1
|
Grande G, Li Y, Trevisan C, Rizzuto D, Kalpouzos G, Ding M, Laukka EJ, Bellander T, Fratiglioni L, Qiu C. Lung function in relation to brain aging and cognitive transitions in older adults: A population-based cohort study. Alzheimers Dement 2024. [PMID: 38970219 DOI: 10.1002/alz.14079] [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: 10/17/2023] [Revised: 04/27/2024] [Accepted: 05/29/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND We investigated the association of peak expiratory flow (PEF) with dementia; cognitive impairment, no dementia (CIND); and transition from CIND to dementia, and possible underlying neuropathological mechanisms. METHODS A population-based cohort of adults aged 60+ was followed over 15 years to detect dementia (Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria), CIND (assessed through a cognitive battery), and progression from CIND to dementia, in relation to baseline PEF observations. A subsample (n = 462) had 6-year follow-up data on brain magnetic resonance imaging markers of neurodegeneration and small vessel disease. RESULTS In fully adjusted models, poor PEF performance (< 10th vs. ≥ 80th percentile) was associated with increased hazards for dementia (hazard ratio [HR] = 1.89; 95% confidence interval [CI] = 1.23-2.92) and CIND (HR = 1.55; 95% CI = 1.01-2.38) and CIND progression to dementia, although not statistically significantly (HR = 2.44; 95% CI = 0.78-6.88). People with poor PEF also experienced the fastest ventricular enlargement (β coefficient = 0.67 mL/year; 95% CI = 0.13-1.21) and had the highest likelihood of developing lacunes (odds ratio = 5.05; 95% CI = 1.01-25.23). DISCUSSION Poor lung function contributes to cognitive deterioration possibly through accelerated brain atrophy and microvascular damage. HIGHLIGHTS Poor lung function increased the risk of dementia and mild cognitive impairment (MCI). Poor lung function accelerated the progression from MCI to dementia. Poor lung function was linked to brain microvascular damage and global brain atrophy.
Collapse
Affiliation(s)
- Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Centre, Stockholm, Sweden
| | - Yuanjing Li
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Caterina Trevisan
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Debora Rizzuto
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Centre, Stockholm, Sweden
| | - Grégoria Kalpouzos
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Mozhu Ding
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Erika J Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Centre, Stockholm, Sweden
| | - Tom Bellander
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Centre, Stockholm, Sweden
| | - Chengxuan Qiu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| |
Collapse
|
2
|
Valletta M, Vetrano DL, Xia X, Rizzuto D, Roso-Llorach A, Calderón-Larrañaga A, Marengoni A, Laukka EJ, Canevelli M, Bruno G, Fratiglioni L, Grande G. Multimorbidity patterns and 18-year transitions from normal cognition to dementia and death: A population-based study. J Intern Med 2023; 294:326-335. [PMID: 37306092 DOI: 10.1111/joim.13683] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Several chronic diseases accelerate cognitive decline; however, it is still unknown how different patterns of multimorbidity influence individuals' trajectories across the cognitive continuum. OBJECTIVES We aimed to investigate the impact of multimorbidity and of specific multimorbidity patterns on the transitions across cognitive stages (normal cognition, cognitive impairment, no dementia [CIND], dementia) and death. METHODS We included 3122 dementia-free individuals from the Swedish National study on Aging and Care in Kungsholmen. Using fuzzy c-means cluster analysis, multimorbid participants were classified into mutually exclusive groups characterized by commonly coexisting chronic diseases. Participants were followed up to 18 years to detect incident CIND, dementia, or death. Transition hazard ratios (HRs), life expectancies, and time spent in different cognitive stages were estimated using multistate Markov models. RESULTS At baseline, five multimorbidity patterns were identified: neuropsychiatric, cardiovascular, sensory impairment/cancer, respiratory/metabolic/musculoskeletal, and unspecific. Compared to the unspecific pattern, the neuropsychiatric and sensory impairment/cancer ones showed reduced hazards of reverting from CIND to normal cognition (HR 0.53, 95% CI 0.33-0.85 and HR 0.60, 95% CI 0.39-0.91). Participants in the cardiovascular pattern exhibited an increased hazard of progression from CIND to dementia (HR 1.70, 95% CI 1.15-2.52) and for all transitions to death. Subjects with the neuropsychiatric and cardiovascular patterns showed reduced life expectancy at age 75, with an anticipation of CIND (up to 1.6 and 2.2 years, respectively) and dementia onset (up to 1.8 and 3.3 years, respectively). CONCLUSIONS Multimorbidity patterns differentially steer individual trajectories across the cognitive continuum of older adults and may be used as a risk stratification tool.
Collapse
Affiliation(s)
- Martina Valletta
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Xin Xia
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Debora Rizzuto
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Albert Roso-Llorach
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Alessandra Marengoni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Erika J Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Marco Canevelli
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Giuseppe Bruno
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| |
Collapse
|
3
|
Figeys M, Villarey S, Leung AWS, Raso J, Buchan S, Kammerer H, Rawani D, Kohls-Wiebe M, Kim ES. tDCS over the left prefrontal Cortex improves mental flexibility and inhibition in geriatric inpatients with symptoms of depression or anxiety: A pilot randomized controlled trial. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:997531. [PMID: 36386776 PMCID: PMC9641275 DOI: 10.3389/fresc.2022.997531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/04/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Patients with depression and/or anxiety are commonly seen in inpatient geriatric settings. Both disorders are associated with an increased risk of cognitive impairments, notably in executive functioning. Transcranial direct current stimulation (tDCS), a type of non-invasive brain stimulation, involves the administration of a low-dose electrical current to induce neuromodulation, which ultimately may act on downstream cognitive processing. OBJECTIVE The purpose of this study was to determine the effects of tDCS on executive functioning in geriatric inpatients with symptoms of depression and/or anxiety. DESIGN Pilot Randomized Controlled Trial. SETTING Specialized geriatric wards in a tertiary rehabilitation hospital. METHODS Thirty older-aged adults were recruited, of which twenty completed ten-to-fifteen sessions of 1.5 mA anodal or sham tDCS over the left dorsolateral prefrontal cortex. Cognitive assessments were administered at baseline and following the tDCS protocol; analyses examined the effects of tDCS on cognitive performance between groups (anodal or sham tDCS). RESULTS tDCS was found to increase inhibitory processing and cognitive flexibility in the anodal tDCS group, with significant changes on the Stroop test and Trail Making Test-Part B. No significant changes were observed on measures of attention or working memory. DISCUSSION These results provide preliminary evidence that tDCS-induced neuromodulation may selectively improve cognitive processing in older adults with symptoms of depression and/or anxiety. CLINICAL TRIALS REGISTRATION www.clinicaltrials.gov, NCT04558177.
