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Hou Y, Liu W, He T, Chen A. Association between the performance of executive function and the remission of depressive state after clinical treatment in patients with depression. J Affect Disord 2024; 364:28-36. [PMID: 39038627 DOI: 10.1016/j.jad.2024.07.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 07/09/2024] [Accepted: 07/16/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Previous studies have reported that patients with depression have significant cognitive impairment. The aim of this study is to comprehensively evaluate the impairment of executive functions in patients with depression and whether the cognitive behavior performance of executive function is association with remission of depressive state after clinical treatment. METHODS We used cognitive-behavioral test to evaluate the performance of executive functions of 95 inpatients with depression before hospitalization and conducted two follow-up evaluations of their depression status on the 15th day of hospitalization and approximately 9 months after discharge. RESULTS The performance of executive function except the accuracy of inhibition control in patients with depression were significantly worse than that of healthy controls. Multivariate linear regression analysis found that the reaction time of working memory not only had a significant linear relationship with the baseline depression scores of patients with depression, but also had a significant linear relationship with the reduced depression scores after two follow-up visits. LIMITATIONS We only used cognitive-behavioral data as indicators to evaluate the cognitive performances of participants and only measured three components of executive function. CONCLUSIONS The reaction time of working memory was a stable and effective predictor of symptom relief in patients with depression after clinical treatment. These results provide initial evidence for working memory to predict the clinical prognosis of inpatients with depression prospectively, which could be further leveraged to improve intervention approaches and analyze the heterogeneity of depression.
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Affiliation(s)
- Yongqing Hou
- Department of Neurobiology and Department of Neurology of Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; National Health Commission and Chinese Academy of Medical Sciences Key Laboratory of Medical Neurobiology, Ministry of Education Frontier Center of Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou 310058, China; Mental Health Center of Guangyuan, Sichuan, Guangyuan 628000, China.
| | - Wen Liu
- Mental Health Center of Guangyuan, Sichuan, Guangyuan 628000, China
| | - Tianbao He
- Mental Health Center of Guangyuan, Sichuan, Guangyuan 628000, China
| | - Antao Chen
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China.
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Rong J, Zhang N, Wang Y, Cheng P, Zhao D. Development and validation of a nomogram to predict the depressive symptoms among older adults: A national survey in China. J Affect Disord 2024; 361:367-375. [PMID: 38897299 DOI: 10.1016/j.jad.2024.06.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 05/21/2024] [Accepted: 06/14/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Depressive symptoms (DS) have become a global public health problem. However, a risk prediction model for DS in the elderly population has not been established. The purpose of this study was to develop and validate a predictive nomogram to screen for DS in the elderly population. METHODS A cross-sectional data of 3396 participants aged 60 and over were obtained from the China Health and Retirement Longitudinal Study 2018 (CHARLS). Participants were divided into the development and validation set. Predictive factors were selected through a single-factor analysis, and then a predictive model nomogram was established. The discrimination, calibration, and clinical validity were evaluated using the receiver operating characteristic (ROC) curves, Hosmer-Lemeshow tests, and decision curve analyses (DCA). RESULTS A total of 2379 and 1017 participants were included in the development and validation set, respectively. The analysis found that gender, residence, dyslipidemia, self-rated health, and ADL disability were risk factors for DS in older adults, and were included in the final model. This nomogram showed an acceptable predictive performance as evaluated by the area under the ROC curve with values of 0.684 (95 % confidence interval (CI): 0.663-0.706) and 0.687 (95 % CI: 0.655-0.719) in the development and validation set, respectively. The calibration curve indicated that the model was accurate, and DCA demonstrated a good clinical application value. CONCLUSION Five factors were selected to establish a nomogram for predicting DS in older adults. The nomogram has a good evaluation performance and can be used as a reliable tool to predict DS among older adults.
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Affiliation(s)
- Jian Rong
- Department of Scientific Research, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, PR China
| | - Ningning Zhang
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Yu Wang
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Pan Cheng
- Department of Scientific Research, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, PR China
| | - Dahai Zhao
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Anhui, China.
