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Ogawa K, Shirai K, Nozaki S, Shikimoto R, Sawada N, Mimura M, Iso H, Tsugane S. The association between midlife living arrangement and psychiatrist-diagnosed depression in later life: who among your family members reduces the risk of depression? Transl Psychiatry 2022; 12:156. [PMID: 35410408 PMCID: PMC9001692 DOI: 10.1038/s41398-022-01880-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/18/2022] [Accepted: 02/25/2022] [Indexed: 11/09/2022] Open
Abstract
This study investigates the longitudinal association between living arrangements and psychiatrists' diagnosis of depression in the general population. In 1990, 1254 Japanese men and women aged 40-59 years were enroled and completed questionnaires on the living arrangement in the Japan Public Health Center-based Prospective Study (JPHC Study) and participated in a mental health screening (2014-2015). The study diagnosed a major depressive disorder (MDD) assessed by well-trained certified psychiatrists through medical examinations. During the follow-up, a total of 105 participants (36 men and 69 women) aged 64-84 years were diagnosed with MDD by psychiatrists. Living with a child (ren) was associated with a reduced risk of MDD for men but not for women; the respective multivariable ORs (95% CIs) were 0.42 (0.19-0.96) and 0.59 (0.32-1.09). These associations remained unchanged after adjusting for living with spouse and parent(s). In conclusion, living with a child (ren) was associated with a reduced risk of MDD in men, suggesting the role of a child (ren) in the prevention of MDD.
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Affiliation(s)
- Kento Ogawa
- grid.136593.b0000 0004 0373 3971Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, Japan
| | - Kokoro Shirai
- grid.136593.b0000 0004 0373 3971Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, Japan
| | - Shoko Nozaki
- grid.26091.3c0000 0004 1936 9959Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Ryo Shikimoto
- grid.26091.3c0000 0004 1936 9959Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Norie Sawada
- grid.272242.30000 0001 2168 5385Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Masaru Mimura
- grid.26091.3c0000 0004 1936 9959Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, Japan.
| | - Shoichiro Tsugane
- grid.272242.30000 0001 2168 5385Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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Computerized Cognitive Training: A Review of Mechanisms, Methodological Considerations, and Application to Research in Depression. JOURNAL OF COGNITIVE ENHANCEMENT 2021. [DOI: 10.1007/s41465-021-00209-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Motara H, Olusoga T, Russell G, Jamieson S, Ahmed S, Brindle N, Pillai A, Scarsbrook A, Patel C, Chowdhury F. Clinical impact and diagnostic accuracy of 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography/computed tomography (PET/CT) brain imaging in patients with cognitive impairment: a tertiary centre experience in the UK. Clin Radiol 2017; 72:63-73. [DOI: 10.1016/j.crad.2016.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 08/04/2016] [Accepted: 08/11/2016] [Indexed: 01/06/2023]
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Esbensen AJ, Johnson EB, Amaral JL, Tan CM, Macks R. Differentiating Aging Among Adults With Down Syndrome and Comorbid Dementia or Psychopathology. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 121:13-24. [PMID: 26701071 PMCID: PMC5391688 DOI: 10.1352/1944-7558-121.1.13] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Differences were examined between three groups of adults with Down syndrome in their behavioral presentation, social life/activities, health, and support needs. We compared those with comorbid dementia, with comorbid psychopathology, and with no comorbid conditions. Adults with comorbid dementia were more likely to be older, have lower functional abilities, have worse health and more health conditions, and need more support in self-care. Adults with comorbid psychopathology were more likely to exhibit more behavior problems and to be living at home with their families. Adults with no comorbidities were most likely to be involved in community employment. Differences in behavioral presentation can help facilitate clinical diagnoses in aging in Down syndrome, and implications for differential diagnosis and service supports are discussed.
