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The association between subjective cognitive decline and quality of life: A population-based study. J Clin Neurosci 2022; 98:60-65. [DOI: 10.1016/j.jocn.2022.01.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/28/2022] [Accepted: 01/29/2022] [Indexed: 12/28/2022]
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Xu WQ, Lin LH, Ding KR, Ke YF, Huang JH, Hou CL, Jia FJ, Wang SB. The role of depression and anxiety in the relationship between poor sleep quality and subjective cognitive decline in Chinese elderly: Exploring parallel, serial, and moderated mediation. J Affect Disord 2021; 294:464-471. [PMID: 34325166 DOI: 10.1016/j.jad.2021.07.063] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/20/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Poor sleep quality exacerbates subjective cognitive decline (SCD). Mental health may play an important role in the relationship, but the potential underlying mechanisms remain unknown. METHODS A cross-sectional study was conducted on older adult residents in Guangdong province, south China from November 2020 to March 2021. A total of 717 adults aged 60 years and over were recruited for a face-to-face investigation on a range of socio-demographic factors, lifestyle behaviors, sleep quality, SCD, depressive and anxiety symptoms. Parallel, serial and moderated mediation models were used to examine whether depression and anxiety mediated in the poor sleep quality-SCD linkage. RESULTS Both direct and indirect effects of poor sleep quality on SCD symptoms were found. Anxiety and depressive symptoms mediated the relationship between poor sleep quality and SCD symptoms(βAnxiety = 0.123, 95%CI: 0.079 to 0.173; βDepression=0.274, 95%CI: 0.200 to 0.348), respectively. Serial mediation analyses indicated that depressive and anxiety symptoms co-play a serial mediating role in the association of poor sleep quality and SCD symptoms (βa=0.052, 95% CI: 0.026 to 0.084; βb=0.077, 95% CI: 0.033 to 0.128). Moderated mediation model revealed that the mediation of depressive symptoms on the relationship between poor sleep quality and SCD symptoms was moderated by anxiety symptoms(β=0.318, 95% CI: 0.164 to 0.472). LIMITATIONS The study is the cross-sectional design, which limits the causal inference ability. CONCLUSIONS These findings provided new insights into possible avenues for prevention and intervention on SCD through sleep-based treatments with a multi-faceted approach on psychiatric disorders.
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Affiliation(s)
- Wen-Qi Xu
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Li-Hua Lin
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong province, China
| | - Kai-Rong Ding
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China; Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Yun-Fei Ke
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Jia-Hao Huang
- Yuexiu District Center for Disease Control, Guangzhou, Guangdong Province, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong province, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong province, China; Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China.
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Wickrama KAS, O’Neal CW. Couple processes of family economic hardship, depressive symptoms, and later-life subjective memory impairment: moderating role of relationship quality. Aging Ment Health 2021; 25:1666-1675. [PMID: 32349526 PMCID: PMC7643052 DOI: 10.1080/13607863.2020.1758917] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To examine a) processes through which family economic hardship (FEH) contributes to spouses' mental health and subsequent subjective memory impairment (SMI) in later years and b) the moderating effect of overall relationship quality on these associations. METHODS With prospective data over 27 years from a sample of 224 husbands and wives in enduring marriages, the present study utilized latent growth curves to identify how FEH trajectories are associated with both spouses' depressive symptoms trajectories across their mid-later years (average age 40-65 years) and subsequent SMI in later life (> 67 years). The moderating role of relationship quality between depressive symptoms and SMI was also examined. RESULTS FEH experiences across the mid-later years (1991-2015) explained variation in husbands' and wives' depressive symptoms trajectories (1994-2015). Change in depressive symptoms was associated with husbands' and wives' SMI in later life (2017) after taking the level of depressive symptoms into account. Spousal dependencies, including partner effects, existed among husbands' and wives' depressive symptoms trajectories and SMI outcomes. Some of these dependencies were moderated by couples' overall relationship quality. CONCLUSION FEH has a persistent influence on husbands' and wives' SMI in later years. Depressive symptoms mediated the influence of FEH on later wellbeing. The findings are discussed as they relate to family systems and life course stress process theories. Implications are addressed at multiple levels including national- and state-policies and clinical interventions.
