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Jain U, Ma M. Together in sickness and in health: Spillover of physical, mental, and cognitive health among older English couples. HEALTH ECONOMICS 2024; 33:1989-2012. [PMID: 38820139 DOI: 10.1002/hec.4860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 06/02/2024]
Abstract
Using data from eight waves of the English Longitudinal Study of Aging, we study the cross-domain and cross-spouse spillover of health among married adults aged 50 and above in England. We apply the system generalized method of moments to linear dynamic panel models for physical, mental, and cognitive health, controlling for individual heterogeneity and the influence of marriage market matching and shared environments. Our findings reveal bidirectional spillovers between memory abilities and mobility difficulty among men, as well as between depressive symptoms and mobility difficulty among women. Worsening mobility increases the risk of depression in men, but not vice versa. Additionally, gender-specific cross-spouse effects are observed. Women's mental health is significantly influenced by their spouse's mental health, while this effect is weaker for men. Conversely, men's mental health is notably affected by their spouse's physical health. These results highlight the importance of considering spillovers within families and across health domains when developing policies to promote health and reduce health disparities among the elderly population.
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Affiliation(s)
- Urvashi Jain
- Mitchell College of Business, University of South Alabama, Mobile, Alabama, USA
| | - Mingming Ma
- International Business School Suzhou, Xi'an Jiaotong-Liverpool University, Suzhou, China
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2
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Zhao X, Jin L, Sun SB. Bidirectional Association Between Internet Use and Episodic Memory Among Older Adults: A Longitudinal Mediation Study. J Appl Gerontol 2024; 43:829-840. [PMID: 38016114 DOI: 10.1177/07334648231214944] [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] [Indexed: 11/30/2023] Open
Abstract
Using nationally representative longitudinal data from three waves of the China Health and Retirement Longitudinal Study (CHARLS), we assessed whether social participation and mental health were channels through which internet use and episodic memory mutually influenced each other. Cross-lagged panel models with multiple mediators were employed for the mediation analysis. The results reveal that social participation and depressive symptoms were mechanisms underlying the internet-cognition interplay. Among men, an increased chance of contacting friends served as a pathway connecting internet use with better episodic memory. Conversely, men with better episodic memory were more likely to use the internet partially due to their higher chances of having contact with friends and engaging in group activities. Among women, engagement in group activities and depressive symptoms were two channels through which internet use and episodic memory positively influenced each other. Our findings provide practical implications for slowing cognitive aging and narrowing the digital divide.
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Affiliation(s)
- Xiaohang Zhao
- National Institute of Social Development, Chinese Academy of Social Sciences, Beijing, China
| | - Lei Jin
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong, China
| | - Skylar Biyang Sun
- School of International Development and Cooperation, University of International Business and Economics, Beijing, China
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3
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Xian G, Chai Y, Gong Y, He W, Ma C, Zhang X, Zhang J, Ma Y. The relationship between healthy lifestyles and cognitive function in Chinese older adults: the mediating effect of depressive symptoms. BMC Geriatr 2024; 24:299. [PMID: 38549104 PMCID: PMC10979595 DOI: 10.1186/s12877-024-04922-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/26/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Previous studies have proven the positive relationship between healthy lifestyles and cognitive function in older adults. However, the specific impacts and mechanisms require further investigation. Therefore, this study aimed to investigate whether healthy lifestyles and cognitive function were associated with Chinese older adults and whether depressive symptoms mediated their association. METHODS 8272 valid samples were included using the latest data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Pearson's test was applied to investigate the relationship between the key variables. Regression models were employed to examine the mediating effects of healthy lifestyles, using Sobel's test and the bootstrap method to confirm path effects. RESULTS There was a significant correlation between healthy lifestyles, depressive symptoms, and cognitive function (p < 0.01). Healthy lifestyles directly impact cognitive function (β = 0.162, p < 0.01). Healthy lifestyles had a significant effect on depressive symptoms (β=-0.301, p < 0.01), while depressive symptoms have a significant impact on cognitive function (β=-0.108, p < 0.01). Depressive symptoms partially mediated the effect of healthy lifestyles on cognitive function (β = 0.032, p < 0.01). The Sobel and bootstrap tests confirmed the robustness of the regression analysis results. CONCLUSION Depressive symptoms mediate the relationship between healthy lifestyles and cognitive function. Our findings suggest that prevention strategies for cognitive impairment in older adults should focus on healthy lifestyles and mental health.
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Affiliation(s)
- Guowei Xian
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Yulin Chai
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Yunna Gong
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Wenfeng He
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Chunxiao Ma
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Xiaolin Zhang
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Jing Zhang
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Yong Ma
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China.
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Yuan J, Wang Y, Liu Z. Temporal relationship between depression and cognitive decline in the elderly: a two-wave cross-lagged study in a Chinese sample. Aging Ment Health 2023; 27:2179-2186. [PMID: 37339082 DOI: 10.1080/13607863.2023.2225432] [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: 09/06/2022] [Accepted: 06/04/2023] [Indexed: 06/22/2023]
Abstract
Objectives: Less information is available about the temporal relationship between depression in the elderly and cognitive decline. In the current study, we (1) evaluated the temporal association between depression and cognitive decline in older adults over a 4-year period; (2) indicated which cognitive domains have a strong temporal relationship with depression.Methods: Using data from China Family Panel Studies, we examined the relationship between depression and cognition among adults aged 65 and older with a cross-lagged design.Results: The results showed that initial depression affected subsequent cognitive function, especially immediate and delayed recall, but that cognition decline did not predict depression over time.Conclusion: The findings suggest that depression precedes cognitive decline in older adults, which is of great significance for the future research of mild cognitive impairment and dementia in the elderly.
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Affiliation(s)
- Jing Yuan
- School of Nursing, Hebei University, Baoding, China
| | - Yan Wang
- School of Nursing, Hebei University, Baoding, China
| | - Zejun Liu
- Department of Psychology, Educational College, Shanghai Normal University, Shanghai, China
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Gondi V, Deshmukh S, Brown PD, Wefel JS, Armstrong TS, Tome WA, Gilbert MR, Konski A, Robinson CG, Bovi JA, Benzinger TLS, Roberge D, Kundapur V, Kaufman I, Shah S, Usuki KY, Baschnagel AM, Mehta MP, Kachnic LA. Sustained Preservation of Cognition and Prevention of Patient-Reported Symptoms With Hippocampal Avoidance During Whole-Brain Radiation Therapy for Brain Metastases: Final Results of NRG Oncology CC001. Int J Radiat Oncol Biol Phys 2023; 117:571-580. [PMID: 37150264 PMCID: PMC11070071 DOI: 10.1016/j.ijrobp.2023.04.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/18/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
PURPOSE Initial report of NRG Oncology CC001, a phase 3 trial of whole-brain radiation therapy plus memantine (WBRT + memantine) with or without hippocampal avoidance (HA), demonstrated neuroprotective effects of HA with a median follow-up of fewer than 8 months. Herein, we report the final results with complete cognition, patient-reported outcomes, and longer-term follow-up exceeding 1 year. METHODS AND MATERIALS Adult patients with brain metastases were randomized to HA-WBRT + memantine or WBRT + memantine. The primary endpoint was time to cognitive function failure, defined as decline using the reliable change index on the Hopkins Verbal Learning Test-Revised (HVLT-R), Controlled Oral Word Association, or the Trail Making Tests (TMT) A and B. Patient-reported symptom burden was assessed using the MD Anderson Symptom Inventory with Brain Tumor Module and EQ-5D-5L. RESULTS Between July 2015 and March 2018, 518 patients were randomized. The median follow-up for living patients was 12.1 months. The addition of HA to WBRT + memantine prevented cognitive failure (adjusted hazard ratio, 0.74, P = .016) and was associated with less deterioration in TMT-B at 4 months (P = .012) and HVLT-R recognition at 4 (P = .055) and 6 months (P = .011). Longitudinal modeling of imputed data showed better preservation of all HVLT-R domains (P < .005). Patients who received HA-WBRT + Memantine reported less symptom burden at 6 (P < .001 using imputed data) and 12 months (P = .026 using complete-case data; P < .001 using imputed data), less symptom interference at 6 (P = .003 using complete-case data; P = .0016 using imputed data) and 12 months (P = .0027 using complete-case data; P = .0014 using imputed data), and fewer cognitive symptoms over time (P = .043 using imputed data). Treatment arms did not differ significantly in overall survival, intracranial progression-free survival, or toxicity. CONCLUSIONS With median follow-up exceeding 1 year, HA during WBRT + memantine for brain metastases leads to sustained preservation of cognitive function and continued prevention of patient-reported neurologic symptoms, symptom interference, and cognitive symptoms with no difference in survival or toxicity.
