1
|
Esteves CS, Lima MP, Gonzatti V, de Oliveira CR, de Lima Argimon II, Irigaray TQ. Depressive Symptoms and Cognitive Functioning of Elderly from the Family Health Strategy. AGEING INTERNATIONAL 2019. [DOI: 10.1007/s12126-017-9313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
2
|
Eraydin IE, Mueller C, Corbett A, Ballard C, Brooker H, Wesnes K, Aarsland D, Huntley J. Investigating the relationship between age of onset of depressive disorder and cognitive function. Int J Geriatr Psychiatry 2019; 34:38-46. [PMID: 30259558 DOI: 10.1002/gps.4979] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 08/06/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Depressive disorder is commonly associated with impaired cognitive function; however, it is unclear whether the age of onset of the first episode of depression, current depression severity, or historical severity of depressive episodes are associated with cognitive performance. METHODS This study examined baseline cross-sectional data from the ongoing online PROTECT study. A total of 7344 participants, 50 years or older, with a history of depression and no diagnosis of dementia were divided into three groups according to age of onset of their first depressive episode: early-onset, midlife-onset, and late-onset. Performance on measures of visuospatial episodic memory, executive function, verbal working, and visual working memory were evaluated. Demographic and clinical characteristics such as age, education, and severity of symptoms during their worst previous depressive episode and current depression severity were included in multivariate regression models. RESULTS The late-onset depression group scored significantly lower on the verbal reasoning task than the early-onset group while there were no significant differences found on the other tasks. Midlife-onset depression participants performed better in the visual episodic memory task, but worse on the verbal reasoning task, than early-onset depression participants. Current depression severity was negatively correlated with all four cognitive domains, while historical severity score was found to be significantly associated with cognitive performance on the verbal reasoning and spatial working memory tasks. CONCLUSIONS The most important indicator of cognitive performance in depression appears to be current, rather than historic depression severity; however, late-onset depression may be associated with more executive impairment than an early-onset depression.
Collapse
Affiliation(s)
- Irem Ece Eraydin
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christoph Mueller
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | | | | | | | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | |
Collapse
|
3
|
Liao W, Zhang X, Shu H, Wang Z, Liu D, Zhang Z. The characteristic of cognitive dysfunction in remitted late life depression and amnestic mild cognitive impairment. Psychiatry Res 2017; 251:168-175. [PMID: 28208078 DOI: 10.1016/j.psychres.2017.01.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 12/05/2016] [Accepted: 01/09/2017] [Indexed: 11/30/2022]
Abstract
Remitted late life depression exhibits persistent cognitive impairments and enhances the risk of dementia. This study aimed to examine the characteristics of cognitive dysfunction in remitted late life depression and amnestic mild cognitive impairment (MCI). Remitted late life depression (n=61), amnestic MCI (n=61) and age-education-matched controls (n=65) were evaluated with a battery of neuropsychological tests grouped into executive function, memory, processing speed, attention and visuospatial domains. Compared with control subjects, amnestic MCI individuals showed more severe cognitive impairments in all domains, while remitted late life depression individuals performed worse in executive function and memory. The pattern of cognitive profiles significantly differed between remitted late life depression and amnestic MCI groups, which might be mainly attributed to worse impairments in memory and executive function in amnestic MCI individuals. Executive function was the core impaired cognitive domain mediating the influence of predictors on other cognitions in both remitted late life depression and amnestic MCI groups, which indicated a possible etiopathogenic mechanism underlying the conversion to dementia.
