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Haniff ZR, Bocharova M, Mantingh T, Rucker JJ, Velayudhan L, Taylor DM, Young AH, Aarsland D, Vernon AC, Thuret S. Psilocybin for dementia prevention? The potential role of psilocybin to alter mechanisms associated with major depression and neurodegenerative diseases. Pharmacol Ther 2024; 258:108641. [PMID: 38583670 DOI: 10.1016/j.pharmthera.2024.108641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024]
Abstract
Major depression is an established risk factor for subsequent dementia, and depression in late life may also represent a prodromal state of dementia. Considering current challenges in the clinical development of disease modifying therapies for dementia, the focus of research is shifting towards prevention and modification of risk factors to alter the neurodegenerative disease trajectory. Understanding mechanistic commonalities underlying affective symptoms and cognitive decline may reveal biomarkers to aid early identification of those at risk of progressing to dementia during the preclinical phase of disease, thus allowing for timely intervention. Adult hippocampal neurogenesis (AHN) is a phenomenon that describes the birth of new neurons in the dentate gyrus throughout life and it is associated with spatial learning, memory and mood regulation. Microglia are innate immune system macrophages in the central nervous system that carefully regulate AHN via multiple mechanisms. Disruption in AHN is associated with both dementia and major depression and microgliosis is a hallmark of several neurodegenerative diseases. Emerging evidence suggests that psychedelics promote neuroplasticity, including neurogenesis, and may also be immunomodulatory. In this context, psilocybin, a serotonergic agonist with rapid-acting antidepressant properties has the potential to ameliorate intersecting pathophysiological processes relevant for both major depression and neurodegenerative diseases. In this narrative review, we focus on the evidence base for the effects of psilocybin on adult hippocampal neurogenesis and microglial form and function; which may suggest that psilocybin has the potential to modulate multiple mechanisms of action, and may have implications in altering the progression from major depression to dementia in those at risk.
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Affiliation(s)
- Zarah R Haniff
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| | - Mariia Bocharova
- Department of Old Age Psychiatry, Division of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Tim Mantingh
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - James J Rucker
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, United Kingdom
| | - Latha Velayudhan
- Department of Old Age Psychiatry, Division of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - David M Taylor
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, United Kingdom
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, United Kingdom
| | - Dag Aarsland
- Department of Old Age Psychiatry, Division of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Wolfson Centre for Age Related Diseases, Division of Neuroscience of the Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Stavanger University Hospital, Stavanger, Norway
| | - Anthony C Vernon
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; MRC Centre for Neurodevelopmental Disorders, King's College London, United Kingdom.
| | - Sandrine Thuret
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
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Cecchini V, Agahi N. Does losing family members in midlife matter for late-life mental and cognitive health? A longitudinal study of older Swedes spanning 30 years. Aging Ment Health 2024:1-9. [PMID: 38644675 DOI: 10.1080/13607863.2024.2341877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 04/05/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES Mental and cognitive health is crucial to ensure well-being in older age. However, prolonged periods of stress, grief, and bereavement might compromise mental health balance, leading to profound changes. This study investigated the sex-stratified associations between midlife bereavement experiences (e.g. sibling loss, spousal loss, and multiple losses) and late-life depression (LLD) and cognitive impairment. METHOD Linked data from the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) were used. Multiple logistic regressions were performed to examine the associations between midlife bereavement and LLD (n = 1078) and cognitive impairment (n = 995), separately. RESULTS Sibling loss and multiple losses in midlife were associated with lower odds of LLD, especially among women. Among men, sibling loss in midlife was associated with lower odds of cognitive impairment, while the experience of two losses among women suggested an increased (but non-significant) risk of cognitive impairment. Interaction analyses did not show significant effects between bereavement and gender on LLD and cognitive impairment. CONCLUSION Midlife bereavement might have gendered implications on LLD and cognitive impairment, but associations need to be confirmed by well-powered studies. Further research is warranted to elucidate the association between multiple midlife losses and reduced LLD risk.