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Affiliation(s)
- Vinai Gondi
- Northwestern Medicine Cancer Center Warrenville and Northwestern Medicine Proton Center, Department of Radiation Oncology, Warrenville, Illinois.
| | - Snehal Deshmukh
- NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania
| | - Paul D Brown
- Mayo Clinic, Department of Radiation Oncology, Rochester, Minnesota
| | - Jeffrey S Wefel
- University of Texas MD Anderson Cancer Center, Department of Neuro-Oncology, Houston, Texas
| | - Terri S Armstrong
- National Cancer Institute Center for Cancer Research, Bethesda, Maryland
| | - Wolfgang A Tome
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Mark R Gilbert
- University of Texas MD Anderson Cancer Center, Department of Neuro-Oncology, Houston, Texas
| | - Andre Konski
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | | | - Joseph A Bovi
- Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | | | | | - Isaac Kaufman
- Wayne State University/Karmanos Cancer Institute, Detroit, Michigan
| | - Sunjay Shah
- Delaware/Christiana Care National Cancer Institute Community Oncology Research Program, Wilmington, Delaware
| | | | | | | | - Lisa A Kachnic
- Columbia University, Vagelos Colleg of Physicians and Surgeons, New York, New York
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Liang W, Miao J, Wang Y, Sun W, Pan C, Chen M, Li G, Lan Y, Qiu X, Zhao X, Jing P, Chen G, Mei J, Zhu Z. Longitudinal relationships between depressive symptoms and cognitive function after stroke: A cross-lagged panel design. J Psychosom Res 2023; 174:111486. [PMID: 37729753 DOI: 10.1016/j.jpsychores.2023.111486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/02/2023] [Accepted: 09/04/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE Stroke is a leading cause of mortality and disability. This study aimed to investigate the temporal and directional relationships between post-stroke depressive symptoms and cognitive impairment using a cross-lagged panel design. Depressive symptoms and cognitive impairment are two common post-stroke complications. However, the precise underlying mechanism remains unclear despite their close relationship. Therefore, elucidating the causal relationship between these two issues is of great clinical significance for improving the poor prognosis of stroke. METHODS This study employed a hospital-based multicenter prospective cohort design. A total of 610 patients with ischemic stroke were eligible. Depressive symptoms (measured using the seventeen-item Hamilton Rating Scale for Depression) and cognitive function (measured using the Montreal Cognitive Assessment) were assessed at baseline and the 12-month follow-up. Spearman's correlation was used to examine the correlation between cognitive function and depressive symptoms. Additionally, a cross-lagged panel analysis was employed to elucidate the causal relationship between these factors after adjusting for potential covariates. RESULTS The results of a four-iteration cross-lagged panel analysis substantiated a bidirectional relationship between post-stroke depressive symptoms and cognitive function over time. Specifically, higher scores for early depressive symptoms were associated with lower scores for later cognitive function; additionally, higher baseline cognitive function scores were associated with lower depressive symptom scores at a later point. CONCLUSION This study establishes a reciprocally causal long-term relationship between depressive symptoms and cognitive function after an ischemic stroke. Therefore, interventions aimed at improving cognitive function and ameliorating depressive symptoms may positively affect both cognition and mood. TRIAL REGISTRATION ChiCTR-ROC-17013993.
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Affiliation(s)
- Wenwen Liang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Jinfeng Miao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Yanyan Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Wenzhe Sun
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Chensheng Pan
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Man Chen
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Guo Li
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Yan Lan
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Xiuli Qiu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Xin Zhao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Ping Jing
- Department of Neurology, Wuhan Central Hospital, Wuhan, Hubei 430014, China
| | - Guohua Chen
- Department of Neurology, Wuhan First Hospital, Wuhan, Hubei 430022, China
| | - Junhua Mei
- Department of Neurology, Wuhan First Hospital, Wuhan, Hubei 430022, China
| | - Zhou Zhu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
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Monin JK, McAvay G, Newkirk K, Samper-Ternent R. Longitudinal associations between cognitive functioning and depressive symptoms among couples in the Mexican Health and Aging Study. Int Psychogeriatr 2023; 35:576-586. [PMID: 36599661 PMCID: PMC10319915 DOI: 10.1017/s1041610222000898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To examine the bidirectional associations between older adult spouses' cognitive functioning and depressive symptoms over time and replicate previous findings from the United States (US) in Mexico. DESIGN Longitudinal, dyadic path analysis with the actor-partner interdependence model. SETTING Data were from the three most recent interview waves (2012, 2015, and 2018) of the Mexican Health and Aging Study (MHAS), a longitudinal national study of adults aged 50+ years in Mexico. PARTICIPANTS Husbands and wives from 905 community-dwelling married couples (N = 1,810). MEASUREMENTS The MHAS cognitive battery measured cognitive function. Depressive symptoms were assessed using a modified nine-item Center for Epidemiologic Studies Depression Scale. Baseline covariates included age, education, number of children, limitation with any activity of daily living, limitation with any instrumental activity of daily living, and pain. RESULTS As hypothesized, there were significant within-individual associations in which one person's own cognitive functioning and own depressive symptoms predicted their own follow-up cognitive functioning and depressive symptoms, respectively. In addition, a person's own cognitive functioning predicted their own depressive symptoms, and a person's own depressive symptoms predicted their own cognitive functioning over time. As hypothesized, there was a significant partner association such that one person's depressive symptoms predicted more depressive symptoms in the partner. CONCLUSION Findings from this study of older Mexican couples replicates findings from studies of older couples in the US, showing that depressive symptoms in one partner predict depressive symptoms in the other partner over time; however, there was no evidence for cognition-depression partner associations over time.
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Affiliation(s)
- Joan K. Monin
- Social and Behavioral Sciences Department, Yale School of Public Health, New Haven, CT, USA
| | - Gail McAvay
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Katie Newkirk
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Rafael Samper-Ternent
- School of Public Health, The University of Texas Health Science Center, Houston, TX, USA
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Liu Y, Yang X, Xu Y, Wu Y, Zhong Y, Yang S. Cognitive Function and Depressive Symptoms among Chinese Adults Aged 40 Years and Above: The Mediating Roles of IADL Disability and Life Satisfaction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4445. [PMID: 36901451 PMCID: PMC10002125 DOI: 10.3390/ijerph20054445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this study was to investigate the relationship between cognitive function and depressive symptoms among Chinese adults aged 40 years and above, as well as the series of multiple mediating effects of Instrument Activities of Daily Living disability and life satisfaction on this relationship. The data was obtained from the China Health and Retirement Longitudinal Study (CHARLS, 2013-2018), including 6466 adults aged 40 years and above. The mean age of the adults was 57.7 ± 8.5. The SPSS PROCESS macro program was conducted to examine the mediating effects. The results indicated that there was a significant association between cognitive function and depressive symptoms five years later (B = -0.1500, 95%CI: -0.1839, -0.1161), which could also be demonstrated through three mediation pathways: (1) the mediating pathway through IADL disability (B = -0.0247, 95%CI: -0.0332, -0.0171); (2) the mediating pathway through life satisfaction (B = 0.0046, 95%CI: 0.0000, 0.0094); and (3) the chain mediation pathway through IADL disability and life satisfaction (B = -0.0012, 95%CI: -0.0020, -0.0003). Both IADL disability and life satisfaction have been proven to be crucial mediators for the relationship between cognitive function and depressive symptoms five years later. It is necessary to improve individuals' cognitive function and reduce the negative impact of disability on them, which is important to enhance their life satisfaction and prevent depressive symptoms.
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Best JR, Cosco TD. An analysis of dynamic, bidirectional associations between memory and verbal fluency with depressive symptoms in middle- and older-aged adults: A cohort study. J Affect Disord 2022; 318:400-408. [PMID: 36113688 DOI: 10.1016/j.jad.2022.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/22/2022] [Accepted: 09/09/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVES This study compared two approaches to analyzing bidirectional associations between aspects of cognition-specifically, verbal memory and fluency-and depression using multi-wave longitudinal data. The cross-lagged panel model (CLPM) does not distinguish between- versus within-person variation, whereas the random-intercepts CLPM (RI-CLPM) partitions variation into a stable, trait-like component that varies across individuals and a wave-specific deviation that varies within individuals. METHODS Observational study of 47,719 adults ages 45 to 95 from the Survey of Health, Ageing, and Retirement in Europe (mean age = 63 years, SD = 9 years at first assessment; 57 % female). Participants completed at least four of 8 biennial waves of data collection from 2004 and 2020. Depressive symptoms were assessed by the EURO-D. Cognition was assessed by animal fluency, and immediate and delayed word recall. Multi-group CLPMs and RI-CLPMs were fit on middle-aged (45-65 year) and older (65+ years) males and females. RESULTS The estimates from the CLPMs indicated bidirectionality in the associations between cognition and depression, whereas the RI-CLPMs provided clearer evidence that changes in depression may produce subsequent changes in cognition, rather than vice versa. Prospective associations were small and consistent across age, sex and cognitive measure. LIMITATIONS Measures of executive function-a domain of cognition affected by aging and related to mood-were not available. CONCLUSIONS CLPMs and RI-CLPMs address conceptually distinct questions about how verbal memory and fluency may be dynamically related to depression, and therefore, produce different inferences from the same data about how these aspects of cognition and depression are related.
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Affiliation(s)
- John R Best
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada; Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada; Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Theodore D Cosco
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada; Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada; Oxford Institute of Population Ageing, University of Oxford, Oxford, United Kingdom
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Csajbók Z, Sieber S, Cullati S, Cermakova P, Cheval B. Physical activity partly mediates the association between cognitive function and depressive symptoms. Transl Psychiatry 2022; 12:414. [PMID: 36167692 PMCID: PMC9515096 DOI: 10.1038/s41398-022-02191-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 09/08/2022] [Accepted: 09/16/2022] [Indexed: 11/09/2022] Open
Abstract
Cognitive function, physical activity, and depressive symptoms are intertwined in later life. Yet, the nature of the relationship between these three variables is unclear. Here, we aimed to determine which of physical activity or cognitive function mediated this relationship. We used large-scale longitudinal data from 51,191 adults 50 years of age or older (mean: 64.8 years, 54.7% women) from the Survey of Health, Ageing and Retirement in Europe (SHARE). Results of the longitudinal mediation analyses combined with autoregressive cross-lagged panel models showed that the model with physical activity as a mediator better fitted the data than the model with cognitive function as a mediator. Moreover, the mediating effect of physical activity was 8-9% of the total effect of cognitive function on depressive symptoms. Our findings suggest that higher cognitive resources favor the engagement in physical activity, which contributes to reduced depressive symptoms.