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Affiliation(s)
- Kandauda A. S. Wickrama
- Department of Human Development and Family Science, The University of Georgia, 107 Family Science Center I (House A), Athens, GA 30602
| | - Catherine Walker O’Neal
- Department of Human Development and Family Science, The University of Georgia, 107 Family Science Center II (House D), Athens, GA 30602
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Gasser AI, Salamin V, Zumbach S. Dépression de la personne âgée ou maladie d’Alzheimer prodromique : quels outils pour le diagnostic différentiel ? Encephale 2018; 44:52-58. [DOI: 10.1016/j.encep.2017.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 02/25/2017] [Accepted: 03/01/2017] [Indexed: 01/23/2023]
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Heser K, Bleckwenn M, Wiese B, Mamone S, Riedel-Heller SG, Stein J, Lühmann D, Posselt T, Fuchs A, Pentzek M, Weyerer S, Werle J, Weeg D, Bickel H, Brettschneider C, König HH, Maier W, Scherer M, Wagner M. Late-Life Depressive Symptoms and Lifetime History of Major Depression: Cognitive Deficits are Largely Due to Incipient Dementia rather than Depression. J Alzheimers Dis 2018; 54:185-99. [PMID: 27497475 DOI: 10.3233/jad-160209] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Late-life depression is frequently accompanied by cognitive impairments. OBJECTIVE Whether these impairments indicate a prodromal state of dementia, or are a symptomatic expression of depression per se is not well-studied. METHODS In a cohort of very old initially non-demented primary care patients (n = 2,709, mean age = 81.1 y), cognitive performance was compared between groups of participants with or without elevated depressive symptoms and with or without subsequent dementia using ANCOVA (adjusted for age, sex, and education). Logistic regression analyses were computed to predict subsequent dementia over up to six years of follow-up. The same analytical approach was performed for lifetime major depression. RESULTS Participants with elevated depressive symptoms without subsequent dementia showed only small to medium cognitive deficits. In contrast, participants with depressive symptoms with subsequent dementia showed medium to very large cognitive deficits. In adjusted logistic regression models, learning and memory deficits predicted the risk for subsequent dementia in participants with depressive symptoms. Participants with a lifetime history of major depression without subsequent dementia showed no cognitive deficits. However, in adjusted logistic regression models, learning and orientation deficits predicted the risk for subsequent dementia also in participants with lifetime major depression. CONCLUSION Marked cognitive impairments in old age depression should not be dismissed as "depressive pseudodementia", but require clinical attention as a possible sign of incipient dementia. Non-depressed elderly with a lifetime history of major depression, who remained free of dementia during follow-up, had largely normal cognitive performance.