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Takimoto K, Takebayashi H, Yoshikawa Y, Sasano H, Tsujishita S, Ikeda K. Association between Motoric Cognitive Risk Syndrome and Indicators of Reflecting Independent Living among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:1808. [PMID: 39337149 PMCID: PMC11431772 DOI: 10.3390/healthcare12181808] [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: 07/30/2024] [Revised: 08/29/2024] [Accepted: 09/06/2024] [Indexed: 09/30/2024] Open
Abstract
The purpose of this study was to examine whether motoric cognitive risk syndrome (MCR) is associated with various indicators of independent living among community-dwelling older adults in Japan. The study design was a cross-sectional study, and the participants were 107 community-dwelling older adults (mean age 79 ± 7 years) who were living independently. The participants were administered the Questionnaire for Medical Checkup of Old-Old (QMCOO) as an indicator of health status and the Japan Science and Technology Agency Index of Competence (JST-IC) as an indicator of higher levels of functioning capacity, among others. In addition, we assessed physical frailty (J-CHS), sarcopenia (AWGS2019), and MCR (slow gait + subjective memory complaints), which are predictors of adverse events in the elderly. Multiple regression analysis with QMCOO as the response variable showed that MCR (p = 0.01, β: 0.25) and physical frailty (p < 0.01, β: 0.43) were significantly associated. In addition, analysis with JST-IC as the response variable showed that MCR (p = 0.03, β: -0.20), physical frailty (p = 0.01, β: -0.24) and age (p = 0.02, β: -0.21) were significantly associated. In conclusion, MCR was found to be similarly associated with QMCOO and JST-IC as physical frailty. It is expected that the MCR will be used as an initial screening tool to identify signs of risk in community-dwelling older people, as it is easy to diagnose.
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Affiliation(s)
- Koji Takimoto
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, 3-15-1 Nakatomigaoka, Nara 631-8524, Japan
| | - Hideaki Takebayashi
- Department of Rehabilitation, Faculty of Health Sciences, University of Kochi Health Sciences, 2500-2 Otsu, Kochi 781-5103, Japan
| | - Yoshiyuki Yoshikawa
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, 3-15-1 Nakatomigaoka, Nara 631-8524, Japan
| | - Hiromi Sasano
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, 3-15-1 Nakatomigaoka, Nara 631-8524, Japan
| | - Soma Tsujishita
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe International University, 9-1-6 Koyocho-naka, Higashinada-ku, Kobe 658-0032, Japan
| | - Koji Ikeda
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, 3-15-1 Nakatomigaoka, Nara 631-8524, Japan
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4
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Wang Z, Dou Y, Chen L, Feng W, Zou Y, Xiao J, Wang J, Zou Z. Mendelian randomization identifies causal effects of major depressive disorder on accelerated aging. J Affect Disord 2024; 358:422-431. [PMID: 38750800 DOI: 10.1016/j.jad.2024.05.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Evidence links major depressive disorder (MDD) with aging, but it's unclear if MDD accelerates aging and what factors mediate this transition. METHODS Two-sample Mendelian randomization (MR) analyses were applied to estimate the causal association between MDD and frailty index (FI), telomere length (TL), and appendicular lean mass (ALM) from available genome-wide association studies in populations of European ancestry. Furthermore, we conducted mediation MR analyses to assess the mediating effects of 31 lifestyle factors or diseases on the causal relationship between MDD and aging. RESULTS MDD was significantly causally associated with increased FI (βIVW = 0.23, 95 % CI = 0.18 to 0.28, p = 1.20 × 10-17), shorter TL (βIVW = -0.04, 95 % CI = -0.07 to -0.01, p = 0.01), and decreased ALM (βIVW = -0.07, 95 % CI = -0.11 to -0.03, p = 3.54 × 10-4). The mediation analysis through two-step MR revealed smoking initiation (9.09 %), hypertension (6.67 %) and heart failure (5.36 %) mediated the causal effect of MDD on FI. Additionally, alcohol use disorders and alcohol dependence on the causal relationship between MDD and TL were found to be 17.52 % and 17.13 % respectively. LIMITATIONS Confounding, statistical power, and Euro-centric focus limit generalization. CONCLUSION Overall, individuals with MDD may be at a higher risk of experiencing premature aging, and this risk is partially influenced by the pathways involving smoking, alcohol use, and cardiovascular health. It underscores the importance of early intervention and comprehensive health management in individuals with MDD to promote healthy aging and overall well-being.