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Affiliation(s)
- Zsófia Csajbók
- Faculty of Humanities, Charles University, Prague, Czech Republic.
| | - Stefan Sieber
- LIVES Centre, Swiss Centre of Expertise in Life Course Research, Lausanne, Switzerland ,grid.8591.50000 0001 2322 4988Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Stéphane Cullati
- grid.8534.a0000 0004 0478 1713Population Health Laboratory, University of Fribourg, Fribourg, Switzerland ,grid.8591.50000 0001 2322 4988Department of Readaptation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Pavla Cermakova
- grid.4491.80000 0004 1937 116XSecond Faculty of Medicine, Charles University, Prague, Czech Republic ,grid.447902.cNational Institute of Mental Health, Klecany, Czech Republic
| | - Boris Cheval
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland. .,Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Geneva, Switzerland.
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Gao Z, Liu C, Yang L, Mei X, Wei X, Kuang J, Zhou K, Xu M. Longitudinal Association Between Depressive Symptoms and Cognitive Function Among Older Adults: A Latent Growth Curve Modeling Approach. Int J Public Health 2022; 67:1605124. [PMID: 36213141 PMCID: PMC9537360 DOI: 10.3389/ijph.2022.1605124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/08/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives: Although the evidence from numerous longitudinal studies has indicated a remarkable change in cognitive function (CF) and depressive symptoms (DS) over time, the parallel latent growth curve model (LGCM) has seldom been used to simultaneously investigate the relationship between their change trajectories. This study aimed to examine whether a change in DS was associated with CF over time using an LGCM. Methods: Data were collected from the Chinese Longitudinal Healthy Longevity Survey’s 2011, 2014, and 2018 waves. A parallel LGCM examined the association between CF and DS. Results: The multivariate conditioned model’s goodness of fit supported the validity of the longitudinal model (Tucker-Lewis index [TLI] = 0.90, comparative fit index [CFI] = 0.96, root mean square error of approximation [RMSEA] = 0.04). The results showed that the CF intercept was positively to the DS slope (β = 0.42, p = 0.004). The CF and DS slopes were significantly linked (β = −0.65, p = 0.002). Conclusion: The findings expand the knowledge about CF’s effect on DS in older adults.
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Affiliation(s)
- Zihan Gao
- School of Nursing, Qingdao University, Qingdao, China
| | - Cuiping Liu
- School of Nursing, Qingdao University, Qingdao, China
| | - Li Yang
- School of Nursing, Qingdao University, Qingdao, China
- *Correspondence: Li Yang,
| | - Xinyi Mei
- School of Nursing, Wuhan University of Science and Technology, Wuhan, China
| | - Xiao Wei
- School of Nursing, Qingdao University, Qingdao, China
| | - Jinke Kuang
- School of Nursing, Qingdao University, Qingdao, China
| | - Kexin Zhou
- School of Nursing, Qingdao University, Qingdao, China
| | - Mengfan Xu
- School of Nursing, Qingdao University, Qingdao, China
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Brugiavini A, Di Novi C, Orso CE. Visiting parents in times of COVID-19: The impact of parent-adult child contacts on the psychological health of the elderly. ECONOMICS AND HUMAN BIOLOGY 2022; 46:101152. [PMID: 35700656 PMCID: PMC9172389 DOI: 10.1016/j.ehb.2022.101152] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 05/20/2022] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
Using the 8th wave of the SHARE and the SHARE Corona Survey, we investigated whether the disruption of parent-adult child contacts due to social distancing restrictions increased the symptoms of depression among old age individuals during the first wave of the COVID-19 pandemic. We model the relationship between the disruption of parent-adult child contacts and the mental health of the elderly using a recursive simultaneous equation model for binary variables. Our findings show that the likelihood of disruption of parent-adult child contacts was higher with adult children who do not live with or close to their parents (i.e., in the same household or in the same building) for whom contact disruption increases about 15 %. The duration of restrictions to movement and lockdowns also has a positive and significant effect on parent-child contact disruption: an additional week of lockdown significantly increases the probability of parent-child contact disruption, by about 1.5 %. The interventions deemed essential to reduce the spread of the pandemic, such as the "stay-at-home" order, necessarily disrupted personal parent-child contacts and the social processes that facilitate psychological well-being, increasing the probability of suffering from a deepening depressed mood by about 17 % for elderly parents.
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Affiliation(s)
- Agar Brugiavini
- Department of Economics, Ca' Foscari University of Venice, Italy
| | - Cinzia Di Novi
- European Commission, Joint Research Centre (JRC), Ispra, Italy.
| | - Cristina Elisa Orso
- Department of Law, Economics, and Cultures, Insubria University, Como, Italy
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13
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Jilili M, Liu L. Examining the impact of functional disability and cognitive impairment on mental health of Chinese elderly. SOCIAL WORK IN HEALTH CARE 2022; 61:338-352. [PMID: 35792711 DOI: 10.1080/00981389.2022.2091080] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 04/28/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
Depression and anxiety, as the two most prevalent psychiatric disorders, pose a huge challenge to the quality of life of the elderly. Using a sample of 7,721 elderly from the latest Chinese Longitudinal Health and Longevity Survey (CLHLS), the present study intended to explore the association between mental health and socioeconomic status, physical functional disability, and cognitive impairment among Chinese elderly by adopting multivariate logistic regression analyses. The results revealed that depression, anxiety, and their comorbidity are significantly higher in the elderly with instrumental activities of daily living (IADL) disability, cognitive impairment, financial strain, and living alone. Findings of the study will provide implications for policymakers, social workers, and individual caregivers to develop necessary intervention measures to improve the mental health of the elderly and promote successful aging.
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Affiliation(s)
- Maitixirepu Jilili
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, Jiangsu Province, China
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14
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Jindra C, Li C, Tsang RSM, Bauermeister S, Gallacher J. Depression and memory function - evidence from cross-lagged panel models with unit fixed effects in ELSA and HRS. Psychol Med 2022; 52:1428-1436. [PMID: 32914740 DOI: 10.1017/s0033291720003037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Individuals with depression are often found to perform worse on cognitive tests and to have an increased risk of dementia. The causes and the direction of these associations are however not well understood. We looked at two specific hypotheses, the aetiological risk factor hypothesis and the reverse causality hypothesis. METHOD We analysed observational data from two cohorts, English Longitudinal Study of Ageing (ELSA) and Health and Retirement Study (HRS), using cross-lagged panel models with unit fixed effects. Each model was run once with depression and repeated with cognition as the dependent variable and the other variable as the main explanatory variable. All models were estimated separately for contemporaneous effects and lagged effects up to 8 years in the past. We contrasted the results with models making the random effects assumption. RESULTS Evidence from the fixed effects models is mixed. We find no evidence for the reverse causality hypothesis in ELSA and HRS. While there is no evidence for the aetiological risk factors hypothesis in ELSA, results from HRS indicate some effects. CONCLUSION Our findings suggest that current levels of cognitive function do not influence future levels of depression. Results in HRS provide some evidence that current levels of depressive symptoms influence future cognition.
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Affiliation(s)
- Christoph Jindra
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, United Kingdom
| | - Chenlu Li
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, United Kingdom
| | - Ruby S M Tsang
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, United Kingdom
| | - Sarah Bauermeister
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, United Kingdom
| | - John Gallacher
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, United Kingdom
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15
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Tieks A, Oude Voshaar RC, Zuidersma M. Daily associations between affect and cognitive performance in older adults with depression and cognitive impairment: a series of seven single-subject studies in the Netherlands. BMC Geriatr 2022; 22:133. [PMID: 35177005 PMCID: PMC8851709 DOI: 10.1186/s12877-022-02797-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background Comorbidity between depression and cognitive impairment is common in older adults, increases the disease burden disproportionally, and leads to diagnostic uncertainty. Insight into individual daily associations between affect and cognitive performance may help in personalizing diagnosis and treatment decisions. Our objective was to get insight into the daily associations between affect and cognitive performance within individual older adults. Methods In this single-subject study seven older adults with both depression and cognitive impairment filled in electronic diaries daily for 62-93 consecutive days evaluating positive affect (PA), negative affect (NA), working memory (WM) and visual learning (VL). Time-series analyses using vector autoregressive modelling, Granger causality tests and cumulative orthogonalized impulse response function analyses were performed for each individual separately. Results In one patient higher NA was associated with better WM the next day. For another patient days with higher NA and lower PA were days with worse WM. For a third patient better VL was associated with lower NA and higher PA the next day. No associations were found for four patients. Conclusions These results highlight heterogeneity in the daily associations between affect and cognitive performance and stress the relevance of single-subject studies. These studies may be an important step towards personalized diagnosis and treatment in old age psychiatry. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02797-y.
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Affiliation(s)
- Alieke Tieks
- University of Groningen, University Medical Center Groningen, Interdisciplinary center Psychopathology and Emotion regulation, Groningen, the Netherlands
| | - Richard C Oude Voshaar
- University of Groningen, University Medical Center Groningen, Interdisciplinary center Psychopathology and Emotion regulation, Groningen, the Netherlands
| | - Marij Zuidersma
- University of Groningen, University Medical Center Groningen, Interdisciplinary center Psychopathology and Emotion regulation, Groningen, the Netherlands. .,Department of Psychiatry, HPC CC72, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, Netherlands.
