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Jaramillo ET. Place-based strengths and vulnerabilities for mental wellness among rural minority older adults: an intervention development study protocol. BMJ Open 2024; 14:e088348. [PMID: 38844399 PMCID: PMC11163646 DOI: 10.1136/bmjopen-2024-088348] [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] [Received: 05/03/2024] [Accepted: 05/24/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION Severe inequities in depression and its diagnosis and treatment among rural-dwelling, racial-minority and ethnic-minority older adults compared with their urban white counterparts result in cognitive impairment, comorbidities and increased mortality, presenting a growing public health concern as the United States (US) population ages. These inequities are often attributable to social and environmental factors, including economic insecurity, histories of trauma, gaps in transportation and safety-net services, and disparities in access to policy-making processes rooted in colonialism. This constellation of factors renders racial-minority and ethnic-minority older adults 'structurally vulnerable' to mental ill health. Fewer data exist on protective factors associated with social and environmental contexts, such as social support, community attachment and a meaningful sense of place. Scholarship on the social determinants of health widely recognises the importance of such place-based factors. However, little research has examined how they shape disparities in depression and treatment specifically, limiting the development of practical approaches addressing these factors and their effects on mental well-being for rural minority populations. METHODS AND ANALYSIS This community-driven mixed-method study uses quantitative surveys, qualitative interviews and ecological network research with 125 rural American Indian and Latinx older adults in New Mexico and 28 professional and non-professional social supporters to elucidate how place-based vulnerabilities and protective factors shape experiences of depression among older adults. Data will serve as the foundation of a community-driven plan for a multisystem intervention focused on the place-based causes of disparities in depression. Intervention Mapping will guide the intervention development process. ETHICS AND DISSEMINATION This study has been reviewed and approved by the University of New Mexico Health Sciences Center Institutional Review Board. All participants will provide informed consent. Study results will be disseminated within the community of study through community meetings and presentations, as well as broadly via peer-reviewed journals, conference presentations and social media.
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Affiliation(s)
- Elise Trott Jaramillo
- College of Population Health, University of New Mexico, Albuquerque, New Mexico, USA
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Qin A, Xu L, Hu F, Qin W, Zhang X, Pei Z, Zhao Y, Fu J. Association between cognitive functioning and lifetime suicidal ideation among Chinese older adults: the mediating effect of depression. Eur Geriatr Med 2024; 15:225-234. [PMID: 38165610 DOI: 10.1007/s41999-023-00912-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/28/2023] [Indexed: 01/04/2024]
Abstract
PURPOSE Existing evidence indicates an association between cognitive functioning and both geriatric depression and suicidality, with mixed evidence regarding the direction of the relationship between cognitive functioning and aspects of geriatric lifetime suicidal ideation. This study aims to examine the relationship between cognitive functioning, depression, and suicide ideation and to explore the intermediary role of depression between cognitive functioning and suicidal ideation in the older adults. METHODS A multi-stage random cluster sampling method was used to collect a sample of 3896 individuals aged 60 and above. Descriptive statistics of the sample data were analyzed using one-way ANOVA, and then the correlation between variables was obtained by binary logistic regression analysis. SPSS macro program PROCESS V3.5 was used to test the mediating role of depression in the relationship between cognitive function and lifetime suicidal ideation. RESULTS The prevalence of lifetime suicidal ideation among older adults was 3.9%. Lifetime suicidal ideation was associated with depression (OR = 1.308, P < 0.001) but was not significantly correlated with cognitive function (OR = 0.972, P > 0.05). The relationship between cognitive function and depression was also supported in this study (β = - 0.0841, P < 0.001). Depression completely mediated the relationship between cognitive function and lifetime suicidal ideation. CONCLUSION There was no significant correlation between cognitive impairment in older adults and a heightened risk of lifetime suicidal ideation. However, this relationship was completely mediated by depression. It is crucial to prevent the onset of depression among older adults with cognitive impairment, as depression is strongly linked to lifetime suicidal ideation.
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Affiliation(s)
- Afei Qin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Lingzhong Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Fangfang Hu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Wenzhe Qin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Xiaohong Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Zhongfei Pei
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Yan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Jing Fu
- Nursing Department of Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China.
- Blood Purification Center of Qilu Hospital, Shandong University, Jinan, Shandong, China.
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Zhang B, Lin Y, Hu M, Sun Y, Xu M, Hao J, Zhu C. Associations between trajectories of depressive symptoms and rate of cognitive decline among Chinese middle-aged and older adults: An 8-year longitudinal study. J Psychosom Res 2022; 160:110986. [PMID: 35905513 DOI: 10.1016/j.jpsychores.2022.110986] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To investigate the associations between trajectories of depressive symptoms and rate of cognitive decline among Chinese middle-aged and older adults. METHODS A population-based cohort data from the Chinese Health and Retirement Longitudinal Study (CHARLS) were utilized. The cohort was followed up for 8 years and assessments of depressive symptoms and cognitive performance were conducted in 2011, 2013, 2015, and 2018. Group-based trajectory modeling (GBTM) was conducted to identify heterogeneous trajectories of depressive symptoms. Linear mixed models (LMMs) were performed to examine the associations between trajectories of depressive symptoms and rate of decline in global cognitive function, episodic memory, and executive function. RESULTS Among 9264 middle-aged and older adults, five depressive symptoms trajectory groups were determined: constantly low (n = 3206, 34.6%), constantly medium (n = 3747, 40.5%), increasing (n = 899, 9.7%), decreasing (n = 929, 10.0%), and constantly high (n = 483, 5.2%). Individuals with increasing depressive symptoms exhibited the fastest decline in global cognitive function and episodic memory, followed by participants reporting constantly high or medium depressive symptoms. A significantly higher rate of decline in executive function was only observed among subjects who had increasing depressive symptoms in comparison with their counterparts with constantly low depressive symptoms. There was no significant difference in rate of cognitive decline between individuals with decreasing depressive symptoms and those demonstrating constantly low depressive symptoms. CONCLUSION Increasing depressive symptoms co-occurred with the steepest cognitive decline among Chinese middle-aged and older adults, which potentially suggested that interventions targeting to alleviating cognitive decline should be given priority among individuals with deterioration of depressive symptoms.