Collapse
Affiliation(s)
- Mathieu Figeys
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada,Alberta Health Services, Edmonton, AB, Canada,Correspondence: Mathieu Figeys
| | - Sheryn Villarey
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Ada W. S. Leung
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada,Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada
| | - Jim Raso
- Alberta Health Services, Edmonton, AB, Canada
| | - Steven Buchan
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | | | - David Rawani
- Alberta Health Services, Edmonton, AB, Canada,Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | | | - Esther S. Kim
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada,Department of Communication Sciences and Disorders, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
4
|
Huan Y, Mujun X, Xin L, Ping Z, Limei F, Aming L, Xinquan L. Short Sleep Duration as a Risk Factor for Depression, Anxiety and Fatigue in Patients with Leukemia. Neuropsychiatr Dis Treat 2022; 18:1573-1582. [PMID: 35937713 PMCID: PMC9346604 DOI: 10.2147/ndt.s362229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 06/18/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Our study aimed to investigate the level of depression, anxiety, and fatigue in patients with leukemias, and analyze the influence of sleep duration on the mental symptoms of patients with leukemias. METHODS A total of 127 patients were enrolled in our study and completed the questionnaire survey. Self-Assessment Depression Scale (SDS), Self-Assessment Anxiety Scale (SAS), and the Fatigue Scale-14 (FS-14) were adopted. The patient's lifestyle information, including exercise, alcohol abuse, and smoking, was obtained from the patient's self-report. RESULTS Depression score of patients with sleep duration >8 hours (long duration group) was 56.21±11.63, which was significantly lower than that of patients sleep duration between 6 and 8 hours (medium duration group) with 59.61±8.77 and patients sleep <6 hours (short duration group) with 64.82±6.42 (P = 0.007). Similarly, the anxiety score of long duration group, medium duration group and short duration group was 45.36±11.41, 48.26±6.96 and 53.53±5.87, respectively (P = 0.005). The fatigue score of short duration group is 8.47±2.45, which is higher than others (P = 0.046). To further identify the relationship, we evaluated physical fatigue and mental fatigue levels in patients with or without symptoms of depression. We found that patients with symptoms of depression have a higher score both in physical fatigue and mental fatigue (all p < 0.001). Similar trend was observed in patients with or without symptoms of anxiety (all p < 0.001). However, alzhough patients with leukemia in long duration group have the highest score of physical fatigue (p = 0.016), no significant difference in mental fatigue was found in different sleeping duration group (p = 0.587). Furthermore, multivariate analyses were conducted and revealed that sleep duration was the independent factor associated with depression (OR = 0.270, P = 0.003) and anxiety (OR = 0.473, P = 0.010). CONCLUSION For leukemia patients with short sleep duration, a prompt evaluation of their level of depression, anxiety, and fatigue and the initiation of timely interventions is essential.
Collapse
Affiliation(s)
- Yu Huan
- Department of Hematology, Chenzhou First People's Hospital, Chenzhou City, Hunan Province, People's Republic of China
| | - Xiong Mujun
- Department of Hematology, Chenzhou First People's Hospital, Chenzhou City, Hunan Province, People's Republic of China
| | - Liao Xin
- Department of Hematology, Chenzhou First People's Hospital, Chenzhou City, Hunan Province, People's Republic of China
| | - Zhu Ping
- Department of Hematology, Chenzhou First People's Hospital, Chenzhou City, Hunan Province, People's Republic of China
| | - Fu Limei
- Department of Hematology, Chenzhou First People's Hospital, Chenzhou City, Hunan Province, People's Republic of China
| | - Lei Aming
- Department of Hematology, Chenzhou First People's Hospital, Chenzhou City, Hunan Province, People's Republic of China
| | - Liang Xinquan
- Department of Hematology, Chenzhou First People's Hospital, Chenzhou City, Hunan Province, People's Republic of China
| |
Collapse
|
5
|
Francisco HC, Bregola A, Ottaviani AC, Luchesi BM, Orlandi FDS, Fraga FJ, Costa-Guarisco L, Pavarini SCI. Associação entre fatores psicossociais e funcionais e desempenho de idosos em linguagem e fluência verbal. REVISTA CEFAC 2022. [DOI: 10.1590/1982-0216/20222460822s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RESUMO Objetivo: identificar fatores psicossociais e funcionais associados ao desempenho de idosos em linguagem e fluência verbal. Métodos: estudo realizado com 149 idosos cadastrados no serviço de atenção primária à saúde de uma cidade do interior de São Paulo. Foram utilizados um questionário de caracterização sociodemográfica, Exame Cognitivo de Addenbrooke - Revisado (domínios de fluência verbal e de linguagem), Escala de Depressão Geriátrica, Escala de Estresse Percebido, Medical Outcomes Study, WHOQOL-OLD e Escala de Atividades Instrumentais da Vida Diária. Os participantes foram divididos em tercis de acordo com o desempenho em linguagem e fluência verbal: T1 = melhor desempenho, T2 = desempenho mediano e T3 = pior desempenho. Foram comparados os grupos T1 e T3 e realizada uma regressão binária para analisar os fatores associados ao melhor desempenho em linguagem e fluência verbal. Resultados: as variáveis associadas ao melhor desempenho de linguagem comparando T1 e T3 foram: maior escolaridade, maior renda e melhor funcionalidade. Para a melhor fluência verbal, os fatores associados foram: maior escolaridade e melhor funcionalidade. Conclusão: a escolaridade e a funcionalidade mostraram-se importantes fatores associados ao bom desempenho da linguagem e da fluência verbal, enquanto a renda mostrou-se associada apenas ao bom desempenho de linguagem.
Collapse
|
6
|
Francisco HC, Bregola A, Ottaviani AC, Luchesi BM, Orlandi FDS, Fraga FJ, Costa-Guarisco L, Pavarini SCI. Association between psychosocial and functional factors and language and verbal fluency performance in older adults. REVISTA CEFAC 2022. [DOI: 10.1590/1982-0216/20222460822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
ABSTRACT Purpose: to identify psychosocial and functional factors associated with language and verbal fluency performance in older adults. Methods: a study conducted with 149 older adults registered in a primary health care service in a city in inland São Paulo. Instruments such as a sociodemographic questionnaire, the Addenbrooke Cognitive Examination-Revised (verbal fluency and language domains), Geriatric Depression Scale, Perceived Stress Scale, Medical Outcomes Study, WHOQOL-OLD, and Instrumental Activities of Daily Living Scale, were used. Participants were divided into tertiles, according to their language and verbal fluency performance: T1 = best performance, T2 = median performance, and T3 = worst performance. Groups T1 and T3 were compared, and a binary regression was conducted to analyze the factors associated with the best language and verbal fluency performance. Results: higher educational attainment, higher income, and better functioning were the factors associated with the best language performance comparing T1 and T3, while higher educational attainment and better functioning were associated with the best verbal fluency. Conclusion: educational attainment and functioning proved to be important factors associated with good language and verbal fluency performance, while income was associated only with good language performance.
Collapse
|
7
|
Villalobos D, Pacios J, Vázquez C. Cognitive Control, Cognitive Biases and Emotion Regulation in Depression: A New Proposal for an Integrative Interplay Model. Front Psychol 2021; 12:628416. [PMID: 33995183 PMCID: PMC8119761 DOI: 10.3389/fpsyg.2021.628416] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
Research traditions on cognition and depression focus on relatively unconnected aspects of cognitive functioning. On one hand, the neuropsychological perspective has concentrated on cognitive control difficulties as a prominent feature of this condition. On the other hand, the clinical psychology perspective has focused on cognitive biases and repetitive negative patterns of thinking (i.e., rumination) for emotional information. A review of the literature from both fields reveals that difficulties are more evident for mood-congruent materials, suggesting that cognitive control difficulties interact with cognitive biases to hinder cognitive switching, working memory updating, and inhibition of irrelevant information. Connecting research from these two traditions, we propose a novel integrative cognitive model of depression in which the interplay between mood-congruent cognitive control difficulties, cognitive biases, and rumination may ultimately lead to ineffective emotion-regulation strategies to downregulate negative mood and upregulate positive mood.