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Affiliation(s)
- Kathrin Heser
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Markus Bleckwenn
- Department of General Practice and Family Medicine, University of Bonn, Bonn, Germany
| | - Birgitt Wiese
- Working Group Medical Statistics and IT Infrastructure, Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Silke Mamone
- Working Group Medical Statistics and IT Infrastructure, Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Dagmar Lühmann
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tina Posselt
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University Munich, Munich, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University Munich, Munich, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.,DZNE, Center for Neurodegenerative Diseases, Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.,DZNE, Center for Neurodegenerative Diseases, Bonn, Germany
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Oh JH, Yi YJ, Shin CJ, Park C, Kang S, Kim J, Kim IS. [Effects of Silver-Care-Robot Program on Cognitive Function, Depression, and Activities of Daily Living for Institutionalized Elderly People]. J Korean Acad Nurs 2016; 45:388-96. [PMID: 26159140 DOI: 10.4040/jkan.2015.45.3.388] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to identify the effects on cognitive function, depression, and activities of daily living of Silver-Care-Robot Program for institutionalized elders. METHODS This study was a nonequivalent control group pretest-posttest design. The participants were 42 institutionalized elders (17 in the experimental group and 25 in the control group). The Silver-Care-Robot Program was provided as an intervention which was conducted twice a week for 5 weeks. The Silver-Care-Robot Program is an integrated entertainment program to help the mental, emotional, and physical health of elderly people. Pre-test was conducted on the two groups, and, in order to examine the effects of intervention, a post-test was conducted after 5 weeks. RESULTS There were significant differences in cognitive function and ADL (activities of daily living) between two groups after the program. But the difference in depression in the institutionalized elders was not statistically significant between the two groups. CONCLUSION The Silver-Care-Robot Program should be considered as a regular program for cognitive function and activities of daily living for institutionalized elders.
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Affiliation(s)
- Jin Hwan Oh
- Department of Nursing, Suwon Science College, Hwaseong, Korea
| | - Yeo Jin Yi
- College of Nursing, Gachon University, Incheon, Korea.
| | - Chul Jin Shin
- College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Cheonshu Park
- Intelligent Cognitive Technology Research Department, ETRI (Electronics and Telecommunications Research Institute), Daejeon, Korea
| | - Sangseung Kang
- Intelligent Cognitive Technology Research Department, ETRI (Electronics and Telecommunications Research Institute), Daejeon, Korea
| | - Jaehong Kim
- Intelligent Cognitive Technology Research Department, ETRI (Electronics and Telecommunications Research Institute), Daejeon, Korea
| | - In Sook Kim
- Department of Nursing, Suwon Science College, Hwaseong, Korea
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Ismail Z, Malick A, Smith EE, Schweizer T, Fischer C. Depression versus dementia: is this construct still relevant? Neurodegener Dis Manag 2014; 4:119-26. [PMID: 24832029 DOI: 10.2217/nmt.14.5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Cognitive impairment has long been identified as a component of late-life depression (LLD), and depressive symptoms are common in neurodegeneration. Depression may confer a greater risk of cognitive decline in a cognitively intact population and further cognitive decline in a mild cognitive impairment population compared with those without depression. Exploration of the link between cognitive impairment in LLD and the depressive features of neurodegeneration is an essential part of a diagnostic algorithm. In this review, we will discuss these links; we will address depressive symptoms as a risk factor for dementia and as a prodrome to dementia. We will review clinical subtypes and imaging markers as predictors of development of dementia in depressed patients and explore vascular etiologies. We will also explore LLD and dementia as a spectrum, rather than mutually exclusive diagnostic entities.
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Affiliation(s)
- Zahinoor Ismail
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
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Wickrama KKAS, O'Neal CW. The influence of working later in life on memory functioning. ADVANCES IN LIFE COURSE RESEARCH 2013; 18:288-295. [PMID: 24796712 DOI: 10.1016/j.alcr.2013.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 08/08/2013] [Accepted: 09/03/2013] [Indexed: 06/03/2023]
Abstract
This article examines the influence of work status on subsequent memory trajectories in later years. Using a subsample of 8165 older adults who participated in the Health and Retirement Study and were 65 years or older in 2002, we examined work status and memory functioning after controlling for age and demographic characteristics. In growth curve analyses, work status predicted the rate of immediate memory decline from 2002 to 2006 with full-time employed individuals showing less immediate memory decline after controlling for age. However, work status categories were not associated with subsequent age-adjusted delayed memory trajectories. The findings from these growth curve analyses support the hypothesis that working late in life helps to impede immediate memory declines that often occur in later years.
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Affiliation(s)
- Kandauda K A S Wickrama
- Department of Human Development and Family Science, The University of Georgia, Athens, GA 30602, United States.
| | - Catherine Walker O'Neal
- Department of Human Development and Family Science, The University of Georgia, Athens, GA 30602, United States.
