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Divers R, Robinson A, Miller L, Davis K, Reed C, Calamia M. Examining heterogeneity in depression symptoms and associations with cognition and everyday function in MCI. J Clin Exp Neuropsychol 2022; 44:185-194. [PMID: 35862574 PMCID: PMC9665159 DOI: 10.1080/13803395.2022.2102154] [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: 03/15/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Although there is some evidence that different symptoms of depression have differential effects on cognition in older adults, these relationships remain understudied in older adults with mild cognitive impairment (MCI). METHOD Older adults (>50 years old) were classified as having MCI by Alzheimer's Disease Research Centers (ADRCs). Exploratory factor analyses and factor mixture modeling were used to determine depression symptom classes. Classes were then compared across different domains of cognition (i.e., memory, attention, language, and executive function) and informant-rated everyday function. RESULTS Analyses revealed six, distinct symptom classes (i.e., somatic symptoms, severely depressed, anhedonic symptoms, cognitive symptoms, minimally depressed, and low life satisfaction symptoms). Classes significantly varied on all measures of cognition and everyday function. In particular, the anhedonic class often showed the most substantial decline (on par with the severely depressed class), while the low life satisfaction class often showed the least (on par with the minimally depressed class). CONCLUSIONS To our knowledge, this is the first study to examine the relationship between depression symptom profiles and cognitive and everyday function in those with MCI. Our findings show that depression symptoms greatly differ in their associations with cognitive and everyday function. It may be beneficial for clinicians to specifically note if patients with MCI are reporting anhedonic and somatic symptoms of depression specifically.
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Affiliation(s)
- Ross Divers
- Department of Psychology, Louisiana State University, Baton Rouge, United States of America
| | - Anthony Robinson
- Department of Psychology, Louisiana State University, Baton Rouge, United States of America
| | - Luke Miller
- Department of Psychology, Louisiana State University, Baton Rouge, United States of America
| | - Katrail Davis
- Department of Psychology, Louisiana State University, Baton Rouge, United States of America
| | - Christopher Reed
- Department of Psychology, Louisiana State University, Baton Rouge, United States of America
| | - Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, United States of America
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2
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Fusi G, Colombo B, Zanetti M, Crepaldi M, Rozzini L, Rusconi ML. The Effect of Psychological Symptoms on Divergent Thinking in Healthy Older Adults. CREATIVITY RESEARCH JOURNAL 2021. [DOI: 10.1080/10400419.2021.1892413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Giulia Fusi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | | | | | - Maura Crepaldi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Luca Rozzini
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Maria Luisa Rusconi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
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3
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Szymkowicz SM, Dotson VM, Vanderploeg RD. Weak associations between depressive symptom severity, depressive symptom clusters, and cognitive performance in young to middle-aged men without clinical depression. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:921-935. [PMID: 33119426 DOI: 10.1080/13825585.2020.1840505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Evidence suggests different depressive symptoms are related to specific aspects of cognition, especially in older adults. The current study extended this literature by examining depressive symptom severity, symptom clusters, and cognitive functioning in young-to-middle aged adults. A sample of 2,560 men (mean age = 38.12 ± 2.41 years) withvalid Minnesota Multiphasic Personality Inventories (MMPI) and completed cognitive measures was drawn from a Vietnam veterans study. Bootstrapped regressions examined relationships between cognitive performance, MMPI Depression scores, and Harris-Lingoes depression subscales after covariate adjustments. Follow-up analyses investigated non-elevated and elevated depressive symptom groups. We found inverse relationships between specific subscales (Subjective Depression and Mental Dullness) and attentional control. No significant relationships were evident for total depressive symptoms or for the group analyses. Findings suggest weak associations between depressive symptoms and cognition in young to middle-aged men without clinical depression, which adds to the literature on inconsistent findings in depressive symptom-cognition relationships.
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Affiliation(s)
- Sarah M Szymkowicz
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Vonetta M Dotson
- Department of Psychology, Georgia State University, Atlanta, GA, USA.,Gerontology Institute, Georgia State University, Atlanta, GA, USA
| | - Rodney D Vanderploeg
- Mental Health and Behavioral Sciences Service, James A. Haley Veterans' Hospital, Tampa, FL, USA
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4
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Norton J, Carrière I, Pérès K, Gabelle A, Berr C, Ritchie K, Ancelin ML. Sex-specific depressive symptoms as markers of pre-Alzheimer dementia: findings from the Three-City cohort study. Transl Psychiatry 2019; 9:291. [PMID: 31712553 PMCID: PMC6848073 DOI: 10.1038/s41398-019-0620-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/24/2019] [Accepted: 10/20/2019] [Indexed: 12/13/2022] Open
Abstract
Late-life depression, as a potential marker of pre-dementia, has seldom been explored by symptom dimension and sex, despite sexual dimorphic differences. This study aimed to examine whether specific depressive dimensions were associated with pre-Alzheimer's disease dementia (pre-AD), separately for women and men. Data were drawn from 5617 (58% women) community-dwellers aged 65+ recruited in 1999-2000 and followed at 2-year intervals for 12 years. We used Cox proportional hazard models to study associations between time-dependent Centre for Epidemiologic Studies-Depression Scale (CES-D) symptom dimensions (namely somatic, depressed, positive affect, and interpersonal challenge) and pre-AD, defined retrospectively from validated diagnoses established 3.5 (IQR: 3.2-4.0) years onwards. Analyses were performed according to overall depressive symptomatology (DS+: CES-D score ≥ 16) and antidepressant/anxiolytic medication use (AA). Results indicated that in DS+ women only, all four dimensions were significantly associated with pre-AD in the AA- group, in particular somatic item 'Mind' and depressed affect items 'Depressed' and 'Blues'. The most depression-specific dimension, depressed affect, was also significantly associated with pre-AD in the DS- AA- women (HR:1.28, 95%CI: 1.12;1.47). In both sexes, in the DS- groups somatic affect was the most robust pre-AD marker, irrespective of treatment (women: HR = 1.22, 95%CI: 1.08;1.38; men: HR = 1.30, 95%CI: 1.14;1.48). Our findings highlight sex-specific associations between depressive symptom dimensions and pre-AD, modulated by depressive symptomatology and treatment. Assessment of specific symptom dimensions taking into account overall symptomatology and treatment could help identify and target high-risk AD-dementia profiles for interventions.
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Affiliation(s)
- Joanna Norton
- Inserm, U1061, Montpellier, France. .,Montpellier University, Montpellier, France.
| | - Isabelle Carrière
- grid.457377.5Inserm, U1061 Montpellier, France ,0000 0001 2097 0141grid.121334.6Montpellier University, Montpellier, France
| | - Karine Pérès
- grid.457371.3Inserm, U1219 Bordeaux, France ,0000 0001 2106 639Xgrid.412041.2Bordeaux University, Bordeaux, France
| | - Audrey Gabelle
- grid.457377.5Inserm, U1061 Montpellier, France ,0000 0001 2097 0141grid.121334.6Montpellier University, Montpellier, France ,0000 0000 9961 060Xgrid.157868.5Memory Research and Resources Center, Department of Neurology, CHU Montpellier, Montpellier, France
| | - Claudine Berr
- grid.457377.5Inserm, U1061 Montpellier, France ,0000 0001 2097 0141grid.121334.6Montpellier University, Montpellier, France
| | - Karen Ritchie
- grid.457377.5Inserm, U1061 Montpellier, France ,0000 0001 2097 0141grid.121334.6Montpellier University, Montpellier, France ,0000 0004 1936 7988grid.4305.2Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Marie-Laure Ancelin
- grid.457377.5Inserm, U1061 Montpellier, France ,0000 0001 2097 0141grid.121334.6Montpellier University, Montpellier, France
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5
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Ivanova MY, Achenbach T, Leite M, Almeida V, Caldas C, Turner L, Dumas JA. Empirically derived dimensional syndromes of self-reported psychopathology: Cross-cultural comparisons of Portuguese and US elders. Int J Geriatr Psychiatry 2018; 33:695-702. [PMID: 29280195 DOI: 10.1002/gps.4840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/09/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE As the world population ages, mental health professionals increasingly need empirically supported assessment instruments for older adult psychopathology. This study tested the degree to which syndromes derived from self-ratings of psychopathology by elders in the US would fit self-ratings by elders in Portugal. METHODS The Older Adult Self-Report (OASR) was completed by 352 60- to 102-year-olds in Portuguese community and residential settings. RESULTS Confirmatory factor analyses tested the fit of the 7-syndrome OASR model to self-ratings by Portuguese elders. The primary fit index (Root Mean Square Error of Approximation) showed good fit, while secondary fit indices (the Comparative Fit Index and the Tucker-Lewis Index) showed acceptable fit. Loadings of 95 of the 97 items on their expected syndromes were statistically significant (mean = .63), indicating that the items measured the syndromes well. Correlations between latent factors, ie, between the hypothesized syndrome constructs measured by the items, averaged .66. The correlations between syndromes reflect varying degrees of comorbidity between problems comprising particular pairs of syndromes. CONCLUSIONS The results support the syndrome structure of the OASR for Portuguese elders, offering Portuguese clinicians and researchers a useful instrument for assessing a broad spectrum of psychopathology. The results also offer a core of empirically supported taxonomic constructs of later life psychopathology as a basis for advancing clinical practice, training, and cross-cultural research.