Collapse
Affiliation(s)
- Dolores Villalobos
- Department of Experimental Psychology, School of Psychology, Complutense University of Madrid, Madrid, Spain.,Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain
| | - Javier Pacios
- Department of Experimental Psychology, School of Psychology, Complutense University of Madrid, Madrid, Spain.,Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain
| | - Carmelo Vázquez
- Department of Clinical Psychology, School of Psychology, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
8
|
Interactive effects of elevated homocysteine and late-life depression on cognitive impairment. J Affect Disord 2020; 277:212-217. [PMID: 32829197 DOI: 10.1016/j.jad.2020.08.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/02/2020] [Accepted: 08/10/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Both an elevated homocysteine (Hcy) level and depression are risk factors for cognitive impairment in the general population, but no study has analyzed whether the coexistence of an elevated Hcy level and late-life depression (LLD) is associated with worse cognitive performance. OBJECTIVE We aimed to investigate the relationship between Hcy levels and cognitive function in individuals with LLD and whether the coexistence of an elevated Hcy level and LLD is associated with worse cognitive performance. METHODS A total of 113 LLD patients and 89 normal controls underwent a standardized clinical interview and comprehensive neuropsychological assessment battery. Plasma concentrations of Hcy were detected. Factorial analyses were performed to examine the impact of the coexistence of an elevated Hcy level and LLD on cognitive performance. RESULTS Plasma Hcy levels in patients with LLD were significantly higher than that in normal controls. Only for LLD patients, Hcy level was negatively correlated with global cognition, executive function, attention, and visual space. The factorial analysis showed that there was a significant interactive effect of Hcy level (normal and elevated levels) and LLD (with and without LLD) on global cognition. In post hoc comparisons, the elderly individuals with both elevated Hcy levels and LLD tended to have the worst global cognitive function compared with those with LLD or elevated Hcy levels alone. CONCLUSIONS The coexistence of an elevated Hcy level and LLD was associated with worse cognitive performance. Early intervention should be initiated to protect cognition in LLD patients with elevated Hcy levels.
Collapse
|
9
|
Ribeiro A, Rosa B, Oliveira J, Lopes P. Depression, social support, executive functioning, functionality, and quality of life in institutionalized elderly people. PSYCHOLOGY, COMMUNITY & HEALTH 2020. [DOI: 10.5964/pch.v8i1.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim
Our aim was to study the executive functioning, functionality, and quality of life of institutionalized old aged persons and to determine the potential roles of self-reported depression and satisfaction with social support on these domains.
Method
The sample comprised 36 volunteers (13 males and 23 females) aged between 71 and 94 years. The measures used consisted of well-established battery of neuropsychological tests. A comparative study was performed.
Results
Participants with depressive symptoms shown impaired executive functioning. Cognitive flexibility, functionality in instrumental activities of daily living, and quality of life are more affected in participants with higher levels of depression that also report higher levels of satisfaction with social support.
Conclusion
This result is intriguing and may highlight the relevance of considering not only depression, but also factors related to social isolation and loneliness in the explanation of cognitive performance, functionality, and quality of life.
Collapse
|
10
|
Vermeulen T, Lauwers T, Van Diermen L, Sabbe BG, van der Mast RC, Giltay EJ. Cognitive Deficits in Older Adults With Psychotic Depression: A Meta-Analysis. Am J Geriatr Psychiatry 2019; 27:1334-1344. [PMID: 31378679 DOI: 10.1016/j.jagp.2019.07.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/18/2019] [Accepted: 07/18/2019] [Indexed: 11/30/2022]
Abstract
A major depressive disorder with psychotic features, that is, psychotic depression (PD), is often accompanied by cognitive deficits, particularly in older patients. We aimed to assess to what extent various cognitive domains are affected in older patients with PD compared to those with nonpsychotic depression (NPD). Therefore, a systematic search was conducted in Medline, Embase, Web of Science, the Cumulative Index to Nursing and Allied Literature (CINAHL), Google Scholar, and Cochrane for all relevant studies. Hereafter, we conducted a meta-analysis of seven studies on cognitive deficits in older adults (55+ years), comparing patients with PD and patients with NPD. Compared to patients with NPD, those with PD not only showed a significantly poorer performance on overall cognitive function, with a Hedges' g effect size of -0.34 (95% confidence interval: -0.56; -0.12; p = 0.003), but also on nearly all separate cognitive domains, with Hedges' g effect sizes ranging from -0.26 to -0.64 (all p's <0.003), of which attention was most adversely affected. Verbal fluency showed no significant effect, although this analysis may have been underpowered. The funnel plot suggested no significant publication bias (Egger test intercept: -2.47; 95% confidence interval: -5.50; 0.55; p = 0.09). We conclude that older patients with PD show more cognitive deficits on all cognitive domains, except for verbal fluency, compared to patients with NPD. It is crucial that clinicians and researchers take cognitive deficits into consideration in older adults with PD.
Collapse
Affiliation(s)
- Tom Vermeulen
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (TV, LVD, BGS, and RCvdM), Antwerp, Belgium.
| | - Tina Lauwers
- Scientific Initiative for Neuropsychiatric and Psychopharmacological Studies, University Psychiatric Hospital Duffel (TL, LVD, and BGS), Duffel, Antwerp, Belgium
| | - Linda Van Diermen
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (TV, LVD, BGS, and RCvdM), Antwerp, Belgium; Scientific Initiative for Neuropsychiatric and Psychopharmacological Studies, University Psychiatric Hospital Duffel (TL, LVD, and BGS), Duffel, Antwerp, Belgium
| | - Bernard G Sabbe
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (TV, LVD, BGS, and RCvdM), Antwerp, Belgium; Scientific Initiative for Neuropsychiatric and Psychopharmacological Studies, University Psychiatric Hospital Duffel (TL, LVD, and BGS), Duffel, Antwerp, Belgium
| | - Roos C van der Mast
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (TV, LVD, BGS, and RCvdM), Antwerp, Belgium; University Medical Centre Leiden, University of Leiden, (RCvdM and EJG), Leiden, the Netherlands
| | - Erik J Giltay
- University Medical Centre Leiden, University of Leiden, (RCvdM and EJG), Leiden, the Netherlands
| |
Collapse
|
11
|
Mekari S, Dupuy O, Martins R, Evans K, Kimmerly DS, Fraser S, Neyedli HF. The effects of cardiorespiratory fitness on executive function and prefrontal oxygenation in older adults. GeroScience 2019; 41:681-690. [PMID: 31728899 PMCID: PMC6885073 DOI: 10.1007/s11357-019-00128-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 10/21/2019] [Indexed: 12/13/2022] Open
Abstract
Reviews on cardiovascular fitness and cognition in older adults suggest that a higher level of cardiorespiratory fitness may protect the brain against the effects of aging. Although studies reveal positive effects of cardiorespiratory fitness on executive function, more research is needed to clarify the underlying mechanisms of these effects in older adults. The aim of the current study was to assess the association between cardiorespiratory fitness level, cerebral oxygenation, and cognitive performance in older adults (OAs). Seventy-four OAs (68 ± 6.3 years) gave their written, informed consent to participate in the study. Complete data was collected from 66 participants. All participants underwent a cycle ergometer maximal continuous graded exercise test in order to assess their peak power output (PPO) and a neuropsychological paper and pencil tests (Trail Making Test A and B) while changes in left prefrontal cortex oxygenation were measured with functional near-infrared spectroscopy (fNIRS). The results reveal increased cardiorespiratory fitness was associated with decreased response time (i.e., better performance) on the Trail Making Test (B) (standardized β = - 0.42, p < 0.05). Cerebral oxygenation in higher fit older adults mediated the relationship with improved executive functioning (standardized β = - 0.08, p < 0.05). Specifically, in older adults with higher cardiorespiratory fitness (based on a median split), cerebral oxygenation was related to executive functioning but no such relationship existed in lower fit adults.