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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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De Nardi T, Sanvicente-Vieira B, Grassi-Oliveira R. Déficits na memória de trabalho em idosos com depressão maior: uma revisão sistemática. PSICOLOGIA: TEORIA E PESQUISA 2013. [DOI: 10.1590/s0102-37722013000200011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A depressão em idosos é associada com prejuízos cognitivos, entretanto a extensão destes à Memória de Trabalho (MT) ainda não é consensual. Portanto, o objetivo deste estudo é revisar sistematicamente as associações encontradas entre MT e depressão em idosos. Para tanto conduzimos uma revisão sistemática dos artigos publicados entre 2000 e 2011 nas principais bases de dados internacionais. Posteriormente a aplicação dos critérios de exclusão, 17 artigos foram revisados integralmente. Os resultados apresentam evidências da associação entre depressão geriátrica e prejuízos da MT, que em alguns trabalhos ainda foram mantidos mesmo após a remissão da sintomatologia de humor.
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Balash Y, Mordechovich M, Shabtai H, Giladi N, Gurevich T, Korczyn AD. Subjective memory complaints in elders: depression, anxiety, or cognitive decline? Acta Neurol Scand 2013; 127:344-50. [PMID: 23215819 DOI: 10.1111/ane.12038] [Citation(s) in RCA: 194] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To study the association of subjective memory complaints (SMC) with affective state and cognitive performance in elders. MATERIALS AND METHODS We studied community dwelling elderly persons with normal physical examination. Participants completed questionnaires regarding memory difficulties and lifestyle habits, the Geriatric Depression Scale (GDS) and the Spielberger State-Trait Anxiety Inventory (STAI). Depending on their answers to the question about their memory condition, participants were divided into complainers and non-complainers and to five groups according to their MMSE scores. These data have been compared to objective cognitive performance according to Mindstreams - a computerized neuropsychological battery. A logistic regression was performed to evaluate odds ratios (OR) and 95% confidence intervals (CI) for those factors, which were associated with SMС (dependent variable). RESULTS Of 636 consecutive subjects (61% females), 507 participants (79.7%) had SMС. Presence of SMC was inversely correlated with MMSE scores, (r = -0.108; P for trend = 0.007). GDS and STAI scores were higher among subjects with SMC (OR = 1.23: CI 95%: 1.1-1.36 and OR = 1.03: CI 95%: 1.01-1.07, respectively). SMC did not correlate with objective cognitive performance measured by Mindstreams. CONCLUSIONS Subjective memory complaints are associated with sub-syndromal depression and anxiety in healthy cognitively normal elders.
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Affiliation(s)
| | | | - H. Shabtai
- Tel-Aviv Sourasky Medical Center; Tel Aviv; Israel
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Potter GG, Wagner HR, Burke JR, Plassman BL, Welsh-Bohmer KA, Steffens DC. Neuropsychological predictors of dementia in late-life major depressive disorder. Am J Geriatr Psychiatry 2013; 21:297-306. [PMID: 23395197 PMCID: PMC3376682 DOI: 10.1016/j.jagp.2012.12.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 08/24/2011] [Accepted: 10/20/2011] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Major depressive disorder is a likely risk factor for dementia, but some cases of major depressive disorder in older adults may actually represent a prodrome of this condition. The purpose of this study was to use neuropsychological test scores to predict conversion to dementia in a sample of depressed older adults diagnosed as nondemented at the time of neuropsychological testing. DESIGN Longitudinal, with mean follow-up of 5.45 years. SETTING Outpatient depression treatment study at Duke University. PARTICIPANTS Thirty nondemented individuals depressed at the time of neuropsychological testing and later diagnosed with incident dementia; 149 nondemented individuals depressed at the time of neuropsychological testing and a diagnosis of cognitively normal. METHODOLOGY All participants received clinical assessment of depression, were assessed to rule out prevalent dementia at the time of study enrollment, completed neuropsychological testing at the time of study enrollment, and were diagnosed for cognitive disorders on an annual basis. RESULTS Nondemented, acutely depressed older adults who converted to dementia during the study period exhibited broadly lower cognitive performances at baseline than acutely depressed individuals who remained cognitively normal. Discriminant function analysis indicated that 2 neuropsychological tests, Recognition Memory (from the Consortium to Establish a Registry for Alzheimer's Disease neuropsychological battery) and Trail Making B, best predicted dementia conversion. CONCLUSIONS Depressed older adults with cognitive deficits in the domains of memory and executive functions during acute depression are at higher risk for developing dementia. Some cases of late-life depression may reflect a prodrome of dementia in which clinical manifestation of mood changes may co-occur with emerging cognitive deficits.