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Affiliation(s)
- Baiyang Zhang
- Department of epidemiology and health statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yidie Lin
- Department of epidemiology and health statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Meijing Hu
- Department of epidemiology and health statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yue Sun
- Department of epidemiology and health statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Minghan Xu
- Department of epidemiology and health statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jingjing Hao
- Department of epidemiology and health statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Cairong Zhu
- Department of epidemiology and health statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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Hoogendoorn CJ, Qin J, Wang C, Roque N, Laurenceau JP, Katz MJ, Derby CA, Lipton RB, Gonzalez JS. Depressive symptoms mediate the relationship between diabetes and cognitive performance in a community-based sample of older adults. J Diabetes Complications 2022; 36:108183. [PMID: 35718600 DOI: 10.1016/j.jdiacomp.2022.108183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/11/2022] [Accepted: 03/18/2022] [Indexed: 02/07/2023]
Abstract
AIMS To evaluate whether diabetes and prediabetes are associated with impaired cognitive performance among older adults and examine depressive symptoms as a mediator. METHODS We used cross-sectional data from the Einstein Aging Study, a systematically recruited, community-based cohort study of diverse older adults (N = 794; Age Mean (SD) = 78.9 (5.3); 64.4% Non-Hispanic White, 28.7% Non-Hispanic Black, 5.7% Hispanic). Diabetes status was established via self-reported diagnosis, prescribed medications, and fasting blood glucose. Depressive symptoms were assessed using the Geriatric Depression Scale. Cognitive tests included Digit Symbol, Trails-B, Free Recall, Category Fluency, Boston Naming, and Block Design. Linear regression and mediation analyses were applied. RESULTS Compared to those without diabetes, diabetes was associated with worse performance on all cognitive tests (ps < 0.05), except Trails-B (p = 0.53), and increased depressive symptoms (p < 0.01). For diabetes, mediation via increased depressive symptoms was observed for Free Recall (p = 0.044), Category Fluency (p = 0.033), and Boston Naming (p = 0.048). CONCLUSIONS Diabetes was consistently associated with worse cognitive performance and increased depressive symptoms among this older cohort, while prediabetes was not. Mediation findings suggest depressive symptoms may be a biobehavioral pathway linking diabetes and cognition, though the temporal sequence is unclear. If causal, addressing both diabetes and depressive symptoms among older adults may protect cognitive function.
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Affiliation(s)
| | - Jiyue Qin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nelson Roque
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Jean-Philippe Laurenceau
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mindy J Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Carol A Derby
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA; Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
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Friedman EM, Houle JN, Cagney KA, Slaughter ME, Shih RA. The Foreclosure Crisis, Community Change, and the Cognitive Health of Older Adults. J Gerontol B Psychol Sci Soc Sci 2021; 76:956-967. [PMID: 32303760 DOI: 10.1093/geronb/gbaa047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES While home foreclosures are often thought of as a household-level event, the consequences may be far-reaching, and spill over to the broader community. Older adults, in particular, could be affected by the spiral of community changes that result from foreclosures, but we know very little about how the foreclosure crisis is related to older adult health, in particular cognition. METHOD This article uses growth curve models and data from the Health and Retirement Study matched to Census and county-level foreclosure data to examine whether community foreclosures are related to older adults' cognitive health and the mechanisms responsible. RESULTS We find that higher rates of county-level foreclosures are associated with a faster decline in individual cognition at older ages. Although we examined an extensive number of individual and community mechanisms, including individual housing wealth and depressive symptoms, community structural factors, social factors, and perceptions of physical disorder and cohesion, none of the mechanisms examined here explained this relationship. DISCUSSION This study shows that the adverse consequences of home foreclosures spill over to the local community, with implications for the cognitive health of older adults.
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Affiliation(s)
| | - Jason N Houle
- Department of Sociology, Dartmouth College, Hanover, New Hampshire
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Increase in Number of Depression Symptoms Over Time is Related to Worse Cognitive Outcomes in Older Adults With Type 2 Diabetes. Am J Geriatr Psychiatry 2021; 29:1-11. [PMID: 33127316 PMCID: PMC7771631 DOI: 10.1016/j.jagp.2020.09.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Older adults with type 2 diabetes (T2D) are at increased risk for depression, cognitive decline, and dementia compared to those without T2D. Little is known about the association of simultaneous changes in depression symptoms and cognitive decline over time. METHODS Subjects (n=1021; mean age 71.6 [SD=4.6]; 41.2% female) were initially cognitively normal participants of the Israel Diabetes and Cognitive Decline study who underwent evaluations of depression and cognition approximately every 18 months. Cognitive tests were summarized into four cognitive domains: episodic memory, attention/working memory, executive functions, and semantic categorization. The average of the z-scores of the four domains defined global cognition. Depression symptoms were assessed using the Geriatric Depression Scale, 15-item version. We fit a random coefficients model of changes in depression and in cognitive functions, adjusting for baseline sociodemographic and cardiovascular variables. RESULTS Higher number of depression symptoms at baseline was significantly associated with lower baseline cognitive scores in global cognition (estimate = -0.1175, SE = 0.021, DF = 1,014, t = -5.59; p < 0.001), executive functions (estimate = -0.186, SE = 0.036, DF = 1,013, t = -5.15; p = <0.001), semantic categorization (estimate = -0.155, SE = 0.029, DF = 1,008, t = -5.3; p < 0.001), and episodic memory (estimate = -0.08165, SE = 0.027, DF = 1,035, t = -2.92; p = 0.0036), but not with rate of decline in any cognitive domain. During follow-up, a larger increase in number of depression symptoms, was associated with worse cognitive outcomes in global cognition (estimate = -0.1053, SE = 0.027, DF = 1,612, t = -3.77; p = 0.0002), semantic categorization (estimate = -0.123, SE = 0.036, DF = 1,583, t = -3.36; p = 0.0008), and in episodic memory (estimate = -0.165, SE = 0.055, DF = 1,622, t = -3.02; p = 0.003), but the size of this effect was constant over time. CONCLUSION In elderly with T2D, increase in depression symptoms over time is associated with parallel cognitive decline, indicating that the natural course of the two conditions progresses concurrently and suggesting common underlying mechanisms".