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Affiliation(s)
- Masha Y Ivanova
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Thomas Achenbach
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Manuela Leite
- CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra, Portugal
| | - Vera Almeida
- CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra, Portugal.,UCIBIO/REQUIMTE, Laboratório de Tecnologia Farmacêutica, Faculdade de Farmácia, Universidade do Porto, Portugal
| | - Carlos Caldas
- CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra, Portugal.,CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Portugal
| | - Lori Turner
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Julie A Dumas
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
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6
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Szymkowicz SM, Dotson VM, Jones JD, Okun MS, Bowers D. Symptom Dimensions of Depression and Apathy and Their Relationship With Cognition in Parkinson's Disease. J Int Neuropsychol Soc 2018; 24:269-282. [PMID: 29032789 PMCID: PMC5820218 DOI: 10.1017/s1355617717001011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Both depression and apathy, alone and in combination, have been shown to negatively affect cognition in patients with Parkinson's disease (PD). However, the influence of specific symptom dimensions of depression and apathy on cognition is not well understood. The current study investigated the relationship between symptom dimensions of depression and apathy, based on factors identified in Kirsch-Darrow et al. (2011), and memory and executive function in PD. METHODS A sample of 138 non-demented individuals with PD (mean age=64.51±7.43 years) underwent neuropsychological testing and completed the Beck Depression Inventory, 2nd Edition, and Apathy Scale. Separate hierarchical regression models examined the relationship between symptom dimensions of depression and apathy ("pure" depressive symptoms, "pure" apathy, loss of interest/pleasure [anhedonia], and somatic symptoms) and three cognitive domain composites: immediate verbal memory, delayed verbal memory, and executive function. RESULTS After adjusting for general cognitive status and the influence of the other symptom dimensions, "pure" depressive symptoms were negatively associated with the delayed verbal memory composite (p<.034) and somatic symptoms were positively associated with the executive function composite (p<.026). No symptom dimensions were significantly related to the immediate verbal memory composite. CONCLUSIONS Findings suggest that specific mood symptoms are associated with delayed verbal memory and executive function performance in non-demented patients with PD. Further research is needed to better understand possible mechanisms through which specific symptom dimensions of depression and apathy are associated with cognition in PD. (JINS, 2018, 24, 269-282).
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Affiliation(s)
- Sarah M. Szymkowicz
- Department of Clinical & Health Psychology, College of Public Health & Health Professions, University of Florida, Gainesville, FL, USA
| | - Vonetta M. Dotson
- Department of Clinical & Health Psychology, College of Public Health & Health Professions, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Jacob D. Jones
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, CA, USA
| | - Michael S. Okun
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA
- Center for Movement Disorders & Neurorestoration, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Dawn Bowers
- Department of Clinical & Health Psychology, College of Public Health & Health Professions, University of Florida, Gainesville, FL, USA
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA
- Center for Movement Disorders & Neurorestoration, College of Medicine, University of Florida, Gainesville, FL, USA
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7
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Szymkowicz SM, Dotson VM, McLaren ME, De Wit L, O'Shea DM, Talty FT, O'Shea A, Porges EC, Cohen RA, Woods AJ. Precuneus abnormalities in middle-aged to older adults with depressive symptoms: An analysis of BDI-II symptom dimensions. Psychiatry Res 2017; 268:9-14. [PMID: 28837829 PMCID: PMC5593781 DOI: 10.1016/j.pscychresns.2017.08.002] [Citation(s) in RCA: 7] [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] [Received: 01/27/2017] [Revised: 04/28/2017] [Accepted: 08/11/2017] [Indexed: 12/11/2022]
Abstract
We recently reported age-related increases in left precuneus cortical thickness (CT) in older adults with elevated total depressive symptoms. However, it is unclear whether abnormalities in precuneus surface area (SA) are also evident and whether specific symptom dimensions of depression moderated age effects on these measurements. Seventy-three adults completed the Beck Depression Inventory - 2nd edition (BDI-II) and underwent structural neuroimaging. Measures of CT and SA were extracted from the right and left precuneus via FreeSurfer. Regression models included regions of interest as dependent variables, with age, BDI-II subscale scores (e.g., affective, cognitive, and somatic symptoms), and their interactions as independent variables, controlling for mean hemispheric thickness (for CT) or total intracranial volume (for SA). A significant age × somatic symptom interaction was found for left precuneus CT, such that elevated levels of somatic symptoms were significantly associated with age-related cortical thinning. No depressive symptom dimensions moderated the relationship between age and SA, suggesting that CT may be a more sensitive measure of brain abnormalities in middle-aged to older adults with depressive symptoms.
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Affiliation(s)
- Sarah M Szymkowicz
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
| | - Vonetta M Dotson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; Department of Neuroscience, University of Florida, Gainesville, FL, USA
| | - Molly E McLaren
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Liselotte De Wit
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Deirdre M O'Shea
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Francis T Talty
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Andrew O'Shea
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Eric C Porges
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Ronald A Cohen
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Adam J Woods
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; Department of Neuroscience, University of Florida, Gainesville, FL, USA; Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
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8
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Achenbach TM, Ivanova MY, Rescorla LA, Dumas JA. Transdiagnostic Dimensional Assessment of Psychopathology in Later Life. Curr Behav Neurosci Rep 2017. [DOI: 10.1007/s40473-017-0123-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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9
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Vitaliano PP, Ustundag O, Borson S. Objective and Subjective Cognitive Problems among Caregivers and Matched Non-caregivers. THE GERONTOLOGIST 2017; 57:637-647. [PMID: 26903233 PMCID: PMC5881794 DOI: 10.1093/geront/gnv690] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 10/27/2015] [Indexed: 11/14/2022] Open
Abstract
Purpose of the study Caregivers (CGs) have been shown to do more poorly than non-caregivers (NCGs) on objective cognitive tests (Trails B and Digit Symbol Test, DST), but less is known about whether these groups differ in: (a) reports of subjective cognitive problems (SCPs, memory complaints, etc.) and (b) relationships of SCPs with objective cognitive tests, depression, and stress exposure. Such relationships are important because researchers/clinicians use SCPs as proxies for objective cognitive tests. Design and methods One hundred and twenty-two spouse CGs of persons with Alzheimer's disease and 117 demographically matched NCG spouses were compared on Trails B and DST at baseline (T1), 1 year later (T2), and 2 years later (T3) and on SCPs at T1. Results Trails B was slower in CGs than NCGs and DST declined in CGs relative to NCGs. CGs reported more SCPs than NCGs. Depression mediated group differences in Trails and DST and was also associated with SCPs. Trails B and DST explained variance in SCPs in NCGs, but not in CGs. Hours of care explained variance in SCPs in CGs, but not in NCGs. Implications When using SCPs to make inferences about CG cognitive function, researchers/clinicians should consider the possible influence of stress exposures and depression. The lack of associations of objective and subjective cognitive measures may be a reflection of poorer self-monitoring among CGs, a potential new area of CG research.