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Affiliation(s)
- Zuxing Wang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, China.
| | - Yikai Dou
- Mental Health Center and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Lili Chen
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, China
| | - Wenqian Feng
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, China
| | - Yazhu Zou
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, China
| | - Jun Xiao
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, China
| | - Jinyu Wang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, China
| | - Zhili Zou
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, China.
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Menegon F, De Marchi F, Aprile D, Zanelli I, Decaroli G, Comi C, Tondo G. From Mild Cognitive Impairment to Dementia: The Impact of Comorbid Conditions on Disease Conversion. Biomedicines 2024; 12:1675. [PMID: 39200140 PMCID: PMC11351954 DOI: 10.3390/biomedicines12081675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 07/21/2024] [Accepted: 07/23/2024] [Indexed: 09/01/2024] Open
Abstract
The conversion from mild cognitive impairment (MCI) to dementia is influenced by several factors, including comorbid conditions such as metabolic and vascular diseases. Understanding the impact of these comorbidities can help in the disease management of patients with a higher risk of progressing to dementia, improving outcomes. In the current study, we aimed to analyze data from a large cohort of MCI (n = 188) by principal component analysis (PCA) and cluster analysis (CA) to classify patients into distinct groups based on their comorbidity profile and to predict the risk of conversion to dementia. From our analysis, four clusters emerged. CA showed a significantly higher rate of disease progression for Cluster 1, which was predominantly characterized by extremely high obesity and diabetes compared to other clusters. In contrast, Cluster 3, which was defined by a lower prevalence of all comorbidities, had a lower conversion rate. Cluster 2, mainly including subjects with traumatic brain injuries, showed the lowest rate of conversion. Lastly, Cluster 4, including a high load of hearing loss and depression, showed an intermediate risk of conversion. This study underscores the significant impact of specific comorbidity profiles on the progression from MCI to dementia, highlighting the need for targeted interventions and management strategies for individuals with these comorbidity profiles to potentially delay or prevent the onset of dementia.
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Affiliation(s)
- Federico Menegon
- Neurology Unit, Department of Translational Medicine, Maggiore della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (F.M.); (F.D.M.); (D.A.); (I.Z.)
| | - Fabiola De Marchi
- Neurology Unit, Department of Translational Medicine, Maggiore della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (F.M.); (F.D.M.); (D.A.); (I.Z.)
| | - Davide Aprile
- Neurology Unit, Department of Translational Medicine, Maggiore della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (F.M.); (F.D.M.); (D.A.); (I.Z.)
| | - Iacopo Zanelli
- Neurology Unit, Department of Translational Medicine, Maggiore della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (F.M.); (F.D.M.); (D.A.); (I.Z.)
| | - Greta Decaroli
- Neurology Unit, Department of Translational Medicine, Sant’Andrea Hospital, University of Piemonte Orientale, Corso Abbiate 21, 13100 Vercelli, Italy; (G.D.); (C.C.)
| | - Cristoforo Comi
- Neurology Unit, Department of Translational Medicine, Sant’Andrea Hospital, University of Piemonte Orientale, Corso Abbiate 21, 13100 Vercelli, Italy; (G.D.); (C.C.)
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, 28100 Novara, Italy
| | - Giacomo Tondo
- Neurology Unit, Department of Translational Medicine, Maggiore della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (F.M.); (F.D.M.); (D.A.); (I.Z.)
- Neurology Unit, Department of Translational Medicine, Sant’Andrea Hospital, University of Piemonte Orientale, Corso Abbiate 21, 13100 Vercelli, Italy; (G.D.); (C.C.)