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Brouwer J, van den Berg F, Knooihuizen R, Loerts H, Keijzer M. Exploring Language Learning as a Potential Tool against Cognitive Impairment in Late-Life Depression: Two Meta-Analyses and Suggestions for Future Research. Behav Sci (Basel) 2020; 10:E132. [PMID: 32878051 PMCID: PMC7551097 DOI: 10.3390/bs10090132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 11/16/2022] Open
Abstract
Late-life depression (LLD) affects about an eighth of community-dwelling seniors. LLD impacts well-being, with loneliness and small social networks being typical. It has also been linked to cognitive dysfunction and an increased risk of developing dementia. Safety and efficacy of pharmacological treatments for LLD have been debated, and cognitive dysfunction often persists even after remission. Various cognitive interventions have been proposed for LLD. Among these, one has received special attention: foreign language learning could serve as a social intervention that simultaneously targets brain structures affected in LLD. Lifelong bilingualism may significantly delay the onset of cognitive impairment symptoms by boosting cognitive reserve. Even late-life foreign language learning without lifelong bilingualism can train cognitive flexibility. It is then counterintuitive that the effects of language learning on LLD have never been examined. In order to create a theoretical basis for further interdisciplinary research, this paper presents a status quo of current work through two meta-analyses investigating cognitive functioning in LLD on the one hand and in senior bilinguals or seniors following a language course on the other hand. While LLD was consistently associated with cognitive dysfunction, inconsistent results were found for bilingualism and language learners. Possible reasons for this and suggestions for future research are subsequently discussed.
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Affiliation(s)
- Jelle Brouwer
- Department of Linguistics & English as a Second Language, University of Groningen, 9712 EK Groningen, The Netherlands; (F.v.d.B.); (R.K.); (M.K.)
| | - Floor van den Berg
- Department of Linguistics & English as a Second Language, University of Groningen, 9712 EK Groningen, The Netherlands; (F.v.d.B.); (R.K.); (M.K.)
| | - Remco Knooihuizen
- Department of Linguistics & English as a Second Language, University of Groningen, 9712 EK Groningen, The Netherlands; (F.v.d.B.); (R.K.); (M.K.)
| | - Hanneke Loerts
- Department of Minorities and Multilingualism, University of Groningen, 9712 EK Groningen, The Netherlands;
| | - Merel Keijzer
- Department of Linguistics & English as a Second Language, University of Groningen, 9712 EK Groningen, The Netherlands; (F.v.d.B.); (R.K.); (M.K.)
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Hudon C, Escudier F, De Roy J, Croteau J, Cross N, Dang-Vu TT, Zomahoun HTV, Grenier S, Gagnon JF, Parent A, Bruneau MA, Belleville S. Behavioral and Psychological Symptoms that Predict Cognitive Decline or Impairment in Cognitively Normal Middle-Aged or Older Adults: a Meta-Analysis. Neuropsychol Rev 2020; 30:558-579. [PMID: 32394109 DOI: 10.1007/s11065-020-09437-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/30/2020] [Indexed: 12/12/2022]
Abstract
Epidemiological studies have revealed that behavioral and psychological (or non-cognitive) symptoms are risk factors for cognitive decline in older adults. This study aimed to systematically review the literature and determine which behavioral and psychological symptoms are most predictive of future cognitive decline among individuals with no pre-existing cognitive impairments. The selected studies included middle-aged or older adults without cognitive impairments. The predictors were assessed using behavioral and psychological questionnaires, or diagnostic interviews, to identify non-cognitive symptoms or psychiatric clinical conditions. The follow-up period was at least one year, and the design of the selected studies was either retrospective or prospective. This study compared individuals with and without non-cognitive manifestations and resulted in one of three outcomes: (a) a score change on a cognitive measure, (b) a diagnosis of mild cognitive impairment, or (c) a diagnosis of Alzheimer's disease or dementia. Four online databases were searched for eligible studies from the database inception to January 17, 2017: MEDLINE (PubMed), Embase (OVID), PsycINFO, and Web of Science. Pooled effect sizes were estimated using a random-effect model. Higgins I2, the Q statistic, and tau-squared were used to quantify the observed heterogeneity between the studies. Results indicate that depression and sleep duration (long and short) were the most consistent associations between behavioral or psychological symptoms and cognitive decline. This meta-analysis supports the need to assess behavioral and psychological symptoms in cognitively intact older adults to identify those who are at risk for cognitive decline.
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Affiliation(s)
- Carol Hudon
- École de psychologie, Université Laval, 2601, ch. de la Canardière (F-2400), Québec, QC, G1J 2G3, Canada. .,CERVO Brain Research Centre, Québec, QC, Canada.