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Affiliation(s)
- Peter P. Vitaliano
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
- Department of Psychology, University of Washington, Seattle
| | - Ozge Ustundag
- Department of Psychology, University of Washington, Seattle
| | - Soo Borson
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
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10
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Korten NCM, Comijs HC, Penninx BWJH, Deeg DJH. Perceived stress and cognitive function in older adults: which aspect of perceived stress is important? Int J Geriatr Psychiatry 2017; 32:439-445. [PMID: 27059116 DOI: 10.1002/gps.4486] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 02/29/2016] [Accepted: 03/15/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Few studies examined the association between perceived stress and cognitive function in older adults. This study will examine which aspects of perceived stress especially impact cognitive function. METHODS Cross-sectional data of 1099 older adults between 64 and 100 years from the Longitudinal Aging Study Amsterdam were used. Perceived stress and its subscales perceived helplessness and perceived self-efficacy were measured with the Perceived Stress Scale. Cognitive function was assessed regarding memory, processing speed and executive function. Univariate and multivariate linear regression analyses were performed between the stress measures and the domains of cognitive function. RESULTS Perceived stress was associated with worse processing speed, direct and delayed recall, semantic fluency and digit span backwards (range β = -0.10; -0.11; p < 0.01). The subscale perceived helplessness showed negative associations only with processing speed (β = -0.06, p < 0.05) and delayed recall (β = -0.06, p < 0.05), which became nonsignificant after the adjustment for depressive symptoms or sense of mastery. The subscale perceived self-efficacy was significantly associated with better cognitive function, also after adjustment for depressive symptoms or sense of mastery (range β = 0.10; 0.18; p < 0.01). CONCLUSIONS In older adults, especially perceived self-efficacy showed independent associations with a broad range of cognitive functions. Perceived self-efficacy might be an important factor in reducing stress and the prevention of cognitive decline. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Nicole C M Korten
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Hannie C Comijs
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Dorly J H Deeg
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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11
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Brailean A, Aartsen MJ, Muniz-Terrera G, Prince M, Prina AM, Comijs HC, Huisman M, Beekman A. Longitudinal associations between late-life depression dimensions and cognitive functioning: a cross-domain latent growth curve analysis. Psychol Med 2017; 47:690-702. [PMID: 27834162 PMCID: PMC5426346 DOI: 10.1017/s003329171600297x] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 10/16/2016] [Accepted: 10/17/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cognitive impairment and depression often co-occur in older adults, but it is not clear whether depression is a risk factor for cognitive decline, a psychological reaction to cognitive decline, or whether changes in depressive symptoms correlate with changes in cognitive performance over time. The co-morbid manifestation of depression and cognitive impairment may reflect either a causal effect or a common cause, depending on the specific symptoms experienced and the cognitive functions affected. METHOD The study sample comprised 1506 community-dwelling older adults aged ⩾65 years from the Longitudinal Aging Study Amsterdam (LASA). We conducted cross-domain latent growth curve analyses to examine longitudinal associations between late-life depression dimensions (i.e. depressed affect, positive affect, and somatic symptoms) and specific domains of cognitive functioning (i.e. processing speed, inductive reasoning, immediate recall, and delayed recall). RESULTS Poorer delayed recall performance at baseline predicted a steeper increase in depressed affect over time. Steeper decline in processing speed correlated with a steeper increase in somatic symptoms of depression over time. CONCLUSIONS Our findings suggest a prospective association between memory function and depressed affect, whereby older adults may experience an increase in depressed affect in reaction to poor memory function. Somatic symptoms of depression increased concurrently with declining processing speed, which may reflect common neurodegenerative processes. Our findings do not support the hypothesis that depression symptoms may be a risk factor for cognitive decline in the general population. These findings have potential implications for the treatment of late-life depression and for the prognosis of cognitive outcomes.
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Affiliation(s)
- A. Brailean
- Department of Health Service and Population
Research, King's College London, Institute of Psychiatry,
Psychology and Neuroscience, Centre for Global Mental Health,
London, UK
| | - M. J. Aartsen
- NOVA - Norwegian Social Research, Center for
Welfare and Labor Research, Oslo,
Norway
| | | | - M. Prince
- Department of Health Service and Population
Research, King's College London, Institute of Psychiatry,
Psychology and Neuroscience, Centre for Global Mental Health,
London, UK
| | - A. M. Prina
- Department of Health Service and Population
Research, King's College London, Institute of Psychiatry,
Psychology and Neuroscience, Centre for Global Mental Health,
London, UK
| | - H. C. Comijs
- VU University Medical Centre, Department of
Psychiatry and the EMGO Institute for Health and Care Research,
Amsterdam, The Netherlands
| | - M. Huisman
- VU University Medical Center, Department of
Epidemiology and Biostatistics and the EMGO Institute for Health and Care
Research, Amsterdam, The Netherlands
- Department of Sociology, VU
University, Amsterdam, The
Netherlands
| | - A. Beekman
- VU University Medical Centre, Department of
Psychiatry and the EMGO Institute for Health and Care Research,
Amsterdam, The Netherlands
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12
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Brailean A, Comijs HC, Aartsen MJ, Prince M, Prina AM, Beekman A, Huisman M. Late-life depression symptom dimensions and cognitive functioning in the Longitudinal Aging Study Amsterdam (LASA). J Affect Disord 2016; 201:171-8. [PMID: 27235820 PMCID: PMC4914607 DOI: 10.1016/j.jad.2016.05.027] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/18/2016] [Indexed: 12/03/2022]
Abstract
BACKGROUND Depression often co-occurs in late-life in the context of declining cognitive functions, but it is not clear whether specific depression symptom dimensions are differentially associated with cognitive abilities. METHODS The study sample comprised 3107 community-dwelling older adults from the Longitudinal Aging Study Amsterdam (LASA). We applied a Multiple Indicators Multiple Causes (MIMIC) model to examine the association between cognitive abilities and latent dimensions of the Center for Epidemiologic Studies Depression Scale (CES-D), while accounting for differential item functioning (DIF) due to age, gender and cognitive function levels. RESULTS A factor structure consisting of somatic symptoms, positive affect, depressed affect, and interpersonal difficulties fitted the data well. Higher levels of inductive reasoning were significantly associated with lower levels of depressed affect and somatic symptoms, whereas faster processing speed was significantly associated with lower levels of somatic symptoms. DIF due to age and gender was found, but the magnitude of the effects was small and did not alter substantive conclusions. LIMITATIONS Due to the cross-sectional context of this investigation, the direction of influence between depression symptom levels and cognitive function levels cannot be established. Furthermore, findings are relevant to non-clinical populations, and they do not clarify whether certain DIF effects may be found only at high or low levels of depression. CONCLUSIONS Our findings suggest differential associations between late-life depression dimensions and cognitive abilities in old age, and point towards potential etiological mechanisms that may underline these associations. These findings carry implications for the prognosis of cognitive outcomes in depressed older adults.