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Lai LC, Huang DM, Peng J, Cao XY, Feng XL, Tao PY, Pan X, Pan QN, Fan DJ, Lu SY, Li CL, Pan YF, Dong PX, Chai YD, Huang P, Wu HC, Huang HQ. Depressive symptom mediates the association between the number of chronic diseases and cognitive impairment: a multi-center cross-sectional study based on community older adults. Front Psychiatry 2024; 15:1404229. [PMID: 39086730 PMCID: PMC11288913 DOI: 10.3389/fpsyt.2024.1404229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/27/2024] [Indexed: 08/02/2024] Open
Abstract
Objective The purpose of this study was to understand the relationship between the multiple chronic conditions (MCC), mental health and cognitive function of older adults in the community, and to propose a hypothesis that depressive symptom mediate the number of chronic diseases and cognitive impairment in older adults. Method Participants aged 65 years and older from 35 communities in 14 cities in Guangxi, China were recruited. The residents' depressive symptom (PHQ-9) and cognitive status (AD-8) were evaluated, Chi-square test was used to explore the effects of different socio-demographic characteristics on depressive symptom and cognitive impairment. Pearson correlation analysis and the process model 4 were used to explore the relationship between the number of chronic diseases, depressive symptom and cognitive impairment. Result A total of 11,582 older adults were included in our analysis. The rate of MCC reaching 26.53%. Hypertension combined with diabetes accounts for the highest proportion of two chronic diseases (13.2%). Among the combination of three chronic diseases, the highest incidence of coexisting hypertension combined with cervical/lumbar spondylosis, and rheumatoid arthritis (7.1%). In this study, depression symptoms accounted for 12.9% of older adults aged 65 and above, and cognitive impairment accounted for 27.4%. Female, older age, reside in urban areas, lower educational levels, no spouse, live alone, and MCC were risk factors for depressive symptom and cognitive impairment in older adults (P<0.05). Depressive symptom had a mediating effect in the number of chronic diseases and cognitive impairment, and the mediating effect (1.109) accounted for 44.13% of the total effect (0.247). Conclusion The mental health of the older adult needs to be taken seriously, and improving depressive symptom can reduce the occurrence of cognitive impairment in older patients with MCC to a certain extent.
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Affiliation(s)
- Li-Chong Lai
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Dong-Mei Huang
- Rehabilitation Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jie Peng
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiao-Ying Cao
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiao-Ling Feng
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Pin-Yue Tao
- Anesthesiology Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiao Pan
- Ear, Nose, Throat, Head and Neck Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Qi-Ni Pan
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Deng-Jing Fan
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Shu-Yu Lu
- Anesthesiology Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Cai-Li Li
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yan-Fei Pan
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Peng-Xin Dong
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yi-Dan Chai
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Ping- Huang
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Hai-Chen Wu
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Hui-Qiao Huang
- Party Committee Office, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Vittengl JR. Low household income, financial literacy, or financial health: Which is the strongest risk factor and outcome of depressive symptomatology? J Affect Disord 2024; 344:18-24. [PMID: 37820953 DOI: 10.1016/j.jad.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/04/2023] [Accepted: 10/08/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Depression's relations to psychosocial processes are complex, bidirectional, and include financial functioning. The current study compared the extent to which household income, financial literacy (knowledge and skill), and financial health (saving, spending, borrowing, and planning behavior) were risk factors and outcomes of depression. METHODS A United States national sample of working-aged adults (N = 6565) completed self-report measures of financial functioning and depression in years 2020 and 2022. Depression scales assessed both negative (depressive symptoms) and positive (life satisfaction) affective dimensions. RESULTS Lower income, less financial literacy, and especially poorer financial health correlated significantly with more depressive symptoms and lower life satisfaction. Poorer financial health demonstrated the strongest prospective relations with increasing depressive symptoms and decreasing life satisfaction over the two-year retest interval. In parallel, higher depressive symptoms and lower life satisfaction each predicted subsequent decreases in financial health. LIMITATIONS Results from this longitudinal, observational study suggested but could not establish causal connections between depression and financial functioning. The study's novel results require replication before clinical application. CONCLUSIONS More so than low income or limited financial literacy, poor financial health is both a risk factor and potential outcome of depression, including more depressive symptoms and lower life satisfaction. If these findings are replicated, financial health may be an important research and clinical target for depression assessment, prevention, and treatment.