| | - Frédérique Escudier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Jessie De Roy
- Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada.,Centre de recherche, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NÎM, Montréal, QC, Canada
| | - Jordie Croteau
- Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit, Université Laval, Québec, QC, Canada.,Population Health and Practice-Changing Research Group, Research Centre of CHU de Québec-Université Laval, Québec, QC, Canada
| | - Nathan Cross
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Department of Health, Kinesiology and Applied Physiology, Concordia University, Montréal, QC, Canada
| | - Thien Thanh Dang-Vu
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Department of Health, Kinesiology and Applied Physiology, Concordia University, Montréal, QC, Canada
| | - Hervé Tchala Vignon Zomahoun
- Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit, Université Laval, Québec, QC, Canada.,Population Health and Practice-Changing Research Group, Research Centre of CHU de Québec-Université Laval, Québec, QC, Canada
| | - Sébastien Grenier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université de Montréal, Montréal, QC, Canada
| | - Jean-François Gagnon
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada.,Centre de recherche, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NÎM, Montréal, QC, Canada
| | | | - Marie-Andrée Bruneau
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychiatrie, Université de Montréal, Montréal, QC, Canada
| | - Sylvie Belleville
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université de Montréal, Montréal, QC, Canada
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Saenz JL, Garcia MA, Downer B. Late life depressive symptoms and cognitive function among older Mexican adults: the past and the present. Aging Ment Health 2020; 24:413-422. [PMID: 30588839 PMCID: PMC6597334 DOI: 10.1080/13607863.2018.1544214] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 10/30/2018] [Indexed: 01/20/2023]
Abstract
Objective: To evaluate associations between depression and individual cognitive domains and how changes in depressive symptoms relate to cognition three years later in the context of Mexico, a developing country experiencing rapid aging.Method: Data comes from the 2012 and 2015 waves of the Mexican Health and Aging Study (n = 12,898, age 50+). Depression is ascertained using a modified Center for Epidemiologic Studies - Depression Scale. Cognition is assessed using verbal learning, verbal memory, visual scanning, verbal fluency, visuospatial ability, visual memory, and orientation tasks. Depressive symptoms and cognitive functioning were both measured in 2012 and 2015. Scores across cognitive domains are modeled using ordinary least squares regression, adjusting for demographic, health, and economic covariates.Results: When depression and cognition were measured concurrently in 2015, depression exhibited associations with all cognitive domains. When considering a respondent's history of depression, individuals who had elevated depressive symptoms in 2012 and recovered by 2015 continued to exhibit poorer cognitive function in 2015 in verbal learning, verbal memory, visual scanning, and verbal fluency tasks compared to individuals who were neither depressed in 2012 nor 2015.Conclusions: Depression was associated with cognition across cognitive domains among older Mexican adults. Despite improvements in depressive symptomatology, formerly depressed respondents continued to perform worse than their counterparts without a history of depression on several cognitive tasks. In addition to current mental health status, researchers should consider an individual's history of depression when assessing the cognitive functioning of older adults.
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Affiliation(s)
- Joseph L. Saenz
- University of Southern California, Davis School of Gerontology, Los Angeles, CA
| | - Marc A. Garcia
- University of Texas Medical Branch, Sealy Center on Aging, Galveston, TX
| | - Brian Downer
- University of Texas Medical Branch, Division of Rehabilitation Sciences, Galveston, TX
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Wang J, Zhu WH, Li YF, Zhu WW. Interaction between worsening cognitive function and deteriorating functional status on depressive symptoms among Chinese community-dwelling elders. Geriatr Gerontol Int 2020; 20:343-347. [PMID: 32064723 DOI: 10.1111/ggi.13887] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/29/2019] [Accepted: 01/24/2020] [Indexed: 12/20/2022]
Abstract
AIM Cognitive impairment and functional deterioration are common in later life and often co-occur with depressive symptoms (DS). This study aims to examine the individual effects and possible interaction between worsening cognitive function (CF) and deteriorating functional status (FS) on DS using large sample, longitudinal data. METHODS Elderly people who completed the baseline survey of China Health and Retirement Longitudinal Study (CHARLS 2011) and the third wave survey (2015) were included. A multivariable logistic regression model was used to assess the individual effects. The relative excess risk due to interaction (RERI), the attributable proportion due to interaction (AP) and synergy index (SI) were calculated to evaluate the additive interaction. RESULTS Worsening CF and deteriorating FS were associated with the increase in DS, while unchanged or improved CF and FS were associated with the decrease in DS. In addition, decreased (increased) FS led to more severe (improved) DS than decreased (increased) CF. The additive interaction between worsening CF and deteriorating FS on the increase in DS was significant. The estimates and 95% CI of the RERI, AP and SI were 0.626 (0.061, 1.190), 0.222 (0.042, 0.402) and 1.526 (1.016, 2.291) respectively. CONCLUSIONS Both worsening CF and deteriorating FS have positive interactions with the increase in DS. It is vital to focus on DS of elderly people with worsening CF and/or FS and to adopt interventions. Geriatr Gerontol Int 2020; 20: 343-347.
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Affiliation(s)
- Juan Wang
- School of Public Health, Guangzhou Medical University, Guangzhou, China.,The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei-Heng Zhu
- College of Information Science and Technology, Jinan University, Guangzhou, China
| | - You-Fu Li
- Department of Neurology of The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei-Wen Zhu
- Department of Neurology of The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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11
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Ahmed A, Bowen A, Feng CX, Muhajarine N. Trajectories of maternal depressive and anxiety symptoms from pregnancy to five years postpartum and their prenatal predictors. BMC Pregnancy Childbirth 2019; 19:26. [PMID: 30642277 PMCID: PMC6332639 DOI: 10.1186/s12884-019-2177-y] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 01/04/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Maternal depression and anxiety have distinct constellations of symptom trajectories, which are associated with factors that may vary between different groups of women. The aim of this study was to identify subgroups of women who exhibit unique longitudinal trajectory patterns of depressive and anxiety symptoms from pregnancy to 5 years postpartum and the antenatal predictors associated with these maternal groups. METHODS The study used a longitudinal data collected from 615 women in Saskatchewan from pregnancy to 5 years postpartum. Semiparametric group-based models were used to identify latent maternal depressive and anxiety trajectory groups. Multinomial logit models were then used to assess the association between maternal characteristics and the identified latent trajectory groups. RESULTS We identified four trajectory groups of maternal depressive symptoms: low-stable (35%); moderate-stable (54%); moderate-increasing (5%); and high-decreasing (6%), and three trajectory groups of maternal anxiety symptoms: very low-stable (13%); low-stable (58%); and moderate-stable (29%). We also identified several risk factors, most notably history of depression and stress, that were significantly associated with these trajectories. CONCLUSION History of depression and increased stress are significant risk factors that can be identified during regular perinatal visits; therefore, clinicians should inquire about these risk factors to identify women at high risk of ongoing depression or anxiety.