Collapse
Affiliation(s)
- Wenxiang Liao
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu 210009, China
| | - Xiangrong Zhang
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu 210009, China; Department of Geriatric Psychiatry Affiliated Nanjing Brain Hospital Nanjing Medical University, Nanjing, Jiangsu 210029, China.
| | - Hao Shu
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu 210009, China
| | - Zan Wang
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu 210009, China
| | - Duan Liu
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu 210009, China
| | - ZhiJun Zhang
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu 210009, China.
| |
Collapse
|
4
|
Nilsson J, Thomas AJ, Stevens LH, McAllister-Williams RH, Ferrier IN, Gallagher P. The interrelationship between attentional and executive deficits in major depressive disorder. Acta Psychiatr Scand 2016; 134:73-82. [PMID: 27037665 DOI: 10.1111/acps.12570] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Cognitive dysfunction is an established feature of major depressive disorder (MDD). However, it remains unclear whether deficits in different cognitive domains are relatively independent or originate from a circumscribed 'primary deficit'. This study tested the hypothesis that a deficit in attention represents a primary deficit in depression. METHOD Neuropsychological function was assessed in 30 depressed patients with MDD and 34 control participants. Cognitive composites were derived from a minimum of three tests and included attention, executive function, visuospatial memory and verbal memory. A multivariate analysis of variance was used to assess group differences in overall cognitive performance, and multiple regression models were used to evaluate the role of attention in deficits in other domains. RESULTS The cognitive deficit in the depressed sample was found to be characterized by poorer performance in attention and executive function. When evaluating the interrelationship between the two deficits, the attentional deficit was found to persist when variability in executive function was statistically accounted for, whilst the executive deficit was eliminated when attention was accounted for. CONCLUSION The results demonstrated that the attentional deficit could not be explained by deficits in executive function, which provides support for a primary attention deficit in depression.
Collapse
Affiliation(s)
- J Nilsson
- Aging Research Center, Karolinska Institutet, Stockholm, Sweden.,Stockholm University, Stockholm, Sweden.,Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle, upon Tyne, UK
| | - A J Thomas
- Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle, upon Tyne, UK
| | - L H Stevens
- Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle, upon Tyne, UK.,Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - R H McAllister-Williams
- Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle, upon Tyne, UK
| | - I N Ferrier
- Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle, upon Tyne, UK
| | - P Gallagher
- Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle, upon Tyne, UK
| |
Collapse
|
5
|
Taylor WD, Aizenstein HJ, Alexopoulos GS. The vascular depression hypothesis: mechanisms linking vascular disease with depression. Mol Psychiatry 2013; 18:963-74. [PMID: 23439482 PMCID: PMC3674224 DOI: 10.1038/mp.2013.20] [Citation(s) in RCA: 544] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 01/09/2013] [Accepted: 01/18/2013] [Indexed: 02/07/2023]
Abstract
The 'Vascular Depression' hypothesis posits that cerebrovascular disease may predispose, precipitate or perpetuate some geriatric depressive syndromes. This hypothesis stimulated much research that has improved our understanding of the complex relationships between late-life depression (LLD), vascular risk factors, and cognition. Succinctly, there are well-established relationships between LLD, vascular risk factors and cerebral hyperintensities, the radiological hallmark of vascular depression. Cognitive dysfunction is common in LLD, particularly executive dysfunction, a finding predictive of poor antidepressant response. Over time, progression of hyperintensities and cognitive deficits predicts a poor course of depression and may reflect underlying worsening of vascular disease. This work laid the foundation for examining the mechanisms by which vascular disease influences brain circuits and influences the development and course of depression. We review data testing the vascular depression hypothesis with a focus on identifying potential underlying vascular mechanisms. We propose a disconnection hypothesis, wherein focal vascular damage and white matter lesion location is a crucial factor, influencing neural connectivity that contributes to clinical symptomatology. We also propose inflammatory and hypoperfusion hypotheses, concepts that link underlying vascular processes with adverse effects on brain function that influence the development of depression. Testing such hypotheses will not only inform the relationship between vascular disease and depression, but also provide guidance on the potential repurposing of pharmacological agents that may improve LLD outcomes.