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Affiliation(s)
- Guy G. Potter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC,Center for the Study of Aging and Human Development, Duke University
| | - H. Ryan Wagner
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - James R. Burke
- Division of Neurology, Department of Medicine, Duke University Medical Center,Joseph and Kathleen Bryan Alzheimer’s Disease Research Center, Duke University
| | - Brenda L. Plassman
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Kathleen A. Welsh-Bohmer
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC,Division of Neurology, Department of Medicine, Duke University Medical Center
| | - David C. Steffens
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
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Karantzoulis S, Galvin JE. Distinguishing Alzheimer's disease from other major forms of dementia. Expert Rev Neurother 2012; 11:1579-91. [PMID: 22014137 DOI: 10.1586/ern.11.155] [Citation(s) in RCA: 219] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Alzheimer's disease (AD) is the most common and most studied cause of dementia. Significant advances have been made since the first set of clinical criteria for AD were put forth in 1984 that are now captured in the new criteria for AD published in 2011. Key features include recognition of a broad AD spectrum (from preclinical to mild cognitive impairment to AD dementia) and requirement of AD biomarkers for diagnosis. Correctly diagnosing dementia type is increasingly important in an era when potential disease-modifying agents are soon to be marketed. The typical AD dementia syndrome has at its core, an amnestic syndrome of the hippocampal type, followed by associated deficits in word-finding, spatial cognition, executive functions and neuropsychiatric changes. Atypical presentations of AD have also been identified that are presumed to have a different disease course. It can be difficult to distinguish between the various dementia syndromes given the overlap in many common clinical features across the dementias. The clinical difficulty in diagnosis may reflect the underlying pathology, as AD often co-occurs with other pathologies at autopsy, such as cerebrovascular disease or Lewy bodies. Neuropsychological evaluation has provided clinicians and researchers with profiles of cognitive strengths and weaknesses that help to define the dementias. There is yet no single behavioral marker that can reliably discriminate AD from the other dementias. The combined investigation of cognitive and neurobehavioral symptoms coupled with imaging markers could provide a more accurate approach for differentiating between AD and other major dementia syndromes in the future.
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Affiliation(s)
- Stella Karantzoulis
- Center of Excellence on Brain Aging and Department of Neurology, New York University Langone Medical Center, NY, USA.