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Affiliation(s)
- Asma Ahmed
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Purvis Hall, 1020 Pine Avenue W, Room 27, Montreal, Quebec H3A 1A2 Canada
| | - Angela Bowen
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Health Sciences Building, Room 4246, Saskatoon, Saskatchewan S7N 2Z4 Canada
| | - Cindy Xin Feng
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Health Sciences Building, Room 3338, Saskatoon, Saskatchewan S7N 2Z4 Canada
| | - Nazeem Muhajarine
- College of Medicine, University of Saskatchewan, 104 Clinic Place, Health Sciences Building, Room 3246, Saskatoon, Saskatchewan S7N 2Z4 Canada
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12
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Mozhui K, Snively BM, Rapp SR, Wallace RB, Williams RW, Johnson KC. Genetic Analysis of Mitochondrial Ribosomal Proteins and Cognitive Aging in Postmenopausal Women. Front Genet 2017; 8:127. [PMID: 28983317 PMCID: PMC5613226 DOI: 10.3389/fgene.2017.00127] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 09/04/2017] [Indexed: 11/24/2022] Open
Abstract
Genes encoding mitochondrial ribosomal proteins (MRPs) have been linked to aging and longevity in model organisms (i.e., mice, Caenorhabditis elegans). Here we evaluated if the MRPs have conserved effects on aging traits in humans. We utilized data from 4,504 participants of the Women's Health Initiative Memory Study (WHIMS) who had both longitudinal cognitive data and genetic data. Two aging phenotypes were considered: (1) gross lifespan (time to all-cause mortality), and (2) cognitive aging (longitudinal rate of change in modified mini-mental state scores). We tested genetic association with variants in 78 members of the MRP gene family. Genetic association tests were done at the single nucleotide polymorphism (SNP) level, and at gene-set level using two distinct procedures (GATES and MAGMA). We included SNPs in APOE and adjusted the tests for the APOE-ε4 allele, a known risk factor for dementia. The strongest association signal is for the known cognitive aging SNP, rs429358, in APOE (p-value = 5 × 10-28 for cognitive aging; p-value = 0.03 for survival). We found no significant association between the MRPs and survival time. For cognitive aging, we detected SNP level association for rs189661478 in MRPL23 (p-value < 9 × 10-6). Furthermore, the gene-set analysis showed modest but significant association between the MRP family and cognitive aging. In conclusion, our results indicate a potential pathway-level association between the MRPs and cognitive aging that is independent of the APOE locus. We however did not detect association between the MRPs and lifespan.
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Affiliation(s)
- Khyobeni Mozhui
- Department of Preventive Medicine, University of Tennessee Health Science CenterMemphis, TN, United States
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science CenterMemphis, TN, United States
| | - Beverly M. Snively
- Department of Biostatistical Sciences, Wake Forest University School of MedicineWinston-Salem, NC, United States
| | - Stephen R. Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of MedicineWinston-Salem, NC, United States
| | - Robert B. Wallace
- Department of Epidemiology, University of Iowa College of Public HealthIowa City, IA, United States
| | - Robert W. Williams
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science CenterMemphis, TN, United States
| | - Karen C. Johnson
- Department of Preventive Medicine, University of Tennessee Health Science CenterMemphis, TN, United States
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Sex Differences in the Relationship between Depressive Symptoms and Risk of Amnestic Mild Cognitive Impairment. Am J Geriatr Psychiatry 2017; 25:13-22. [PMID: 27986237 PMCID: PMC5215465 DOI: 10.1016/j.jagp.2016.08.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 08/25/2016] [Accepted: 08/29/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The relationship between depressive symptoms and subsequent cognitive impairment in older adults is controversial. Sex differences and the differences in the method of categorizing depressive symptoms may contribute to the inconsistencies. The authors examined the effect of severity of baseline depressive symptoms on risk of incident amnestic mild cognitive impairment (aMCI) separately in men and women. METHODS Community-dwelling and cognitively healthy older adults (aged ≥ 70 years) from the Einstein Aging Study completed the 15-item Geriatric Depression Scale (GDS-15) at their baseline visit. Participants were categorized into "no/low symptoms" (GDS-15 score = 0-2), "mild symptoms" (GDS-15 score = 3-5), and "moderate/severe symptoms" (GDS-15 score > 6) groups. Sex-stratified Cox proportional hazards models, adjusted for age, education, and antidepressant medication, estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for incident aMCI as a function of depressive symptoms group. RESULTS We followed 572 women (mean age: 78) and 345 men (mean age: 77) for 4.2 years on average (range: 1.0-14.6 years). Ninety women and 64 men developed aMCI during follow-up. Cox models revealed that compared with no/low depressive symptoms, mild symptoms were associated with a two times greater risk of developing aMCI in men (HR: 2.22; 95% CI: 1.26-3.89) but not in women (HR: 1.26; 95% CI: 0.77-2.06). Conversely, moderate/severe depressive symptoms were associated with a two times greater risk of developing aMCI in women (HR: 1.99; 95% CI: 1.05-3.77) but not in men (HR: 0.28; 95% CI: 0.04-2.11), possibly because of low statistical power in this subgroup. CONCLUSION Results indicate that mild depressive symptoms in men and moderate/severe symptoms in women may represent a marker for future cognitive impairment.