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Affiliation(s)
- Anna J Esbensen
- Anna J. Esbensen, Emily Boshkoff Johnson, Joseph L. Amaral, Christine M. Tan, and Ryan Macks, Cincinnati Children's Hospital Medical Center
| | - Emily Boshkoff Johnson
- Anna J. Esbensen, Emily Boshkoff Johnson, Joseph L. Amaral, Christine M. Tan, and Ryan Macks, Cincinnati Children's Hospital Medical Center
| | - Joseph L Amaral
- Anna J. Esbensen, Emily Boshkoff Johnson, Joseph L. Amaral, Christine M. Tan, and Ryan Macks, Cincinnati Children's Hospital Medical Center
| | - Christine M Tan
- Anna J. Esbensen, Emily Boshkoff Johnson, Joseph L. Amaral, Christine M. Tan, and Ryan Macks, Cincinnati Children's Hospital Medical Center
| | - Ryan Macks
- Anna J. Esbensen, Emily Boshkoff Johnson, Joseph L. Amaral, Christine M. Tan, and Ryan Macks, Cincinnati Children's Hospital Medical Center
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Korsnes MS, Ulstein ID. Cognitive Effects of Late Life Depression: Review of Neuropsychological Findings. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/jbbs.2014.43018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Schwarzbach M, Luppa M, Sikorski C, Fuchs A, Maier W, van den Bussche H, Pentzek M, Riedel-Heller SG. The relationship between social integration and depression in non-demented primary care patients aged 75 years and older. J Affect Disord 2013; 145:172-8. [PMID: 22871528 DOI: 10.1016/j.jad.2012.07.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 07/18/2012] [Accepted: 07/18/2012] [Indexed: 11/15/2022]
Abstract
BACKGROUND Social integration seems to be associated with depression in late life. But the measurement of social integration still lacks a strong consensus. To date in most studies the different domains of social integration have been examined separately. AIMS In order to improve comparability among studies, we used the social integration index (SII), which covers all domains of social integration, to examine the association of social integration and depression in non-demented primary care patients aged 75 years and older. METHOD Data were derived from the longitudinal German study on Aging, Cognition and Dementia in primary care patients. Included in the cross-sectional survey were 1028 non-demented subjects aged 75 years and older. The GDS-15 Geriatric Depression Scale was used to measure depression with a threshold of ≥6. Associations of the SII and further potential risk factors and depression were analysed using multivariate logistic regression models. RESULTS The SII was significantly associated with depression in the elderly. After full adjustment for all variables, odds of depression were significantly higher for lower levels of the SII, having a care level, impaired vision and mobility and subjective memory complaints. CONCLUSION Because the social integration index covers several aspects of social integration, the results seem to be more significant than considering only one of these domains alone. Further research is needed to prove the practicability of the social integration index and to supply the literature with consistent results regarding the association of social integration and depression. Elderly with depression could benefit from increased social networks and enhanced social integration, which points to the development of social programs and social policies that maximize the engagement of older adults in social activities and volunteer roles.
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Affiliation(s)
- Michaela Schwarzbach
- Institute of Social Medicine, Occupational Health and Public Health, Public Health Research Unit, University of Leipzig, Philipp-Rosenthal-Straße 55, D-04103 Leipzig, Germany.
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An Analysis of Changes in Cerebral Blood Flood Velocities in Depressive Pseudo-Dementia and Alzheimer Disease Patients. Neurologist 2010; 16:358-63. [DOI: 10.1097/nrl.0b013e3181a2eace] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
INTRODUCTION Major depressive disorder (MDD) is thought to negatively impact cognitive function; however, the relationship has not been well explored. OBJECTIVE This study examined the association between depression severity and global cognitive function and memory in subjects with severe, treatment-resistant MDD. METHODS We enrolled 66 subjects with Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosed unipolar MDD in a multicenter trial to assess the efficacy and neurocognitive effects of electroconvulsive therapy (ECT). We measured depression severity with the 24 item Hamilton Rating Scale for Depression (HRSD(24)). Neuropsychologic measures included the Mini Mental State Examination (MMSE), Rey Auditory Verbal Learning Test (RAVLT), and the Complex Figure Test (CFT). Correlational and regression analyses were conducted to explore associations between depression severity and cognitive function. RESULTS The mean age of the subjects was 53.6 years (SD=15.8), 65% were female, and mean HRSD(24) was 33.9 (SD=6.7). Mean demographic-corrected T-scores for each neurocognitive measure were in the average to borderline range, and HRSD(24) values were unrelated to performance on the MMSE, RAVLT immediate and delayed recall, and CFT immediate and delayed recall. CONCLUSION In this sample of severely depressed subjects referred for ECT, depression severity was unrelated to global cognitive function or memory. Future research should examine the interactions between other depressive characteristics and neurocognitive function.
