the Health and Retirement Study 2010-2018. J Affect Disord 2024; 364:286-294. [PMID: 39142592 DOI: 10.1016/j.jad.2024.08.017] [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: 01/15/2024] [Revised: 07/01/2024] [Accepted: 08/09/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Depression has been found to be associated with cognitive decline, but whether longer depressive durations lead to more severe cognitive declines has not been investigated. We aimed to estimate the association between depressive duration and cognitive decline in middle-aged and older Americans based on a large-scale representative population study. METHODS We included 27,886 participants from the Health and Retirement Study (HRS) in 2010-2018. Four datasets with 2-, 4-, 6-, and 8-year consecutive interviews were further derived which involving persistent depressed and persistent depression-free individuals. Multiple linear regressions were constructed to estimate the effects of each depressive duration on the decline in global cognition, memory and mental status. Meta-regressions were performed to test the linear trends and to explore the heterogeneity between sex, age and baseline cognitive function along with subgroup analyses. RESULTS Depressive durations of 2, 4, 6, and 8 years were associated with reductions in global cognitive scores of 0.62 points (95% CI: 0.51-0.73), 0.77 points (95% CI: 0.60-0.94), 0.83 points (95% CI: 0.55-1.10), and 1.09 points (95% CI: 0.63-1.55), respectively, indicating a linear trend (P = 0.016). More pronounced associations were observed in middle-aged adults and females. Similar patterns were found in the associations between depressive duration and two subdomains, i.e., memory and mental health. LIMITATIONS This study is essentially a cross-sectional study and therefore cannot provide causal associations. CONCLUSIONS Longer depressive durations were linearly related to more severe cognitive declines. Timely intervention for depression targeted middle-aged adults can more effectively alleviate cognition-related burdens.
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Affiliation(s)
- Wei Wang
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Kai Lu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Qianqian Du
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Chen Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Junyu Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Yuxin Wei
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Menghan Yao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Sheng Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Xuelin Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Xinyue Tian
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Tao Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Fei Yin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Yue Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China.
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Wong M, Kiss A, Herrmann N, Lanctôt KL, Gallagher D. Modifiable Risk Factors Associated With Cognitive Decline in Late Life Depression: Findings From the Canadian Longitudinal Study on Aging: Facteurs de risque modifiables associés au déclin cognitif dans la dépression en fin de vie : constatations de l'Étude longitudinale canadienne sur le vieillissement. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024; 69:708-716. [PMID: 38751067 PMCID: PMC11351061 DOI: 10.1177/07067437241255095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
OBJECTIVE Depression in later life is associated with a two-fold increased risk of dementia. It is not clear to what extent potentially modifiable risk factors account for this association. METHOD Older adults (age 50 + ) with objective health measures (n = 14,014) from the Canadian Longitudinal Study on Aging were followed for a mean duration of 35 months. Linear regression analyses were used to determine if clinically significant depression (Centre for Epidemiologic Studies Depression scale score (CESD) ≥ 10) was associated with global cognitive decline, assessed with a neuropsychological battery during follow-up, and if modifiable risk factors mediated this association. RESULTS Depression was associated with an excess of risk factors for cognitive decline including: vascular disease, hypertension, diabetes, apnoea during sleep, higher body mass index, smoking, physical inactivity and lack of social participation. In regression analyses depression remained independently associated with cognitive decline over time (beta -0.060, P = 0.038) as did cerebrovascular disease (beta -0.197, P < 0.001), HbA1C (beta -0.059, P < 0.001), visual impairment (beta -0.070, P = 0.007), hearing impairment (beta -0.098, P < 0.001) and physical inactivity (beta -0.075, P = 0.014). In mediation analyses, we found that cerebrovascular disease (z = -3.525, P < 0.001), HbA1C (z = -4.976, P < 0.001) and physical inactivity (z = -3.998, P < 0.001) partially mediated the association between depression and cognitive decline. CONCLUSIONS In this large sample of Canadian older adults incorporating several objective health measures, older adults with depression were at increased risk of cognitive decline and had an excess of potentially modifiable risk factors. Clinicians should pay particular attention to control of diabetes, physical inactivity and risk factors for cerebrovascular disease in older adults presenting with depression as they can contribute to accelerated cognitive decline and may be addressed during routine clinical care.