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Balash Y, Mordechovich M, Shabtai H, Merims D, Giladi N. Subjective memory decline in healthy community-dwelling elders. What does this complain mean? Acta Neurol Scand 2010; 121:194-7. [PMID: 20003090 DOI: 10.1111/j.1600-0404.2009.01159.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Subjective feelings of memory decline are fairly common among the elderly. The causes of this are heterogeneous, and may be related to both affective and cognitive disorders. We attempted to explore the associations between subjective and cognitive measures. MATERIALS AND METHODS Healthy subjects were studied. They completed questionnaires regarding memory difficulties and lifestyle habits, the Geriatric Depression scale (GDS), and the Spielberger State-Trait Anxiety Inventory. Cognitive functions were tested using the Mini-Mental State Exam and supplemented with NeuroTrax, a computerized neurophysiological battery. Univariate logistic regression model was applied to estimate odd ratios (OR) and 95% confidence intervals of associations. RESULTS Of 341 consecutive non-depressed subjects, 257 participants (75.4%) reported subjective memory decline (SMD). Subjects with and without SMD did not differ in age, gender, education, marital status, employment and life-style. Subjects with SMD had elevated GDS scores (OR = 1.14, 95% CI: 1.003-1.29), white anxiety level showed a tendency to be increased (OR = 1.03, 95% CI: 0.99-1.06). Comparison of cognitive performance has not revealed differences in cognitive domains between subjects with and without SMD. CONCLUSIONS SMD in healthy elderly people is associated with sub-clinical depression even among those without objectively measured cognitive decline.
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Affiliation(s)
- Y Balash
- Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.
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von Gunten A, Pocnet C, Rossier J. The impact of personality characteristics on the clinical expression in neurodegenerative disorders—A review. Brain Res Bull 2009; 80:179-91. [DOI: 10.1016/j.brainresbull.2009.07.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Revised: 07/05/2009] [Accepted: 07/06/2009] [Indexed: 11/27/2022]
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Ertel KA, Glymour MM, Berkman LF. Effects of social integration on preserving memory function in a nationally representative US elderly population. Am J Public Health 2008; 98:1215-20. [PMID: 18511736 PMCID: PMC2424091 DOI: 10.2105/ajph.2007.113654] [Citation(s) in RCA: 220] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2007] [Indexed: 01/10/2023]
Abstract
OBJECTIVES We tested whether social integration protects against memory loss and other cognitive disorders in late life in a nationally representative US sample of elderly adults, whether effects were stronger among disadvantaged individuals, and whether earlier cognitive losses explained the association (reverse causation). METHODS Using data from the Health and Retirement Study (N = 16,638), we examined whether social integration predicted memory change over 6 years. Memory was measured by immediate and delayed recall of a 10-word list. Social integration was assessed by marital status, volunteer activity, and frequency of contact with children, parents, and neighbors. We examined growth-curve models for the whole sample and within subgroups. RESULTS The mean memory score declined from 11.0 in 1998 to 10.0 in 2004. Higher baseline social integration predicted slower memory decline in fully adjusted models (P<.01). Memory among the least integrated declined at twice the rate as among the most integrated. This association was largest for respondents with fewer than 12 years of education. There was no evidence of reverse causation. CONCLUSIONS Our study provides evidence that social integration delays memory loss among elderly Americans. Future research should focus on identifying the specific aspects of social integration most important for preserving memory.
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Affiliation(s)
- Karen A Ertel
- Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02115, USA
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Wright SL, Persad C. Distinguishing between depression and dementia in older persons: neuropsychological and neuropathological correlates. J Geriatr Psychiatry Neurol 2007; 20:189-98. [PMID: 18004006 DOI: 10.1177/0891988707308801] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dementia and depression are frequently comorbid among older adult patients. Depression is related to cognitive decrement and can even represent the first signs of a neurodegenerative process. It can be difficult to distinguish depressed patients exhibiting the first signs of dementia from those whose cognition will improve with treatment. In this article, studies from the neuropsychological literature are reviewed that aid in accurate diagnosis and prognosis. Furthermore, the relationship between depression and dementia is explored by examining potential neurobiological mechanisms that may potentiate both syndromes in the context of the ongoing debate on depression as a prodrome and/or a risk factor for dementia. This article is concluded with suggestions for clinicians when deciding who to refer for neuropsychological assessment and with ideas for further research that might promote a better understanding of the complex association between depression and dementia during old age.
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Affiliation(s)
- Sara L Wright
- Department of Psychiatry, University of Michigan Medical Center, Veterans Affairs Medical Center, GRECC, Ann Arbor, MI 48105, USA.
