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Ronat L, Hanganu A. Neuropsychiatric and cognitive features of major depressive disorder in aging, based on the data from the US National Alzheimer's Coordinating Center (NACC). L'ENCEPHALE 2024; 50:130-136. [PMID: 37088582 DOI: 10.1016/j.encep.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 01/03/2023] [Accepted: 01/12/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVE The diagnosis of Major Depressive Disorder (MDD) is based on the DSM-V criteria and is established by a clinician. This allows quantifying depression based on clinical criteria. As such, MDD differs from other types of depressions that are measured by subjective scales. Here, we evaluated the MDD risk factor on other neuropsychiatric symptoms (NPS) as well as MDD association with cognitive performance in Alzheimer's disease (AD), Mild Cognitive Impairment (MCI) and Healthy Controls (HC). METHODS Data of 208 patients with AD, 291 patients with MCI and 647 HC were extracted from the National Alzheimer's Coordinating Center database. All participants included in this study were assessed by a physician for the MDD criteria, underwent an NPS evaluation using the NeuroPsychiatric Inventory, and a comprehensive cognitive assessment. Participants were classified as being with and without MDD. We performed logistic regression and MANCOVA models respectively with NPS and cognitive performance as variables of interest and MDD as fixed factors within each group. The MANCOVA was controlled for the effects of age, sex, and education. RESULTS MDD increased the risk for psychotic, affective and behavioral NPS in MCI, as well as affective and behavioral NPS in HC and AD. Also, MCI with MDD had lower performance on selective attention and mental flexibility. CONCLUSIONS MDD seems to increase the probability of a prevalence of NPS in all groups (HC, MCI and AD). Longitudinal data processing would help to understand the neuropsychiatric evolution of elderly subjects with MDD.
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Affiliation(s)
- L Ronat
- Centre de recherche de l'institut universitaire de gériatrie de Montréal, M7819, 4545 ch. Queen-Mary, H3W 1W6, Montréal, QC, Canada; Faculté de médecine, département de médecine, université de Montréal, Québec, Canada
| | - A Hanganu
- Centre de recherche de l'institut universitaire de gériatrie de Montréal, M7819, 4545 ch. Queen-Mary, H3W 1W6, Montréal, QC, Canada; Faculté des arts et des sciences, département de psychologie, université de Montréal, Québec, Canada.
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Sarant JZ, Busby PA, Schembri AJ, Fowler C, Harris DC. ENHANCE: a comparative prospective longitudinal study of cognitive outcomes after 3 years of hearing aid use in older adults. Front Aging Neurosci 2024; 15:1302185. [PMID: 38356856 PMCID: PMC10864469 DOI: 10.3389/fnagi.2023.1302185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/12/2023] [Indexed: 02/16/2024] Open
Abstract
Background With an aging population, the prevalence of hearing loss and dementia are increasing rapidly. Hearing loss is currently considered the largest potentially modifiable risk factor for dementia. The effect of hearing interventions on cognitive function should therefore be investigated, as if effective, these may be successfully implemented to modify cognitive outcomes for older adults with hearing loss. Methods This prospective longitudinal observational cohort study compared outcomes of a convenience sample of prospectively recruited first-time hearing aid users without dementia from an audiology center with those of community-living older adults participating in a large prospective longitudinal cohort study with/without hearing loss and/or hearing aids. All participants were assessed at baseline, 18 months, and 36 months using the same measures. Results Participants were 160 audiology clinic patients (48.8% female patient; mean age 73.5 years) with mild-severe hearing loss, fitted with hearing aids at baseline, and 102 participants of the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Aging (AIBL) (55.9% female patient; mean age 74.5 years). 18- and 36-month outcomes of subsets of the first participants to reach these points and complete the cognition assessment to date are compared. Primary comparative analysis showed cognitive stability for the hearing aid group while the AIBL group declined on working memory, visual attention, and psychomotor function. There was a non-significant trend for decline in visual learning for the AIBL group versus no decline for the hearing aid group. The hearing aid group showed significant decline on only 1 subtest and at a significantly slower rate than for the AIBL participants (p < 0.05). When education effects on cognitive trajectory were controlled, the HA group still performed significantly better on visual attention and psychomotor function (lower educated participants only) compared to the AIBL group but not on working memory or visual learning. Physical activity had no effect on cognitive performance trajectory. Conclusion Hearing aid users demonstrated significantly better cognitive performance to 3 years post-fitting, suggesting that hearing intervention may delay cognitive decline/dementia onset in older adults. Further studies using appropriate measures of cognition, hearing, and device use, with longer follow-up, are required.