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Affiliation(s)
- Jeffrey R Vittengl
- Department of Psychology, Truman State University, 100 E. Normal St., Kirksville, MO 63501, USA.
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Karska J, Pszczołowska M, Gładka A, Leszek J. Correlations between Dementia and Loneliness. Int J Mol Sci 2023; 25:271. [PMID: 38203442 PMCID: PMC10779072 DOI: 10.3390/ijms25010271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
This review describes associations between dementia and loneliness on the neurobiological and epidemiological levels according to the recent body of literature. The aim of this study was to highlight major lines of research in this field. Sociocognitive skills and social interactions present complex interdependencies with dementia which may be explained by two theories. According to the first one, not sufficiently engaging in social or cognitive activities results in brain atrophy. The second one claims that brain neurogenesis and synaptic density are being increased by social connections. The relationship between loneliness and dementia could be mediated by sensory loss, including hearing and visual impairment, as well as depression and psychotic symptoms. Loneliness itself might cause a depletion in sensory and cognitive stimulation which results in a decrease in neural reserve. Certain changes in the structures of the brain caused by loneliness were found in imaging examination. Loneliness appears to be a crucial risk factor for dementia in recent times due to the modern lifestyle and consequences of the outbreak of COVID-19. Additional studies are required to understand more completely the key tenets of this topic and therefore to improve the prevention and treatment of dementia.
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Affiliation(s)
- Julia Karska
- Department of Psychiatry, Wrocław Medical University, Pasteura 10, 50-367 Wrocław, Poland; (J.K.)
| | | | - Anna Gładka
- Department of Psychiatry, Wrocław Medical University, Pasteura 10, 50-367 Wrocław, Poland; (J.K.)
| | - Jerzy Leszek
- Department of Psychiatry, Wrocław Medical University, Pasteura 10, 50-367 Wrocław, Poland; (J.K.)
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Giannouli V, Tsolaki M. In the Hands of Hypnos: Associations between Sleep, Cognitive Performance and Financial Capacity in aMCI and Mild AD. Sleep Sci 2023; 16:231-236. [PMID: 37425966 PMCID: PMC10325838 DOI: 10.1055/s-0043-1770796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
Objective The aim of this monocentric observational study is to assess whether sleep disorders can predict financial capacity in single-and multiple-domain aMCI (amnestic Mild Cognitive Impairment), mild Alzheimer's Disease (AD), and healthy controls. Methods Older participants from Northern Greece were examined with several neuropsychological tests, including Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). Sleep duration and quality were based on caregiver/family members' reports in the Sleep Disorders Inventory (SDI). Results These preliminary findings coming from 147 participants indicate for the first time that apart from MMSE, complex cognitive functions, such as financial capacity may be also directly linked to the frequency of sleep-disturbed behaviours as indicated by SDI frequency questions, both in aMCI and mild AD. Discussion An urgency for further investigation of the neglected sleep factor should be added in financial capacity assessment protocols.
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Affiliation(s)
- Vaitsa Giannouli
- Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece, Greece
| | - Magda Tsolaki
- Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece, Greece
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10
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Pluck G. The Misguided Veneration of Averageness in Clinical Neuroscience: A Call to Value Diversity over Typicality. Brain Sci 2023; 13:860. [PMID: 37371340 DOI: 10.3390/brainsci13060860] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Research and practice in clinical neurosciences often involve cognitive assessment. However, this has traditionally used a nomothetic approach, comparing the performance of patients to normative samples. This method of defining abnormality places the average test performance of neurologically healthy individuals at its center. However, evidence suggests that neurological 'abnormalities' are very common, as is the diversity of cognitive abilities. The veneration of central tendency in cognitive assessment, i.e., equating typicality with healthy or ideal, is, I argue, misguided on neurodiversity, bio-evolutionary, and cognitive neuroscientific grounds. Furthermore, the use of average performance as an anchor point for normal performance is unreliable in practice and frequently leads to the mischaracterization of cognitive impairments. Examples are explored of how individuals who are already vulnerable for socioeconomic reasons can easily be over-pathologized. At a practical level, by valuing diversity rather than typicality, cognitive assessments can become more idiographic and focused on change at the level of the individual. The use of existing methods that approach cognitive assessment ideographically is briefly discussed, including premorbid estimation methods and informant reports. Moving the focus away from averageness to valuing diversity for both clinical cognitive assessments and inclusion of diverse groups in research is, I argue, a more just and effective way forward for clinical neurosciences.