Collapse
Affiliation(s)
- Said Mekari
- School of Kinesiology, Acadia University, 550 Main Street, Wolfville, Nova Scotia, B4P 2R6, Canada.
| | - Olivier Dupuy
- Laboratory MOVE (EA 6314), Faculty of Sport Sciences, University of Poitiers, Poitiers, France
| | - Ricardo Martins
- School of Kinesiology, Acadia University, 550 Main Street, Wolfville, Nova Scotia, B4P 2R6, Canada
| | - Kailey Evans
- School of Kinesiology, Acadia University, 550 Main Street, Wolfville, Nova Scotia, B4P 2R6, Canada
| | - Derek S Kimmerly
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health Halifax, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Heather F Neyedli
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health Halifax, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
12
|
Schwert C, Stohrer M, Aschenbrenner S, Weisbrod M, Schröder A. Neurocognitive profile of outpatients with unipolar depressive disorders. J Clin Exp Neuropsychol 2019; 41:913-924. [PMID: 31437083 DOI: 10.1080/13803395.2019.1634180] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | | | - Steffen Aschenbrenner
- Department of Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Baden-Baden, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Baden-Baden, Germany
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | | |
Collapse
|
13
|
Simpson IC, Dumitrache CG, Calet N. Mental health symptoms and verbal fluency in elderly people: Evidence from the Spanish longitudinal study of aging. Aging Ment Health 2019; 23:670-679. [PMID: 29634354 DOI: 10.1080/13607863.2018.1448969] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Depression and loneliness are highly prevalent in old age. Moreover these mental health symptoms adversely affect the verbal fluency of the elderly. We examined the relationship between depression and loneliness with verbal fluency in people aged 50 years or older. METHOD Research data were collected during the pilot study of the Longitudinal Aging Study in Spain (ELES) in which a representative sample of non-institutionalized Spanish older people was assessed. Here, the cross-sectional data for 962 participants were analysed using hierarchical regressions, controlling for age, education level, overall cognitive functioning, social networks and satisfaction with family. RESULTS Higher levels of cognitive functioning were associated with higher verbal fluency. Females showed higher levels of phonological fluency. Neither depression nor loneliness were significant predictors of phonological fluency but loneliness was a significant predictor of semantic fluency. For mild levels of loneliness, the rate of decline in semantic fluency slows in the oldest ages. In contrast, for severe loneliness the rate of decline in semantic fluency increases in the oldest ages. CONCLUSIONS Depressive symptoms, loneliness and cognitive impairment are all prominent in ageing and therefore their impact on ageing needs to be better understood. Early detection of loneliness, along with the implementation of intervention for individuals diagnosed with loneliness is advisable in order to avoid negative repercussions for the verbal fluency of these individuals.
Collapse
Affiliation(s)
- Ian Craig Simpson
- a Human Neuroscience Lab, Department of Psychology , Universidad Loyola Andalucía , Seville , Spain
| | | | - Nuria Calet
- b Department of Developmental and Educational Psychology, University of Granada , Granada , Spain
| |
Collapse
|
14
|
Kamourieh S, Braga RM, Leech R, Mehta A, Wise RJS. Speech Registration in Symptomatic Memory Impairment. Front Aging Neurosci 2018; 10:201. [PMID: 30038566 PMCID: PMC6046456 DOI: 10.3389/fnagi.2018.00201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 06/13/2018] [Indexed: 11/20/2022] Open
Abstract
Background: An inability to recall recent conversations often indicates impaired episodic memory retrieval. It may also reflect a failure of attentive registration of spoken sentences which leads to unsuccessful memory encoding. The hypothesis was that patients complaining of impaired memory would demonstrate impaired function of “multiple demand” (MD) brain regions, whose activation profile generalizes across cognitive domains, during speech registration in naturalistic listening conditions. Methods: Using functional MRI, brain activity was measured in 22 normal participants and 31 patients complaining of memory impairment, 21 of whom had possible or probable Alzheimer’s disease (AD). Participants heard a target speaker, either speaking alone or in the presence of distracting background speech, followed by a question to determine if the target speech had been registered. Results: Patients performed poorly at registering verbal information, which correlated with their scores on a screening test of cognitive impairment. Speech registration was associated with widely distributed activity in both auditory cortex and in MD cortex. Additional regions were most active when the target speech had to be separated from background speech. Activity in midline and lateral frontal MD cortex was reduced in the patients. A central cholinesterase inhibitor to increase brain acetylcholine levels in half the patients was not observed to alter brain activity or improve task performance at a second fMRI scan performed 6–11 weeks later. However, individual performances spontaneously fluctuated between the two scanning sessions, and these performance differences correlated with activity within a right hemisphere fronto-temporal system previously associated with sustained auditory attention. Conclusions: Midline and lateralized frontal regions that are engaged in task-dependent attention to, and registration of, verbal information are potential targets for transcranial brain stimulation to improve speech registration in neurodegenerative conditions.
Collapse
Affiliation(s)
- Salwa Kamourieh
- Computational, Cognitive, and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Rodrigo M Braga
- Computational, Cognitive, and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, United Kingdom.,Center for Brain Science, Harvard University, Cambridge, MA, United States
| | - Robert Leech
- Computational, Cognitive, and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Amrish Mehta
- Department of Neuroradiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Richard J S Wise
- Computational, Cognitive, and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, United Kingdom
| |
Collapse
|
15
|
Laukka EJ, Dykiert D, Allerhand M, Starr JM, Deary IJ. Effects of between-person differences and within-person changes in symptoms of anxiety and depression on older age cognitive performance. Psychol Med 2018; 48:1350-1358. [PMID: 29039283 PMCID: PMC6088541 DOI: 10.1017/s0033291717002896] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 08/28/2017] [Accepted: 09/05/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Anxiety and depression are both important correlates of cognitive function. However, longitudinal studies investigating how they covary with cognition within the same individual are scarce. We aimed to simultaneously estimate associations of between-person differences and within-person variability in anxiety and depression with cognitive performance in a sample of non-demented older people. METHODS Participants in the Lothian Birth Cohort 1921 study, a population-based narrow-age sample (mean age at wave 1 = 79 years, n = 535), were examined on five occasions across 13 years. Anxiety and depression were measured with the Hospital Anxiety and Depression Scale (HADS) and cognitive performance was assessed with tests of reasoning, logical memory, and letter fluency. Data were analyzed using two-level linear mixed-effects models with within-person centering. RESULTS Divergent patterns were observed for anxiety and depression. For anxiety, between-person differences were more influential; people who scored higher on HADS anxiety relative to other same-aged individuals demonstrated poorer cognitive performance on average. For depression, on the other hand, time-varying within-person differences were more important; scoring higher than usual on HADS depression was associated with poorer cognitive performance relative to the average level for that participant. Adjusting for gender, childhood mental ability, emotional stability, and disease burden attenuated these associations. CONCLUSIONS The results from this study highlight the importance of addressing both between- and within-person effects of negative mood and suggest that anxiety and depression affect cognitive function in different ways. The current findings have implications for assessment and treatment of older age cognitive deficits.