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Affiliation(s)
- Julia Z. Sarant
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, VIC, Australia
| | - Peter A. Busby
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Christopher Fowler
- The Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
| | - David C. Harris
- Department of Economics, The University of Melbourne, Melbourne, VIC, Australia
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Fernández Fernández R, Martín JI, Antón MAM. Depression as a Risk Factor for Dementia: A Meta-Analysis. J Neuropsychiatry Clin Neurosci 2023; 36:101-109. [PMID: 38111332 DOI: 10.1176/appi.neuropsych.20230043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Dementia is a syndrome characterized by the deterioration of cognitive function beyond what is expected. The increased risk of developing this syndrome resulting from established modifiable risk factors, such as depressive episodes, is currently a subject of interest. The aim of this study was to review the scientific evidence that addresses the relationship between depression and dementia. A bibliographic search of the PubMed and PsycInfo databases for articles published over the past 20 years was conducted with the following medical subject heading terms: depression or depressive, dementia, and incidence or cohort studies. After articles meeting the inclusion criteria were selected, relevant moderating variables were grouped as sample characteristics, methodological characteristics, extrinsic characteristics, and outcome variables. The 26 selected studies resulted in a sample comprising 1,760,262 individuals. Statistical analysis revealed a pooled relative risk for the development of dementia of 1.82 (95% CI=1.62-2.06). The primary variables evaluated were the diagnostic methods for depression and dementia and the presence of depression. Other variables, such as mean age, methodological quality of each study, follow-up time, and publication year, were also evaluated. Age was statistically but not clinically significant. No relevant publication bias or alterations in the results were found when accounting for the quality of the studies. It is recommended that new moderating variables be evaluated or that existing variables be reformulated in future studies.
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Affiliation(s)
- Roberto Fernández Fernández
- Department of Psychiatry, Infanta Cristina University Hospital, Madrid (Fernández Fernández); Department of Methodology of Behavioral Sciences, National University of Distance Education (UNED), Madrid (all authors)
| | - Javier Ibias Martín
- Department of Psychiatry, Infanta Cristina University Hospital, Madrid (Fernández Fernández); Department of Methodology of Behavioral Sciences, National University of Distance Education (UNED), Madrid (all authors)
| | - María Araceli Maciá Antón
- Department of Psychiatry, Infanta Cristina University Hospital, Madrid (Fernández Fernández); Department of Methodology of Behavioral Sciences, National University of Distance Education (UNED), Madrid (all authors)
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Zhang R, Peng X, Song X, Long J, Wang C, Zhang C, Huang R, Lee TMC. The prevalence and risk of developing major depression among individuals with subthreshold depression in the general population. Psychol Med 2023; 53:3611-3620. [PMID: 35156595 PMCID: PMC10277767 DOI: 10.1017/s0033291722000241] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/10/2022] [Accepted: 01/17/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Subthreshold depression could be a significant precursor to and a risk factor for major depression. However, reliable estimates of the prevalence and its contribution to developing major depression under different terminologies depicting subthreshold depression have to be established. METHODS By searching PubMed and Web of Science using predefined inclusion criteria, we included 1 129 969 individuals from 113 studies conducted. The prevalence estimates were calculated using the random effect model. The incidence risk ratio (IRR) was estimated by measuring the ratio of individuals with subthreshold depression who developed major depression compared to that of non-depressed individuals from 19 studies (88, 882 individuals). RESULTS No significant difference in the prevalence among the different terminologies depicting subthreshold depression (Q = 1.96, p = 0.5801) was found. By pooling the prevalence estimates of subthreshold depression in 113 studies, we obtained a summary prevalence of 11.02% [95% confidence interval (CI) 9.78-12.33%]. The youth group had the highest prevalence (14.17%, 95% CI 8.82-20.55%), followed by the elderly group (12.95%, 95% CI 11.41-14.58%) and the adult group (8.92%, 95% CI 7.51-10.45%). Further analysis of 19 studies' incidence rates showed individuals with subthreshold depression had an increased risk of developing major depression (IRR = 2.95, 95% CI 2.33-3.73), and the term minor depression showed the highest IRR compared with other terms (IRR = 3.97, 95% CI 3.17-4.96). CONCLUSIONS Depression could be a spectrum disorder, with subthreshold depression being a significant precursor to and a risk factor for major depression. Proactive management of subthreshold depression could be effective for managing the increasing prevalence of major depression.