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Affiliation(s)
- Anamaria Brailean
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Health Service and Population Research, Centre for Global Mental Health, London, UK.
| | - Hannie C. Comijs
- VU University Medical Centre, Department of Psychiatry and the EMGO Institute for Health and Care Research, Amsterdam, the Netherlands
| | - Marja J. Aartsen
- NOVA - Norwegian Social Research, Center for Welfare and Labor Research, Oslo, Norway
| | - Martin Prince
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Health Service and Population Research, Centre for Global Mental Health, London, UK
| | - A. Matthew Prina
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Health Service and Population Research, Centre for Global Mental Health, London, UK
| | - Aartjan Beekman
- VU University Medical Centre, Department of Psychiatry and the EMGO Institute for Health and Care Research, Amsterdam, the Netherlands
| | - Martijn Huisman
- VU University, Department of Sociology, Amsterdam, the Netherlands,VU University Medical Center, Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, Department of Sociology, Amsterdam, the Netherlands
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Dimensions of depressive symptoms and cingulate volumes in older adults. Transl Psychiatry 2016; 6:e788. [PMID: 27093070 PMCID: PMC4872407 DOI: 10.1038/tp.2016.49] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/13/2015] [Accepted: 12/21/2015] [Indexed: 12/12/2022] Open
Abstract
Clinical depression and subthreshold depressive symptoms in older adults have been linked to structural changes in the cingulate gyrus. The cingulate comprises functionally distinct subregions that may have distinct associations with different types, or symptom dimensions, of depression. This study examined the relationship between symptom dimensions of depression and gray matter volumes in the anterior cingulate, posterior cingulate and isthmus of the cingulate in a nonclinical sample. The study included 41 community-dwelling older adults between the ages of 55 and 81. Participants received a structural magnetic resonance imaging scan and completed the Center for Epidemiologic Studies Depression Scale. Subscale scores for depressed mood, somatic symptoms and lack of positive affect were calculated, and Freesurfer was used to extract cingulate gray matter volumes. Regression analyses were conducted to examine the relationship between depressive symptoms and volumes of cingulate subregions while controlling for sex, age and estimated total intracranial volume. Higher scores on the depressed mood subscale were associated with larger volumes in the left posterior cingulate and smaller volumes in the isthmus cingulate. Higher scores on the somatic symptoms subscale were significantly related to smaller volumes in the posterior cingulate. A trend was observed for a positive relationship between higher scores on the lack of positive affect subscale and larger volumes in the anterior cingulate cortex. These results are consistent with previous findings of altered cingulate volumes with increased depressive symptomatology and suggest specific symptom dimensions of depression may differ in their relationship with subregions of the cingulate.
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Depressive Mood and Testosterone Related to Declarative Verbal Memory Decline in Middle-Aged Caregivers of Children with Eating Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13030286. [PMID: 27072418 PMCID: PMC4808949 DOI: 10.3390/ijerph13030286] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 02/25/2016] [Accepted: 03/01/2016] [Indexed: 11/17/2022]
Abstract
Caring for children diagnosed with a chronic psychological disorder such as an eating disorder (ED) can be used as a model of chronic stress. This kind of stress has been reported to have deleterious effects on caregivers’ cognition, particularly in verbal declarative memory of women caregivers. Moreover, high depressive mood and variations in testosterone (T) levels moderate this cognitive decline. The purpose of this study was to characterize whether caregivers of individuals with EDs (n = 27) show declarative memory impairments compared to non-caregivers caregivers (n = 27), using for this purpose a standardized memory test (Rey’s Auditory Verbal Learning Test). Its purpose was also to examine the role of depressive mood and T in memory decline. Results showed that ED caregivers presented high depressive mood, which was associated to worse verbal memory performance, especially in the case of women. In addition, all caregivers showed high T levels. Nonetheless, only in the case of women caregivers did T show a curvilinear relationship with verbal memory performance, meaning that the increases of T were associated to the improvement in verbal memory performance, but only up to a certain point, as after such point T continued to increase and memory performance decreased. Thus, chronic stress due to caregiving was associated to disturbances in mood and T levels, which in turn was associated to verbal memory decline. These findings should be taken into account in the implementation of intervention programs for helping ED caregivers cope with caregiving situations and to prevent the risk of a pronounced verbal memory decline.
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Lugtenburg A, Zuidersma M, Oude Voshaar RC, Schoevers RA. Symptom Dimensions of Depression and 3-Year Incidence of Dementia: Results From the Amsterdam Study of the Elderly. J Geriatr Psychiatry Neurol 2016; 29:99-107. [PMID: 26404165 DOI: 10.1177/0891988715606235] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To evaluate the association between depressive symptom dimensions and incident dementia in a community sample of older persons. METHODS Depressive symptoms at baseline and incident dementia at 3-year follow-up were assessed with the Geriatric Mental State (GMS)-Automated Geriatric Examination for Computer Assisted Taxonomy in nondemented persons aged 65 years or older. Exploratory and confirmatory bifactor analysis on the depression items yielded a general depression factor characterized by all GMS items and a cognitive/motivational factor characterized by cognitive and motivational "depressive" symptoms and the absence of depressed mood. RESULTS Ninety-three of 1911 persons had developed dementia at follow-up. The general depression factor increased the risk of dementia after adjustment for covariates (odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.14-1.92), but the cognitive/motivational factor did not (OR: 1.05, 95% CI: 0.75-1.47). However, in 1725 nondepressed older persons, the cognitive/motivational factor significantly predicted dementia after adjustment for covariates (OR: 1.53, 95% CI: 1.03-2.28) but not anymore after additional adjustment for subjective memory complaints (OR: 1.41, 95% CI: 0.94-2.13). The general depression factor did not significantly predict dementia in nondepressed older persons (OR: 1.15, 95% CI: 0.80-1.66). CONCLUSION Our findings suggest that the increased risk of dementia associated with depressive symptoms in many previous studies appears to be heterogeneous, that is, it is likely due to different underlying pathways, including a pathway involving depression itself and a pathway in which cognitive and motivational symptoms reflect subjective cognitive complaints, particularly in the absence of depressed mood. These different pathways might warrant a different treatment approach.
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Affiliation(s)
- Astrid Lugtenburg
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Marij Zuidersma
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Richard C Oude Voshaar
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Pantzar A, Atti AR, Bäckman L, Laukka EJ. Effects of psychiatric history on cognitive performance in old-age depression. Front Psychol 2015; 6:865. [PMID: 26175699 PMCID: PMC4483519 DOI: 10.3389/fpsyg.2015.00865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 06/12/2015] [Indexed: 11/13/2022] Open
Abstract
Cognitive deficits in old-age depression vary as a function of multiple factors; one rarely examined factor is long-term psychiatric history. We investigated effects of psychiatric history on cognitive performance in old-age depression and in remitted persons. In the population-based Swedish National Study on Aging and Care in Kungsholmen study, older persons (≥60 years) without dementia were tested with a cognitive battery and matched to the Swedish National Inpatient Register (starting 1969). Participants were grouped according to current depression status and psychiatric history and compared to healthy controls (n = 96). Group differences were observed for processing speed, attention, executive functions, and verbal fluency. Persons with depression and psychiatric inpatient history (n = 20) and late-onset depression (n = 49) performed at the lowest levels, whereas cognitive performance in persons with self-reported recurrent unipolar depression (n = 52) was intermediate. Remitted persons with inpatient history of unipolar depression (n = 38) exhibited no cognitive deficits. Heart disease burden, physical inactivity, and cumulative inpatient days modulated the observed group differences in cognitive performance. Among currently depressed persons, those with inpatient history, and late onset performed at the lowest levels. Importantly, remitted persons showed no cognitive deficits, possibly reflecting the extended time since the last admission (m = 15.6 years). Thus, the present data suggest that cognitive deficits in unipolar depression may be more state- than trait-related. Information on profiles of cognitive performance, psychiatric history, and health behaviors may be useful in tailoring individualized treatment.