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Gaestel Y, Amieva H, Letenneur L, Dartigues JF, Fabrigoule C. Cube drawing performances in normal ageing and Alzheimer's disease: data from the PAQUID elderly population-based cohort. Dement Geriatr Cogn Disord 2006; 21:22-32. [PMID: 16254427 DOI: 10.1159/000089216] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/18/2005] [Indexed: 11/19/2022] Open
Abstract
To assess the influence of age and other sociodemographical variables, depressive symptomatology and the occurrence of Alzheimer's disease (AD) on cube drawing, we examined the performance of 858 normal subjects and 17 incident AD patients in the PAQUID population-based study. Cube drawing was first performed on verbal command and, in case of failure, a model of a cube was given to the subjects to copy. Normal subjects had some difficulties in drawing a cube on verbal command, evidenced by 40% failure in the drawing-to-command condition, while only 17% still failed in the drawing-to-copy condition. Multivariate logistic regressions showed that age, gender, and educational level were associated with cube drawing failure in both conditions, but depressive symptomatology was only associated with persistent failure in the drawing-to-copy condition. Seventy-six point five percent of incident AD subjects failed in the drawing-to-command condition and 64.7% did not benefit from the presentation of the model. Analysis showed that persistent failure in the copy condition was the best level of differentiation between normal and AD subjects.
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Affiliation(s)
- Yann Gaestel
- INSERM U 593, University Victor Segalen Bordeaux 2, Bordeaux, France.
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Green HJ, Pakenham KI, Gardiner RA. Cognitive deficits associated with cancer: A model of subjective and objective outcomes. PSYCHOL HEALTH MED 2005. [DOI: 10.1080/13548500500093308] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Holtzer R, Burright RG, Donovick PJ. The sensitivity of dual-task performance to cognitive status in aging. J Int Neuropsychol Soc 2004; 10:230-8. [PMID: 15012843 DOI: 10.1017/s1355617704102099] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2002] [Revised: 06/20/2003] [Indexed: 11/06/2022]
Abstract
The present study examined dual-task performance in elders with cognitive impairments and normal controls. The participants (N = 60; M age = 84.6) were recruited from residential facilities and the community. They were assigned to one of three groups: (1) cognitive impairment; (2) residential facility control; (3) community control. Two different dual-task conditions were comprised of simple tests that are presumably processed via separate perceptual modalities: 1 visual-manual and 1 auditory-verbal. The first condition consisted of a visual cancellation test and an auditory digit span. The second condition was comprised of an alternate form of the visual cancellation test and letter fluency. MANOVA examined the effect of cognitive status (3-level independent variable) on 3 indices of dual-task performance (letter fluency, digit span, visual cancellation). Analyses controlled for age, education and performance on each test when performed alone. The results revealed that the cognitive impairment group incurred significantly greater dual-task costs compared to both control groups. Furthermore, as was evident from discriminant function analyses, the dual-task measures were very accurate and better than the traditional neuropsychological measures at discriminating elders with cognitive impairments from normal controls. (JINS, 2004, 10, 230-238.)