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Huentelman MJ, Papassotiropoulos A, Craig DW, Hoerndli FJ, Pearson JV, Huynh KD, Corneveaux J, Hänggi J, Mondadori CRA, Buchmann A, Reiman EM, Henke K, de Quervain DJF, Stephan DA. Calmodulin-binding transcription activator 1 (
CAMTA1
) alleles predispose human episodic memory performance. Hum Mol Genet 2007; 16:1469-77. [PMID: 17470457 DOI: 10.1093/hmg/ddm097] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Little is known about the genes and proteins involved in the process of human memory. To identify genetic factors related to human episodic memory performance, we conducted an ultra-high-density genome-wide screen at > 500 000 single nucleotide polymorphisms (SNPs) in a sample of normal young adults stratified for performance on an episodic recall memory test. Analysis of this data identified SNPs within the calmodulin-binding transcription activator 1 (CAMTA1) gene that were significantly associated with memory performance. A follow up study, focused on the CAMTA1 locus in an independent cohort consisting of cognitively normal young adults, singled out SNP rs4908449 with a P-value of 0.0002 as the most significant associated SNP in the region. These validated genetic findings were further supported by the identification of CAMTA1 transcript enrichment in memory-related human brain regions and through a functional magnetic resonance imaging experiment on individuals matched for memory performance that identified CAMTA1 allele-specific upregulation of medial temporal lobe brain activity in those individuals harboring the 'at-risk' allele for poorer memory performance. The CAMTA1 locus encodes a purported transcription factor that interfaces with the calcium-calmodulin system of the cell to alter gene expression patterns. Our validated genomic and functional biological findings described herein suggest a role for CAMTA1 in human episodic memory.
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Affiliation(s)
- Matthew J Huentelman
- Neurogenomics Division, The Translational Genomics Research Institute, 445 N Fifth Street, Phoenix, AZ 85004, USA
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Paleacu D, Shutzman A, Giladi N, Herman T, Simon ES, Hausdorff JM. Effects of Pharmacological Therapy on Gait and Cognitive Function in Depressed Patients. Clin Neuropharmacol 2007; 30:63-71. [PMID: 17414938 DOI: 10.1097/01.wnf.0000240949.41691.95] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the relationship among affective status, cognitive function, and gait in depressed patients and to evaluate the effects of treatment of depression on gait and cognitive function. METHODS Nineteen patients recently diagnosed with clinical depression (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) were recruited from a psychiatric outpatient clinic. Evaluation included the Hamilton Depression Rating Scale (HAM-D), the Mini-Mental State Examination, a computerized neuropsychological battery (Mindstreams, NeuroTrax Corp, New York, NY), and Barthel's Index of Instrumental Activities of Daily Living. Temporal parameters of gait were quantified using a stopwatch and force-sensitive insoles. All assessments were performed at baseline and after approximately 10 weeks of treatment with antidepressants. RESULTS The patients' mean age was 68.6 +/- 9.1 years (15 women). Therapy significantly (P < 0.001) improved the affective state (HAM-D scores). There were small but significant improvements in gait speed (P = 0.033), stride time variability (P = 0.036), and gait asymmetry (P = 0.038). With the exception of the hand-eye coordination index, all tested cognitive domains also improved significantly. Baseline depression scores correlated with changes in depression: patients with higher HAM-D scores at baseline had more significant improvement in their affect (P < 0.001). Changes in HAM-D were not significantly correlated with changes in gait or changes on computerized tests of cognitive function (P > 0.10). CONCLUSIONS Depressive symptoms are associated with gait and cognitive impairment. Moreover, the present results suggest that these domains improve in response to antidepressant medication.
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Affiliation(s)
- Diana Paleacu
- Neurology Service and Memory Clinic, Abarbanel Mental Health Center, Bat-Yam, Israel.
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