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Affiliation(s)
- Melissa Wong
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Alex Kiss
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Krista L. Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Hédouin R, Roy JC, Desmidt T, Robert G, Coloigner J. Microstructural brain assessment in late-life depression and apathy using diffusion MRI multi-compartments models and tractometry. Sci Rep 2024; 14:18193. [PMID: 39107406 PMCID: PMC11303796 DOI: 10.1038/s41598-024-67535-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 07/12/2024] [Indexed: 08/10/2024] Open
Abstract
Late-life depression (LLD) is both common and disabling and doubles the risk of dementia onset. Apathy might constitute an additional risk of cognitive decline but clear understanding of its pathophysiology is lacking. While white matter (WM) alterations have been assessed using diffusion tensor imaging (DTI), this model cannot accurately represent WM microstructure. We hypothesized that a more complex multi-compartment model would provide new biomarkers of LLD and apathy. Fifty-six individuals (LLD n = 35, 26 females, 75.2 ± 6.4 years, apathy evaluation scale scores (41.8 ± 8.7) and Healthy controls, n = 21, 16 females, 74.7 ± 5.2 years) were included. In this article, a tract-based approach was conducted to investigate novel diffusion model biomarkers of LLD and apathy by interpolating microstructural metrics directly along the fiber bundle. We performed multivariate statistical analysis, combined with principal component analysis for dimensional data reduction. We then tested the utility of our framework by demonstrating classically reported from the literature modifications in LDD while reporting new results of biological-basis of apathy in LLD. Finally, we aimed to investigate the relationship between apathy and microstructure in different fiber bundles. Our study suggests that new fiber bundles, such as the striato-premotor tracts, may be involved in LLD and apathy, which bring new light of apathy mechanisms in major depression. We also identified statistical changes in diffusion MRI metrics in 5 different tracts, previously reported in major cognitive disorders dementia, suggesting that these alterations among these tracts are both involved in motivation and cognition and might explain how apathy is a prodromal phase of degenerative disorders.
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Affiliation(s)
- Renaud Hédouin
- Univ Rennes, INRIA, CNRS, INSERM, IRISA UMR 6074, Empenn ERL U 1228, 35000, Rennes, France
| | - Jean-Charles Roy
- Univ Rennes, INRIA, CNRS, INSERM, IRISA UMR 6074, Empenn ERL U 1228, 35000, Rennes, France
- CIC 1414, CHU de Rennes, INSERM, Rennes, France
- Adult University Psychiatry Department, Guillaume Régnier Hospital, Rennes, France
| | - Thomas Desmidt
- CHU de Tours, Tours, France
- UMR 1253, iBrain, Université de Tours, INSERM, Tours, France
- CIC 1415, CHU de Tours, INSERM, Tours, France
| | - Gabriel Robert
- Univ Rennes, INRIA, CNRS, INSERM, IRISA UMR 6074, Empenn ERL U 1228, 35000, Rennes, France
- CIC 1414, CHU de Rennes, INSERM, Rennes, France
- Adult University Psychiatry Department, Guillaume Régnier Hospital, Rennes, France
| | - Julie Coloigner
- Univ Rennes, INRIA, CNRS, INSERM, IRISA UMR 6074, Empenn ERL U 1228, 35000, Rennes, France.
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Zheng S, Ma R, Yang Y, Li G. Psilocybin for the treatment of Alzheimer's disease. Front Neurosci 2024; 18:1420601. [PMID: 39050672 PMCID: PMC11266071 DOI: 10.3389/fnins.2024.1420601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024] Open
Abstract
Alzheimer's disease (AD) stands as a formidable neurodegenerative ailment and a prominent contributor to dementia. The scarcity of available therapies for AD accentuates the exigency for innovative treatment modalities. Psilocybin, a psychoactive alkaloid intrinsic to hallucinogenic mushrooms, has garnered attention within the neuropsychiatric realm due to its established safety and efficacy in treating depression. Nonetheless, its potential as a therapeutic avenue for AD remains largely uncharted. This comprehensive review endeavors to encapsulate the pharmacological effects of psilocybin while elucidating the existing evidence concerning its potential mechanisms contributing to a positive impact on AD. Specifically, the active metabolite of psilocybin, psilocin, elicits its effects through the modulation of the 5-hydroxytryptamine 2A receptor (5-HT2A receptor). This modulation causes heightened neural plasticity, diminished inflammation, and improvements in cognitive functions such as creativity, cognitive flexibility, and emotional facial recognition. Noteworthy is psilocybin's promising role in mitigating anxiety and depression symptoms in AD patients. Acknowledging the attendant adverse reactions, we proffer strategies aimed at tempering or mitigating its hallucinogenic effects. Moreover, we broach the ethical and legal dimensions inherent in psilocybin's exploration for AD treatment. By traversing these avenues, We propose therapeutic potential of psilocybin in the nuanced management of Alzheimer's disease.