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Affiliation(s)
- Roee Holtzer
- Cognitive Neuroscience Division of the Taub Institute, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
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Theml T, Heldmann B, Jahn T. Der Beitrag der Neuropsychologie zum Problem der Differentialdiagnose Depression versus Demenz. ZEITSCHRIFT FUR NEUROPSYCHOLOGIE 2001. [DOI: 10.1024//1016-264x.12.4.302] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung: Die Differentialdiagnose Depression versus Demenz ist für den Kliniker eine schwierige und für Betroffene und Angehörige folgenreiche Entscheidung. Viele ältere depressive Patientinnen und Patienten haben kognitive Defizite, die auf den ersten Blick den Symptomen einer beginnenden Demenz ähneln, beispielsweise Beeinträchtigungen mnestischer und exekutiver Funktionen. Diese Beeinträchtigungen sind keineswegs immer reversibel, wie der häufig verwendete, jedoch problematische Begriff “Pseudodemenz” suggeriert. Für die Differentialdiagnose ist ein multidisziplinärer Ansatz erforderlich, der psychopathologische, neurologische, neuroradiologische, labormedizinische und neuropsychologische Befunde integriert. In unserer Übersicht referieren wir Ergebnisse von Metaanalysen, ausgewählte neuere Untersuchungsbefunde und eigene klinischen Erfahrungen im Hinblick auf die Frage, welche kognitiven Funktionen in der neuropsychologischen Diagnostik berücksichtigt werden sollten, um die Validität differentialdiagnostischer Entscheidungen zu verbessern.
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Affiliation(s)
- Tina Theml
- Klinikum rechts der Isar der TU München, München
| | | | - Thomas Jahn
- Klinikum rechts der Isar der TU München, München
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Xavier FMF, Ferraz MPT, Bertollucci P, Poyares D, Moriguchi EH. Episódio depressivo maior, prevalência e impacto sobre qualidade de vida, sono e cognição em octogenários. BRAZILIAN JOURNAL OF PSYCHIATRY 2001. [DOI: 10.1590/s1516-44462001000200004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVOS: Determinar a prevalência de depressão maior em uma população de sujeitos acima de 80 anos residentes na comunidade, comparar os padrões de sono e a função cognitiva entre controles normais e sujeitos com depressão maior e estimar a freqüência de outros transtornos psiquiátricos entre controles e sujeitos deprimidos. MÉTODOS: De uma população de 219 habitantes com mais de 80 anos, residentes em um município semi-rural no sul do Brasil (município de Veranópolis, RS), selecionou-se uma amostra randômica e representativa de 77 sujeitos (35%). Desse grupo, 5 sujeitos que apresentavam critérios de DSM-IV para depressão maior foram comparados com 50 controles sem diagnóstico de demência, delirium ou qualquer transtorno do humor. Os padrões de sono foram avaliados pelo Índice de Pittsburgh de Qualidade do Sono e por um diário do ciclo sono/vigília completado ao longo de duas semanas. Para a avaliação cognitiva, foram usados 5 testes neuropsicológicos: teste de lembranças seletivas de Buschke-Fuld; teste lista de palavras da bateria do CERAD; teste de fluência verbal; e 2 subtestes da bateria de memória de Wechsler. RESULTADOS: A prevalência de depressão maior foi de 7,5%. Sujeitos com esse diagnóstico, quando comparados a sujeitos do grupo-controle, apresentavam mais freqüentemente comorbidade com transtorno de ansiedade generalizada, usavam mais benzodiazepínicos e tinham uma pior qualidade de vida pela escala "Short-form 36". Os idosos deprimidos, quando comparados aos controles, tinham os mesmos padrões de sono e apresentavam o mesmo desempenho nos testes neuropsicológicos. CONCLUSÃO: Os resultados corroboram o conceito de que episódios depressivos são freqüentes entre idosos com mais de 80 anos, causando impacto sobre a qualidade de vida associada à saúde e cursando comorbidade freqüente com transtorno de ansiedade generalizada. Entre os idosos octogenários residentes na comunidade, a depressão maior não aparecia clinicamente sob a forma de "pseudodemência" depressiva e nem tinha impacto sobre os padrões de sono.