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Affiliation(s)
- Valeria Cecchini
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Neda Agahi
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Forbes M, Lotfaliany M, Mohebbi M, Reynolds CF, Woods RL, Orchard S, Chong T, Agustini B, O'Neil A, Ryan J, Berk M. Depressive symptoms and cognitive decline in older adults. Int Psychogeriatr 2024:1-12. [PMID: 38623851 DOI: 10.1017/s1041610224000541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
OBJECTIVES Few studies have examined the impact of late-life depression trajectories on specific domains of cognitive function. This study aims to delineate how different depressive symptom trajectories specifically affect cognitive function in older adults. DESIGN Prospective longitudinal cohort study. SETTING Australia and the United States of America. PARTICIPANTS In total, 11,035 community-dwelling older adults with a mean age of 75 years. MEASUREMENTS Depressive trajectories were modelled from depressive symptoms according to annual Centre for Epidemiological Studies Depression Scale 10 (CES-D-10) surveys. Four trajectories of depressive symptoms were identified: low ("nondepressed"), consistently mild ("subthreshold depression"), consistently moderate ("persistent depression"), and initially low but increasing ("emerging depression"). Global cognition (Modified Mini-Mental State Examination [3MS]), verbal fluency (Controlled Oral Word Association Test [COWAT]), processing speed (Symbol Digit Modalities Test [SDMT]), episodic memory (Hopkins Verbal Learning Test - Revised [HVLT-R]), and a composite z-score were assessed over a subsequent median 2 years. RESULTS Subthreshold depression predicted impaired performance on the SDMT (Cohen's d -0.04) and composite score (-0.03); emerging depression predicted impaired performance on the SDMT (-0.13), HVLT-R (-0.09), 3 MS (-0.08) and composite score (-0.09); and persistent depression predicted impaired performance on the SDMT (-0.08), 3 MS (-0.11), and composite score (-0.09). CONCLUSIONS Depressive symptoms are associated with later impaired processing speed. These effects are small. Diverse depression trajectories have different impacts on cognitive function.
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Affiliation(s)
- Malcolm Forbes
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia
| | - Mojtaba Lotfaliany
- School of Medicine, Barwon Health, Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Geelong, VC, Australia
| | - Mohammadreza Mohebbi
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia
| | | | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Suzanne Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Trevor Chong
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Bruno Agustini
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia
| | - Adrienne O'Neil
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia
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Li B, Jiang W, Han SS, Ye YP, Li YX, Lou H, Zhang JY. Influence of moderate-to-high intensity physical activity on depression levels: a study based on a health survey of Chinese university students. BMC Public Health 2024; 24:1023. [PMID: 38609890 PMCID: PMC11015539 DOI: 10.1186/s12889-024-18433-w] [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: 12/02/2023] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
OBJECTIVE The study aims to examine how moderate-to-vigorous physical activity (MVPA) affects the severity of depression symptoms among Chinese college students. Additionally, it seeks to analyze the mediating mechanisms involving self-rated health and general self-efficacy. METHODS The study utilized data from the 2023 Chinese College Health Tracking Survey and employed multiple linear regression and structural equation modeling techniques to investigate the impacts of MVPA on depression levels and its underlying mediating mechanisms among college students. The primary cohort comprised 49,717 enrolled college students from 106 universities in China. RESULTS A total of 41,620 valid questionnaires were collected (response rate: 83.7%), with females accounting for 58.6%. In the past month, approximately 30.2% of college students engaged in MVPA. Self-rated health (B = - 0.282, P < 0.001) and general self-efficacy (B = - 0.133, P < 0.001) significantly influenced college students' depression scores. Even after controlling for other variables, participating in MVPA remained significantly associated with reduced depression scores (B = - 0.062, P = 0.002). The results of the structural equation model showed that MVPA not only directly decreased college students' depression scores but also indirectly reduced the likelihood of depression occurrence by improving their physical health status and general self-efficacy. CONCLUSION The lack of physical activity among Chinese college students is evident. Engaging in MVPA can reduce the likelihood of depression among college students. MVPA achieves this reduction by enhancing college students' general self-efficacy and improving their physical health. The factors influencing depression levels among college students are multifaceted. For future interventions targeting college students' mental health, comprehensive approaches that incorporate behavioral and psychological factors should be emphasized.
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Affiliation(s)
- Bo Li
- Institute of Sports Science, Nantong University, 226019, Nantong, China
| | - Wei Jiang
- School of Physical Education, Henan University of Economics and Law, 450046, Zhengzhou, China
| | - Shan-Shan Han
- Institute of Sports Science, Nantong University, 226019, Nantong, China
| | - Yu-Peng Ye
- School of Physical Education, Jing-gang-shan University, 343009, Ji'an, China
| | - Ya-Xing Li
- Physical Education College, Shangqiu University, 476000, Shangqiu, China
| | - Hu Lou
- Institute of Sports Science, Nantong University, 226019, Nantong, China
| | - Jun-Yong Zhang
- School of Physical Education, Henan University of Economics and Law, 450046, Zhengzhou, China.