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Affiliation(s)
- Siyi Zheng
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rong Ma
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Yang
- Department of General Medicine, Binzhou Medical University Hospital, Binzhou, China
| | - Gang Li
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Levy SA, Misiura MB, Grant JG, Adrien TV, Taiwo Z, Armstrong R, Dotson VM. Depression, Vascular Burden, and Dementia Prevalence in Late Middle-Aged and Older Black Adults. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae009. [PMID: 38374692 PMCID: PMC10926943 DOI: 10.1093/geronb/gbae009] [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: 06/20/2023] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES Late-life depression and white matter hyperintensities (WMH) have been linked to increased dementia risk. However, there is a dearth of literature examining these relationships in Black adults. We investigated whether depression or WMH volume are associated with a higher likelihood of dementia diagnosis in a sample of late middle-aged to older Black adults, and whether dementia prevalence is highest in individuals with both depression and higher WMH volume. METHODS Secondary data analysis involved 443 Black participants aged 55+ with brain imaging within 1 year of baseline visit in the National Alzheimer's Coordinating Center Uniform Data Set. Chi-square analyses and logistic regression models controlling for demographic variables examined whether active depression in the past 2 years, WMH volume, or their combination were associated with higher odds of all-cause dementia. RESULTS Depression and higher WMH volume were associated with a higher prevalence of dementia. These associations remained after controlling for demographic factors, as well as vascular disease burden. Dementia risk was highest in the depression/high WMH volume group compared to the depression-only group, high WMH volume-only group, and the no depression/low WMH volume group. Post hoc analyses comparing the Black sample to a demographically matched non-Hispanic White sample showed associations of depression and the combination of depression and higher WMH burden with dementia were greater in Black compared to non-Hispanic White individuals. DISCUSSION Results suggest late-life depression and WMH have independent and joint relationships with dementia and that Black individuals may be particularly at risk due to these factors.
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Affiliation(s)
- Shellie-Anne Levy
- Department of Clinical and Health Psychology, The Center for Cognitive Aging and Memory, University of Florida, Gainesville, Florida, USA
- The Center for Cognitive Aging and Memory, University of Florida, Gainesville, Florida, USA
| | - Maria B Misiura
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Jeremy G Grant
- Department of Clinical and Health Psychology, The Center for Cognitive Aging and Memory, University of Florida, Gainesville, Florida, USA
| | - Tamare V Adrien
- Department of Clinical and Health Psychology, The Center for Cognitive Aging and Memory, University of Florida, Gainesville, Florida, USA
| | - Zinat Taiwo
- Department of Rehabilitation Psychology and Neuropsychology, TIRR Memorial Hermann, Houston, Texas, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
| | - Rebecca Armstrong
- Department of Clinical and Health Psychology, The Center for Cognitive Aging and Memory, University of Florida, Gainesville, Florida, USA
| | - Vonetta M Dotson
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
- Gerontology Institute, Georgia State University, Atlanta, Georgia, USA
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Fernández Fernández R, Martín JI, Antón MAM. Depression as a Risk Factor for Dementia: A Meta-Analysis. J Neuropsychiatry Clin Neurosci 2023; 36:101-109. [PMID: 38111332 DOI: 10.1176/appi.neuropsych.20230043] [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] [Indexed: 12/20/2023]
Abstract
Dementia is a syndrome characterized by the deterioration of cognitive function beyond what is expected. The increased risk of developing this syndrome resulting from established modifiable risk factors, such as depressive episodes, is currently a subject of interest. The aim of this study was to review the scientific evidence that addresses the relationship between depression and dementia. A bibliographic search of the PubMed and PsycInfo databases for articles published over the past 20 years was conducted with the following medical subject heading terms: depression or depressive, dementia, and incidence or cohort studies. After articles meeting the inclusion criteria were selected, relevant moderating variables were grouped as sample characteristics, methodological characteristics, extrinsic characteristics, and outcome variables. The 26 selected studies resulted in a sample comprising 1,760,262 individuals. Statistical analysis revealed a pooled relative risk for the development of dementia of 1.82 (95% CI=1.62-2.06). The primary variables evaluated were the diagnostic methods for depression and dementia and the presence of depression. Other variables, such as mean age, methodological quality of each study, follow-up time, and publication year, were also evaluated. Age was statistically but not clinically significant. No relevant publication bias or alterations in the results were found when accounting for the quality of the studies. It is recommended that new moderating variables be evaluated or that existing variables be reformulated in future studies.