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Affiliation(s)
- Flávio MF Xavier
- Pontifícia Universidade Católica do Rio Grande do Sul; Organização Mundial da Saúde, Brasil; Universidade Federal de São Paulo, Brasil
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Pouget R, Yersin B, Wietlisbach V, Bumand B, Büla CJ. Depressed mood in a cohort of elderly medical inpatients: prevalence, clinical correlates and recognition rate. AGING (MILAN, ITALY) 2000; 12:301-7. [PMID: 11073350 DOI: 10.1007/bf03339851] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The objectives of this prospective cohort study were to 1) determine the prevalence of depressed mood, 2) identify the characteristics associated with it, and 3) evaluate the recognition rate of depressed mood by clinicians. The study population was a cohort of 401 elderly patients, aged 75 years and older, admitted to the internal medicine service of a tertiary care academic medical center in Western Switzerland over six months. We excluded patients with severe cognitive impairment, terminal disease or those living in a nursing home. Data on demographics, medical, physical, social and mental status were collected upon admission. Presence of depressed mood was defined as a score > or = 6 on the Geriatric Depression Scale (GDS), short form (15-item). An independent reviewer performed a discharge summary abstraction to assess recognition rate. Subjects' mean age was 82.4 years, 60.9% were women. Overall, 90 patients (22.40%) had an abnormal GDS score (> or =6). Compared to those without a depressed mood, these subjects were (all p<0.05) older (83.5 vs 82.0 years), more frequently living alone (66.7 vs 55.0%), dependent in both basic activities of daily living (BADL) and instrumental ADL (48.9 vs 36.0%, and 91.1 vs 84.9%, respectively), and cognitively impaired (47.8 vs 27.7% with MMSE score<24). In addition, they had more comorbidities (Charlson index 1.6 vs 1.2). In multivariate analysis, an independent association remains for subjects living alone (OR 1.8, 95%CI 1.1-3.0), with cognitive impairment (OR 1.9, 95%CI 1.1-3.2), and comorbidities (OR 1.3 per point, 95%CI 1.1-1.5). Detection rate during the index hospitalization was only 16.7% (15/90). In conclusion, depressed mood was frequent but rarely detected in this population. These findings emphasize the need to improve screening efforts, and to develop additional strategies such as using a pre-screening question to enhance clinical recognition.
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Affiliation(s)
- R Pouget
- Division of Geriatric Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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15
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Veiel HO. A preliminary profile of neuropsychological deficits associated with major depression. J Clin Exp Neuropsychol 1997; 19:587-603. [PMID: 9342691 DOI: 10.1080/01688639708403745] [Citation(s) in RCA: 351] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A profile of neuropsychological deficits of clinically depressed (major depression) but otherwise unimpaired individuals is presented, based on a meta-analysis of all studies published since 1975 and meeting stringent methodological and sample selection criteria. Deficits are discussed separately for different cognitive areas in terms of mean size of deficit, variability between studies, variability of individual scores in depressed populations relative to that of controls, and expected proportion of depressed individuals scoring two standard deviations or more below the mean of controls. The neuropsychological deficits of individuals with major depression are shown to be consistent with a global-diffuse impairment of brain functions with particular involvement of the frontal lobes. Recent neuro-imaging studies also indicating frontal dysfunction in clinical (functional) depression are referred to. Both the severity and the profile of cognitive deficiencies in depression are postulated to be similar to those seen in moderately severe traumatic brain injury.