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16
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Teles M, Shi D. Depressive symptoms as a predictor of memory decline in older adults: A longitudinal study using the dual change score model. Arch Gerontol Geriatr 2021; 97:104501. [PMID: 34399242 DOI: 10.1016/j.archger.2021.104501] [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: 06/02/2021] [Revised: 07/15/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
The directionality of the longitudinal association between depressive symptoms and memory remains a topic of intense debate. A unidirectional association where depression impacts the change in memory (or vice-versa) and a bidirectional association where the trajectories of both dimensions affect each other lead to different clinical implications. METHOD This study investigated the depression-memory longitudinal association in a sample of 2057 older adults aged between 60 and 99 years old from the Virginia Cognitive Aging Project. The bivariate dual change score model was used to investigate the directionality of the association between episodic memory and three dimensions of depression (somatic symptoms, depressed affect, and positive affect) throughout ten years (five measurement points), controlling for education and sex. RESULTS the bidirectional model showed the best fit between somatic symptoms and memory, with a significant coupling effect observed from initial somatic symptoms to subsequent changes in memory. For depressed and positive affect, the unidirectional model with initial levels of depression predicting following changes in memory showed the best fit to the data, with significant coupling effects observed. Higher initial levels of somatic symptoms and depressed affect predicted a subsequent decline in memory, and higher initial levels of positive affect predicted subsequent better memory performance. Statistical adjustments for covariates (education and sex) had no significant influence on these associations. CONCLUSIONS Our findings support a unidirectional association with higher depressive symptoms preceding a steeper decline in memory in older adults. We discuss the clinical implications for depressive symptoms as a predictor of subsequent memory decline.
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Affiliation(s)
- Mariana Teles
- Department of Psychology, University of Virginia, 1023 Millmont street, 220B room, Charlottesville, VA 22903, United States.
| | - Dingjing Shi
- Department of Psychology, University of Oklahoma, United States
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17
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Aichele S, Ghisletta P. Memory Deficits Precede Increases in Depressive Symptoms in Later Adulthood. J Gerontol B Psychol Sci Soc Sci 2020; 74:943-953. [PMID: 29385518 DOI: 10.1093/geronb/gbx183] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 12/29/2017] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We examined bidirectional, time-ordered associations between age-related changes in depressive symptoms and memory. METHOD Data came from 107,599 community-dwelling adults, aged 49-90 years, who participated in the Survey of Health, Ageing, and Retirement in Europe (SHARE). Depressive symptoms were measured with the EURO-D inventory, and memory was evaluated as delayed recall of a 10-word list. Participants were assessed up to five times at 2-year intervals. Dynamic structural equation models were used to estimate longitudinal and time-ordered (lead-lag) relations between depressive symptoms and memory performance. RESULTS Depressive symptoms increased and memory scores decreased across the observed age range, with worsening mostly evident after age 62 years. These long-term changes were moderately negatively correlated (r = -.53, p < .001). A time-ordered effect emerged such that age-specific memory deficits preceded shorter-term increases in depression symptoms. This effect can be translated such that each 1-point decrement on a 10-point memory scale at a given age predicted a 14.5% increased risk for depression two years later. Statistical adjustment for covariates (sex, education, re-test, smoking, and body mass index) had little influence on these associations. CONCLUSION In later adulthood, lower memory performance at a given age predicts subsequent 2-year increases in depressive symptoms.
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Affiliation(s)
- Stephen Aichele
- Swiss National Center of Competence in Research LIVES-Overcoming vulnerability: Life course perspectives, Universities of Lausanne and of Geneva, Switzerland
| | - Paolo Ghisletta
- Swiss National Center of Competence in Research LIVES-Overcoming vulnerability: Life course perspectives, Universities of Lausanne and of Geneva, Switzerland.,Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.,Swiss Distance Learning University, Switzerland
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18
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Chiu NKH, Ehgoetz Martens KA, Mok VCT, Lewis SJG, Matar E. Prevalence and predictors of mood disturbances in idiopathic REM sleep behaviour disorder. J Sleep Res 2020; 30:e13040. [PMID: 32255236 DOI: 10.1111/jsr.13040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/28/2020] [Accepted: 03/13/2020] [Indexed: 11/29/2022]
Abstract
Depression and anxiety are commonly associated with synucleinopathies. Mood disturbances have also been reported in patients with idiopathic REM sleep behaviour disorder (iRBD) and are difficult to treat due to exacerbation of sleep symptoms with standard antidepressants. Despite this, detailed prevalence studies of mood symptomatology and contributors to mood disturbances in iRBD are limited. Mood, sleep, autonomic, cognitive and motor symptoms were assessed in 49 well-characterized patients with iRBD using a variety of clinical scales. Spearman correlations, factor analysis and multiple linear regression were used to uncover associations between mood and non-motor and motor symptoms. The prevalence of significant depression was 17.0% and that of anxiety was 14.6% in the iRBD cohort. Age and disease duration were not correlated with these affective symptoms in iRBD patients. We found depression was significantly predicted by the presence and severity of motor, sleep and cognitive symptoms. Anxiety was predicted by the severity of nocturnal and daytime sleep-related symptoms, cognitive symptoms and autonomic symptoms, with a differential effect depending on the questionnaire used. Depression and anxiety are common in iRBD patients and can be significantly explained by specific sets of non-motor and motor symptoms. These associations provide insight into the underlying pathophysiology and emphasize the importance of a holistic approach to mood disturbance in this population, which may circumvent the reliance on pharmacotherapy that can exacerbate dream enactment behaviour.
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Affiliation(s)
- Nicholas K H Chiu
- Forefront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.,Department of Medicine and Therapeutics, Faculty of Medicine, Margaret K.L. Cheung Research Centre for Management of Parkinsonism, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kaylena A Ehgoetz Martens
- Forefront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Vincent C T Mok
- Department of Medicine and Therapeutics, Faculty of Medicine, Margaret K.L. Cheung Research Centre for Management of Parkinsonism, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Simon J G Lewis
- Forefront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Elie Matar
- Forefront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.,Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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19
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Åström E, Rönnlund M, Adolfsson R, Grazia Carelli M. Depressive symptoms and time perspective in older adults: associations beyond personality and negative life events. Aging Ment Health 2019; 23:1674-1683. [PMID: 30450950 DOI: 10.1080/13607863.2018.1506743] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: To examine the extent to which time perspective, an individual's habitual way of relating to the past, the present, and the future time frames, accounts for variations in self-reported depressive symptoms among older adults. Method: Four hundred two participants (60-90 years) completed the Center for Epidemiological Studies Depression scale (CES-D) and the Swedish Zimbardo Time perspective Inventory (S-ZTPI). The influence of personality as reflected by the Temperament and Character Inventory (TCI) and self-reported negative life events (NLEs) were controlled for in hierarchic regression analyses. Results: The six S-ZTPI dimensions accounted for 24.5% of the variance in CES-D scores beyond age and gender. Half of the variance remained when the TCI factors and NLEs were controlled for. Past Negative, Future Negative, and Past Positive (inverse association) were the significant unique predictors. Significant age interactions were observed for two S-ZTPI dimensions, with a diminished association to depressive symptoms for Future Negative and a magnified association for Present Fatalistic with higher age. Conclusions: The results demonstrate a substantial relation between facets of time perspective and depressive symptoms in old age. They also indicate an age-related shift in the relative importance from concerns about of the future (Future Negative) to the present (Present Fatalistic) with increased age. In young old-age, when the future is more 'open', future worries (Future Negative) may be a more frequent source of distress. In late senescence, perceived threats to autonomy (e.g. physical health problems and cognitive deficits), as reflected by higher scores on Present Fatalistic, may instead have more bearing on mood state.
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Affiliation(s)
| | | | - Rolf Adolfsson
- Department of Clinical Sciences, Division of Psychiatry, Umeå University , Umeå , Sweden
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20
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Choi EY, Kim YS, Lee HY, Shin HR, Park S, Cho SE. The moderating effect of subjective age on the association between depressive symptoms and cognitive functioning in Korean older adults. Aging Ment Health 2019; 23:38-45. [PMID: 29052424 DOI: 10.1080/13607863.2017.1390733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Depressive symptoms are greatly associated with cognitive impairment in older adults. Recent growing body of literature has reported that the subjective perception of one's own age (subjective age) predicts both cognitive performance and mental well-being in old age. This study aims to examine whether subjective age moderates the association between depressive symptoms and cognitive functioning in a representative sample of Korean older adults. To address this research question, we employed the Stereotype-Embodiment Theory as a theoretical guide. METHOD Data are from the 2016 Dementia Literacy Survey collected by Kyung Hee University, and 526 community-dwelling Korean older adults (ages 60-79) completed the questionnaire about depressive symptoms, cognitive functioning, and subjective age. RESULTS According to the hierarchical regression analysis, both higher levels of depressive symptoms and older subjective age were associated with poorer cognitive functioning. Further analyses showed that subjective age attenuated the effect of depressive symptoms on cognitive functioning: when older adults have a higher level of depression, those with younger subjective age reported a higher level of cognitive functioning than those with older subjective age. CONCLUSION Based on the findings from this study, both theoretical and practical implications were discussed.