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Affiliation(s)
- Roberto Fernández Fernández
- Department of Psychiatry, Infanta Cristina University Hospital, Madrid (Fernández Fernández); Department of Methodology of Behavioral Sciences, National University of Distance Education (UNED), Madrid (all authors)
| | - Javier Ibias Martín
- Department of Psychiatry, Infanta Cristina University Hospital, Madrid (Fernández Fernández); Department of Methodology of Behavioral Sciences, National University of Distance Education (UNED), Madrid (all authors)
| | - María Araceli Maciá Antón
- Department of Psychiatry, Infanta Cristina University Hospital, Madrid (Fernández Fernández); Department of Methodology of Behavioral Sciences, National University of Distance Education (UNED), Madrid (all authors)
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Jauregi-Zinkunegi A, Langhough R, Johnson SC, Mueller KD, Bruno D. Comparison of the 10-, 14- and 20-Item CES-D Scores as Predictors of Cognitive Decline. Brain Sci 2023; 13:1530. [PMID: 38002491 PMCID: PMC10669678 DOI: 10.3390/brainsci13111530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/18/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023] Open
Abstract
The association between depressive symptomatology and cognitive decline has been examined using the Centre for Epidemiologic Studies-Depression Scale (CES-D); however, concerns have been raised about this self-report measure. Here, we examined how the CES-D total score from the 14- and 10-item versions compared to the 20-item version in predicting progression to cognitive decline from a cognitively unimpaired baseline. Data from 1054 participants were analysed using ordinal logistic regression, alongside moderator and receiver-operating characteristics curve analyses. All baseline total scores significantly predicted progression to cognitive decline. The 14-item version was better than the 20-item version in predicting consensus diagnosis, as shown by their AICs, while also showing the highest accuracy when discriminating between participants by diagnosis at last visit. We did not find sex to moderate the relationship between CES-D score and cognitive decline. Current findings suggest the 10- and 14-item versions of the CES-D are comparable to the 20-item version, and that the 14-item version may be better at predicting longitudinal consensus diagnosis compared to the 20-item version.
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Affiliation(s)
| | - Rebecca Langhough
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA; (R.L.)
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA; (R.L.)
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Veterans Hospital, Madison, WI 53225, USA
| | - Kimberly D. Mueller
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA; (R.L.)
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Davide Bruno
- School of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK;
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Feng V, Lanctot K, Herrmann N, Kiss A, Fischer CE, Flint AJ, Mah L, Mulsant BH, Pollock BG, Rajji TK, Tumati S, Verhoeff NP, Graff-Guerrero A, Gallagher D. Lipopolysaccharide, Immune Biomarkers and Cerebral Amyloid-Beta Deposition in Older Adults With Mild Cognitive Impairment & Major Depressive Disorder. Am J Geriatr Psychiatry 2023; 31:786-795. [PMID: 37211499 DOI: 10.1016/j.jagp.2023.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Inflammatory activation and increased immune response to lipopolysaccharide occur in both depression and cognitive decline and may link these two conditions. We investigated whether lipopolysaccharide (LPS), LPS binding protein (LBP) and peripheral biomarkers of immune response were associated with increased cerebral deposition of amyloid-beta (Abeta) in older adults with mild cognitive impairment (MCI) and remitted major depressive disorder (rMDD). DESIGN Cross-sectional analysis. SETTING Five academic health centers in Toronto. PARTICIPANTS Older adults with MCI with/without rMDD. MEASUREMENTS We investigated the associations among serum LPS, LBP, biomarkers of inflammatory activation - Interleukin-6 (IL-6), C-reactive protein (CRP), monocyte chemoattractant protein-1 (MCP-1), and cerebral Abeta deposition quantified by positron emission tomography. RESULTS Among 133 study participants (82 with MCI and 51 with MCI+rMDD) there was no association between LPS (beta - 0.17, p = 0.8) or LBP (beta - 0.11, p = 0.12) and global deposition of Abeta following adjustment for age, gender, and APOE genotype in multivariable regression analyses. LBP was positively correlated with CRP (r = 0.5, p <0.001) and IL-6 (r = 0.2, p = 0.02) but no inflammatory biomarker was associated with Abeta deposition; rMDD was not associated with deposition of Abeta (beta -0.09, p = 0.22). CONCLUSION In this cross-sectional analysis, we did not find an association among LPS/LBP, immune biomarkers or rMDD and global deposition of Abeta. Future analyses should assess the longitudinal relationships between peripheral and central biomarkers of immune activation, depression and cerebral Abeta deposition.