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Affiliation(s)
- H O Veiel
- Psychological Consultants Inc., Vancouver, B.C., Canada
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desRosiers G, Hodges JR, Berrios G. The neuropsychological differentiation of patients with very mild Alzheimer's disease and/or major depression. J Am Geriatr Soc 1995; 43:1256-63. [PMID: 7594160 DOI: 10.1111/j.1532-5415.1995.tb07402.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To evaluate the usefulness of standardized neuropsychological tests in the psychometric differentiation of patients with very mild or mild Alzheimer's Disease (AD) and/or major depression presenting in a tertiary clinic with memory/attention complaints. DESIGN Controlled prospective clinicoexperimental design. SETTING Multidisciplinary Memory Clinic at Addenbroke's Hospital, Cambridge, England. PARTICIPANTS Twenty-four patients with a clinical diagnosis of Alzheimer's disease (12 with major depression and 12 without), 12 patients with major depressive illness but without AD, and 12 healthy control subjects, all matched for age, sex, education levels, and estimates of premorbid intellectual potential. MEASUREMENTS Mini-Mental State Examination (MMSE), Wechsler's Logical Memory (WLM) and Visual Reproduction (WVR), immediate and delayed reproduction, Wechsler's paired Associate Learning (WPAL), including the Easy and Hard subsets. Warrington's Recognition Memory for Faces (WRMF), Kendrick's Object Learning (KOLT) and Digit Copying (KDCT) Tests. OUTCOME MEASURES Minimum 2-year follow-up diagnosis. RESULTS Statistically, patients with very mild AD were distinguished clearly from those without AD on most tests of memory functions. Psychometrically, only KOLT and an index of retention on WLM and WVR were specific enough to avoid false positives, a requirement for second-stage tools. They also proved sensitive enough to suggest their role as first-stage instruments when screening for primary dementia in high-functioning patients scoring above the cut-point on MMSE. CONCLUSIONS As efforts intensify to develop more powerful means to identify patients with Alzheimer's disease in its earliest stages, inclusion of specialist tests posing greater cognitive challenge than standard mental status scales has been one strategy. Our study explored how some of these neuropsychological tools behave psychometrically when analyzed on a single-case basis, and the results suggest a few are sensitive enough to boost detection above base rates alone while also being specific enough to reduce false alarms. Retention on Wechsler's Logical Memory and Visual Reproduction tasks and scores on Kendrick's Object Learning Test helped decrease the degree of ambiguity when cognitive profiles were used to distinguish depressed patients with Alzheimer disease from those without.
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Affiliation(s)
- G desRosiers
- Addenbrooke's Hospital, University of Cambridge Clinical Schools, UK
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Lamberty GJ, Kennedy CM, Flashman LA. Clinical utility of the CERAD word list memory test. ACTA ACUST UNITED AC 1995. [DOI: 10.1207/s15324826an0203&4_12] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Bieliauskas LA, Lamberty GJ. Simple reaction time and depression in the elderly. AGING, NEUROPSYCHOLOGY, AND COGNITION 1995. [DOI: 10.1080/13825589508256592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
The effects of age and depression on cognitive function were investigated in two groups of in-patient major depressives aged under and over 60 years who were tested when depressed and after recovery. The majority of the tests showed impaired performance during depression with improvement after recovery, and also differences between the two age-groups in both the depressed and recovered phases. However, the older subjects were not more severely affected by depression than the younger subjects. The pattern of impairment associated with depression was different to that associated with older age: depression affected performance on more 'complex tasks', whereas age was associated particularly with slowing on timed tests. This study did not suggest that the impairment from baseline due to the depression is greater in the elderly than in younger subjects.
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Affiliation(s)
- A F Tarbuck
- Department of Old Age Psychiatry, Fulbourn Hospital, Cambridge
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Ramchandani D, Schindler B, Matthews M, Podell K. Many faces of dementia on a neurology inpatient unit. PSYCHOSOMATICS 1994; 35:395-9. [PMID: 8084990 DOI: 10.1016/s0033-3182(94)71761-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- D Ramchandani
- Department of Psychiatry, Medical College of Pennsylvania, Philadelphia 19129
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Abstract
The clinical term "pseudodementia" has remained a permanent nosological entity in the literature for over 100 years. Indeed, recognition of the fact that clinical symptoms associated with reversible neuropsychiatric conditions can mimic irreversible disorders was known as early as the middle of the 19th century. The importance of the term lies in the inherent assumption that the presenting dementia is not real, or is at least reversible, and therefore treatable. Nonetheless, there continues to be controversy regarding the validity and appropriate clinical use of the term. This article reviews the evolution and clinical utility of the term pseudodementia and attempts to redirect investigative efforts toward an understanding of the neuroanatomical substrates that underlie depression and cognitive impairment in the elderly. Based on a critical analysis of the relevant literatures, a subcortical-frontal neuroanatomical substrate of late-life depression is supported. Further, the presence of leukoaraiosis, as measured by magnetic resonance imaging, is proposed as a potential neurobiological marker that contributes to the depressed mood, cognitive impairment, and later cognitive deterioration of some elderly depressed.
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Affiliation(s)
- P D Nussbaum
- Allegheny Neuropsychiatric Institute, Medical College of Pennsylvania, Oakdale 15071
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