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Affiliation(s)
- Eun Young Choi
- a Graduate School of East-West Medical Science , Kyung Hee University , Yongin-si , Republic of Korea
| | - Young Sun Kim
- a Graduate School of East-West Medical Science , Kyung Hee University , Yongin-si , Republic of Korea
| | - Hee Yun Lee
- b School of Social Work , University of Minnesota , St. Paul , MN , USA
| | - Hye Ri Shin
- a Graduate School of East-West Medical Science , Kyung Hee University , Yongin-si , Republic of Korea
| | - SeolWoo Park
- a Graduate School of East-West Medical Science , Kyung Hee University , Yongin-si , Republic of Korea
| | - Sung Eun Cho
- a Graduate School of East-West Medical Science , Kyung Hee University , Yongin-si , Republic of Korea
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21
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Aichele S, Rabbitt P, Ghisletta P. Illness and intelligence are comparatively strong predictors of individual differences in depressive symptoms following middle age. Aging Ment Health 2019; 23:122-131. [PMID: 29077479 DOI: 10.1080/13607863.2017.1394440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We compared the importance of socio-demographic, lifestyle, health, and multiple cognitive measures for predicting individual differences in depressive symptoms in later adulthood. METHOD Data came from 6203 community-dwelling older adults (age 41-93 years at study entry) from the United Kingdom. Predictors (36 in total) were assessed up to four times across a period of approximately 12 years. Depressive symptoms were measured with the Geriatric Depression Scale. Statistical methods included multiple imputation (for missing data), random forest analysis (a machine learning approach), and multivariate regression. RESULTS On average, depressive symptoms increased gradually following middle age and appeared to accelerate in later life. Individual differences in depressive symptoms were most strongly associated with differences in combined symptoms of physical illness (positive relation) and fluid intelligence (negative relation). The strength of association between depressive symptoms and fluid intelligence was unaffected by differences in health status within a subsample of chronically depressed individuals. CONCLUSION Joint consideration of general health status and fluid intelligence may facilitate prediction of depressive symptoms severity during later life and may also serve to identify sub-populations of community-dwelling elders at risk for chronic depression.
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Affiliation(s)
- Stephen Aichele
- a Swiss National Center of Competence in Research LIVES - Overcoming Vulnerability: Life Course Perspectives , Universities of Lausanne and of Geneva , Switzerland
| | - Patrick Rabbitt
- b Department of Experimental Psychology , University of Oxford , Oxford , UK
| | - Paolo Ghisletta
- a Swiss National Center of Competence in Research LIVES - Overcoming Vulnerability: Life Course Perspectives , Universities of Lausanne and of Geneva , Switzerland.,c Faculty of Psychology and Educational Sciences , University of Geneva , Geneva , Switzerland.,d Swiss Distance Learning University , Brig , Switzerland
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22
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Aichele S, Ghisletta P, Corley J, Pattie A, Taylor AM, Starr JM, Deary IJ. Fluid Intelligence Predicts Change in Depressive Symptoms in Later Life: The Lothian Birth Cohort 1936. Psychol Sci 2018; 29:1984-1995. [PMID: 30359210 PMCID: PMC6291904 DOI: 10.1177/0956797618804501] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We examined reciprocal, time-ordered associations between age-related changes in fluid intelligence and depressive symptoms. Participants were 1,091 community-dwelling older adults from the Lothian Birth Cohort 1936 study who were assessed repeatedly at 3-year intervals between the ages of 70 and 79 years. On average, fluid intelligence and depressive symptoms worsened with age. There was also a dynamic-coupling effect, in which low fluid intelligence at a given age predicted increasing depressive symptoms across the following 3-year interval, whereas the converse did not hold. Model comparisons showed that this coupling parameter significantly improved overall fit and had a correspondingly moderately strong effect size, accounting on average for an accumulated 0.9 standard-deviation increase in depressive symptoms, following lower cognitive performance, across the observed age range. Adjustment for sociodemographic and health-related covariates did not significantly attenuate this association. This implies that monitoring for cognitive decrements in later life may expedite interventions to reduce related increases in depression risk.
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Affiliation(s)
- Stephen Aichele
- Swiss National Centre of Competence in Research LIVES, Universities of Lausanne and Geneva
| | - Paolo Ghisletta
- Swiss National Centre of Competence in Research LIVES, Universities of Lausanne and Geneva.,Faculty of Psychology and Educational Sciences, University of Geneva.,Swiss Distance Learning University
| | - Janie Corley
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh
| | - Alison Pattie
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh
| | - Adele M Taylor
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh
| | - John M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh.,Alzheimer Scotland Dementia Research Centre, University of Edinburgh
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh
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23
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Yu J, Lim HY, Abdullah FNDM, Chan HM, Mahendran R, Ho R, Kua EH, Power MJ, Feng L. Directional associations between memory impairment and depressive symptoms: data from a longitudinal sample and meta-analysis. Psychol Med 2018; 48:1664-1672. [PMID: 29113607 DOI: 10.1017/s0033291717003154] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Previous cross-lagged studies on depression and memory impairment among the elderly have revealed conflicting findings relating to the direction of influence between depression and memory impairment. The current study aims to clarify this direction of influence by examining the cross-lagged relationships between memory impairment and depression in an Asian sample of elderly community dwellers, as well as synthesizing previous relevant cross-lagged findings via a meta-analysis. METHODS A total of 160 participants (Mage = 68.14, s.d. = 5.34) were assessed across two time points (average of 1.9 years apart) on measures of memory and depressive symptoms. The data were then fitted to a structural equation model to examine two cross-lagged effects (i.e. depressive symptoms→memory; memory→depressive symptoms). A total of 14 effect-sizes for each of the two cross-lagged directions were extracted from six studies (including the present; total N = 8324). These effects were then meta-analyzed using a three-level mixed effects model. RESULTS In the current sample, lower memory ability at baseline was associated with worse depressive symptoms levels at follow-up, after controlling for baseline depressive symptoms. However, the reverse effect was not significant; baseline depressive symptoms did not predict subsequent memory ability after controlling for baseline memory. The results of the meta-analysis revealed the same pattern of relationship between memory and depressive symptoms. CONCLUSIONS These results provide robust evidence that the relationship between memory impairment and depressive symptoms is unidirectional; memory impairment predicts subsequent depressive symptoms but not vice-versa. The implications of these findings are discussed.
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Affiliation(s)
- Junhong Yu
- Department of Psychological Medicine,National University Hospital,Singapore,Singapore
| | | | | | | | | | | | | | - Michael John Power
- Department of Psychology,National University of Singapore,Singapore,Singapore
| | - Lei Feng
- Department of Psychological Medicine,Yong Loo Lin School of Medicine,National University of Singapore,Singapore,Singapore
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24
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Camacho A, Tarraf W, Jimenez DE, Gallo LC, Gonzalez P, Kaplan RC, Lamar M, Khambaty T, Thyagarajan B, Perreira KM, Hernandez R, Cai J, Daviglus ML, Wassertheil-Smoller S, González HM. Anxious Depression and Neurocognition among Middle-Aged and Older Hispanic/Latino Adults: Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Results. Am J Geriatr Psychiatry 2018; 26:238-249. [PMID: 28684241 PMCID: PMC5752627 DOI: 10.1016/j.jagp.2017.06.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 06/01/2017] [Accepted: 06/01/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The purpose of this study is to examine the association between verbal learning, fluency, and processing speed with anxious depression symptomatology (ADS) among diverse Hispanics. We hypothesized an inverse association of anxious depression with neurocognition among Hispanics of different heritage. DESIGN Data are from the Hispanic Community Health Study/Study of Latinos. The sample included 9,311participants aged 45-74 years (mean: 56.5 years). A latent class analysis of items from the Center for Epidemiological Studies for Depression scale and the Spielberger Trait Anxiety Inventory was used to derive an anxious depression construct. Neurocognitive measures included scores on the Brief Spanish English Verbal Learning Test (B-SEVLT, learning and recall trials), Word Fluency (WF), Digit Symbol Substitution (DSS) test, and a Global Cognitive Score (GCS). We fit survey linear regression models to test the associations between anxious depression symptomatology and cognitive function. We tested for effect modification by sex, Hispanic heritage, and age groups. RESULTS Among men, 71.6% reported low, 23.3% moderate, and 5.1% high ADS. Among women, 55.1% reported low, 33.2% moderate, and 11.8% high ADS. After controlling for age, sex, sociodemographic characteristics, cardiovascular risk factors and disease, and antidepressant use, we found significant inverse associations between moderate and high anxious depression (ref:low) with B-SEVLT learning and recall, DSS and GCS. Moderate, but not high, anxious depression was inversely associated with WF. Associations were not modified by sex, Hispanic heritage, or age. CONCLUSIONS Increased anxious depression symptomatology is associated with decreased neurocognitive function among Hispanics. Longitudinal studies are needed to establish temporality and infer if negative emotional symptoms precede cognitive deficits.
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Affiliation(s)
- Alvaro Camacho
- Departments of Psychiatry, Family Medicine, and Public Health, University of California San Diego, San Diego, CA.
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI
| | - Daniel E Jimenez
- Department of Psychiatry and Behavioral Sciences, Center of Aging, University of Miami, Miami, FL
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA
| | - Patricia Gonzalez
- Graduate School of Public Health, San Diego State University, San Diego, CA
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Melissa Lamar
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL
| | | | | | - Krista M Perreira
- Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill, NC
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL
| | - Jianwen Cai
- Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill, NC
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL
| | | | - Hector M González
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI
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Kim BJ, Liu L, Nakaoka S, Jang S, Browne C. Depression among older Japanese Americans: The impact of functional (ADL & IADL) and cognitive status. SOCIAL WORK IN HEALTH CARE 2018; 57:109-125. [PMID: 29236614 DOI: 10.1080/00981389.2017.1397588] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE The objective of this article is to investigate the relationship between activities of daily living, instrumental activities of daily living, cognitive impairment, and depression among Japanese American elders. METHODS A cross-sectional study of 207 older Japanese Americans (68 years and older) was conducted in Los Angeles, California and Honolulu, Hawaii. Independent variables included activities of daily living, instrumental activities of daily living, and cognitive functioning. Age, gender, marital status, and income were also identified. Depression was the dependent variable. RESULTS Descriptive analyses were done to show group differences in terms of gender, age and marital status. Gender (male) and marital status (married) were the determinants of lower rates of depression. Lower rates of IADL and cognitive functioning were significant determinants of higher rates of depression among older Japanese Americans. CONCLUSIONS This study provides empirical evidence that physical and cognitive functioning are directly associated with depression in older Japanese Americans. Social workers need to provide the services of ethnic-based via formal agencies in order to prevent depression of older Japanese Americans. Also, it is important to have sensitivity and competency to assess depressive symptoms and refer elders to an appropriate mental health agency.