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Affiliation(s)
- Vivian Feng
- Neuropsychopharmacology Research Group (VF, KL, NH, AK, ST, DG), Sunnybrook Research Institute, Toronto, Canada
| | - Krista Lanctot
- Neuropsychopharmacology Research Group (VF, KL, NH, AK, ST, DG), Sunnybrook Research Institute, Toronto, Canada; Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group (VF, KL, NH, AK, ST, DG), Sunnybrook Research Institute, Toronto, Canada; Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Alex Kiss
- Neuropsychopharmacology Research Group (VF, KL, NH, AK, ST, DG), Sunnybrook Research Institute, Toronto, Canada; Department of Health Policy, Management and Evaluation (AK), University of Toronto, Toronto, Canada
| | - Corinne E Fischer
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Keenan Research Centre for Biomedical Science (CEF), St. Michael's Hospital, Toronto, Canada
| | - Alastair J Flint
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Centre for Mental Health (AJF), University Health Network and University of Toronto, Toronto, Canada
| | - Linda Mah
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Psychiatry (LM, NPV), Baycrest Health Sciences Centre, Toronto, Canada; Rotman Research Institute (LM), Baycrest Health Sciences Centre, Toronto, Canada
| | - Benoit H Mulsant
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Adult Neurodevelopment and Geriatric Psychiatry Division (BHM, BGP, TKR, AG-G), Centre for Addiction and Mental Health, Toronto, Canada; Toronto Dementia Research Alliance (BMH, BGP, TKR, NPV), University of Toronto, Toronto, Canada
| | - Bruce G Pollock
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Adult Neurodevelopment and Geriatric Psychiatry Division (BHM, BGP, TKR, AG-G), Centre for Addiction and Mental Health, Toronto, Canada; Toronto Dementia Research Alliance (BMH, BGP, TKR, NPV), University of Toronto, Toronto, Canada
| | - Tarek K Rajji
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Adult Neurodevelopment and Geriatric Psychiatry Division (BHM, BGP, TKR, AG-G), Centre for Addiction and Mental Health, Toronto, Canada; Toronto Dementia Research Alliance (BMH, BGP, TKR, NPV), University of Toronto, Toronto, Canada
| | - Shankar Tumati
- Neuropsychopharmacology Research Group (VF, KL, NH, AK, ST, DG), Sunnybrook Research Institute, Toronto, Canada
| | - Nicolaas Paul Verhoeff
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Psychiatry (LM, NPV), Baycrest Health Sciences Centre, Toronto, Canada; Toronto Dementia Research Alliance (BMH, BGP, TKR, NPV), University of Toronto, Toronto, Canada
| | - Ariel Graff-Guerrero
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Adult Neurodevelopment and Geriatric Psychiatry Division (BHM, BGP, TKR, AG-G), Centre for Addiction and Mental Health, Toronto, Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group (VF, KL, NH, AK, ST, DG), Sunnybrook Research Institute, Toronto, Canada; Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
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10
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Qin A, Wang M, Xu L. Increased Intake of Vegetables and Fruits Improves Cognitive Function among Chinese Oldest Old: 10-Year Follow-Up Study. Nutrients 2023; 15:2147. [PMID: 37405378 PMCID: PMC10180819 DOI: 10.3390/nu15092147] [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: 03/07/2023] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND In view of the rapidly accelerating aging process in China, this study looked at the associations between vegetables and fruits intake pattens and cognitive function among the oldest old in China using the genetic sub study from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). METHODS This study screened respondents who participated in all four surveys of longitudinal data from the CLHLS, and a total of 2454 participants were ultimately included. The relationships of cognitive function with vegetables and fruits intake patterns were examined using Generalized-estimating equations. RESULTS The prevalence range of mild cognitive impairment (MCI) was 14.3% to 16.9% at T1 to T3 and 32.7% at T4. There was a significant increase in the prevalence of MCI from T1 to T4 (β = 0.054; 95% CI, 0.037 to 0.070; p < 0.001; adjusted). The V+/F+ pattern significantly improved cognitive function in Chinese older adults compared with the V-/F- pattern (OR, 1.026; 95% CI, 1.001-1.053; p < 0.05). CONCLUSION Older adults who frequently consume both fruits and vegetables experience a reduction in MCI risk relative to those consuming these food groups infrequently-emphasizing the critical importance of the regular intake of both fruits and vegetables in maintaining cognitive function.