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Affiliation(s)
- Alexandra Pantzar
- Aging Research Center, Karolinska Institutet and Stockholm University Stockholm, Sweden
| | | | - Lars Bäckman
- Aging Research Center, Karolinska Institutet and Stockholm University Stockholm, Sweden ; Stockholm Gerontology Research Center Stockholm, Sweden
| | - Erika J Laukka
- Aging Research Center, Karolinska Institutet and Stockholm University Stockholm, Sweden
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McLaren ME, Szymkowicz SM, Kirton JW, Dotson VM. Impact of Education on Memory Deficits in Subclinical Depression. Arch Clin Neuropsychol 2015; 30:387-93. [PMID: 26109434 DOI: 10.1093/arclin/acv038] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2015] [Indexed: 02/04/2023] Open
Abstract
Elevated depressive symptoms are associated with cognitive deficits, while higher education protects against cognitive decline. This study was conducted to test if education level moderates the relationship between depressive symptoms and cognitive function. Seventy-three healthy, dementia-free adults aged 18-81 completed neuropsychological tests, as well as depression and anxiety questionnaires. Controlling for age, sex, and state anxiety, we found a significant interaction of depressive symptoms and education for immediate and delayed verbal memory, such that those with a higher education level performed well regardless of depressive symptomatology, whereas those with lower education and high depressive symptoms had worse performance. No effects were found for executive functioning or processing speed. Results suggest that education protects against verbal memory deficits in individuals with elevated depressive symptoms. Further research on cognitive reserve in depression-related cognitive deficits and decline is needed to understand the mechanisms behind this phenomenon.
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Affiliation(s)
- Molly E McLaren
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, USA
| | - Sarah M Szymkowicz
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, USA
| | - Joshua W Kirton
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, USA
| | - Vonetta M Dotson
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, USA Department of Neuroscience, University of Florida, Gainesville, FL, USA
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18
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Romero-Martínez A, González-Bono E, Salvador A, Moya-Albiol L. Declarative verbal memory impairments in middle-aged women who are caregivers of offspring with autism spectrum disorders: The role of negative affect and testosterone. Memory 2015; 24:640-9. [DOI: 10.1080/09658211.2015.1034727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kirton JW, Resnick SM, Davatzikos C, Kraut MA, Dotson VM. Depressive symptoms, symptom dimensions, and white matter lesion volume in older adults: a longitudinal study. Am J Geriatr Psychiatry 2014; 22:1469-77. [PMID: 24211028 PMCID: PMC3984387 DOI: 10.1016/j.jagp.2013.10.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 09/18/2013] [Accepted: 10/07/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE White matter lesions (WMLs) are associated with depressive symptoms in older adults. However, it is not clear whether different symptom dimensions of depression have distinct associations with WMLs. The authors assessed the longitudinal relationships of the Center for Epidemiologic Studies Depression Scale (CES-D) total score and subscale scores with WML volume in the Baltimore Longitudinal Study of Aging. METHODS Using a prospective observational design, the authors examined WML volume and depressive symptoms at 1- to 2-year intervals for up to 9 years in 116 dementia-free participants (mean age: 68.78 ± 7.68). At each visit, depressive symptoms were measured with the CES-D and WML volumes were quantified from structural magnetic resonance imaging scans. RESULTS Higher CES-D full-scale scores were associated with greater WML volume and with a faster rate of volume increases over time in women, especially at older ages. Higher depressed mood and somatic symptoms subscale scores were associated with greater increases in WML volume over time at older ages. In men, depressed mood and somatic symptoms were associated with larger WML volume at baseline. CONCLUSION Findings confirm an association between WMLs and depressive symptoms and suggest that depressed mood and somatic symptoms may be stronger predictors of depression-related brain changes than lack of well-being. Age and sex may moderate the relationships between depressive symptoms and WMLs. Understanding particular symptom dimensions of depressive symptoms has implications for treatment and may lead to targeted interventions and more precise knowledge of mechanisms underlying depression.
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Affiliation(s)
- Joshua W Kirton
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD
| | - Christos Davatzikos
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Michael A Kraut
- Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD
| | - Vonetta M Dotson
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL.
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20
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Abstract
BACKGROUND Late-life depression is a heterogeneous disorder, whereby cognitive impairments are often observed. This study examines which clinical characteristics and symptom dimensions of late-life depression are especially impacting on specific cognitive domains. METHODS Cross-sectional data of 378 depressed and 132 non-depressed older adults between 60-93 years, from the Netherlands Study of Depression in Older adults (NESDO) were used. Depressed older adults were recruited from both inpatient and outpatient mental healthcare institutes and general practices, and diagnosed according to DSM-IV-TR criteria. Multivariable associations were examined with depression characteristics (severity, onset, comorbidity, psychotropic medication) and symptom dimensions as independent variables and cognitive domains (episodic memory, processing speed, interference control, working memory) as dependent variables. RESULTS Late-life depression was associated with poorer cognitive functioning. Within depressed participants, higher severity of psychopathology and having a first depressive episode was associated with poorer cognitive functioning. The use of tricyclic antidepressants, serotonergic and noradrenergic working antidepressants, and benzodiazepines was associated with worse cognitive functioning. Higher scores on the mood dimension were associated with poorer working memory and processing speed, whereas higher scores on a motivational and apathy dimension were associated with poorer episodic memory and processing speed. CONCLUSIONS Heterogeneity in late-life depression may lead to differences in cognitive functioning. Higher severity and having a first depressive episode was associated with worse cognitive performance. Additionally, different domains of cognitive functioning were associated with specific symptom dimensions. Our findings on the use of psychotropic medication suggest that close monitoring on cognitive side effects is needed.
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Grenier S, Payette MC, Langlois F, Vu TTM, Bherer L. Depressive symptoms are independently associated with recurrent falls in community-dwelling older adults. Int Psychogeriatr 2014; 26:1-9. [PMID: 24758735 DOI: 10.1017/s104161021400074x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
ABSTRACT Background: Falls and depression are two major public health problems that affect millions of older people each year. Several factors associated with falls are also related to depressive symptoms such as medical conditions, sleep quality, use of medications, cognitive functioning, and physical capacities. To date, studies that investigated the association between falls and depressive symptoms did not control for all these shared factors. The current study addresses this issue by examining the relationship between falls and depression symptoms after controlling for several confounders. Methods: Eighty-two community-dwelling older adults were enrolled in this study. The Geriatric Depression Scale (GDS-30) was used to evaluate the presence of depressive symptoms, and the following question was used to assess falls: "Did you fall in the last 12 months, and if so, how many times?" Results: Univariate analyses indicated that the number of falls was significantly correlated with gender (women), fractures, asthma, physical inactivity, presence of depressive symptoms, complaints about quality of sleep, use of antidepressant drugs, and low functional capacities. Multivariate analyses revealed that depressive symptoms were significantly and independently linked to recurrent falls after controlling for confounders. Conclusions: Results of the present study highlight the importance of assessing depressive symptoms during a fall risk assessment.
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Affiliation(s)
- Sébastien Grenier
- Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
| | - Marie-Christine Payette
- Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
| | - Francis Langlois
- Institut universitaire de gériatrie de Sherbrooke (IUGS), Montréal, Québec, Canada
| | - Thien Tuong Minh Vu
- Institut universitaire de gériatrie de Montréal (IUGM), Montréal, Québec, Canada
| | - Louis Bherer
- Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
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Pantzar A, Laukka EJ, Atti AR, Fastbom J, Fratiglioni L, Bäckman L. Cognitive deficits in unipolar old-age depression: a population-based study. Psychol Med 2014; 44:937-947. [PMID: 23842200 DOI: 10.1017/s0033291713001736] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND There is substantial variability in the degree of cognitive impairment among older depressed persons. Inconsistencies in previous findings may be due to differences in clinical and demographic characteristics across study samples. We assessed the influence of unipolar depression and severity of depression on cognitive performance in a population-based sample of elderly persons aged ⩾60 years. METHOD Eighty-nine persons fulfilled ICD-10 criteria for unipolar depression (mild, n = 48; moderate, n = 38; severe, n = 3) after thorough screening for dementia (DSM-IV criteria), psychiatric co-morbidities and antidepressant pharmacotherapy. Participants (n = 2486) were administered an extensive cognitive test battery. RESULTS Moderate/severe unipolar depression was associated with poorer performance on tasks assessing processing speed, attention, executive function, verbal fluency, episodic memory and vocabulary. Mild depression was associated with poorer performance in processing speed, and few differences between mild and moderate/severe depression were observed. No association between depression and short-term memory, general knowledge or spatial ability was observed. Increasing age did not exacerbate the depression-related cognitive deficits, and the deficits remained largely unchanged after excluding persons in a preclinical phase of dementia. Furthermore, depression-related cognitive deficits were not associated with other pharmacological treatments that may affect cognitive performance. CONCLUSIONS Cognitive deficits in unipolar old-age depression involve a range of domains and the cognitive deficits seem to follow the spectrum of depression severity. The finding that mild depression was also associated with poorer cognitive functioning underscores the importance of detecting mild depression in elderly persons.