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Affiliation(s)
- Bum Jung Kim
- a Department of Social Welfare , Chung-Ang University , Seoul , South Korea
- b School of Social Work , University of Hawaii at Manoa , Honolulu , HI , USA
| | - Lin Liu
- b School of Social Work , University of Hawaii at Manoa , Honolulu , HI , USA
| | - Susan Nakaoka
- b School of Social Work , University of Hawaii at Manoa , Honolulu , HI , USA
| | - Sumi Jang
- c Department of Social Welfare , Cheongju University , Cheongju , South Korea
| | - Colette Browne
- b School of Social Work , University of Hawaii at Manoa , Honolulu , HI , USA
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Hernandez R, Cheung E, Liao M, Boughton SW, Tito LG, Sarkisian C. The Association Between Depressive Symptoms and Cognitive Functioning in Older Hispanic/Latino Adults Enrolled in an Exercise Intervention: Results From the "¡Caminemos!" Study. J Aging Health 2017; 30:843-862. [PMID: 28553810 DOI: 10.1177/0898264317696776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE We examined the association between depressive symptoms and cognitive functioning in older Hispanics/Latinos enrolled in an exercise intervention. METHOD We analyzed baseline, 1-year, and 2-year in-person interview data collected from Hispanics/Latinos aged ≥60 years participating in an exercise intervention across 27 senior centers ( N = 572). RESULTS Mean age was 73.13 years; 77% female. At baseline, older adults screening positive for depression were 1.58 times more likely to experience cognitive impairment ( p = .04); controlling for demographics and comorbid chronic conditions. Compared to peers with little to no depressive symptoms, lower cognitive functioning scores were evident at each follow-up assessment point where elevated depressive symptoms were present, but baseline depression was not associated with cognitive function in longitudinal analyses. DISCUSSION In older Hispanics/Latinos enrolled in an exercise intervention, though baseline depression did not predict cognitive function over time, elevated symptoms of depression were associated with greater cognitive impairment at every point in this study.
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Affiliation(s)
| | - Elaine Cheung
- 2 Northwestern University Weinberg College of Arts and Sciences, Chicago, IL, USA
| | - Minli Liao
- 3 Morgan State University, Baltimore, MD, USA
| | | | - Lisett G Tito
- 1 University of Illinois at Urbana-Champaign, IL, USA
| | - Catherine Sarkisian
- 4 David Geffen School of Medicine at UCLA, CA, USA.,5 VA Greater Los Angeles Healthcare System, CA, USA
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Giannouli V. Serum brain-derived neurotrophic factor and depressive symptoms in coronary heart disease patients: A word on methodology. Psychoneuroendocrinology 2017; 79:175. [PMID: 28256361 DOI: 10.1016/j.psyneuen.2017.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 02/10/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Vaitsa Giannouli
- Institute of Neurobiology, Bulgarian Academy of Sciences, Bulgaria.
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Brailean A, Aartsen MJ, Muniz-Terrera G, Prince M, Prina AM, Comijs HC, Huisman M, Beekman A. Longitudinal associations between late-life depression dimensions and cognitive functioning: a cross-domain latent growth curve analysis. Psychol Med 2017; 47:690-702. [PMID: 27834162 PMCID: PMC5426346 DOI: 10.1017/s003329171600297x] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 10/16/2016] [Accepted: 10/17/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cognitive impairment and depression often co-occur in older adults, but it is not clear whether depression is a risk factor for cognitive decline, a psychological reaction to cognitive decline, or whether changes in depressive symptoms correlate with changes in cognitive performance over time. The co-morbid manifestation of depression and cognitive impairment may reflect either a causal effect or a common cause, depending on the specific symptoms experienced and the cognitive functions affected. METHOD The study sample comprised 1506 community-dwelling older adults aged ⩾65 years from the Longitudinal Aging Study Amsterdam (LASA). We conducted cross-domain latent growth curve analyses to examine longitudinal associations between late-life depression dimensions (i.e. depressed affect, positive affect, and somatic symptoms) and specific domains of cognitive functioning (i.e. processing speed, inductive reasoning, immediate recall, and delayed recall). RESULTS Poorer delayed recall performance at baseline predicted a steeper increase in depressed affect over time. Steeper decline in processing speed correlated with a steeper increase in somatic symptoms of depression over time. CONCLUSIONS Our findings suggest a prospective association between memory function and depressed affect, whereby older adults may experience an increase in depressed affect in reaction to poor memory function. Somatic symptoms of depression increased concurrently with declining processing speed, which may reflect common neurodegenerative processes. Our findings do not support the hypothesis that depression symptoms may be a risk factor for cognitive decline in the general population. These findings have potential implications for the treatment of late-life depression and for the prognosis of cognitive outcomes.
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Affiliation(s)
- A. Brailean
- Department of Health Service and Population
Research, King's College London, Institute of Psychiatry,
Psychology and Neuroscience, Centre for Global Mental Health,
London, UK
| | - M. J. Aartsen
- NOVA - Norwegian Social Research, Center for
Welfare and Labor Research, Oslo,
Norway
| | | | - M. Prince
- Department of Health Service and Population
Research, King's College London, Institute of Psychiatry,
Psychology and Neuroscience, Centre for Global Mental Health,
London, UK
| | - A. M. Prina
- Department of Health Service and Population
Research, King's College London, Institute of Psychiatry,
Psychology and Neuroscience, Centre for Global Mental Health,
London, UK
| | - H. C. Comijs
- VU University Medical Centre, Department of
Psychiatry and the EMGO Institute for Health and Care Research,
Amsterdam, The Netherlands
| | - M. Huisman
- VU University Medical Center, Department of
Epidemiology and Biostatistics and the EMGO Institute for Health and Care
Research, Amsterdam, The Netherlands
- Department of Sociology, VU
University, Amsterdam, The
Netherlands
| | - A. Beekman
- VU University Medical Centre, Department of
Psychiatry and the EMGO Institute for Health and Care Research,
Amsterdam, The Netherlands
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Downer B, Vickers BN, Al Snih S, Raji M, Markides KS. Effects of Comorbid Depression and Diabetes Mellitus on Cognitive Decline in Older Mexican Americans. J Am Geriatr Soc 2016; 64:109-17. [PMID: 26782859 DOI: 10.1111/jgs.13883] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To assess the relationship between comorbid depression, diabetes mellitus (DM), and cognitive decline in Mexican Americans aged 65 and older. DESIGN Retrospective cohort study with longitudinal analysis. SETTING Texas, New Mexico, Colorado, Arizona, and California. PARTICIPANTS Hispanic Established Populations for the Epidemiologic Study of the Elderly. MEASUREMENTS Cognition was assessed using the Mini-Mental State Examination (MMSE). Depression was defined as a score of 16 or greater on the Center for Epidemiologic Studies Depression Scale. DM was defined as according to self-reported history or taking insulin or oral hypoglycemic medication. RESULTS Participants with depression and DM declined an average of 6.5 points on the MMSE; depression only, 4.4 points; DM only, 7.8 points; and neither condition, 4.2 points across the six examination waves. Participants with DM declined an average of 0.18 more points on the MMSE per year (P=.001) than those with neither DM nor depression, and those with comorbid DM and depression declined 0.25 more points per year (P=.002). Depression was associated with significantly greater cognitive decline (β^=-0.11, P=.05) after excluding participants with baseline cognitive impairment (MMSE score≤17). Participants with DM were 1.08 (95% CI=1.03-1.12) times as likely as those with neither DM nor depression, and those with comorbid DM and depression were 1.08 (95% CI=1.01-1.15) times as likely as those with neither DM nor depression to develop severe cognitive impairment per year. CONCLUSION DM and comorbid depression and DM are risk factors for cognitive decline in older Mexican Americans. Interventions that reduce the prevalence of depression and DM in Mexican Americans may decrease the number of older adults who experience cognitive decline.
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Affiliation(s)
- Brian Downer
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas
| | - Benjamin N Vickers
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas
| | - Soham Al Snih
- Department of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, Texas
| | - Mukaila Raji
- Division of Geriatrics, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Kyriakos S Markides
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas
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Graziane JA, Beer JC, Snitz BE, Chang CCH, Ganguli M. Dual Trajectories of Depression and Cognition: A Longitudinal Population-Based Study. Am J Geriatr Psychiatry 2016; 24:364-73. [PMID: 26560510 PMCID: PMC4841743 DOI: 10.1016/j.jagp.2015.08.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 08/09/2015] [Accepted: 08/11/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To examine the relationships over time between dual trajectories of depressive symptoms and several cognitive domains. METHODS In a 5-year longitudinal study, 1,978 randomly selected individuals aged 65+ years at recruitment were assessed annually. Repeated measures were of depressive symptoms on the modified Center for Epidemiologic Studies Depression Scale and composite scores in the cognitive domains of attention, executive function, memory, language, and visuospatial function. Latent class trajectories were identified for depression and for each cognitive domain and their associations investigated using dual trajectory modeling. Cognitive trajectories with z scores below -1 were designated as persistently low. RESULTS Five depressive symptom trajectories were observed: rarely depressed (60.5%); low-grade, decreasing symptoms (18.5%); low-grade, increasing symptoms (9.6%); moderate-grade symptoms (7.4%); and consistent higher-grade symptoms (4.0%). For each cognitive domain six trajectories were observed. The rarely depressed and low-grade decreasing symptom groups were the least likely to have persistently low cognition. The symptom trajectory most strongly associated with persistently low functioning in each domain was not the higher-grade group but rather the low-grade increasing group in the case of attention and the moderate-grade trajectory in the other four domains. CONCLUSION Consistently higher-grade depressive symptoms are less strongly associated with poor cognitive functioning than with either moderate- or low-grade increasing depressive symptom trajectories, over time and across different domains. Examining both depression and cognition longitudinally allows heterogeneity of both to be addressed, revealing latent groups with potential diagnostic and prognostic implications.