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Affiliation(s)
- Graham Pluck
- Clinical Cognitive Sciences Laboratory, Faculty of Psychology, Chulalongkorn University, Borommaratchachonnani Srisattaphat Building, 254 Phayathai Road, Bangkok 10330, Thailand
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Beneath the Top of the Iceberg: Financial Capacity Deficits in Mixed Dementia with and without Depression. Healthcare (Basel) 2023; 11:healthcare11040505. [PMID: 36833039 PMCID: PMC9956589 DOI: 10.3390/healthcare11040505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Nowadays, controversy exists regarding the influence of comorbid depression on cognition in old age. Additionally, we still know little about the influence of depression in mixed dementia (MD), that is, in cases where there is the co-existence of Alzheimer's disease and vascular dementia (VaD). Given that the assessment of financial capacity is pivotal for independent living as well as in the prevention of financial exploitation and abuse in old age, in this pilot study, we aimed to examine whether comorbid depression in MD patients can influence financial capacity performance. A total of 115 participants were recruited. They were divided into four groups: MD patients with and without depressive symptoms and healthy elderly without depression as well as older adults suffering from depression. Participants were examined with a number of neuropsychological tests, including the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), and Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). The results of this study suggested that financial capacity as measured with LCPLTAS in MD patients was severely impaired when depression co-existed compared to patients suffering only from depression and healthy controls. Deficits in financial capacity in MD and comorbid depression should be a point on which healthcare professionals should focus during neuropsychological assessment in order to prevent financial exploitation.
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Stressful life events, general cognitive performance, and financial capacity in healthy older adults and Alzheimer's disease patients. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2023:10.1007/s40211-022-00451-y. [PMID: 36600106 DOI: 10.1007/s40211-022-00451-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/11/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND The influence of stressful life events on general cognition and for the first time on financial capacity performance of patients with a diagnosis of Alzheimer's disease (AD) and in healthy controls (HC) is assessed. METHODS A total of 268 participants (122 patients and 146 HCs with similar demographics) were examined with a number of neuropsychological tests, including Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), and Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS) for measuring financial capacity. The life change unit (LCU) method was also used. RESULTS HCs reported more stressful events than AD patients before the onset of the disease as the LCU load was higher for them (51.80 vs. 27.50), but in both groups the level of LCU load was far below 100, which is the threshold suggested for the induction of a psychosomatic disorder. The most frequently reported life event for AD patients was increased family arguments (n = 45/122), followed by increase in responsibilities (n = 32/122) and financial difficulties (n = 29/122), while the HC group reported problems within the family (n = 56/146), change in health status (n = 32/146), and a death of a beloved family member (n = 27/146). Regressions indicate no causal role for recent life events in the etiopathogenesis of AD, but an influence only of MMSE and diagnosis on financial capacity. CONCLUSIONS Stressful life events do not seem to be important in financial capacity and relevant vulnerability to financial exploitation for either HCs or AD patients; therefore clinicians should not consider them per se as a possible aggravating factor for financial deficits.
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Relationship between Depression and Cognitive Inhibition in Men with Heroin or Methamphetamine Use Disorder in First-Time Mandatory Detoxification. Healthcare (Basel) 2022; 11:healthcare11010070. [PMID: 36611530 PMCID: PMC9819117 DOI: 10.3390/healthcare11010070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/18/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
Previous studies have shown that males with substance use disorder (SUD) in their first mandatory detoxification experience high rates of depression. It is unknown whether this high depression incidence contributes to impaired inhibition. In this work, two studies were undertaken to examine the role of depression in cognitive inhibition in heroin and methamphetamine withdrawal. We used the Beck Depression Inventory (BDI) and the self-control scale (SCS) to explore the relationship between depression and impulse inhibition in patients participating in mandatory drug treatment for the first time (Study 1). The results showed that depression negatively predicted impulse inhibition. The Stroop color-word interference task was used to explore the role of patients' depression in their inhibitory abilities (Study 2). The results showed that the high-depression group had weaker inhibition performances in the Stroop color-word interference task compared to the low-depression group. This study shows that cognitive inhibition is weaker in people with high-depression addiction than in those with low depression. This result suggests that attention should be paid to the role of depressive comorbidity when conducting working memory training treatment for substance addiction.