Collapse
Affiliation(s)
- W D Taylor
- Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University, Nashville, TN 37212, USA.
| | | | | |
Collapse
|
6
|
De Nardi T, Sanvicente-Vieira B, Grassi-Oliveira R. Déficits na memória de trabalho em idosos com depressão maior: uma revisão sistemática. PSICOLOGIA: TEORIA E PESQUISA 2013. [DOI: 10.1590/s0102-37722013000200011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A depressão em idosos é associada com prejuízos cognitivos, entretanto a extensão destes à Memória de Trabalho (MT) ainda não é consensual. Portanto, o objetivo deste estudo é revisar sistematicamente as associações encontradas entre MT e depressão em idosos. Para tanto conduzimos uma revisão sistemática dos artigos publicados entre 2000 e 2011 nas principais bases de dados internacionais. Posteriormente a aplicação dos critérios de exclusão, 17 artigos foram revisados integralmente. Os resultados apresentam evidências da associação entre depressão geriátrica e prejuízos da MT, que em alguns trabalhos ainda foram mantidos mesmo após a remissão da sintomatologia de humor.
Collapse
|
7
|
Wu D, Yuan Y, Bai F, You J, Li L, Zhang Z. Abnormal functional connectivity of the default mode network in remitted late-onset depression. J Affect Disord 2013; 147:277-87. [PMID: 23270974 DOI: 10.1016/j.jad.2012.11.019] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 11/06/2012] [Accepted: 11/06/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND The functional neural network model has been a major method used to investigate mechanisms of neuropsychopathy. There is considerable evidence that late-onset depression (LOD) is the prodrome, or the early clinical manifestation, of Alzheimer's disease (AD). The default mode network (DMN) is one of the neural networks that can be used to explore the complex relationships between depressive symptoms, episodic memory deficits and other cognitive impairments. To date, no study has directly linked the DMN to LOD while focusing on episodic memory and the influence of apolipoprotein E4 (APOE4), a major genetic risk factor for AD in LOD patients. METHODS In total, 33 remitted LOD (rLOD) patients and 33 elderly controls underwent fMRI scanning using low-frequency BOLD signal imaging during the resting state and during an episodic memory task. Furthermore, function-based functional connectivities (FCs) in the region of interesting (ROI) (posterior cingulate cortex (PCC) of the DMN) were analysed to explore interactions between disease states, task states and genetic risk factors (APOE4). RESULTS Compared to healthy control subjects (HC), the FCs between the PCC and the right medial temporal lobe of the rLOD patients were significantly stronger during rest (p<0.005) and significantly weaker (p<0.05) during performance of the task. The mode of change from rest to task performance in the HC was in contrast to the mode of change in the rLOD patients. The FCs of the rLOD patients without APOE4 were significantly increased (p<0.05) in the resting state, but the rLOD patients who carried APOE4 showed a trend toward decreased FCs. LIMITATIONS The sample size was small. While the study was cross-sectional, we did not differentiate between the various types of antidepressants the patients used, which may have had different effects on cognitive function, especially on episodic memory. CONCLUSION Our results suggested that rLOD might be the prodrome, or the early clinical manifestation, of AD and that rLOD patients with APOE4 showed an increased risk for episodic memory decline and AD.
Collapse
Affiliation(s)
- Di Wu
- The Department of Neurology, Affiliated ZhongDa Hospital and Institute of Neuropsychiatry of Southeast University, Nanjing 210009, China
| | | | | | | | | | | |
Collapse
|
8
|
Snyder HR. Major depressive disorder is associated with broad impairments on neuropsychological measures of executive function: a meta-analysis and review. Psychol Bull 2013; 139:81-132. [PMID: 22642228 PMCID: PMC3436964 DOI: 10.1037/a0028727] [Citation(s) in RCA: 1002] [Impact Index Per Article: 91.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cognitive impairments are now widely acknowledged as an important aspect of major depressive disorder (MDD), and it has been proposed that executive function (EF) may be particularly impaired in patients with MDD. However, the existence and nature of EF impairments associated with depression remain strongly debated. Although many studies have found significant deficits associated with MDD on neuropsychological measures of EF, others have not, potentially due to low statistical power, task impurity, and diverse patient samples, and there have been no recent, comprehensive, meta-analyses investigating EF in patients with MDD. The current meta-analysis uses random-effects models to synthesize 113 previous research studies that compared participants with MDD to healthy control participants on at least one neuropsychological measure of EF. Results of the meta-analysis demonstrate that MDD is reliably associated with impaired performance on neuropsychological measures of EF, with effect sizes ranging from 0.32 to 0.97. Although patients with MDD also have slower processing speed, motor slowing alone cannot account for these results. In addition, some evidence suggests that deficits on neuropsychological measures of EF are greater in patients with more severe current depression symptoms, and those taking psychotropic medications, whereas evidence for effects of age was weaker. The results are consistent with the theory that MDD is associated with broad impairment in multiple aspects of EF. Implications for treatment of MDD and theories of EF are discussed. Future research is needed to establish the specificity and causal link between MDD and EF impairments.