Collapse
Affiliation(s)
- E. J. Laukka
- Department of Neurobiology, Care Sciences, and Society (NVS), Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - D. Dykiert
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - M. Allerhand
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - J. M. Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Geriatric Medicine Unit, University of Edinburgh, Edinburgh, UK
| | - I. J. Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
16
|
Tomadesso C, de La Sayette V, de Flores R, Bourgeat P, Villemagne VL, Egret S, Eustache F, Chételat G. Neuropsychology and neuroimaging profiles of amyloid-positive versus amyloid-negative amnestic mild cognitive impairment patients. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2018; 10:269-277. [PMID: 29780872 PMCID: PMC5956939 DOI: 10.1016/j.dadm.2018.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Introduction Patients with amnestic mild cognitive impairment (aMCI) are heterogeneous as regard to their amyloid status. The present study aimed at highlighting the neuropsychological, brain atrophy, and hypometabolism profiles of amyloid-positive (Aβpos) versus amyloid-negative (Aβneg) aMCI patients. Methods Forty-four aMCI patients and 24 Aβneg healthy controls underwent neuropsychological, structural magnetic resonance imaging and 18F-fluorodeoxyglucose positron emission tomography scans. Data were compared between groups in specific regions of interest and voxelwise with statistical parametric mapping. Results When directly comparing Aβpos to Aβneg aMCI, the former had lower performances in episodic memory tests (P = .02 to P < .001) while the latter had worse scores in working memory (P = .01) and language (P < .005). Compared to Aβneg healthy controls, both aMCI subgroups showed similar profiles of atrophy and hypometabolism, with no difference between both aMCI subgroups. Conclusion In a sample of aMCI patients recruited and scanned in the same center, the main difference at baseline between Aβpos and Aβneg aMCI concerned the neuropsychological profile, but not the structural magnetic resonance imaging or 18F-fluorodeoxyglucose positron emission tomography profiles of brain alterations. Amyloid-positive (Aβpos) amnestic mild cognitive impairment (aMCI) had lower performances than amyloid-negative (Aβneg) aMCI in episodic memory. Aβneg aMCI had lower performances than Aβpos aMCI in working memory and language. Aβneg and Aβpos aMCI did not differ in terms of brain atrophy or metabolism. Cognition is more efficient than neuroimaging to discriminate Aβneg from Aβpos aMCI.
Collapse
Affiliation(s)
- Clémence Tomadesso
- Inserm, Inserm U1077, Université de Caen Normandie, Ecole Pratique des Hautes Etudes, Caen, France.,Inserm, Inserm UMR-S U1237, Université de Caen-Normandie, GIP Cyceron, Boulevard H. Becquerel, Caen, France
| | - Vincent de La Sayette
- Inserm, Inserm U1077, Université de Caen Normandie, Ecole Pratique des Hautes Etudes, Caen, France.,CHU de Caen, Service de Neurologie, Caen, France
| | - Robin de Flores
- Inserm, Inserm UMR-S U1237, Université de Caen-Normandie, GIP Cyceron, Boulevard H. Becquerel, Caen, France
| | - Pierrick Bourgeat
- CSIRO Digital Productivity Flagship, The Australian e-Health Research Centre-BioMedIA, Herston, Queensland, Australia
| | - Victor L Villemagne
- Department of Molecular Imaging and Therapy, Centre for PET, Austin Health, Heidelberg, Victoria, Australia.,The Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia
| | - Stéphanie Egret
- Inserm, Inserm UMR-S U1237, Université de Caen-Normandie, GIP Cyceron, Boulevard H. Becquerel, Caen, France
| | - Francis Eustache
- Inserm, Inserm U1077, Université de Caen Normandie, Ecole Pratique des Hautes Etudes, Caen, France
| | - Gaël Chételat
- Inserm, Inserm UMR-S U1237, Université de Caen-Normandie, GIP Cyceron, Boulevard H. Becquerel, Caen, France
| |
Collapse
|
17
|
Overton M, Pihlsgård M, Elmståhl S. Up to speed: Birth cohort effects observed for speed of processing in older adults: Data from the Good Ageing in Skåne population study. INTELLIGENCE 2018. [DOI: 10.1016/j.intell.2018.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
18
|
Marseglia A, Fratiglioni L, Laukka EJ, Santoni G, Pedersen NL, Bäckman L, Xu W. Early Cognitive Deficits in Type 2 Diabetes: A Population-Based Study. J Alzheimers Dis 2018; 53:1069-78. [PMID: 27314527 PMCID: PMC4981902 DOI: 10.3233/jad-160266] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Evidence links type 2 diabetes to dementia risk. However, our knowledge on the initial cognitive deficits in diabetic individuals and the factors that might promote such deficits is still limited. This study aimed to identify the cognitive domains initially impaired by diabetes and the factors that play a role in this first stage. Within the population-based Swedish National Study on Aging and Care–Kungsholmen, 2305 cognitively intact participants aged ≥60 y were identified. Attention/working memory, perceptual speed, category fluency, letter fluency, semantic memory, and episodic memory were assessed. Diabetes (controlled and uncontrolled) and prediabetes were ascertained by clinicians, who also collected information on vascular disorders (hypertension, heart diseases, and stroke) and vascular risk factors (VRFs, including smoking and overweight/obesity). Data were analyzed with linear regression models. Overall, 196 participants (8.5%) had diabetes, of which 144 (73.5%) had elevated glycaemia (uncontrolled diabetes); 571 (24.8%) persons had prediabetes. In addition, diabetes, mainly uncontrolled, was related to lower performance in perceptual speed (β – 1.10 [95% CI – 1.98, – 0.23]), category fluency (β – 1.27 [95% CI – 2.52, – 0.03]), and digit span forward (β – 0.35 [95% CI – 0.54, – 0.17]). Critically, these associations were present only among APOEɛ4 non–carriers. The associations of diabetes with perceptual speed and category fluency were present only among participants with VRFs or vascular disorders. Diabetes, especially uncontrolled diabetes, is associated with poorer performance in perceptual speed, category fluency, and attention/primary memory. VRFs, vascular disorders, and APOE status play a role in these associations.