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Zhang J, Na X, Li Z, Ji JS, Li G, Yang H, Yang Y, Tan Y, Zhang J, Xi M, Su D, Zeng H, Wu L, Zhao A. Sarcopenic obesity is part of obesity paradox in dementia development: evidence from a population-based cohort study. BMC Med 2024; 22:133. [PMID: 38520024 PMCID: PMC10960494 DOI: 10.1186/s12916-024-03357-4] [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: 09/27/2023] [Accepted: 03/14/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Sarcopenic obesity, a clinical and functional condition characterized by the coexistence of obesity and sarcopenia, has not been investigated in relation to dementia risk and its onset. METHODS We included 208,867 participants from UK biobank, who aged 60 to 69 years at baseline. Dementia diagnoses were identified using hospital records and death register data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models to evaluate the associations of obesity, sarcopenia, and sarcopenic obesity with dementia risk, stratified by sex. Stratified analyses were performed across dementia-related polygenic risk score (PRS). Restricted mean survival time models were established to estimate the difference and 95%CIs of dementia onset across different status. Additionally, linear regression models were employed to estimate associations of different status with brain imaging parameters. The mediation effects of chronic diseases were also examined. RESULTS Obese women with high PRS had a decreased risk (HR = 0.855 [0.761-0.961]), but obese men with low PRS had an increased risk (HR = 1.223 [1.045-1.431]). Additionally, sarcopenia was associated with elevated dementia risk (HRwomen = 1.323 [1.064-1.644]; HRmen = 2.144 [1.753-2.621]) in those with low PRS. Among those with high PRS, however, the association was only significant in early-life (HRwomen = 1.679 [1.355-2.081]; HRmen = 2.069 [1.656-2.585]). Of note, sarcopenic obesity was associated with higher dementia risk (HRwomen = 1.424 [1.227-1.653]; HRmen = 1.989 [1.702-2.323]), and results remained similar stratified by PRS. Considering dementia onset, obesity was associated with dementia by 1.114 years delayed in women, however, 0.170 years advanced in men. Sarcopenia (women: 0.080 years; men: 0.192 years) and sarcopenic obesity (women: 0.109 years; men: 0.511 years) respectively advanced dementia onset. Obesity, sarcopenia, and sarcopenic obesity were respectively related to alterations in different brain regions. Association between sarcopenic obesity and dementia was mediated by chronic diseases. CONCLUSIONS Sarcopenic obesity and sarcopenia were respectively associated with increased dementia risk and advanced dementia onset to vary degree. The role of obesity in dementia may differ by sex and genetic background.
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Affiliation(s)
- Junhan Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Xiaona Na
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Zhihui Li
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Guowei Li
- Center for Clinical Epidemiology and Methodology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Haibing Yang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yucheng Yang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yuefeng Tan
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Jian Zhang
- School of Public Health, Peking University, Beijing, China
| | - Menglu Xi
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Donghan Su
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Huatang Zeng
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, China
| | - Liqun Wu
- Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing, China.
- Institute for Healthy China, Tsinghua University, Beijing, China.
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Leng Y, Yaffe K. Harnessing Brain Pathology for Dementia Prevention. JAMA Neurol 2024; 81:229-231. [PMID: 38315478 DOI: 10.1001/jamaneurol.2023.5490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Affiliation(s)
- Yue Leng
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco
| | - Kristine Yaffe
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco
- Departments of Neurology and Epidemiology, University of California, San Francisco, San Francisco
- San Francisco VA Health Care System, San Francisco, California
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Lei C, Wu G, Cui Y, Xia H, Chen J, Zhan X, Lv Y, Li M, Zhang R, Zhu X. Development and validation of a cognitive dysfunction risk prediction model for the abdominal obesity population. Front Endocrinol (Lausanne) 2024; 15:1290286. [PMID: 38481441 PMCID: PMC10932956 DOI: 10.3389/fendo.2024.1290286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/22/2024] [Indexed: 03/26/2024] Open
Abstract