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Affiliation(s)
- Julie A. Graziane
- University of Pittsburgh School of Medicine, Department of Psychiatry
| | - Joanne C. Beer
- University of Pittsburgh School of Medicine, Department of Psychiatry
| | - Beth E. Snitz
- University of Pittsburgh School of Medicine, Department of Neurology
| | - Chung-Chou H. Chang
- University of Pittsburgh School of Medicine, Department of Medicine,University of Pittsburgh Graduate School of Public Health, Department of Biostatistics
| | - Mary Ganguli
- University of Pittsburgh School of Medicine, Department of Psychiatry,University of Pittsburgh School of Medicine, Department of Neurology,University of Pittsburgh Graduate School of Public Health, Department of Epidemiology
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Chiao C, Weng LJ. Mid-life socioeconomic status, depressive symptomatology and general cognitive status among older adults: inter-relationships and temporal effects. BMC Geriatr 2016; 16:88. [PMID: 27099153 PMCID: PMC4839082 DOI: 10.1186/s12877-016-0257-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 04/13/2016] [Indexed: 11/11/2022] Open
Abstract
Background Few longitudinal studies have analyzed how socioeconomic status (SES) influences both depressive and cognitive development over an individual’s life course. This study investigates the change trajectories of both depressive symptomatology and general cognitive status, as well as their associations over time, focusing on the effects of mid-life SES. Methods Data were obtained from the Taiwan Longitudinal Study on Aging (1993–2007), a nationally representative cohort study of older adults in Taiwan. The short form of the Center of Epidemiological Studies-Depression (CES-D) scale that measures depressive symptomatology in two domains (negative affect and lack of positive affect) was used. General cognitive status was assessed using the brief Short Portable Mental Status Questionnaire scale. Assessments of the subjects’ mid-life SES included measurement of the participant’s education and occupation. Analyses were conducted by the parallel latent growth curve modeling. Results The participants’ initial levels of depressive symptomatology and general cognitive status were significantly and negatively correlated; furthermore, any changes in these two outcomes were also correlated over time. The initial assessment of general cognitive status significantly contributed to any advancement towards more severe depressive symptomatology over time, particularly when this occurred in a negative manner. Furthermore, a mid-life SES advantage resulted in a significant reduction in late-life depressive symptomatology and also produced a slower decline in general cognitive status during later life. In contrast, lower mid-life SES exacerbated depressive symptomatology during old age, both at the initial assessment and in terms of the change over time. In addition, female gender was significantly associated with lower general cognitive status and more severe depressive symptomatology in negative affect. Conclusions These findings suggest a complex and longitudinal association between depressive symptomatology and general cognitive status in later life and this complicated relationship seems to be affected by mid-life SES over time.
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Affiliation(s)
- Chi Chiao
- Insitute of Health and Welfare Policy, Research Center for Health and Welfare Policy, College of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.
| | - Li-Jen Weng
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan, R.O.C
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Dzierzewski JM, Potter GG, Jones RN, Rostant OS, Ayotte B, Yang FM, Sachs BC, Feldman BJ, Steffens DC. Cognitive functioning throughout the treatment history of clinical late-life depression. Int J Geriatr Psychiatry 2015; 30:1076-84. [PMID: 25703072 PMCID: PMC4545467 DOI: 10.1002/gps.4264] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 12/29/2014] [Accepted: 01/06/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Previous investigations into the relationship between late-life depressive symptoms and cognitive functioning have resulted in mixed findings concerning whether or not depressive symptoms and cognitive functioning are related. The mixed reports may be due in part to differences in clinical and nonclinical samples and to inadequate consideration of the dynamic nature (i.e., fluctuating course) of depressive symptoms and cognitive functioning in older adults. The current study examined the chronic, acute, and longitudinal relationships between depressive symptoms and cognitive functioning in older adults in an ongoing treatment study of major depressive disorder (MDD). METHODS The neurocognitive outcomes of depression in the elderly study operates in a naturalistic treatment milieu using a pharmacological treatment algorithm and regular psychiatric assessment. Four hundred and fifty-three older adults [mean age 70 years, standard deviation (SD) = 7.2] meeting criteria for MDD at study enrollment received annual neuropsychological testing and depressive symptom monitoring for an average of 8.5 years (SD = 4.5). RESULTS Hierarchical linear modeling revealed that higher age, lower education, and higher average/chronic levels of depressive symptoms were related to lower cognitive functioning. Additionally, results revealed that when an individual's depressive symptoms are higher than is typical for a specific individual, general cognitive function was worse than average. There was no evidence of lagged/longitudinal relationships between depressive symptoms and cognitive functioning in older adults in treatment for MDD. CONCLUSIONS Cognitive functioning and depressive symptoms are concurrently associated in older adults with MDD, highlighting the potential importance for stabilizing mood symptoms as a means to manage cognitive deficits in late-life depression.
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Affiliation(s)
- Joseph M. Dzierzewski
- David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Geriatric Research, Education and Clinical Center, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA
| | - Guy G. Potter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Richard N. Jones
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Ola S. Rostant
- National Institute on Aging, Intramural Research Program, National Institutes of Health and Department of Psychiatry, University of Michigan, Anne Arbor, MI, USA
| | - Brian Ayotte
- Department of Psychology, University of Massachusetts Dartmouth, Dartmouth, MA, USA
| | - Frances M. Yang
- Department of Biostatistics and Epidemiology, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA
| | - Bonnie C. Sachs
- Department of Neurology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA
| | - Betsy J. Feldman
- Partners for Children, School of Social Work, University of Washington, Seattle, WA, USA
| | - David C. Steffens
- Department of Psychiatry, University of Connecticut, Farmington, CT, USA
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Guerrero-Berroa E, Kluger A, Schmeidler J, Sailor K, Lizardi H, Golomb J, Ferris S, Reisberg B. Neuropsychological and neuropsychiatric prediction of global cognitive status among older Spanish-speaking Hispanics and English-speaking whites. J Geriatr Psychiatry Neurol 2014; 27:266-75. [PMID: 24759088 PMCID: PMC4465291 DOI: 10.1177/0891988714532020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Neuropsychological and depression measures have been found to predict cognitive functioning. We compared these associations among whites and Spanish-speaking Hispanics. METHODS Fifty-two pairs of whites and Hispanics were matched demographically and clinically in a cross-sectional study. Hierarchical regression analyses predicted Global Deterioration Scale (GDS) rating by baseline neuropsychological tests and depression symptoms. RESULTS Neuropsychological tests predicted GDS better in whites; depression symptoms--specifically retardation--predicted well in Hispanics but not whites. Immediate recall of the New York University (NYU)-Paragraph Test and the Retardation item of the Hamilton Depression Rating Scale were associated with GDS in Hispanics and delayed recall of the NYU-Paragraph Test and Wechsler Adult Intelligence Scale-Digit Symbol in whites. Neuropsychological tests and depression symptoms predicted GDS differently in Hispanics and whites. DISCUSSION These results suggest that other measures should be considered to increase the predictive accuracy of neuropsychological tests when assessing cognitive status in Spanish-speaking Hispanics. Additional studies of specific ethnic/racial and sociodemographic subgroups are warranted.
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Affiliation(s)
| | - Alan Kluger
- Department of Psychology, Lehman College/City University of New York, New York, NY, USA, Alzheimer's Disease Center, Comprehensive Center on Brain Aging, New York University Langone Medical Center, New York, NY, USA
| | - James Schmeidler
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kevin Sailor
- Department of Psychology, Lehman College/City University of New York, New York, NY, USA
| | - Humberto Lizardi
- Department of Psychology, Lehman College/City University of New York, New York, NY, USA
| | - James Golomb
- Alzheimer's Disease Center, Comprehensive Center on Brain Aging, New York University Langone Medical Center, New York, NY, USA
| | - Steven Ferris
- Alzheimer's Disease Center, Comprehensive Center on Brain Aging, New York University Langone Medical Center, New York, NY, USA
| | - Barry Reisberg
- Alzheimer's Disease Center, Comprehensive Center on Brain Aging, New York University Langone Medical Center, New York, NY, USA
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Yoon JY, Brown RL. Causal inference in cross-lagged panel analysis: a reciprocal causal relationship between cognitive function and depressive symptoms. Res Gerontol Nurs 2014; 7:152-8. [PMID: 24635005 DOI: 10.3928/19404921-20140310-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 02/03/2014] [Indexed: 11/20/2022]
Abstract
Cross-lagged panel analysis (CLPA) is a method of examining one-way or reciprocal causal inference between longitudinally changing variables. It has been used in the social sciences for many years, but not much in nursing research. This article introduces the conceptual and statistical background of CLPA and provides an exemplar of CLPA that examines the reciprocal causal relationship between depression and cognitive function over time in older adults. The 2-year cross-lagged effects of depressive symptoms (T1) on cognitive function (T2) and cognitive function (T1) on depressive symptoms (T2) were significant, which demonstrated a reciprocal causal relationship between cognitive function and depressive mood over time. Although CLPA is a methodologically strong approach to examine the reciprocal causal inferences over time, it is necessary to consider potential sources of spuriousness to lead to false causal relationship and a reasonable time frame to detect the change of the variables.