Collapse
Affiliation(s)
- Anna Marseglia
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Erika J Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Giola Santoni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lars Bäckman
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Weili Xu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, China
| |
Collapse
|
19
|
Seubert J, Laukka EJ, Rizzuto D, Hummel T, Fratiglioni L, Bäckman L, Larsson M. Prevalence and Correlates of Olfactory Dysfunction in Old Age: A Population-Based Study. J Gerontol A Biol Sci Med Sci 2017; 72:1072-1079. [PMID: 28444135 PMCID: PMC5861894 DOI: 10.1093/gerona/glx054] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 03/16/2017] [Indexed: 02/03/2023] Open
Abstract
Background: Olfactory dysfunction (OD) in old age is associated with poor health outcomes. Interrelationships among different correlates of OD can offer insights into the underlying mechanisms, but to date remain understudied. Methods: Odor identification performance and self-reported olfactory functioning were studied in 2,234 people aged 60–90 years, who were free of neurodegenerative disease and enrolled in the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) study, Stockholm, Sweden. OD was defined as the inability to identify more than 10 out of 16 odors (free or cued identification) in a standardized odor identification task. OD prevalence was estimated, and associations with demographic, genetic, vascular, clinical, and behavioral factors, as well as their interactions were examined using multiple logistic regression analyses. Results: Overall prevalence of OD was 24.8% (CI: 23.1; 26.6). Self-reports were characterized by low sensitivity (35%), but high specificity (87%). Advancing age (OR = 15.50, CI = 9.40; 26.10 between the first and last age group), and history of coronary heart disease (OR = 1.35, 95% CI = 1.04; 1.75) were the principal factors associated with an increased probability of OD, whereas female gender (OR = 0.53, 95% CI = 0.43; 0.66) and more years of education (OR = 0.97, CI 0.94; 0.99) were linked to a lower probability. Exploratory interaction analyses indicated that prevalence of OD was particularly elevated among Apolipropotein E (APOE) ε4 allele carriers who were also obese, and that being physically active counteracted the negative impact of cerebrovascular disease on OD. Conclusion: Demographic and genetic factors, but also prior and current health insults, are linked to OD in old age. Modulatory effects of behavioral factors highlight their value as possible prevention targets.
Collapse
Affiliation(s)
- Janina Seubert
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Sweden.,Department of Clinical Neuroscience, Psychology Division, Karolinska Institutet, Stockholm, Sweden
| | - Erika J Laukka
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Sweden
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Sweden
| | - Thomas Hummel
- Department of Otorhinolaryngology, TU Dresden, Germany
| | - Laura Fratiglioni
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Sweden.,Stockholm Gerontology Research Center, Sweden
| | - Lars Bäckman
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Sweden.,Stockholm Gerontology Research Center, Sweden
| | - Maria Larsson
- Gösta Ekman's Laboratory, Department of Psychology, Stockholm University, Sweden
| |
Collapse
|
20
|
Lugtenburg A, Oude Voshaar RC, Van Zelst W, Schoevers RA, Enriquez-Geppert S, Zuidersma M. The relationship between depression and executive function and the impact of vascular disease burden in younger and older adults. Age Ageing 2017; 46:697-701. [PMID: 28398458 DOI: 10.1093/ageing/afx043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 03/11/2017] [Indexed: 02/06/2023] Open
Abstract
Background depression is associated with worse executive function, but underlying mechanisms might differ by age. Aims to investigate whether vascular disease burden affects the association between depression and executive dysfunction differentially by age. Method among 83,613 participants of Lifelines (population-based cohort study), linear regression analyses were applied to examine the association between executive function (Ruff Figural Fluency test, dependent variable) and depression according to DSM-IV criteria (Mini International Neuropsychiatric Interview, independent variable). Results adjusted for demographic characteristics, major depressive disorder was associated with a lower level of executive function in both younger and older adults. Minor depressive disorder was only associated with worse executive function in younger adults. Adding vascular disease burden to the final model with major depressive disorder, reduced this strength of this association by 5.9% in younger and 5.0% in older adults. Conclusions major depression was associated with worse executive function across the lifespan, but minor depression only in younger adults. The impact of vascular burden on the association did not differ between younger and older adults. Therefore, vascular risk reduction is important in both age groups.
Collapse
Affiliation(s)
- Astrid Lugtenburg
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology of Emotion regulation (ICPE), Groningen, The Netherlands
| | - Richard C Oude Voshaar
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology of Emotion regulation (ICPE), Groningen, The Netherlands
| | - Willeke Van Zelst
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology of Emotion regulation (ICPE), Groningen, The Netherlands
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology of Emotion regulation (ICPE), Groningen, The Netherlands
| | - Stefanie Enriquez-Geppert
- Department of Clinical and Developmental Neuropsychology, Rijksuniversiteit Groningen, Groningen, The Netherlands
| | - Marij Zuidersma
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology of Emotion regulation (ICPE), Groningen, The Netherlands
| |
Collapse
|
21
|
Pantzar A, Atti AR, Fratiglioni L, Fastbom J, Bäckman L, Laukka EJ. Cognitive performance in unipolar old-age depression: a longitudinal study. Int J Geriatr Psychiatry 2017; 32:675-684. [PMID: 27246314 DOI: 10.1002/gps.4510] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 03/02/2016] [Accepted: 04/22/2016] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Previous studies on cognitive deficits in acute and remitted states of old-age depression have shown mixed findings. The episodic nature of depression makes repeated assessment of cognitive performance important in order to address reversibility and stability of cognitive deficits. METHODS Dementia-free older participants (≥60 years) from the population-based Swedish National Study on Aging and Care in Kungsholmen who completed neuropsychological testing at baseline (T1) and follow-up (T2) formed the basis of the study sample. Participants were grouped according to depression status at T1 and T2: depressed-remitted (n = 32), remitted-depressed (n = 45), and nondepressed-depressed (n = 29). These groups were compared with a group of randomly selected and matched (age, gender, education, and follow-up time) healthy controls (n = 106) over a period of maximum 6 years. RESULTS Mixed ANCOVAs, controlling for age and gender, revealed depression-related deficits for processing speed, attention, executive function, and category fluency. In remitted states, only processing speed and attention were affected. However, these deficits were attenuated after exclusion of persons using benzodiazepine medications. A general pattern of cognitive decline was observed across all groups for processing speed, executive function, category fluency, and episodic and semantic memory; persons transitioning from a nondepressed to depressed state tended to show exacerbated cognitive decline. CONCLUSIONS The results support the notion that cognitive deficits in depression may be more transient than stable. Consequently, cognitive deficits in depression might be regarded as potential treatment targets rather than stable vulnerabilities. As such, repeated assessment of cognitive functioning may provide an additional marker of treatment response.
Collapse
Affiliation(s)
- Alexandra Pantzar
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Anna Rita Atti
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Bologna University, Bologna, Italy
| | - Laura Fratiglioni
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Johan Fastbom
- 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
| |
Collapse
|
22
|
Anticholinergic drug use is associated with episodic memory decline in older adults without dementia. Neurobiol Aging 2017; 55:27-32. [PMID: 28407520 DOI: 10.1016/j.neurobiolaging.2017.03.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 03/02/2017] [Accepted: 03/06/2017] [Indexed: 02/04/2023]
Abstract
Anticholinergic drug use is common in older adults and has been related to increased dementia risk. This suggests that users of these drugs may experience accelerated cognitive decline. So far, however, longitudinal data on this topic are absent and the available evidence is inconclusive with respect to effects on specific cognitive domains due to suboptimal control of confounding variables. We investigated whether anticholinergic medication use is associated with cognitive decline over 6 years in a population-based study of older adults (aged 60-90; n = 1473) without dementia. We found that users (n = 29) declined more on episodic memory over 6 years compared to nonusers (n = 1418). These results were independent of age, sex, education, overall drug intake, physical activity, depression, cardiovascular risk burden, and cardiovascular disease. By contrast, anticholinergic drug use was unrelated to performance in processing speed, semantic memory, short-term memory, verbal fluency, and global cognition (the Mini-Mental-State Examination). Our results suggest that effects of anticholinergics may be particularly detrimental to episodic memory in older adults, which supports the assertion that the cholinergic system plays an important role in episodic memory formation.