Objectives This study was aimed to develop a nomogram that can accurately predict the likelihood of cognitive dysfunction in individuals with abdominal obesity by utilizing various predictor factors. Methods A total of 1490 cases of abdominal obesity were randomly selected from the National Health and Nutrition Examination Survey (NHANES) database for the years 2011-2014. The diagnostic criteria for abdominal obesity were as follows: waist size ≥ 102 cm for men and waist size ≥ 88 cm for women, and cognitive function was assessed by Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Word Learning subtest, Delayed Word Recall Test, Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). The cases were divided into two sets: a training set consisting of 1043 cases (70%) and a validation set consisting of 447 cases (30%). To create the model nomogram, multifactor logistic regression models were constructed based on the selected predictors identified through LASSO regression analysis. The model's performance was assessed using several metrics, including the consistency index (C-index), the area under the receiver operating characteristic (ROC) curve (AUC), calibration curves, and decision curve analysis (DCA) to assess the clinical benefit of the model. Results The multivariate logistic regression analysis revealed that age, sex, education level, 24-hour total fat intake, red blood cell folate concentration, depression, and moderate work activity were significant predictors of cognitive dysfunction in individuals with abdominal obesity (p < 0.05). These predictors were incorporated into the nomogram. The C-indices for the training and validation sets were 0.814 (95% CI: 0.875-0.842) and 0.805 (95% CI: 0.758-0.851), respectively. The corresponding AUC values were 0.814 (95% CI: 0.875-0.842) and 0.795 (95% CI: 0.753-0.847). The calibration curves demonstrated a satisfactory level of agreement between the nomogram model and the observed data. The DCA indicated that early intervention for at-risk populations would provide a net benefit, as indicated by the line graph. Conclusion Age, sex, education level, 24-hour total fat intake, red blood cell folate concentration, depression, and moderate work activity were identified as predictive factors for cognitive dysfunction in individuals with abdominal obesity. In conclusion, the nomogram model developed in this study can effectively predict the clinical risk of cognitive dysfunction in individuals with abdominal obesity.
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Affiliation(s)
- Chun Lei
- General Practice, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Gangjie Wu
- General Practice, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Yan Cui
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Hui Xia
- General Practice, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Jianbing Chen
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Xiaoyao Zhan
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Yanlan Lv
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Meng Li
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Ronghua Zhang
- College of Pharmacy, Jinan University, Guangzhou, Guangdong, China
- Cancer Research Institution, Jinan University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Jinan University, Guangzhou, Guangdong, China
| | - Xiaofeng Zhu
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong, China
- Traditional Chinese Medicine Department, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
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Marawi T, Zhukovsky P, Brooks H, Bowie CR, Butters MA, Fischer CE, Flint AJ, Herrmann N, Lanctôt KL, Mah L, Pollock BG, Rajji TK, Voineskos AN, Mulsant BH. Heterogeneity of Cognition in Older Adults with Remitted Major Depressive Disorder: A Latent Profile Analysis. Am J Geriatr Psychiatry 2024:S1064-7481(24)00240-9. [PMID: 38403532 DOI: 10.1016/j.jagp.2024.01.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/26/2024] [Accepted: 01/27/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES To identify data-driven cognitive profiles in older adults with remitted major depressive disorder (rMDD) with or without mild cognitive impairment (MCI) and examine how the profiles differ regarding demographic, clinical, and neuroimaging measures. DESIGN Secondary cross-sectional analysis using latent profile analysis. SETTING Multisite clinical trial in Toronto, Canada. PARTICIPANTS One hundred seventy-eight participants who met DSM-5 criteria for rMDD without MCI (rMDD-MCI; n = 60) or with MCI (rMDD + MCI; n = 118). MEASUREMENTS Demographic, clinical, neuroimaging measures, and domain scores from a neuropsychological battery assessing verbal memory, visuospatial memory, processing speed, working memory, language, and executive function. RESULTS We identified three latent profiles: Profile 1 (poor cognition; n = 75, 42.1%), Profile 2 (intermediate cognition; n = 75, 42.1%), and Profile 3 (normal cognition; n = 28, 15.7%). Compared to participants with Profile 3, those with Profile 1 or 2 were older, had lower education, experienced a greater burden of medical comorbidities, and were more likely to have MCI. The profiles did not differ on the severity of residual symptoms, age of onset of rMDD, number of depressive episodes, psychotropic medication, cerebrovascular risk, ApoE4 carrier status, or family history of depression, dementia, or Alzheimer's disease. The profiles differed in cortical thickness of 15 regions, with the most prominent effects for left precentral and pars opercularis, and right inferior parietal and supramarginal. CONCLUSION Older patients with rMDD can be grouped cross-sectionally based on data-driven cognitive profiles that differ from the absence or presence of a diagnosis of MCI. Future research should determine the differential risk for dementia of these data-driven subgroups.