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Lee SH, Kim YB. Which type of social activities may reduce cognitive decline in the elderly?: a longitudinal population-based study. BMC Geriatr 2016; 16:165. [PMID: 27677321 PMCID: PMC5039914 DOI: 10.1186/s12877-016-0343-x] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 09/19/2016] [Indexed: 01/24/2023] Open
Abstract
Background Previous studies have found that social activities are beneficial for the reduction of cognitive decline (CD) in the elderly. However, knowledge regarding the types of social activities that reduce CD in later life is limited. The aim of this study is to examine which type of social activities reduce CD 4 years later among young-old (Y-O) and old-old (O-O) adults. Methods We conducted a secondary analysis using data from cognitively intact adults 65 years of age or older who participated in the Korean Longitudinal Study of Aging (KLoSA). Cognitive function was assessed using the Korean version of the Mini-Mental State Examination (MMSE). We computed CD between 2008 and 2012 by subtracting the Wave 4 MMSE score from the Wave 2 MMSE score. Multivariate linear regression analysis was conducted regarding the effects of social activities on CD after adjusting for age, sex, education, income, marital status, activities of daily living (ADL), instrumental activities of daily living (IADL), chronic diseases, quality of life, depressive symptom, change in depressive symptom, and cognitive functioning at baseline. Results Subjects who participated in senior citizen clubs or senior centers at baseline had a lower risk of CD 4 years later than those who did not in Y-O adults. Frequent contact with offspring by phone or letters was associated with reduced CD in O-O adults. Frequent face-to-face contact with offspring was positively associated with CD in O-O adults. Participating in two or more formal social activities was associated with reduced CD compared with nonparticipation in O-O adults. Conclusion Encouraging older adults to participate in senior citizen clubs or to have frequent contacts with adult children by phone or letters may help reduce CD in later life among older adults. Participation in a variety of formal social activities may also have a beneficial effect on preventing CD in older adults. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0343-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Seung Hee Lee
- Department of Nursing, University of Ulsan, Ulsan, Republic of Korea
| | - Young Bum Kim
- Hallym University Institute of Aging, Chuncheon, Republic of Korea.
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Prolonged ovarian hormone deprivation alters the effects of 17β-estradiol on microRNA expression in the aged female rat hypothalamus. Oncotarget 2016; 6:36965-83. [PMID: 26460619 PMCID: PMC4741909 DOI: 10.18632/oncotarget.5433] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 09/29/2015] [Indexed: 01/10/2023] Open
Abstract
Administration of 17β-estradiol (E2) has beneficial effects on cognitive function in peri- but not post-menopausal women, yet the molecular mechanisms underlying age-related changes in E2 action remain unclear. We propose that there is a biological switch in E2 action that occurs coincident with age and length of time after ovarian hormone depletion, and we hypothesized that age-dependent regulation of microRNAs (miRNAs) could be the molecular basis for that switch. Previously we showed that miRNAs are regulated by E2 in young compared to aged female rats. Here we tested whether increasing lengths of ovarian hormone deprivation in aged females altered E2 regulation of these mature miRNAs. In addition, we determined where along the miRNA biogenesis pathway E2 exerted its effects. Our results showed that age and increased lengths of ovarian hormone deprivation abolished the ability of E2 to regulate mature miRNA expression in the brain. Further, we show that E2 acted at specific points along the miRNA biogenesis pathway.
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Kaup AR, Byers AL, Falvey C, Simonsick EM, Satterfield S, Ayonayon HN, Smagula SF, Rubin SM, Yaffe K. Trajectories of Depressive Symptoms in Older Adults and Risk of Dementia. JAMA Psychiatry 2016; 73:525-31. [PMID: 26982217 PMCID: PMC5082978 DOI: 10.1001/jamapsychiatry.2016.0004] [Citation(s) in RCA: 154] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
IMPORTANCE Depression has been identified as a risk factor for dementia. However, most studies have measured depressive symptoms at only one time point, and older adults may show different patterns of depressive symptoms over time. OBJECTIVE To investigate the association between trajectories of depressive symptoms and risk of dementia in older adults. DESIGN, SETTING, AND PARTICIPANTS This was a prospective cohort investigation of black and white community-dwelling older adults in the Health, Aging, and Body Composition study. Participants were enrolled between May 1997 and June 1998 and followed up through 2001-2002. The dates of this analysis were September 2014 to December 2015. The setting was community research centers in Memphis, Tennessee, and Pittsburgh, Pennsylvania. Trajectories of depressive symptoms were assessed from baseline to year 5. Symptoms were measured with the Center for Epidemiologic Studies Depression Scale Short Form, and trajectories were calculated using latent class growth curve analysis. MAIN OUTCOMES AND MEASURES Incident dementia through year 11, determined by dementia medication use, hospital records, or significant cognitive decline (≥1.5 SD race-specific decline on the Modified Mini-Mental State Examination). We examined the association between depressive symptom trajectories and dementia incidence using Cox proportional hazards regression models adjusted for demographics, health factors that differed between groups, and cognition during the depressive symptom assessment period (baseline to year 5). RESULTS The analytic cohort included 2488 black and white older adults with repeated depressive symptom assessments from baseline to year 5 who were free of dementia throughout that period. Their mean (SD) age at baseline was 74.0 (2.8) years, and 53.1% (n = 1322) were female. The following 3 depressive symptom trajectories were identified: consistently minimal symptoms (62.0% [n = 1542] of participants), moderate and increasing symptoms (32.2% [n = 801] of participants), and high and increasing symptoms (5.8% [n = 145] of participants). Compared with the consistently minimal trajectory, having a high and increasing depressive symptom trajectory was associated with significantly increased risk of dementia (fully adjusted hazard ratio, 1.94; 95% CI, 1.30-2.90), while the moderate and increasing trajectory was not associated with risk of dementia after full adjustment. Sensitivity analyses indicated that the high and increasing trajectory was associated with dementia incidence, while depressive symptoms at individual time points were not. CONCLUSIONS AND RELEVANCE Older adults with a longitudinal pattern of high and increasing depressive symptoms are at high risk for dementia. Individuals' trajectory of depressive symptoms may inform dementia risk more accurately than one-time assessment of depressive symptoms.