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Affiliation(s)
- A Pantzar
- Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - E J Laukka
- Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - A R Atti
- Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - J Fastbom
- Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - L Fratiglioni
- Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - L Bäckman
- Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden
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Schneider G, Zitzmann M, Gromoll J, Ladwig KH, Berger K. The relation between sex hormone levels, the androgen receptor CAGn-polymorphism and depression and mortality in older men in a community study. Psychoneuroendocrinology 2013; 38:2083-90. [PMID: 23602133 DOI: 10.1016/j.psyneuen.2013.03.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 03/21/2013] [Accepted: 03/24/2013] [Indexed: 02/01/2023]
Abstract
BACKGROUND Sex hormones levels and the androgen receptor CAGn polymorphism have been shown to be involved in depressed mood in aging men. But the few prior studies found inconsistent results on the role of both factors. METHODS 186 male participants aged ≥65 years from the community based Memory and Morbidity in Augsburg Elderly (MEMO) Study underwent a physical examination, and a medical interview including two scales (Center for Epidemiologic Studies Depression Scale (CES-D); Activities of Daily Living Scale (ADL). Testosterone, SHBG and LH levels were measured and the androgen receptor CAGn polymorphism was genotyped. χ(2), Mann-Whitney U-test, Pearson's correlations and multivariable linear and logistic regression were used in the analysis. RESULTS Higher depressive scores were significantly associated with higher SHBG-levels (beta coefficient 0.25, p<0.001). SHBG alone explained 8% of variance of the CES-D depression score. Mortality at 10 years follow-up was predicted by higher SHBG levels, higher ADL-scores, older age, current smoking and the depression score at baseline. This model explained 35% of the variance of mortality. The number of CAG repeats was neither related to depression scores nor to mortality. CONCLUSIONS We found positive associations between SHBG levels and old age male depression as well as mortality. Whether SHBG has a testosterone independent effect in this context should be investigated further.
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Affiliation(s)
- Gudrun Schneider
- Department of Psychosomatics and Psychotherapy, University of Muenster, Muenster, Germany.
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Maki Y, Yamaguchi T, Yamaguchi H. Symptoms of Early Dementia-11 Questionnaire (SED-11Q): A Brief Informant-Operated Screening for Dementia. Dement Geriatr Cogn Dis Extra 2013; 3:131-42. [PMID: 23687508 PMCID: PMC3656692 DOI: 10.1159/000350460] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to develop a brief informant-based questionnaire, namely the Symptoms of Early Dementia-11 Questionnaire (SED-11Q), for the screening of early dementia. 459 elderly individuals participated, including 39 with mild cognitive impairment in the Clinical Dementia Rating scale (CDR) 0.5, 233 with mild dementia in CDR 1, 106 with moderate dementia in CDR 2, and 81 normal controls in CDR 0. Informants were required to fill out a 13-item questionnaire. Two items were excluded after analyzing sensitivities and specificities. The final version of the SED-11Q assesses memory, daily functioning, social communication, and personality changes. Receiver operator characteristic curves assessed the utility to discriminate between CDR 0 (no dementia) and CDR 1 (mild dementia). The statistically optimal cutoff value of 2/3, which indicated a sensitivity of 0.84 and a specificity of 0.90, can be applied in the clinical setting. In the community setting, a cutoff value of 3/4, which indicated a sensitivity of 0.76 and a specificity of 0.96, is recommended to avoid false positives. The SED-11Q reliably differentiated nondemented from demented individuals when completed by an informant, and thus is practical as a rapid screening tool in general practice, as well as in the community setting, to decide whether to seek further diagnostic confirmation.
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Affiliation(s)
- Yohko Maki
- Gunma University School of Health Sciences, Gunma University of Health and Welfare, Maebashi, Japan ; Geriatrics Research Institute and Hospital, Gunma University of Health and Welfare, Maebashi, Japan
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Johnson LA, Mauer C, Jahn D, Song M, Wyshywaniuk L, Hall JR, Balldin VH, O'Bryant SE. Cognitive differences among depressed and non-depressed MCI participants: a project FRONTIER study. Int J Geriatr Psychiatry 2013; 28:377-82. [PMID: 22653735 DOI: 10.1002/gps.3835] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 04/24/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Depression is the most commonly reported psychiatric symptom in patients with mild cognitive impairment (MCI). However, more research is needed examining the impact of depression on cognitive functioning in MCI patients. The purpose of this study was to examine differences in cognitive functioning in a sample of community- based, depressed, and non-depressed MCI patients. METHODS One hundred and five participants with MCI were included in this study. Participants were recruited from Project FRONTIER, a study of rural health. Depression was assessed via the Geriatric Depression Scale (GDS-30), and cognition was measured using the Repeatable Battery for the Assessment of Neuropsychological Status. RESULTS The results indicated that depressed MCI participants performed significantly worse than their non-depressed counterparts on several cognitive measures. MCI participants with depression scored significantly lower on immediate memory (t = 3.4, p < 0.01) and delayed memory (t = 2.8, p < 0.01) indices than their non-depressed counterparts. CONCLUSIONS The results of this study indicated that MCI participants with depression experienced greater deficits in cognitive functioning than their non-depressed counterparts. Depressed MCI participants exhibited greater deficits in both immediate and delayed memory. Thus, identifying and treating depression in individuals with MCI may improve memory and cognitive functioning.
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Affiliation(s)
- Leigh A Johnson
- Department of Internal Medicine, University of North Texas Health Sciences Center, Fort Worth, TX, USA.
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Danhauer SC, Legault C, Bandos H, Kidwell K, Costantino J, Vaughan L, Avis NE, Rapp S, Coker LH, Naughton M, Naylor C, Terracciano A, Shumaker S. Positive and negative affect, depression, and cognitive processes in the Cognition in the Study of Tamoxifen and Raloxifene (Co-STAR) Trial. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2012; 20:532-52. [PMID: 23237718 PMCID: PMC3815441 DOI: 10.1080/13825585.2012.747671] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES This study examined the relationship between positive and negative affect, depressive symptoms, and cognitive performance. METHODS The sample consisted of 1479 non-demented, postmenopausal women (mean age = 67 years) at increased risk of breast cancer enrolled in the National Surgical Adjuvant Breast and Bowel Project's Study of Tamoxifen and Raloxifene. At each annual visit, women completed a standardized neuropsychological battery and self-report measures of affect and depression. Data from three visits were used in linear mixed models for repeated measures using likelihood ratio tests. Separate analyses were performed to relate positive/negative affect and depression to each cognitive measure. RESULTS Higher positive affect was associated with better letter fluency (p = .006) and category fluency (p < .0001). Higher negative affect was associated with worse global cognitive function (p < .0001), verbal memory (CVLT List B; p = .002), and spatial ability (p < .0001). Depressive symptoms were negatively associated with verbal knowledge (p = .004), figural memory (p < .0001), and verbal memory (p's ≤ .0001). DISCUSSION Findings are consistent with some prior research demonstrating a link between positive affect and increased verbal fluency and between depressive symptoms and decreased memory. The most novel finding shows that negative affect is related to decreased global cognition and visuospatial ability. Overall, this research in a large, longitudinal sample supports the notion that positive affect is related to increases and negative affect to decreases in performance on distinct cognitive measures.