Collapse
Affiliation(s)
- Hannah R Snyder
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO 80309, USA.
| |
Collapse
|
9
|
Abstract
Late life depression (LLD) is an important area of research given the growing elderly population. The purpose of this review is to examine the available evidence for the biological basis of LLD. Structural neuroimaging shows specific gray matter structural changes in LLD as well as ischemic lesion burden via white matter hyperintensities. Similarly, specific neuropsychological deficits have been found in LLD. An inflammatory response is another possible underlying contributor to the pathophysiology of LLD. We review the available literature examining these multiple facets of LLD and how each may affect clinical outcome in the depressed elderly.
Collapse
Affiliation(s)
- Brianne M Disabato
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | | |
Collapse
|
10
|
Relationship between cognition, magnetic resonance white matter hyperintensities, and cardiovascular autonomic changes in late-life depression. Am J Geriatr Psychiatry 2012; 20:691-9. [PMID: 22609766 DOI: 10.1097/jgp.0b013e31824c0435] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To explore the relationship between specific aspects of cognition, white matter hyperintensities (WMHs), and cardiovascular autonomic parameters in late-life depression (LLD). DESIGN Cross-sectional analysis. SETTING Secondary care psychiatry. PARTICIPANTS Forty-one individuals older than 60 years, with current or previous history of major depression, and 32 age-matched comparison subjects. MEASUREMENTS Cognition was assessed by a standardized computer battery of tasks (Cognitive Drug Research) that measured processing speed, attention, episodic memory, and working memory. Cardiovascular autonomic parameters were estimated by a noninvasive device that calculated blood pressure, heart rate variability, and baroreflex sensitivity (Task Force Monitor). Magnetic resonance imaging was performed on a 3-T magnetic resonance imaging system, and WMH volume was estimated using an automated validated method. RESULTS As expected, cognitive deficits in all tested domains were present in LLD subjects compared with comparison subjects. In the LLD group, processing speed was correlated with scores on memory and working memory tasks. Attentional deficits were correlated with total and periventricular WMH volume, and episodic memory was associated with heart rate variability. There were no associations between cognitive variables and traditional vascular risk factors or between cognitive variables and any of these parameters in the comparison subjects. CONCLUSIONS This study suggests that processing speed may be an important factor underlying deficits in LLD, but it also indicates that other factors, including those related to vascular disease, are important and thus provide further support for the vascular depression hypothesis.