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Giannouli V, Tsolaki M. Is negative affect associated with deficits in financial capacity in nondepressed older adults? A preliminary study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Stamovlasis D, Giannouli V, Vaiopoulou J, Tsolaki M. Catastrophe Theory Applied to Neuropsychological Data: Nonlinear Effects of Depression on Financial Capacity in Amnestic Mild Cognitive Impairment and Dementia. ENTROPY (BASEL, SWITZERLAND) 2022; 24:1089. [PMID: 36010753 PMCID: PMC9407425 DOI: 10.3390/e24081089] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
Financial incapacity is one of the cognitive deficits observed in amnestic mild cognitive impairment and dementia, while the combined interference of depression remains unexplored. The objective of this research is to investigate and propose a nonlinear model that explains empirical data better than ordinary linear ones and elucidates the role of depression. Four hundred eighteen (418) participants with a diagnosis of amnestic MCI with varying levels of depression were examined with the Geriatric Depression Scale (GDS-15), the Functional Rating Scale for Symptoms of Dementia (FRSSD), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). Cusp catastrophe analysis was applied to the data, which suggested that the nonlinear model was superior to the linear and logistic alternatives, demonstrating depression contributes to a bifurcation effect. Depressive symptomatology induces nonlinear effects, that is, beyond a threshold value sudden decline in financial capacity is observed. Implications for theory and practice are discussed.
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Affiliation(s)
- Dimitrios Stamovlasis
- School of Philosophy and Education, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Vaitsa Giannouli
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
| | - Julie Vaiopoulou
- Department of Education, University of Nicosia, Nicosia 2417, Cyprus
- School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Magda Tsolaki
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
- Alzheimer Hellas, 54643 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTh), Balkan Center, Buildings A & B, Thessaloniki, Aristotle University of Thessaloniki, 10th km Thessaloniki-Thermi Rd, P.O. Box 8318, 54124 Thessaloniki, Greece
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Giannouli V, Tsolaki M. Self-Awareness of Cognitive Efficiency, Cognitive Status, Insight, and Financial Capacity in Patients with Mild AD, aMCI, and Healthy Controls: An Intriguing Liaison with Clinical Implications? Neurol Int 2022; 14:628-637. [PMID: 35997360 PMCID: PMC9396975 DOI: 10.3390/neurolint14030051] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 02/04/2023] Open
Abstract
Objectives: This study compares objective measures of cognitive performance with subjective perception of specific performance on neuropsychological tests examining basic cognitive domains, including, for the first time, financial capacity. Additionally, differences in assessment between single- and multiple-domain aMCI, mild AD, and healthy elderly regarding insight are examined. Methods: Participants completed a number of neuropsychological tests and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). After every test, participants were asked to complete the Clinical Insight Rating scale (CIR) and to self-evaluate their performance by comparing it to what they considered as average for people of their age and educational level. Results: These preliminary findings show significant differences in the self-assessment patterns of the four groups in measures of verbal memory, visuospatial perception and memory, executive functions, tests of attention, and financial capacity. Mild AD expressed the highest overestimations, followed by single- and multiple-domain aMCI as well as controls. Accuracy of self-report is not uniform across groups and functional areas. Conclusions: Unawareness of memory deficits in both MCI subtypes is contradictory to subjective memory complaints as being an important component for clinical diagnosis. Financial capacity is overestimated in MCI and mild AD, a finding that has a plethora of clinical and legal implications.
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Moye J. Enhancing Behavioral Health Assessment of Older Adults. Clin Gerontol 2022; 45:437-440. [PMID: 35603713 DOI: 10.1080/07317115.2022.2069374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Jennifer Moye
- VA New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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