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Affiliation(s)
- Suzanne C Danhauer
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157-1063, USA.
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Kyranou M, Paul SM, Dunn LB, Puntillo K, Aouizerat BE, Abrams G, Hamolsky D, West C, Neuhaus J, Cooper B, Miaskowski C. Differences in depression, anxiety, and quality of life between women with and without breast pain prior to breast cancer surgery. Eur J Oncol Nurs 2012; 17:190-5. [PMID: 22892272 DOI: 10.1016/j.ejon.2012.06.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 06/07/2012] [Accepted: 06/11/2012] [Indexed: 12/25/2022]
Abstract
PURPOSE OF THE RESEARCH Little is known about the relationships between pain, anxiety, and depression in women prior to breast cancer surgery. The purpose of this study was to evaluate for differences in anxiety, depression, and quality of life (QOL) in women who did and did not report the occurrence of breast pain prior to breast cancer surgery. We hypothesized that women with pain would report higher levels of anxiety and depression as well as poorer QOL than women without pain. METHODS AND SAMPLE A total of 390 women completed self-report measures of pain, anxiety depression, and QOL prior to surgery. KEY RESULTS Women with preoperative breast pain (28%) were significantly younger, had a lower functional status score, were more likely to be Non-white and to have gone through menopause. Over 37% of the sample reported clinically meaningful levels of depressive symptoms. Almost 70% of the sample reported clinically meaningful levels of anxiety. Patients with preoperative breast pain reported significantly higher depression scores and significantly lower physical well-being scores. No between group differences were found for patients' ratings of state and trait anxiety or total QOL scores. CONCLUSIONS Our a priori hypotheses were only partially supported. Findings from this study suggest that, regardless of pain status, anxiety and depression are common problems in women prior to breast cancer surgery.
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Affiliation(s)
- Maria Kyranou
- School of Nursing, University of California, San Francisco, CA, USA
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van Uden IWM, van Norden AGW, de Laat KF, van Oudheusden LJB, Gons RAR, Tendolkar I, Zwiers MP, de Leeuw FE. Depressive Symptoms and Amygdala Volume in Elderly with Cerebral Small Vessel Disease: The RUN DMC Study. J Aging Res 2011; 2011:647869. [PMID: 22007299 PMCID: PMC3189594 DOI: 10.4061/2011/647869] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 08/13/2011] [Indexed: 01/08/2023] Open
Abstract
Introduction. Late onset depressive symptoms (LODSs) frequently occur in elderly with cerebral small vessel disease (SVD). SVD cannot fully explain LODS; a contributing factor could be amygdala volume. We investigated the relation between amygdala volume and LODS, independent of SVD in 503 participants with symptomatic cerebral SVD. Methods. Patients underwent FLAIR and T1 scanning. Depressive symptoms were assessed with structured questionnaires; amygdala and WML were manually segmented. The relation between amygdala volume and LODS/EODS was investigated and adjusted for age, sex, intracranial volume, and SVD. Results. Patients with LODS had a significantly lower left amygdala volume than those without (P = 0.02), independent of SVD. Each decrease of total amygdala volume (by mL) was related to an increased risk of LODS (OR = 1.77; 95% CI 1.02–3.08; P = 0.04).
Conclusion. Lower left amygdala volume is associated with LODS, independent of SVD. This may suggest differential mechanisms, in which individuals with a small amygdala might be vulnerable to develop LODS.
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Affiliation(s)
- I W M van Uden
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Reinier Postlaan 4, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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Baune BT, Unwin SJ, Quirk F, Golledge J. Neuropsychiatric symptoms in patients with aortic aneurysms. PLoS One 2011; 6:e22632. [PMID: 21799922 PMCID: PMC3142179 DOI: 10.1371/journal.pone.0022632] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 06/29/2011] [Indexed: 12/25/2022] Open
Abstract
Background Emerging evidence suggests that vascular disease confers vulnerability to a late-onset of depressive illness and the impairment of specific cognitive functions, most notably in the domains of memory storage and retrieval. Lower limb athero-thrombosis and abdominal aortic aneurysm (AAA) have both been previously associated with neuropsychiatric symptoms possibly due to associated intracerebral vascular disease or systemic inflammation, hence suggesting that these illnesses may be regarded as models to investigate the vascular genesis of neuropsychiatric symptoms. The aim of this study was to compare neuropsychiatric symptoms such as depression, anxiety and a variety of cognitive domains in patients who had symptoms of peripheral athero-thrombosis (intermittent claudication) and those who had an asymptomatic abdominal aortic aneurysm AAA. Methodology/Principal Findings In a cross-sectional study, 26 participants with either intermittent claudication or AAA were assessed using a detailed neuropsychiatric assessment battery for various cognitive domains and depression and anxiety symptoms (Hamilton Depression and Anxiety Scales). Student t test and linear regression analyses were applied to compare neuropsychiatric symptoms between patient groups. AAA participants showed greater levels of cognitive impairment in the domains of immediate and delayed memory as compared to patients who had intermittent claudication. Cognitive dysfunction was best predicted by increasing aortic diameter. CRP was positively related to AAA diameter, but not to cognitive function. AAA and aortic diameter in particular were associated with cognitive dysfunction in this study. Conclusions/Significance AAA patients are at a higher risk for cognitive impairment than intermittent claudication patients. Validation of this finding is required in a larger study, but if confirmed could suggest that systemic factors peculiar to AAA may impact on cognitive function.
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Affiliation(s)
- Bernhard T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, South Australia, Australia.
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A 35-year longitudinal assessment of cognition and midlife depression symptoms: the Vietnam Era Twin Study of Aging. Am J Geriatr Psychiatry 2011; 19:559-70. [PMID: 21606899 PMCID: PMC3101375 DOI: 10.1097/jgp.0b013e3181ef79f1] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine whether early adult cognitive ability is a risk factor for depressive symptoms in midlife and how genetic and environmental influences explain the association and to examine cross-sectional relationships between depressive symptoms and specific cognitive abilities at midlife. DESIGN A 35-year longitudinal and cross-sectional twin study of cognitive aging. SETTING Large multicenter study in the United States. PARTICIPANTS One thousand two hundred thirty-seven male twins aged 51 to 60 years. MEASUREMENTS At the age of 20 years and midlife, participants completed the same version of a general cognitive ability test (Armed Forces Qualification Test [AFQT]). Midlife testing included an extensive neurocognitive protocol assessing processing speed, verbal memory, visual-spatial memory, working memory, executive function, and visual-spatial ability. Participants completed the Center for Epidemiologic Studies Depression Scale before cognitive testing and provided health and life style information during a medical history interview. RESULTS Lower age 20 AFQT scores predicted higher levels of depressive symptoms at age 55 years (r = -0.16,p <0.001). In bivariate twin modeling, 77% of the correlation between early cognitive ability and midlife depressive symptoms was due to shared genetic influences. Controlling for current age, age 20 AFQT, and nonindependence ofobservations, depressive symptoms were associated with worse midlife AFQT scores and poorer performance in all cognitive domains except verbal memory. CONCLUSION Results suggest that low cognitive ability is a risk factor for depressive symptoms; this association is partly due to shared genetic influences. Crosssectional analyses indicate that the association between depressive symptoms and performance is not linked to specific cognitive domains.
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Scholtissen-In de Braek DMJM, Hurks PPM, van Boxtel MPJ, Dijkstra JB, Jolles J. The identification of attention complaints in the general population and their effect on quality of life. J Atten Disord 2011; 15:46-55. [PMID: 19794137 DOI: 10.1177/1087054709347260] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To provide more insight into subjective attention complaints in a healthy adult and elderly population and how these affect Quality of Life (QoL). METHOD A group of 1,550 healthy Dutch participants complete a postal questionnaire including items from the Maastricht Attention and Memory Checklist (MAC). The impact of attention complaints on QoL is investigated in a subsample of 499 participants. RESULTS Factor analysis (N = 1,550) reveals two factors: Attention and Memory. Attention complaints are related to depressed mood, anxiety, vitality, and sleep problems that can have serious consequences for daily life functioning and QoL (n = 499). Memory complaints are related to other aspects of health, such as pain and changes in health. CONCLUSION Attention complaints in the healthy population are common and related to depression, anxiety, and sleep and several aspects of QoL, such as problems with social functioning, emotional problems, and vitality.