Collapse
|
23
|
Caixeta L, Soares VLD, Vieira RT, Soares CD, Caixeta V, Ferreira SB, Aversi-Ferreira TA. Executive Function Is Selectively Impaired in Old Age Bipolar Depression. Front Psychol 2017; 8:194. [PMID: 28243220 PMCID: PMC5303705 DOI: 10.3389/fpsyg.2017.00194] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 01/30/2017] [Indexed: 12/16/2022] Open
Abstract
Background: Little is known about the cognitive signature of bipolar disorder (BD) in elderly brains. The neuropsychological features of depressive elderly with early-onset BD are largely unknown. This issue is relevant because cognitive impairment can produce an additional impact on the already compromised functionality of elderly with BD. The aim of this study is to assess executive functions (EFs) in the depressive phase of elderly outpatients with early-onset BD. Methods: Forty-nine elderly outpatients with early-onset BD were assessed with several neuropsychological tests for EF in the depressive phase of the disorder. Results: Executive dysfunction is very common in old age bipolar depression. Thirteen patients (26.5%) had a pseudodementia presentation. The worst performances were observed in the following tests: Trail Making B, Stroop Test 3, Backward Digit Span and Wisconsin Card Sorting Test. Conclusion: Executive dysfunction profile in elderly BD is complex and heterogeneous, but most cases display difficulties in working memory, inhibitory control, mental flexibility, and information processing speed. The performance of elderly with bipolar depression in executive assessment can be divided into two main categories: (1) Single EF domain impairment; and (2) Multiple EF domain impairment with or without a pseudodementia syndrome. Executive dysfunction in old age bipolar depression may be explained by lack of sufficient mental energy to run those cognitive processes that require larger amounts of effort to be performed.
Collapse
Affiliation(s)
- Leonardo Caixeta
- Bipolar Disorder Unit, Hospital das Clínicas, School of Medicine, Federal University of GoiásGoiania, Brazil; Unit of Neuropsychiatry, Neuropsychology and Behavior Neurology (UNCO), Federal University of GoiásGoiania, Brazil
| | - Vânia L D Soares
- Unit of Neuropsychiatry, Neuropsychology and Behavior Neurology (UNCO), Federal University of Goiás Goiania, Brazil
| | - Renata T Vieira
- Unit of Neuropsychiatry, Neuropsychology and Behavior Neurology (UNCO), Federal University of Goiás Goiania, Brazil
| | - Cândida D Soares
- Unit of Neuropsychiatry, Neuropsychology and Behavior Neurology (UNCO), Federal University of Goiás Goiania, Brazil
| | - Victor Caixeta
- Bipolar Disorder Unit, Hospital das Clínicas, School of Medicine, Federal University of Goiás Goiania, Brazil
| | - Sandra B Ferreira
- Unit of Neuropsychiatry, Neuropsychology and Behavior Neurology (UNCO), Federal University of Goiás Goiania, Brazil
| | - Tales A Aversi-Ferreira
- Federal University of AlfenasAlfenas, Brazil; System Emotional Science, School of Medicine and Pharmaceutical Sciences, University of ToyamaToyama, Japan
| |
Collapse
|
24
|
Overton M, Pihlsgård M, Elmståhl S. Test administrator effects on cognitive performance in a longitudinal study of ageing. COGENT PSYCHOLOGY 2016. [DOI: 10.1080/23311908.2016.1260237] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Marieclaire Overton
- Division of Geriatric Medicine, Lunds University, Skånes University Hospital, Jan Waldenströms gata 35, CRC Building 28, fl.13, SE-205 02 Malmö, Sweden
| | - Mats Pihlsgård
- Division of Geriatric Medicine, Lunds University, Skånes University Hospital, Jan Waldenströms gata 35, CRC Building 28, fl.13, SE-205 02 Malmö, Sweden
| | - Sölve Elmståhl
- Division of Geriatric Medicine, Lunds University, Skånes University Hospital, Jan Waldenströms gata 35, CRC Building 28, fl.13, SE-205 02 Malmö, Sweden
| |
Collapse
|
25
|
Brewster GS, Peterson L, Roker R, Ellis ML, Edwards JD. Depressive Symptoms, Cognition, and Everyday Function Among Community-Residing Older Adults. J Aging Health 2016; 29:367-388. [PMID: 26951519 DOI: 10.1177/0898264316635587] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to understand the relationships among depressive symptoms, cognition, and functional performance in a community-based sample of older adults. METHOD Older adults ( N = 885) from the Staying Keen in Later Life study completed tests of executive function, speed of processing, and memory. The Center for Epidemiologic Depression Scale assessed depressive symptoms. The Timed Instrumental Activities of Daily Living Test assessed participants' everyday functional performance. RESULTS Depressive symptoms had significant associations with measures of executive function, speed of processing, memory, and everyday functional performance. Cognitive performance completely mediated the association between depressive symptoms and everyday function. DISCUSSION Among community-dwelling older adults, depressive symptoms were associated with impaired cognition across multiple domains, which detrimentally affected everyday function. Health care providers should be aware of these associations to monitor and manage changes in depressive symptoms and cognitive performance and thereby potentially mitigate functional decline.
Collapse
|
26
|
Beckert M, Loureiro F, Menta C, Mello EF, Nogueira EL, von Gunten A, Gomes I. Performance of low-educated elders with depression on Addenbrooke's Cognitive Examination-Revised (ace-r) test. Dement Neuropsychol 2016; 10:19-25. [PMID: 29213426 PMCID: PMC5674909 DOI: 10.1590/s1980-57642016dn10100004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Along with cognitive disorders, depression has been a concern for mental health services due to its highly debilitating effect on the functioning and quality of life of the elderly. However, there is still little understanding of the cognitive alterations resulting from depression or of the difficult differential diagnosis with mild cognitive impairment (MCI). It is known that performance on cognitive tests is strongly influenced by education but few studies have been conducted involving low-educated populations. Objective To evaluate the performance of elders with low education and no dementia on Addenbrooke's Cognitive Examination-Revised (ACE-R) test and its cognitive domains, and compare patients with Current Major Depressive Episode (CMDE) against those without depressive symptoms. Methods A retrospective, cross-sectional analytical study was conducted based on medical files of patients treated at the Cerebral Aging Clinic of the Hospital São Lucas of the PUCRS. The study included 116 individuals with low education (< 8 years of education) aged between 60 and 84 (69.6 ± 6.4) years, with MCDE (N = 41) and controls (N = 75). Results No significant difference was observed between control and MCDE groups in median scores on the ACE-R, Mini-Mental State Examination, and the five cognitive domains. There was also no difference between the groups on separate analyses of results on the clock drawing test, the categorical verbal and phonological fluency test, and the naming test. Conclusion The results of this study showed that depressive symptoms did not influence scores on the ACE-R tests conducted in elders with low education.