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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 250012, China; (A.Q.); (M.W.)
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
| | - Meiqi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (A.Q.); (M.W.)
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
| | - Lingzhong Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (A.Q.); (M.W.)
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
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11
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Babulal GM, Zhu Y, Roe CM, Hudson DL, Williams MM, Murphy SA, Doherty J, Johnson AM, Trani J. The complex relationship between depression and progression to incident cognitive impairment across race and ethnicity. Alzheimers Dement 2022; 18:2593-2602. [PMID: 35213795 PMCID: PMC9402798 DOI: 10.1002/alz.12631] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/14/2022] [Accepted: 01/25/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION We examined baseline differences in depression and antidepressant use among cognitively normal older adults in five ethnoracial groups and assessed whether depression predicted a faster progression to incident cognitive impairment across groups. METHODS Data from the National Alzheimer's Coordinating Center (n = 8168) were used to examine differences between non-Hispanic Whites (nHW), African Americans (AA), Hispanics, Asians, and American Indian and Alaskan Natives in cross-sectional and longitudinal models. RESULTS AA had a lower risk of depression compared to nHW at baseline. No statistical interactions were noted between ethnoracial groups and depression. However, depression independently predicted a faster progression to incident cognitive impairment. Hispanics and Asian participants had a higher hazard for progression compared to nHW. DISCUSSION Previously established risk factors between depression and dementia were not found among AA and nHW participants. The relationship between depression and ethnoracial groups is complex and suggests differential effects on progression from cognitive normality to impairment.
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Affiliation(s)
- Ganesh M. Babulal
- Department of NeurologyWashington University in St. LouisSt. LouisMissouriUSA
- Department of PsychologyFaculty of HumanitiesUniversity of JohannesburgJohannesburgSouth Africa
- Department of Clinical Research and LeadershipThe George Washington University School of Medicine and Health SciencesWashingtonMissouriUSA
- Institute of Public HealthWashington University in St. LouisSt. LouisMissouriUSA
| | - Yiqi Zhu
- School of Social WorkAdelphi UniversityNew YorkUSA
- Brown SchoolWashington University in St. LouisSt. LouisMissouriUSA
| | - Catherine M. Roe
- Department of NeurologyWashington University in St. LouisSt. LouisMissouriUSA
| | - Darrell L. Hudson
- Brown SchoolWashington University in St. LouisSt. LouisMissouriUSA
- Institute of Public HealthWashington University in St. LouisSt. LouisMissouriUSA
| | | | - Samantha A. Murphy
- Department of NeurologyWashington University in St. LouisSt. LouisMissouriUSA
| | - Jason Doherty
- Department of NeurologyWashington University in St. LouisSt. LouisMissouriUSA
| | - Ann M. Johnson
- Center for Clinical StudiesWashington University in St. LouisSaint LouisMissouriUSA
| | - Jean‐Francois Trani
- Brown SchoolWashington University in St. LouisSt. LouisMissouriUSA
- Institute of Public HealthWashington University in St. LouisSt. LouisMissouriUSA
- Centre for Social Development in AfricaUniversity of JohannesburgJohannesburgSouth Africa
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12
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Fei M, Wang F, Wu H, Liu S, Gan J, Ji Y. Characteristics of initial symptoms in patients with dementia with Lewy body disease. Front Neurol 2022; 13:1024995. [PMID: 36313495 PMCID: PMC9596794 DOI: 10.3389/fneur.2022.1024995] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia. Although DLB is characterized by fluctuating cognitive impairment, some symptoms may appear before cognitive impairment, including rapid eye movement, sleep behavior disorder (RBD), psychiatric symptoms, autonomic symptoms, Parkinson's symptoms, etc. Therefore, DLB may be misdiagnosed as other diseases in its early stage. Objective This study aimed to investigate the characteristics of initial symptoms of DLB, which could potentially offer essential clues for the earliest diagnosis of this disorder. Methods A total of 239 patients with probable DLB who visited the cognitive impairment outpatient department of Tianjin Huanhu Hospital from September 2015 to March 2021 were consecutively enrolled. We retrospectively evaluated the initial symptoms of all included participants. The time of onset of initial symptoms was also assessed. Results The most frequent initial symptom was memory loss (53.9%), followed by psychiatric symptoms (34.7%), RBD (20.9%), parkinsonism (15.1%), and autonomic symptoms (10.1%). Significant gender and age differences existed in the initial symptoms of patients with DLB. Conclusions Our study elucidated the initial symptoms in patients with probable DLB. RBD was significantly more reported by men than by women, whereas women showed a higher incidence of visual and auditory hallucinations. A better understanding of the initial symptoms of DLB could lead to a more accurate diagnosis.