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Affiliation(s)
- Tulip Marawi
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Peter Zhukovsky
- Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Heather Brooks
- Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Christopher R Bowie
- Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada; Departments of Psychology and Psychiatry (CRB), Queen's University, Kingston, ON, Canada
| | - Meryl A Butters
- Department of Psychiatry (MAB), University of Pittsburgh, Pittsburgh, PA
| | - Corinne E Fischer
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Keenan Research Centre for Biomedical Science (CEF), St. Michaels Hospital, Toronto, ON, Canada
| | - Alastair J Flint
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Centre for Mental Health (AJF), University Health Network, Toronto, ON, Canada
| | - Nathan Herrmann
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Department of Psychiatry (NH, KLL), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology (NH, KLL), Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Krista L Lanctôt
- Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Department of Psychiatry (NH, KLL), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology (NH, KLL), Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Linda Mah
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Department of Psychiatry (LM), Baycrest Health Services, Rotman Research Institute, University of Toronto, Toronto, ON, Canada
| | - Bruce G Pollock
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada
| | - Tarek K Rajji
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Toronto Dementia Research Alliance (TKR, BHM), University of Toronto, Toronto, ON, Canada
| | - Aristotle N Voineskos
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada
| | - Benoit H Mulsant
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Toronto Dementia Research Alliance (TKR, BHM), University of Toronto, Toronto, ON, Canada.
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Vandenbroucke JP, Sørensen HT, Rehkopf DH, Gradus JL, Mackenbach JP, Glymour MM, Galea S, Henderson VW. Report on the Joint Workshop on the Relations between Health Inequalities, Ageing and Multimorbidity, Iceland, May 3-4, 2023. Clin Epidemiol 2024; 16:9-22. [PMID: 38259327 PMCID: PMC10801289 DOI: 10.2147/clep.s443152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 12/13/2023] [Indexed: 01/24/2024] Open
Abstract
This paper is a summary of key presentations from a workshop in Iceland on May 3-4, 2023 arranged by Aarhus University and with participation of the below-mentioned scientists. Below you will find the key messages from the presentations made by: Professor Jan Vandenbroucke, Department of Clinical Epidemiology, Aarhus University, Emeritus Professor, Leiden University; Honorary Professor, London School of Hygiene & Tropical Medicine, UKProfessor, Chair Henrik Toft Sørensen, Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, DenmarkProfessor David H. Rehkopf, Director, the Stanford Center for Population Health Sciences, Stanford University, CA., USProfessor Jaimie Gradus, Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USProfessor Johan Mackenbach, Emeritus Professor, Department of Public Health, Erasmus University Rotterdam, HollandProfessor, Chair M Maria Glymour, Department of Epidemiology, Boston University School of Public Health, Boston University, Boston, Massachusetts, USProfessor, Dean Sandro Galea, School of Public Health, Boston University, Boston, Massachusetts, USProfessor Victor W. Henderson, Departments of Epidemiology & Population Health and of Neurology & Neurological Sciences, Stanford University, Stanford, CA, US; Department of Clinical Epidemiology, Aarhus University, Aarhus, DK.
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Affiliation(s)
- Jan P Vandenbroucke
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
- Leiden University, Leiden, Netherlands
- London School of Hygiene & Tropical Medicine, London, UK
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
- Aarhus University Hospital, Aarhus, Denmark
| | - David H Rehkopf
- Stanford Center for Population Health Sciences, Stanford University, CA, USA
| | - Jaimie L Gradus
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA
| | - Johan P Mackenbach
- Department of Public Health, Erasmus University Rotterdam, Rotterdam, Holland
| | - M Maria Glymour
- Department of Epidemiology, Boston University School of Public Health, Boston University, Boston, MA, USA
| | - Sandro Galea
- School of Public Health, Boston University, Boston, MA, USA
| | - Victor W Henderson
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
- Departments of Epidemiology & Population Health and of Neurology & Neurological Sciences, Stanford University, Stanford, CA, USA
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Burkhardt G, Goerigk S, Dechantsreiter E, Bulubas L, Soldini A, Zwanzger P, Diemer J, Padberg F, Brunnauer A, Kumpf U. Driving-related cognitive skills during antidepressant transcranial direct current stimulation: results in a subsample from the DepressionDC trial. Front Psychiatry 2023; 14:1255415. [PMID: 38130292 PMCID: PMC10733487 DOI: 10.3389/fpsyt.2023.1255415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023] Open
Abstract
Therapeutic transcranial direct current stimulation (tDCS) is a well-tolerated neuromodulatory intervention. However, there are currently no data on its impact on driving skills. Therefore, we conducted a validated assessment of driving-related cognitive skills in participants of the DepressionDC trial, a multicenter, randomized-controlled trial investigating the antidepressant effects of 6-week prefrontal tDCS in patients with major depressive disorder (MDD). Twenty-one patients (12 women, active tDCS, n = 11, sham, n = 10) underwent an assessment of driving-related cognitive skills before and after the intervention. Using a Bayesian analysis approach, we found no group differences between active tDCS and sham tDCS in the pre-post treatment changes for visual perception (estimated median difference: 3.41 [-3.17, 10.55 89%-CI], BF01: 2.1), stress tolerance (estimated median difference: 0.77 [-2.40, 4.15 89%-CI], BF01: 1.6), and reaction time (estimated median difference: 2.06 [-12.33, 16.83 89%-CI], BF01: 6.5). Our results indicate that repeated sessions of a conventional bifrontal tDCS protocol do not negatively impact driving-related cognitive skills in patients with MDD.