Collapse
Affiliation(s)
- Michele Beckert
- Psychologist, MD, Department of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil
| | - Fernanda Loureiro
- Speech Therapist, MD, PhD, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil
| | - Caroline Menta
- Psychiatrist, MD, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil
| | - Elisa Fasolin Mello
- Psychiatrist, MD, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil
| | - Eduardo L Nogueira
- Psychiatrist, MD, PhD, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil
| | - Armin von Gunten
- Psychiatrist, MD, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil, and Old-Age Psychiatric Service, Department of Psychiatry, Lausanne University Hospital, Switzerland
| | - Irênio Gomes
- Neurologist, MD, PhD, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil
| |
Collapse
|
27
|
Helmes E, Hall F. Performance of psychiatric diagnostic groups on measures and strategies of verbal fluency. APPLIED NEUROPSYCHOLOGY-ADULT 2015; 23:284-94. [DOI: 10.1080/23279095.2015.1056300] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Edward Helmes
- Department of Psychology, James Cook University, Townsville, Queensland, Australia
| | - Fiona Hall
- Department of Psychology, James Cook University, Townsville, Queensland, Australia
| |
Collapse
|
28
|
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.
Collapse
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
| |
Collapse
|
29
|
Current versus lifetime depression, APOE variation, and their interaction on cognitive performance in younger and older adults. Psychosom Med 2015; 77:480-92. [PMID: 26035038 DOI: 10.1097/psy.0000000000000190] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE An interaction effect of depressive symptoms and APOE e4 allele status on cognitive decline has been shown in old age: e4 allele carriers with more depressive symptoms have faster cognitive decline than those with either depression or the e4 allele. We test this interaction effect on four cognitive domains, using a clinical depression measure comparing current versus lifetime depression. METHODS 14,379 individuals aged 18 to 59 years, and 3944 individuals aged 60 to 94 years from the Generation Scotland: Scottish Family Health Study participated. Linear-mixed models-accounting for participant relatedness and demographic and health indices-tested for effects of depression and APOE on cognitive abilities. RESULTS There was no interaction between depression and APOE on cognition (p > .05). Current depression was associated with poorer speed (in both groups) and memory (18- to 59-year-olds); differences ranged from 0.01 to 0.03 standard deviation [SD]. For lifetime depression, cognitive performance was lower for digit symbol in younger adults, but higher for vocabulary in both younger (0.03 SD) and older (0.05 SD) adults. A negative effect of the APOE e4 allele on speed and memory was found in the group 60 years and older (effect sizes of 0.04 SD). CONCLUSIONS The absence of a depression by APOE interaction on cognitive abilities suggests that these synergistic effects only operate at the level of cognitive decline. This implies that it is those biological pathways especially affected by aging that become compromised further by the combined presence of depression and APOE e4 in an individual.
Collapse
|
30
|
Abstract
Although Alzheimer's disease (AD) is a common cause of memory impairment and dementia in the elderly disturbed memory function is a widespread subjective and/or objective symptom in a variety of medical conditions. The early detection and correct distinction of AD from non-AD memory impairment is critically important to detect possibly treatable and reversible underlying causes. In the context of clinical research, it is crucial to correctly distinguish between AD or non-AD memory impairment in order to build homogenous study populations for the assessment of new therapeutic possibilities. The distinction of AD from non-AD memory impairment may be difficult, especially in mildly affected patients, due to an overlap of clinical symptoms and biomarker alterations between AD and certain non-AD conditions. This review aims to describe recent aspects of the differential diagnosis of AD and non-AD related memory impairment and how these may be considered in the presence of memory deficits.
Collapse
Affiliation(s)
- Sönke Arlt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
31
|
Pantzar A, Laukka EJ, Atti AR, Papenberg G, Keller L, Graff C, Fratiglioni L, Bäckman L. Interactive effects of KIBRA and CLSTN2 polymorphisms on episodic memory in old-age unipolar depression. Neuropsychologia 2014; 62:137-42. [PMID: 25080189 DOI: 10.1016/j.neuropsychologia.2014.07.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 07/16/2014] [Accepted: 07/18/2014] [Indexed: 02/07/2023]
Abstract
The KIBRA (rs17070145) C-allele and the CLSTN2 (rs6439886) T-allele have both been associated with poorer episodic memory performance. Given that episodic memory is affected in depression, we hypothesized that the combination of these risk alleles would be particularly detrimental to episodic memory performance in depressed persons. In the population-based SNAC-K study, 2170 participants (≥ 60 years) without dementia (DSM-IV criteria) and antidepressant pharmacotherapy were clinically examined and diagnosed following ICD-10 criteria for unipolar depression, and genotyped for KIBRA and CLSTN2. Participants were categorized according to unipolar depression status (yes, no) and genotype combinations (KIBRA: CC, any T; CLSTN2: TT, any C). Critically, a three-way interaction effect showed that the CC/TT genotype combination was associated with poorer episodic recall and recognition performance only in depressed elderly persons, with depressed CC/TT carriers consistently performing at the lowest level. This finding supports the view that effects of genetic polymorphisms on cognitive functioning may be most easily disclosed at suboptimal levels of cognitive ability, such as in old-age depression.
Collapse
Affiliation(s)
- Alexandra Pantzar
- Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden.
| | - Erika J Laukka
- Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden
| | | | - Goran Papenberg
- Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden; Max Planck Institute for Human Development, Berlin, Germany
| | - Lina Keller
- Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden; Karolinska Institutet, Department NVS, KI-Alzheimer Disease Research Center, Stockholm, Sweden
| | - Caroline Graff
- Karolinska Institutet, Department NVS, KI-Alzheimer Disease Research Center, Stockholm, Sweden; Karolinska University Hospital, Department of Geriatric Medicine, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Lars Bäckman
- Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| |
Collapse
|
32
|
Kimbro LB, Mangione CM, Steers WN, Duru OK, McEwen L, Karter A, Ettner SL. Depression and all-cause mortality in persons with diabetes mellitus: are older adults at higher risk? Results from the Translating Research Into Action for Diabetes Study. J Am Geriatr Soc 2014; 62:1017-22. [PMID: 24823259 PMCID: PMC4057963 DOI: 10.1111/jgs.12833] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To compare the strength of the association between depression and mortality between elderly and younger individuals with diabetes mellitus. DESIGN A survival analysis conducted in a longitudinal cohort study of persons with diabetes mellitus to test the association between depression and mortality in older (≥ 65) and younger (18-65) adults. SETTING Managed care. PARTICIPANTS Persons aged 18 and older with diabetes mellitus who participated in the Wave 2 survey of the Translating Research Into Action for Diabetes (TRIAD) Study (N = 3,341). MEASUREMENTS The primary outcome was mortality risk, which was measured as days until death using linked data from the National Death Index. Depression was measured using the Patient Health Questionnaire. RESULTS After controlling for age, sex, race and ethnicity, income, and other comorbidities, mortality risk in persons with diabetes mellitus was 49% higher in those with depression than in those without, although results varied according to age. After controlling for the same variables, mortality risk in persons aged 65 and older with depression was 78% greater than in those without. For those younger than 65, the effect of depression on mortality was smaller and not statistically significant. CONCLUSION This analysis suggests that the effect of depression on mortality in persons with diabetes mellitus is most significant for older adults. Because there is evidence in the literature that treatment of depression in elderly adults can lead to lower mortality, these results may suggest that older adults with diabetes mellitus should be considered a high-priority population for depression screening and treatment.
Collapse
Affiliation(s)
- Lindsay B Kimbro
- Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | | | | | | | | | | | | |
Collapse
|