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Affiliation(s)
- Min Fei
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
- Department of Neurology, Yuncheng Central Hospital, Shanxi Medical University, Yuncheng, China
| | - Fei Wang
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
- Department of Neurology, Yuncheng Central Hospital, Shanxi Medical University, Yuncheng, China
| | - Hao Wu
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Shuai Liu
- Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Jinghuan Gan
- Department of Neurology, Beijing Tiantan Hospital, China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, China
| | - Yong Ji
- Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
- *Correspondence: Yong Ji
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13
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Kim D, Kiss A, Bronskill SE, Lanctôt KL, Herrmann N, Gallagher D. Association between depression, gender and Alzheimer's neuropathology in older adults without dementia. Int J Geriatr Psychiatry 2022; 37. [PMID: 36047339 DOI: 10.1002/gps.5809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 08/22/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Previous studies regarding the relationship between depression and Alzheimer's neuropathology in older adults without dementia have reported conflicting findings. This study examined whether depression is associated with Alzheimer's neuropathology and whether sex moderates these relationships. METHODS This is a cross-sectional study of older adults without dementia (normal cognition or mild cognitive impairment, age 50+; CDR ≤ 0.5) who had autopsy within 1 year of their last clinic visit in the National Alzheimer's Coordinating Center database (2005-2020). Logistic regression models were fitted to determine if a recent or remote history of depression was associated with amyloid spread beyond the neocortex measured by modified Thal phase score, density of amyloid plaques measured by CERAD score or tau neuropathology measured by modified Braak score. A moderator analysis was performed to determine if any of these associations were moderated by sex. RESULTS This study included 407 participants (96 Thal, 405 Braak, and 406 CERAD). Those who had recently active depression (within previous 2 years) but not remote depression only were more likely to have higher Thal phase score compared to those without a history of depression (OR = 3.74; 95% CI, 1.15-12.17; p = 0.028). Sex did not moderate this association. No significant associations between recent depression and Braak or CERAD scores were observed. CONCLUSION Our findings indicate that the association between late life depression and Alzheimer's neuropathology is associated with spread of amyloid pathology beyond the neocortex to include allocortical and subcortical regions critical for regulation of mood and motivated behavior.
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Affiliation(s)
- Doyoung Kim
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Alex Kiss
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Susan E Bronskill
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Krista L Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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14
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Avan A, Hachinski V. Global, regional, and national trends of dementia incidence and risk factors, 1990-2019: A Global Burden of Disease study. Alzheimers Dement 2022; 19:1281-1291. [PMID: 36044376 DOI: 10.1002/alz.12764] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND An ample literature documents the growing prevalence of dementia and associated costs. Less attention has been paid to decreased dementia incidence in some countries. METHODS We analyzed trends in age-standardized dementia, stroke, and ischemic heart disease (the triple threat) incidence rates and population attributable fraction of death and disability attributable to 12 risk factors in 204 countries and territories and 51 regions using Global Burden of Disease 2019 data. RESULTS During 1990 to 2019, dementia incidence declined in 71 countries; 18 showed statistically significant declines, ranging from -12.1% (95% uncertainty intervals -16.9 to -6.8) to -2.4% (-4.6 to -0.5). During 2010 to 2019, 16 countries showed non-significant declines. Globally, the burden of the triple threat attributable to air pollution, dietary risks, non-optimal temperature, lead exposure, and tobacco use decreased from 1990 to 2019. CONCLUSION The declining incidence of dementia in some countries, despite growing prevalence, is encouraging and urges further investigation.