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Affiliation(s)
- Allison R. Kaup
- Research Service, San Francisco Veterans Affairs Medical Center, San Francisco, California2Department of Psychiatry, University of California, San Francisco
| | - Amy L. Byers
- Research Service, San Francisco Veterans Affairs Medical Center, San Francisco, California2Department of Psychiatry, University of California, San Francisco
| | - Cherie Falvey
- Department of Psychiatry, University of California, San Francisco
| | | | - Suzanne Satterfield
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis
| | - Hilsa N. Ayonayon
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Stephen F. Smagula
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Susan M. Rubin
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Kristine Yaffe
- Department of Psychiatry, University of California, San Francisco7Department of Neurology, University of California, San Francisco8Department of Epidemiology and Biostatistics, University of California, San Francisco9San Francisco Veterans Affairs Medical
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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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Martín-Aragón S, Villar Á, Benedí J. Age-dependent effects of esculetin on mood-related behavior and cognition from stressed mice are associated with restoring brain antioxidant status. Prog Neuropsychopharmacol Biol Psychiatry 2016; 65:1-16. [PMID: 26290950 DOI: 10.1016/j.pnpbp.2015.08.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 08/06/2015] [Accepted: 08/12/2015] [Indexed: 12/20/2022]
Abstract
Dietary antioxidants might exert an important role in the aging process by relieving oxidative damage, a likely cause of age-associated brain dysfunctions. This study aims to investigate the influence of esculetin (6,7-dihydroxycoumarin), a naturally occurring antioxidant in the diet, on mood-related behaviors and cognitive function and its relation with age and brain oxidative damage. Behavioral tests were employed in 11-, 17- and 22-month-old male C57BL/6J mice upon an oral 35day-esculetin treatment (25mg/kg). Activity of antioxidant enzymes, GSH and GSSG levels, GSH/GSSG ratio, and mitochondrial function were analyzed in brain cortex at the end of treatment in order to assess the oxidative status related to mouse behavior. Esculetin treatment attenuated the increased immobility time and enhanced the diminished climbing time in the forced swim task elicited by acute restraint stress (ARS) in the 11- and 17-month-old mice versus their counterpart controls. Furthermore, ARS caused an impairment of contextual memory in the step-through passive avoidance both in mature adult and aged mice which was partially reversed by esculetin only in the 11-month-old mice. Esculetin was effective to prevent the ARS-induced oxidative stress mostly in mature adult mice by restoring antioxidant enzyme activities, augmenting the GSH/GSSG ratio and increasing cytochrome c oxidase (COX) activity in cortex. Modulation of the mood-related behavior and cognitive function upon esculetin treatment in a mouse model of ARS depends on age and is partly due to the enhancement of redox status and levels of COX activity in cortex.
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Affiliation(s)
- Sagrario Martín-Aragón
- Departamento de Farmacología, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain.
| | - Ángel Villar
- Departamento de Farmacología, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
| | - Juana Benedí
- Departamento de Farmacología, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
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Padula CB, Weitlauf JC, Rosen AC, Reiber G, Cochrane BB, Naughton MJ, Li W, Rissling M, Yaffe K, Hunt JR, Stefanick ML, Goldstein MK, Espeland MA. Longitudinal Cognitive Trajectories of Women Veterans from the Women's Health Initiative Memory Study. THE GERONTOLOGIST 2016; 56:115-25. [PMID: 26615021 PMCID: PMC4906317 DOI: 10.1093/geront/gnv663] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 10/05/2015] [Indexed: 12/17/2022] Open
Abstract
PURPOSE OF THE STUDY A comparison of longitudinal global cognitive functioning in women Veteran and non-Veteran participants in the Women's Health Initiative (WHI). DESIGN AND METHODS We studied 7,330 women aged 65-79 at baseline who participated in the WHI Hormone Therapy Trial and its ancillary Memory Study (WHIMS). Global cognitive functioning (Modified Mini-Mental State Examination [3MSE]) in Veterans (n = 279) and non-Veterans (n = 7,051) was compared at baseline and annually for 8 years using generalized linear modeling methods. RESULTS Compared with non-Veterans, Veteran women were older, more likely to be Caucasian, unmarried, and had higher rates of educational and occupational attainment. Results of unadjusted baseline analyses suggest 3MSE scores were similar between groups. Longitudinal analyses, adjusted for age, education, ethnicity, and WHI trial assignment revealed differences in the rate of cognitive decline between groups over time, such that scores decreased more in Veterans relative to non-Veterans. This relative difference was more pronounced among Veterans who were older, had higher educational/occupational attainment and greater baseline prevalence of cardiovascular risk factors (e.g., smoking) and cardiovascular disease (e.g., angina, stroke). IMPLICATIONS Veteran status was associated with higher prevalence of protective factors that may have helped initially preserve cognitive functioning. However, findings ultimately revealed more pronounced cognitive decline among Veteran relative to non-Veteran participants, likely suggesting the presence of risks that may impact neuropathology and the effects of which were initially masked by Veterans' greater cognitive reserve.
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Affiliation(s)
- Claudia B Padula
- VA Palo Alto Health Care System, Sierra Pacific MIRECC and Department of Psychiatry & Behavioral Sciences, Stanford University, Palo Alto, California.
| | - Julie C Weitlauf
- VA Palo Alto Health Care System, Sierra Pacific MIRECC and Department of Psychiatry & Behavioral Sciences, Stanford University, Palo Alto, California. VA Palo Alto Health Care System, Center for Innovation to Implementation, Palo Alto, California
| | - Allyson C Rosen
- VA Palo Alto Health Care System, Sierra Pacific MIRECC and Department of Psychiatry & Behavioral Sciences, Stanford University, Palo Alto, California
| | - Gayle Reiber
- Health Services Research and Development, VA Puget Sound Health Care System, Seattle, Washington
| | | | - Michelle J Naughton
- Division of Population Sciences, College of Medicine, The Ohio State University, Columbus
| | - Wenjun Li
- Department of Medicine, University of Massachusetts Medical School, Worcester. Department of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester
| | - Michelle Rissling
- Durham VA Medical Center, Mid-Atlantic MIRECC, Durham, North Carolina
| | - Kristine Yaffe
- UCSF Department of Psychiatry, Neurology and Epidemiology and Biostatistics, San Francisco VA Medical Center, Sierra Pacific MIRECC, California
| | - Julie R Hunt
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Marcia L Stefanick
- Department of Medicine (Stanford Center for Prevention Research), Stanford University School of Medicine, California. Department of Obstetrics & Gynecology, Stanford University School of Medicine, California
| | - Mary K Goldstein
- VA Palo Alto Health Care System, GRECC, Stanford University School of Medicine, Department of Medicine, Center for Primary Care & Outcomes Research, Palo Alto, California
| | - Mark A Espeland
- Wake Forest School of Medicine, Department of Biostatistical Sciences, One Medical Center Blvd, Winston-Salem, North Carolina
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Pertl MM, Lawlor BA, Robertson IH, Walsh C, Brennan S. Risk of Cognitive and Functional Impairment in Spouses of People With Dementia: Evidence From the Health and Retirement Study. J Geriatr Psychiatry Neurol 2015; 28:260-71. [PMID: 26071444 DOI: 10.1177/0891988715588834] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Caring for a spouse with dementia is a chronic stressor that may compromise caregivers' own cognitive functioning and capacity to provide adequate care. We examined whether having (i) a spouse with dementia and (ii) a spouse who requires assistance with activities of daily living predicted cognitive and functional impairments in respondents to the Health and Retirement Study (n = 7965). Respondents who had a spouse who requires care had poorer cognitive functioning, whereby this relationship was significantly stronger for male respondents. Having a spouse with dementia moderated the relationship between income and cognition and predicted caregiver functional impairment, though not when depression was controlled. Although we found no significant differences on any individual cognitive domains between 179 dementia caregivers and sociodemographically matched noncaregivers, our findings suggest that caregivers, especially men, and low-income individuals who have a spouse with dementia are more vulnerable to adverse cognitive outcomes. Targeting depression in spouses of people with dementia may help to prevent functional impairments.