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Affiliation(s)
- Gerrit Burkhardt
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Stephan Goerigk
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Charlotte Fresenius Hochschule, University of Psychology, Munich, Germany
| | - Esther Dechantsreiter
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lucia Bulubas
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Aldo Soldini
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Peter Zwanzger
- kbo-Inn-Salzach-Klinikum, Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine, Geriatrics and Neurology, Wasserburg am Inn, Germany
| | - Julia Diemer
- kbo-Inn-Salzach-Klinikum, Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine, Geriatrics and Neurology, Wasserburg am Inn, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Alexander Brunnauer
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- kbo-Inn-Salzach-Klinikum, Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine, Geriatrics and Neurology, Wasserburg am Inn, Germany
| | - Ulrike Kumpf
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
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Pan L, Gao B, Zhu J, Guo J. Negative Wealth Shock and Cognitive Decline and Dementia in Middle-Aged and Older US Adults. JAMA Netw Open 2023; 6:e2349258. [PMID: 38147330 PMCID: PMC10751595 DOI: 10.1001/jamanetworkopen.2023.49258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/09/2023] [Indexed: 12/27/2023] Open
Abstract
Importance As a financial hardship, negative wealth shock has been implicated in some adverse health outcomes. However, associations between negative wealth shock and cognitive decline and dementia have not been examined. Objective To investigate whether negative wealth shock was associated with cognitive decline and incident dementia among middle-aged and older US adults. Design, Setting, and Participants The Health and Retirement Study (HRS) is a prospective cohort study conducted biennially among US adults older than 50 years. Data from the HRS from calendar years 1996 to 2020 were analyzed from July 1 to 31, 2023. The final sample included 8082 participants with complete data of interest. Exposures Wealth status was quantified with questionnaires. Negative wealth shock was defined as a loss of 75% or more in total wealth over a 2-year period. Asset poverty was defined as zero or less total net wealth. Main Outcomes and Measures Cognitive function was assessed with the modified Telephone Interview for Cognitive Status (TICS-m). Dementia status was determined with TICS-m scores and proxy assessment. Results Among 8082 participants included (mean [SD] age, 63.7 [5.7] years; 4179 women [51.7%] and 3903 men [48.3%]; 1111 Black [13.7%], 6689 White [82.7%], and 282 other [3.5%]), 1441 developed incident dementia over a median follow-up time of 14 (IQR, 7-20) years. Compared with participants who had positive wealth without shock, those with negative wealth shock had accelerated cognitive decline (β coefficient, -0.014 [95% CI, -0.027 to -0.001]; P = .03) and increased risks of dementia (hazard ratio [HR], 1.27 [95% CI, 1.11-1.46]; P < .001). Higher dementia risks were also found in participants with asset poverty at baseline (HR, 1.61 [95% CI, 1.30-2.00]; P < .001). Associations were found in White participants (HR, 1.34 [95% CI, 1.14-1.58]; P < .001) and participants younger than 65 years (HR, 1.38 [95% CI, 1.13-1.68]; P = .001) but not in other races and ethnicities or those 65 years or older. Conclusions and Relevance In this cohort study, negative wealth shock was associated with accelerated cognitive decline and elevated risks of dementia among middle-aged and older US adults, with modifications by age and ethnicity. These findings should be confirmed by further prospective and interventional studies.
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Affiliation(s)
- Liulu Pan
- Zhejiang University School of Medicine, Hangzhou, China
| | - Bin Gao
- Department of Psychiatry, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Junpeng Zhu
- Center for Rehabilitation Medicine, Department of Psychiatry, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
| | - Jing Guo
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
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