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Wickrama KKAS, O'Neal CW, Kwag KH, Lee TK. Is working later in life good or bad for health? An investigation of multiple health outcomes. J Gerontol B Psychol Sci Soc Sci 2013; 68:807-15. [PMID: 23887930 DOI: 10.1093/geronb/gbt069] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To examine the mutual influences between changes in work status and multiple dimensions of health outcomes (immediate memory, physical disability, and depressive symptoms) over later years. METHODS We used a subsample of 8,524 older adults who participated in the Health and Retirement Study from 1998 to 2008 and were 62 years or older in 1998 to examine work status and health outcomes after controlling for age and background characteristics. RESULTS We present results of cross-lagged auto-regressive models. Work status (level of work) predicted subsequent residual changes in immediate memory over time, whereas immediate memory predicted subsequent residual changes in work status over time, even after controlling for physical disability and depressive symptoms. Similar results were indicated for the associations between work status and physical disability and depressive symptoms over time. DISCUSSION Consistent with social causation and social selection traditions, the findings support bi-directional associations among changes in work status (the level of work), immediate memory, physical disability, and depressive symptoms in later years. Practical implications are discussed.
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Affiliation(s)
- Kandauda K A S Wickrama
- Department of Human Development and Family Science, University of Georgia, Athens, GA 30602, USA
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Baer LH, Tabri N, Blair M, Bye D, Li KZH, Pushkar D. Longitudinal Associations of Need for Cognition, Cognitive Activity, and Depressive Symptomatology With Cognitive Function in Recent Retirees. ACTA ACUST UNITED AC 2012; 68:655-64. [PMID: 23213060 DOI: 10.1093/geronb/gbs112] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Lawrence H Baer
- Centre for Research in Human Development and Department of Psychology, Concordia University, 7141 Sherbrooke Street West Montréal, Québec, Canada H4B 1R6.
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Gale CR, Allerhand M, Deary IJ. Is there a bidirectional relationship between depressive symptoms and cognitive ability in older people? A prospective study using the English Longitudinal Study of Ageing. Psychol Med 2012; 42:2057-2069. [PMID: 23206378 PMCID: PMC3435872 DOI: 10.1017/s0033291712000402] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 02/03/2012] [Accepted: 02/07/2012] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cross-sectional surveys of older people commonly find associations between higher levels of depressive symptoms and poorer cognitive performance, but the direction of effect is unclear. We examined whether there was a bidirectional relationship between depressive symptoms and general cognitive ability in non-demented older people, and explored the role of physical health, smoking, exercise, social class and education as potential confounders of this association and as possible determinants of the rate of change of cognitive decline and depressive symptoms. METHOD The English Longitudinal Study of Ageing consists of people aged 50 years and over. Cognitive function and self-reported depressive symptoms were measured in 2002-2003, 2004-2005, 2006-2007 and 2008-2009. We fitted linear piecewise models with fixed knot positions to allow different slopes for different age groups. Analyses are based on 8611 people. RESULTS Mean cognitive function declined with age; there was no trend in the trajectory of depressive symptoms. Better cognitive function was associated with less depression up to the age of 80 years. Greater depression was associated with a slightly faster rate of cognitive decline but only in people aged 60-80 years. There were no consistent associations across age groups between sex, smoking, education, social class, exercise or number of chronic physical illnesses and the rate of change of cognitive decline or depressive symptoms. CONCLUSIONS In this longitudinal study of older people, there was no consistent evidence that being more depressed led to an acceleration in cognitive decline and no support for the hypothesis that there might be reciprocal dynamic influences between cognitive ability and depressive symptoms.
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Affiliation(s)
- C R Gale
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
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Brown SC, Huang S, Perrino T, Surio P, Borges-Garcia R, Flavin K, Brown CH, Pantin H, Szapocznik J. The relationship of perceived neighborhood social climate to walking in Hispanic older adults: a longitudinal, cross-lagged panel analysis. J Aging Health 2011; 23:1325-51. [PMID: 21885705 PMCID: PMC3788676 DOI: 10.1177/0898264311418502] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study examines possible bidirectional relationships between neighborhood climate (i.e., perceived neighborhood social environment) and walking behavior across a 12-month period in older Hispanics. METHOD A population-based sample of 217 community-dwelling older Hispanics in Miami, Florida, completed measures of perceived neighborhood climate and neighborhood walking, at two assessment time points (12 months apart). RESULTS Structural equation modeling analyses revealed that neighborhood climate predicted subsequent walking 12 months later, such that more positive perceptions of neighborhood climate predicted more walking. Follow-up analyses revealed that older adults who resided in the top half of neighborhoods based on perceived neighborhood climate scores at initial assessment were 2.57 times as likely to have walked at least one block in the last week at follow-up, relative to older adults residing in neighborhoods whose climate was in the lower half. DISCUSSION Perceptions of a more positive neighborhood social environment may promote walking in urban, older Hispanics.
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Affiliation(s)
- Scott C Brown
- Department of Epidemiology and Public Health, Center for Family Studies, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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Soubelet A, Salthouse TA. Correlates of level and change in the Mini-Mental State Examination. Psychol Assess 2011; 23:811-8. [PMID: 21480725 DOI: 10.1037/a0023401] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The goal of the current project was to determine (a) the cognitive abilities assessed by the Mini Mental State Examination (MMSE; M. F. Folstein, S. E. Folstein, & P. R. McHugh, 1975), (b) whether the same abilities are associated with MMSE performance among people of different ages, and (c) whether the same abilities are involved in changes within the same people over time. The authors therefore examined whether the initial levels of 5 cognitive ability constructs (vocabulary, reasoning, memory, space, and speed) predicted initial levels of MMSE performance and whether the initial levels or the changes in these 5 cognitive abilities predicted change in the MMSE performance. The major findings were that 3 cognitive constructs (vocabulary, reasoning, and memory) contribute to performance in the MMSE but that their respective contributions to the MMSE vary as a function of age and time. In particular, individual differences and change in the MMSE are primarily related to individual differences in reasoning among adults younger than about 70 years, whereas both initial level of MMSE performance and longitudinal change in MMSE performance primarily related to initial level and change in memory ability among adults older than 70 years. The results therefore imply that both the level of performance on the MMSE at a single point in time and the change in MMSE over time may represent somewhat different cognitive abilities at different ages.
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Affiliation(s)
- Andrea Soubelet
- Centre for Mental Health Research, Australian National University, Canberra, ACT, Australia.
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Baller M, Boorsma M, Frijters DHM, van Marwijk HWJ, Nijpels G, van Hout HPJ. Depression in Dutch homes for the elderly: under-diagnosis in demented residents? Int J Geriatr Psychiatry 2010; 25:712-8. [PMID: 19806603 DOI: 10.1002/gps.2412] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Although community-based studies reported an increased incidence of depression among demented persons compared with non-demented persons, it is not clear whether this relationship also exists among institutionalised elderly persons. The aim of this study was to compare the prevalence of diagnosed depressive disorders and mood symptoms between demented and non-demented residents living in Dutch homes for the elderly. METHODS Cross-sectional analysis in 16 homes for the elderly of routine outcome measurements by trained nurse assistants using the Resident Assessment Instrument (RAI) between January 2007 and April 2008. Nurse assistants recorded all known medical diagnoses including dementia and depression, as well as a structured observation of the presence or absence of 11 mood symptoms over the last 3 days. RESULTS 313 demented and 463 non-demented residents with complete data were included (99% of all residents, mean age 84 years). 24.6% of participants were diagnosed with a depressive disorder, with no statistically significant difference between demented and non-demented persons (p = 0.237). Mood symptoms were more prevalent in demented residents (p < 0.001, OR 2.14, 95%CI 1.56-2.93). Among residents with mood symptoms, demented residents were less likely to be diagnosed with a depressive disorder than non-demented residents (p = 0.039, OR 0.61, 95%CI 0.38-0.98). CONCLUSIONS The prevalence of diagnosed depressive disorders was comparable between demented and non-demented residents. However, demented residents suffered more from mood symptoms and may be at risk of under-diagnosis of depression.
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Affiliation(s)
- Menke Baller
- Department of General Practice, EMGO-Institute, VU University Medical Center, Amsterdam, The Netherlands
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Tang D, Wang D. Reason or Result? Subjective Well-Being of the Elderly in Urban Beijing: A Cross-Lagged Panel Regression Analysis. AGEING INTERNATIONAL 2009. [DOI: 10.1007/s12126-009-9038-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Brown SC, Mason CA, Perrino T, Hirama I, Verdeja R, Spokane AR, Cruza-Guet MC, Lopez B, Pantin H, Szapocznik J. LONGITUDINAL RELATIONSHIPS BETWEEN NEIGHBORING BEHAVIOR AND DEPRESSIVE SYMPTOMS IN HISPANIC OLDER ADULTS IN MIAMI, FLORIDA. JOURNAL OF COMMUNITY PSYCHOLOGY 2009; 37:618-634. [PMID: 24049216 PMCID: PMC3774058 DOI: 10.1002/jcop.20321] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study examines the relationship between neighboring behavior and depressive symptoms across 3 years in a prospective study of 273 community-dwelling, Hispanic older adults in Miami, Florida. The analyses extend the literature by testing for a bidirectional or reciprocal relationship between neighboring behavior and depressive symptoms over time and examining the relationship between these variables in Hispanic older adults, a group at risk of developing depressive symptoms. Structural Equation Modeling with a cross-lagged panel design showed that depressive symptoms were unrelated to subsequent neighboring behavior. However, neighboring behavior was related to subsequent depressive symptoms at every time point, such that higher levels of neighboring behavior were related to lower levels of depressive symptoms. Findings suggest that neighboring behavior may be a protective factor against depressive symptoms in community-dwelling Hispanic older adults.
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