Collapse
|
11
|
Naismith SL, Norrie LM, Mowszowski L, Hickie IB. The neurobiology of depression in later-life: Clinical, neuropsychological, neuroimaging and pathophysiological features. Prog Neurobiol 2012; 98:99-143. [DOI: 10.1016/j.pneurobio.2012.05.009] [Citation(s) in RCA: 169] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 05/03/2012] [Accepted: 05/09/2012] [Indexed: 02/07/2023]
|
12
|
Novaretti TMDS, Radanovic M, Nitrini R. Screening for cognitive impairment in late onset depression in a Brazilian sample using the BBRC-Edu. Dement Neuropsychol 2012; 6:85-90. [PMID: 29213779 PMCID: PMC5619246 DOI: 10.1590/s1980-57642012dn06020004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Depression and dementia are the most prevalent neuropsychiatric disorders in the elderly population. Alzheimer's disease is the leading cause of dementia in most countries, being responsible for more than half of all dementia cases. Late-onset depression is a frequent cause of cognitive decline in the elderly. Differentiating between cognitive impairment secondary to depression and incipient dementia poses a challenge in the clinical setting. Objective To evaluate the performance of elderly depressed patients using the BBRC-Edu. Methods We studied 25 patients with late onset depression (mean age: 73.6 y (6.6); schooling: 9.1 y (5.7)) and 30 patients with mild AD (mean age 76.6 y (5.4); schooling: 7.5 y (7.1)), who were compared to a control group of 30 healthy elderly (mean age 73.8 y (5.8); schooling: 9.1 y (5.4)) using the CERAD and BBRC-Edu batteries. Results For the CERAD battery, depressed patients performed better than AD patients on all tasks (p<0.0001) except for Constructional Praxis (p>0.05), and performed poorer than controls on verbal fluency (animals) and Word List Recall tasks (p<0.0001). For the BBRC-Edu, depressed patients performed better than AD patients on all tasks (p<0.0001) except for Digit Span (direct order) (p=0.076) and Incidental Memory (p>0.05), and performed worse than controls on Learning (second presentation) and verbal fluency (fruits) tasks (p<0.0001). Conclusion Overall performance on the BBRC-Edu allowed differentiation of controls and depressed patients from AD patients.
Collapse
Affiliation(s)
- Tânia Maria da Silva Novaretti
- State University Paulista Julio de Mesquita Filho, Faculty of Sciences, Marília Campus, Department of Speech, Marília SP, Brazil
| | - Marcia Radanovic
- Behavioral and Cognitive Neurology Unit, Department of Neurology, University Department of Neurology, University of São Paulo School of Medicine, São Paulo SP, Brazil
| | - Ricardo Nitrini
- Behavioral and Cognitive Neurology Unit, Department of Neurology, and Cognitive Disorders Reference Center (CEREDIC), Hospital das Clínicas of the University of São Paulo School of Medicine, São Paulo SP, Brazil
| |
Collapse
|
13
|
da Silva Novaretti TM, D'Ávila Freitas MI, Mansur LL, Nitrini R, Radanovic M. Comparison of language impairment in late-onset depression and Alzheimer's disease. Acta Neuropsychiatr 2011; 23:62-8. [PMID: 26952860 DOI: 10.1111/j.1601-5215.2011.00526.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Depression and dementia are highly prevalent in the elderly. Language impairment is an inherent component of Alzheimer's disease (AD), which can also be encountered in depressed patients. The aim of this study wasto compare the profiles of language abilities in late-onset depression and mild AD groups. METHODS We studied 25 patients with late-onset depression (mean age 73.6 ± 6.6 years; schooling 9.1 ± 5.7 years) and 30 patients with mild AD (77.6 ± 5.4 years; 7.5 ± 7.1 years) using the Arizona Battery for Communication Disorders of Dementia (ABCD), compared to a group of 30 controls (73.8 ± 5.8 years; 9.1 ± 5.4 years). Cut-off scores to discriminate between Controls × Depression and Depression × AD were determined. RESULTS Depressed patients' scores were similar to AD in confrontation naming, concept definition, following commands, repetition and reading comprehension (sentence). Episodic memory and mental status subtests were useful in differentiating depressed patients from AD, a result that was reproduced when using analysis of covariance to control for the effect of age in the same subtests (p = 0.01 and 0.04, respectively). CONCLUSION Language impairment resembling AD was found in the aforementioned language subtests of the ABCD in elderly depressed patients; the mental status and episodic memory subtests were useful to discriminate between AD and depression. The ABCD has proven to be a suitable tool for language evaluation in this population and should aid in the differentiation of AD and pseudodementia (as that of depression).