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Affiliation(s)
- Maria M Pertl
- Neuro-Enhancement for Independent Lives (NEIL) Programme, School of Psychology, Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin 2, Ireland
| | - Brian A Lawlor
- Neuro-Enhancement for Independent Lives (NEIL) Programme, School of Medicine, Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin 2, Ireland
| | - Ian H Robertson
- Neuro-Enhancement for Independent Lives (NEIL) Programme, School of Psychology, Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin 2, Ireland
| | - Cathal Walsh
- Department of Statistics, Trinity College Dublin, Dublin, Ireland
| | - Sabina Brennan
- Neuro-Enhancement for Independent Lives (NEIL) Programme, School of Psychology, Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin 2, Ireland
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Brenes GA, Danhauer SC, Lyles MF, Hogan PE, Miller ME. Barriers to Mental Health Treatment in Rural Older Adults. Am J Geriatr Psychiatry 2015; 23:1172-8. [PMID: 26245880 PMCID: PMC4663185 DOI: 10.1016/j.jagp.2015.06.002] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 05/26/2015] [Accepted: 06/09/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The purpose of this study was to identify the barriers to seeking mental health treatment experienced by rural older adults. We also examined if barriers differed by age and worry severity. METHODS Participants were 478 rural older adults responding to a flyer for a psychotherapy intervention study. Interested participants were screened by telephone, and barriers to mental health treatment were assessed. Participants completed a demographic questionnaire and the Penn State Worry Questionnaire-Abbreviated. RESULTS The most commonly reported barrier to treatment was the personal belief that "I should not need help." Other commonly reported barriers included practical barriers (cost, not knowing where to go, distance), mistrust of mental health providers, not thinking treatment would help, stigma, and not wanting to talk with a stranger about private matters. Multivariable analyses indicated that worry severity and younger age were associated with reporting more barriers. CONCLUSIONS Multiple barriers interfere with older adults seeking treatment for anxiety and depression. Older age is associated with fewer barriers, suggesting that the oldest old may have found strategies for overcoming these barriers. Young-old adults may benefit from interventions addressing personal beliefs about mental health and alternative methods of service delivery.
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Affiliation(s)
- Gretchen A. Brenes
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine
| | - Suzanne C. Danhauer
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine
| | - Mary F. Lyles
- Department of Geriatrics, Wake Forest School of Medicine
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Hamilton JL, Brickman AM, Lang R, Byrd GS, Haines JL, Pericak-Vance MA, Manly JJ. Relationship between depressive symptoms and cognition in older, non-demented African Americans. J Int Neuropsychol Soc 2014; 20:756-63. [PMID: 24840093 PMCID: PMC4142348 DOI: 10.1017/s1355617714000423] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Knowledge of the relationship between depressive symptoms and cognition in older adults has primarily come from studies of clinically depressed, functionally impaired or cognitively impaired individuals, and in predominately White samples. Limited minority representation in depression research exposes the need to examine these associations in more ethnic/racially diverse populations. We sought to examine the relationship between depressive symptoms and cognition in a sample of non-demented older African Americans recruited from surrounding U.S. cities of New York, Greensboro, Miami, and Nashville (N=944). Depressive symptoms were evaluated with the Geriatric Depression Scale (GDS). Cognition was evaluated with a comprehensive neuropsychological battery. Test scores were summarized into attention, executive function, memory, language, and processing speed composites. Controlling for age, education, reading level, and sex, African American older adults who endorsed more symptoms obtained significantly lower scores on measures of memory, language, processing speed, and executive functioning. Further investigation of the causal pathway underlying this association, as well as potential mediators of the relationship between depressive symptoms and cognitive test performance among older African Americans, such as cardiovascular and cerebrovascular disease, may offer potential avenues for intervention.
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Affiliation(s)
- Jamie L Hamilton
- 1Taub Institute for Research on Alzheimer's Disease and the Aging Brain,College of Physicians and Surgeons,Columbia University,New York,New York
| | - Adam M Brickman
- 1Taub Institute for Research on Alzheimer's Disease and the Aging Brain,College of Physicians and Surgeons,Columbia University,New York,New York
| | - Rosalyn Lang
- 5North Carolina Agricultural and Technical State University,Department of Biology,Greensboro,North Carolina
| | - Goldie S Byrd
- 6North Carolina Agricultural and Technical State University,Dean,College of Arts and Sciences,Greensboro,North Carolina
| | - Jonathan L Haines
- 7Center for Human Genetics Research,Vanderbilt University,Nashville,Tennessee
| | - Margaret A Pericak-Vance
- 8John P. Hussman Institute for Human Genomics,Miller School of Medicine,University of Miami,Miami,Florida
| | - Jennifer J Manly
- 1Taub Institute for Research on Alzheimer's Disease and the Aging Brain,College of Physicians and Surgeons,Columbia University,New York,New York
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