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Dotson VM, Zonderman AB, Davatzikos C, Kraut MA, Resnick SM. Frontal Atrophy and Attention Deficits in Older Adults with a History of Elevated Depressive Symptoms. Brain Imaging Behav 2009; 3:358. [PMID: 20161651 DOI: 10.1007/s11682-009-9078-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Studies of older adults with depressive disorders indicate greater cognitive deficits and brain alterations than would be expected for their age. There is some evidence that these findings are present after a single episode of depression, but this work has been cross-sectional in nature. We investigated both cross-sectional and longitudinal associations between a history of elevated depressive symptoms (HDS), frontal lobe volumes, and cognitive performance within the context of normal age-related changes over time in the Baltimore Longitudinal Study of Aging. After controlling for age, HDS was associated with smaller total frontal gray matter volumes and with smaller regional volumes in the cingulate gyrus and orbitofrontal cortex. Men, but not women, with HDS showed deficits in auditory attention span at older ages. Results confirm previous reports that even a single episode of depression is associated with adverse outcomes in older adults but suggest that HDS does not affect longitudinal trajectories of cognitive and brain volume change.
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Affiliation(s)
- Vonetta M Dotson
- Laboratory of Personality and Cognition, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD
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Vitaliano PP, Zhang J, Young HM, Caswell LW, Scanlan JM, Echeverria D. Depressed mood mediates decline in cognitive processing speed in caregivers. THE GERONTOLOGIST 2009; 49:12-22. [PMID: 19363000 DOI: 10.1093/geront/gnp004] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE Very few studies have examined cognitive decline in caregivers versus noncaregivers, and only 1 study has examined mediators of such decline. We evaluated the relationship between caregiver status and decline on the digit symbol test (DST; a measure of processing speed, attention, cognitive-motor translation, and visual scanning) and whether this relationship was mediated by depressed mood. DESIGN AND METHODS Caregivers for spouses with Alzheimer's disease (n = 122) were compared with demographically similar noncaregiver spouses (n = 117) at study entry (Time 1 = T1), T2 (1 year later), and T3 (2 years after T1). RESULTS Caregivers had lower DST scores and higher Hamilton depression scores at T1, T2, and T3 than noncaregivers (all p < .05). Hierarchical linear modeling revealed that although caregivers started well below noncaregivers, they experienced a more rapid rate of decline than noncaregivers (p = .047). Caregivers declined 4.5 times faster than noncaregivers. Greater depressed mood at T1 (p < .01) and T2 (p < .01) predicted DST decline and mediated DST decline in caregivers vs. noncaregivers. IMPLICATIONS Depressed mood in caregivers relative to noncaregivers may influence their greater risk for DST decline. This is important because the DST predicts problem solving and everyday functions necessary for independent living and the potential well-being of their care recipients.
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Affiliation(s)
- Peter P Vitaliano
- Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195-6560, USA.
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Olver IN, Whitford HS, Denson LA, Peterson MJ, Olver SI. Improving informed consent to chemotherapy: a randomized controlled trial of written information versus an interactive multimedia CD-ROM. PATIENT EDUCATION AND COUNSELING 2009; 74:197-204. [PMID: 18945572 DOI: 10.1016/j.pec.2008.08.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Revised: 08/17/2008] [Accepted: 08/30/2008] [Indexed: 05/27/2023]
Abstract
OBJECTIVE This randomized controlled trial aimed to determine whether an interactive CD-ROM improved cancer patients' recall of chemotherapy treatment information over standard written information, and whether demographic, cognitive, and psychological factors better predicted recall than this format of delivery. METHODS One-hundred-and-one new patients about to commence chemotherapy were randomized to receive written information or a CD-ROM containing treatment information before giving informed consent. Patients' recall, concentration, short-term memory, reading comprehension, anxiety, depression, and coping styles were assessed with standardized measures pre-treatment. Seventy-seven patients completed tests for recall of treatment information before their second chemotherapy session. RESULTS Intention-to-treat analyses indicated no significant differences between the written information and CD-ROM groups across recall questions about number of drugs received (p=.43), treatment length (p=.23), and treatment goal (p=.69). Binary logistic regressions indicated that for groups combined different variables predicted each of the recall questions. CONCLUSION An interactive CD-ROM did not improve cancer patients' recall of treatment information enough to warrant changes in consent procedures. PRACTICE IMPLICATIONS Different variables predicted recall of different treatment aspects highlighting the complex nature of attempting to improve patient recall. Attending to the effect of depression on patient knowledge and understanding appears paramount.
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Affiliation(s)
- Ian N Olver
- Royal Adelaide Hospital Cancer Centre, Adelaide, South Australia, Australia.
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Baune BT, Roesler A, Knecht S, Berger K. Single and combined effects of cerebral white matter lesions and lacunar infarctions on cognitive function in an elderly population. J Gerontol A Biol Sci Med Sci 2009; 64:118-24. [PMID: 19164275 DOI: 10.1093/gerona/gln004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study is to investigate the association between single and combined vascular brain changes (white matter lesions [WMLs], lacunar infarctions) and the cognitive domains of memory, processing speed, and motor function in the elderly adults. METHODS In a sample of 268 participants aged 65-83 years of the MEMO (Memory and Morbidity in Augsburg Elderly) population-based study in Augsburg, Germany, cerebral magnetic resonance imaging (MRI) was performed and a detailed neuropsychological test battery applied. Analysis of covariance determined the effects of vascular brain changes on domains of cognitive functioning. RESULTS Strong associations of large WMLs and of MRI-defined lacunar infarction with three different domains of cognitive function even after adjustment for age, gender, and education were found. The combined occurrence of both lesions affected about one in 10 participants and was associated with a strong decrease in cognitive function in all domains. The difference between the groups with only one lesion type (either large WMLs or MRI-defined infarction) and participants affected by both was significant in the domains of processing speed and memory, even after adjustment for important confounders such as age, gender, education, and comorbidities. The effects of both lesion types on cognitive function were not more than additive. CONCLUSIONS Our study shows that both large WMLs and MRI-defined lacunar infarction contribute to impairments in different cognitive domains. The results suggest that their combined occurrence is associated with stronger reductions in cognitive function than each of the two brain lesion types alone.
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Perrino T, Mason CA, Brown SC, Spokane A, Szapocznik J. Longitudinal relationships between cognitive functioning and depressive symptoms among Hispanic older adults. J Gerontol B Psychol Sci Soc Sci 2008; 63:P309-17. [PMID: 18818446 DOI: 10.1093/geronb/63.5.p309] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This study examines the relationship between cognitive functioning and depressive symptoms across 3 years in a prospective study of 273 community-dwelling, Hispanic older adults in Miami. The analyses extend the literature by testing for a bidirectional or reciprocal relationship between depressive symptoms and cognitive functioning over time and by examining the relationship between these variables among Hispanics, an understudied population at risk of developing depressive symptoms and cognitive impairments. Structural equation modeling with a cross-lagged panel design showed that depressive symptoms were unrelated to subsequent cognitive functioning. However, cognitive functioning was related to subsequent depressive symptoms at every time point, such that poorer cognitive functioning was related to higher depressive symptoms. Findings suggest that cognitive declines may predict depressive symptoms in community-dwelling Hispanic older adults.
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Affiliation(s)
- Tatiana Perrino
- Department of Epidemiology & Public Health, University of Miami Miller School of Medicine, 1425 NW 10th Avenue, Room 211, Miami, FL 33136, USA.
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