Collapse
Affiliation(s)
- Tânia M da Silva Novaretti
- Behavioral and Cognitive Neurology Unit, Department of Neurology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Maria I D'Ávila Freitas
- Behavioral and Cognitive Neurology Unit, Department of Neurology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Letícia L Mansur
- Behavioral and Cognitive Neurology Unit, Department of Neurology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Ricardo Nitrini
- Behavioral and Cognitive Neurology Unit, Department of Neurology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Marcia Radanovic
- Behavioral and Cognitive Neurology Unit, Department of Neurology, University of São Paulo School of Medicine, São Paulo, Brazil
| |
Collapse
|
14
|
|
15
|
Gonzalez MT, Hartig T, Patil GG, Martinsen EW, Kirkevold M. Therapeutic horticulture in clinical depression: a prospective study of active components. J Adv Nurs 2010; 66:2002-13. [PMID: 20626473 DOI: 10.1111/j.1365-2648.2010.05383.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM This paper is a report of a study conducted to assess change in depression severity, perceived attentional capacity and rumination (brooding) in individuals with clinical depression during a therapeutic horticulture programme and to investigate if the changes were mediated by experiences of being away and fascination. BACKGROUND Individuals with clinical depression suffer from distortion of attention and rumination. Interventions can help to disrupt maladaptive rumination and promote restoration of depleted attentional capacity. METHOD A single-group study was conducted with a convenience sample of 28 people with clinical depression in 2009. Data were collected before, twice during, and immediately after a 12-week therapeutic horticulture programme, and at 3-month follow-up. Assessment instruments were the Beck Depression Inventory, Attentional Function Index, Brooding Scale, and Being Away and Fascination subscales from the Perceived Restorativeness Scale. FINDINGS Mean Beck Depression Inventory scores declined by 4.5 points during the intervention (F = 5.49, P = 0.002). The decline was clinically relevant for 50% of participants. Attentional Function Index scores increased (F = 4.14, P = 0.009), while Brooding scores decreased (F = 4.51, P = 0.015). The changes in Beck Depression Inventory and Attentional Function Index scores were mediated by increases in Being Away and Fascination, and decline in Beck Depression Inventory scores was also mediated by decline in Brooding. Participants maintained their improvements in Beck Depression Inventory scores at 3-month follow-up. CONCLUSION Being away and fascination appear to work as active components in a therapeutic horticulture intervention for clinical depression.
Collapse
|
16
|
Delaloye C, Moy G, Baudois S, de Bilbao F, Remund CD, Hofer F, Ragno Paquier C, Campos L, Weber K, Gold G, Moussa A, Meiler CC, Giannakopoulos P. Cognitive features in euthymic bipolar patients in old age. Bipolar Disord 2009; 11:735-43. [PMID: 19719786 DOI: 10.1111/j.1399-5618.2009.00741.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Studies of cognition in bipolar disorder (BD) have reported impairments in processing speed, working memory, episodic memory, and executive function, but they have primarily focused on young and middle-aged adults. In such studies, the severity of cognitive deficits increases with the duration of illness. Therefore, one would expect more pronounced deficits in patients with longstanding BD. The first aim of the present study was to determine the pattern and the magnitude of cognitive impairment in older euthymic BD patients. The second aim was to explore the interrelationship between these cognitive deficits and determine whether they reflect a single core impairment or the co-occurrence of independent cognitive deficits. METHODS Twenty-two euthymic elderly BD patients and 22 controls, matched for gender, age, and education, underwent a comprehensive neuropsychological assessment. RESULTS Compared to controls, BD patients had significantly reduced performance in processing speed, working memory, verbal fluency, and episodic memory, but not in executive function. Hierarchical regression analyses showed that verbal fluency and working memory impairments were fully mediated by changes in processing speed. This was not the case for the episodic memory dysfunction. CONCLUSION The cognitive profile in older euthymic BD cases is similar to the one described in younger BD cohorts. Our results further suggest that impaired processing speed plays a major role in the cognitive changes observed in BD patients except for deficits in episodic memory, thus providing strong evidence that processing speed and episodic memory are two core deficits in elderly BD patients.
Collapse
Affiliation(s)
- Christophe Delaloye
- Division of Geriatric Psychiatry, University Hospitals of Geneva, Chêne-Bourg, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|