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Affiliation(s)
- Abolfazl Avan
- Department of Public Health, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Family Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vladimir Hachinski
- Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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15
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Maxwell CJ, Maclagan LC, Harris DA, Wang X, Guan J, Marrie RA, Hogan DB, Austin PC, Vigod SN, Swartz RH, Bronskill SE. Incidence of neurological and psychiatric comorbidity over time: a population-based cohort study in Ontario, Canada. Age Ageing 2022; 51:6520504. [PMID: 35134841 DOI: 10.1093/ageing/afab277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/14/2021] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Comprehensive, population-based investigations of the extent and temporality of associations between common neurological and psychiatric disorders are scarce. METHODS This retrospective cohort study used linked health administrative data for Ontarians aged 40-85 years on 1 April 2002, to estimate the adjusted rate of incident dementia, Parkinson's disease (PD), stroke or mood/anxiety disorder (over 14 years) according to the presence and time since diagnosis of a prior disorder. Sex differences in the cumulative incidence of a later disorder were also examined. RESULTS The cohort included 5,283,546 Ontarians (mean age 56.2 ± 12.1 years, 52% female). The rate of dementia was significantly higher for those with prior PD (adjusted hazard ratio [adjHR] 4.05, 95% confidence interval [CI] 3.99-4.11); stroke (adjHR 2.49, CI 2.47-2.52) and psychiatric disorder (adjHR 1.79, CI 1.78-1.80). The rate of PD was significantly higher for those with prior dementia (adjHR 2.23, CI 2.17-2.30) and psychiatric disorder (adjHR 1.77, CI 1.74-1.81). The rate of stroke was significantly higher among those with prior dementia (adjHR 1.56, CI 1.53-1.58). Prior dementia (adjHR 2.36, CI 2.33-2.39), PD (adjHR 1.80, CI 1.75-1.85) and stroke (adjHR 1.47, CI 1.45-1.49) were associated with a higher rate of an incident psychiatric disorder. Generally, associations were strongest in the 6 months following a prior diagnosis and demonstrated a J-shape relationship over time. Significant sex differences were evident in the absolute risks for several disorders. CONCLUSIONS The observed nature of bidirectional associations between these neurological and psychiatric disorders indicates opportunities for earlier diagnosis and interventions to improve patient care.
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Affiliation(s)
- Colleen J Maxwell
- Schools of Pharmacy and Public Health, Sciences University of Waterloo, Waterloo, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | | | - Daniel A Harris
- ICES, Toronto, Ontario, Canada
- Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - David B Hogan
- Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Peter C Austin
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Simone N Vigod
- ICES, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Richard H Swartz
- ICES, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Susan E Bronskill
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
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16
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Beserra A, Oliveira B, Portugal E, Dutra P, Laks J, Deslandes A, Moraes H. Cortisol Reactivity to a physical stressor in Patients with Depression and Alzheimer's disease. Dement Neuropsychol 2022; 16:61-68. [PMID: 35719259 PMCID: PMC9170255 DOI: 10.1590/1980-5764-dn-2021-0066] [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: 06/30/2021] [Revised: 08/21/2021] [Accepted: 09/16/2021] [Indexed: 11/29/2022] Open
Abstract
Some prevalent mental disorders in the elderly, such as Alzheimer's disease (AD) and major depression disorder (MDD), are associated with chronic stress and consequently with possible dysregulation of hypothalamic–pituitary–adrenal (HPA) axis and cortisol levels in basal conditions or in the reactivity of an acute stressor. However, evidence of cortisol behavior after a physical stressor in patients with AD and MDD is scarce.
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Affiliation(s)
- Ana Beserra
- Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Rio de Janeiro RJ, Brazil.,Universidade Federal do Rio de Janeiro, Laboratório de Neurociência do Exercício, Rio de Janeiro RJ, Brazil
| | - Bruno Oliveira
- Universidade Federal Rural do Rio de Janeiro, Departamento de Educação Física e Esportes, Rio de Janeiro RJ, Brazil
| | - Eduardo Portugal
- Universidade Federal do Rio de Janeiro, Laboratório de Fisiologia do Exercício, Rio de Janeiro RJ, Brazil
| | - Patrícia Dutra
- Universidade do Estado do Rio de Janeiro, Laboratório de Imunofisiologia do Exercício, Rio de Janeiro RJ, Brazil
| | - Jerson Laks
- Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Rio de Janeiro RJ, Brazil.,Universidade do Grande Rio, Programa de Biomedicina Translacional, Rio de Janeiro RJ, Brazil
| | - Andrea Deslandes
- Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Rio de Janeiro RJ, Brazil.,Universidade Federal do Rio de Janeiro, Laboratório de Neurociência do Exercício, Rio de Janeiro RJ, Brazil
| | - Helena Moraes
- Universidade Federal do Rio de Janeiro, Laboratório de Neurociência do Exercício, Rio de Janeiro RJ, Brazil.,Universidade Federal do Rio de Janeiro, Laboratório de Fisiologia do Exercício, Rio de Janeiro RJ, Brazil
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