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Affiliation(s)
- Ruibin Zhang
- Laboratory of Cognitive Control and Brain Healthy, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | | | - Xiaoqi Song
- Laboratory of Cognitive Control and Brain Healthy, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jixin Long
- Laboratory of Cognitive Control and Brain Healthy, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Chanyu Wang
- Laboratory of Cognitive Control and Brain Healthy, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Chichen Zhang
- School of Management, Southern Medical University, Guangzhou, China
| | - Ruiwang Huang
- School of Psychology, South China Normal University, Guangzhou, China
| | - Tatia M. C. Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, SAR China
- Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, SAR China
- Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, China
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Jing Y, Wang W, Peng W, Wang M, Chen X, Liu X, Wang P, Yan F, Yang Y, Wang X, Sun S, Ruan Y, Wang Y. Social support and cognitive function in Chinese older adults who experienced depressive symptoms: is there an age difference? Front Aging Neurosci 2023; 15:1175252. [PMID: 37251805 PMCID: PMC10213363 DOI: 10.3389/fnagi.2023.1175252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/19/2023] [Indexed: 05/31/2023] Open
Abstract
Objective This study examined the moderating effect of overall social support and the different types of social support on cognitive functioning in depressed older adults. We also investigated whether the moderating effect varied according to age. Methods A total of 2,500 older adults (≥60 years old) from Shanghai, China were enrolled using a multistage cluster sampling method. Weighted linear regression and multiple linear regression was utilized to analyze the moderating effect of social support on the relationship between depressive symptoms and cognitive function and to explore its differences in those aged 60-69, 70-79, and 80 years and above. Results After adjusting for covariates, the results indicated that overall social support (β = 0.091, p = 0.043) and support utilization (β = 0.213, p < 0.001) moderated the relationship between depressive symptoms and cognitive function. Support utilization reduced the possibility of the cognitive decline in depressed older adults aged 60-69 years (β = 0.310, p < 0.001) and 80 years and above (β = 0.199, p < 0.001), while objective support increased the possibility of cognitive decline in depressed older people aged 70-79 years (β = -0.189, p < 0.001). Conclusion Our findings highlight the buffering effects of support utilization on cognitive decline in depressed older adults. We suggest that age-specific measures should be taken when providing social support to depressed older adults in order to reduce the deterioration of cognitive function.
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Affiliation(s)
- Yurong Jing
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment, National Health and Family Planning, Commission of the People’s Republic of China, Fudan University, Shanghai, China
| | - Wei Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Wenjia Peng
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment, National Health and Family Planning, Commission of the People’s Republic of China, Fudan University, Shanghai, China
| | - Meng Wang
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment, National Health and Family Planning, Commission of the People’s Republic of China, Fudan University, Shanghai, China
| | - Xiaoli Chen
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment, National Health and Family Planning, Commission of the People’s Republic of China, Fudan University, Shanghai, China
| | - Xinya Liu
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment, National Health and Family Planning, Commission of the People’s Republic of China, Fudan University, Shanghai, China
| | - Pengfei Wang
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment, National Health and Family Planning, Commission of the People’s Republic of China, Fudan University, Shanghai, China
| | - Fei Yan
- School of Public Health, Fudan University, Shanghai, China
| | - Yinghua Yang
- Shanghai Center for Clinical Laboratory, Shanghai, China
| | - Xinguo Wang
- College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Shuangyuan Sun
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ye Ruan
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ying Wang
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment, National Health and Family Planning, Commission of the People’s Republic of China, Fudan University, Shanghai, China
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Fortinsky RH, Robison J, Steffens DC, Grady J, Migneault D, Wakefield D. Association of Race, Ethnicity, Education, and Neighborhood Context With Dementia Prevalence and Cognitive Impairment Severity Among Older Adults Receiving Medicaid-Funded Home and Community-Based Services. Am J Geriatr Psychiatry 2023; 31:241-251. [PMID: 36549993 PMCID: PMC10023377 DOI: 10.1016/j.jagp.2022.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE While racial, ethnic, and socioeconomic group disparities in cognitive impairment and dementia prevalence are well-documented among community-dwelling older adults, little is known about these disparity trends among older adults receiving Medicaid-funded home- and community-based services (HCBS) in lieu of nursing home admission. The authors determined how dementia prevalence and cognitive impairment severity compare by race, ethnicity, educational attainment, and neighborhood context in a Medicaid HCBS population. DESIGN/SETTING A cross-sectional study in Connecticut. PARTICIPANTS Adults age ≥65 in the HCBS program, January-March 2019 (N = 3,520). MEASUREMENTS The data source was Connecticut's HCBS program Universal Assessment tool. The authors employed two outcomes: Cognitive Performance Scale (CPS2), a 9-point measure ranging from cognitively intact-very severe impairment; and presence or not of either diagnosed dementia or CPS2 score ≥4 (major impairment). Neighborhood context was measured using the Social Vulnerability Index (SVI). RESULTS Cohort characteristics: 75.7% female; mean(SD) age = 79.1(8.2); Non-Hispanic White = 47.8%; Hispanic = 33.6%; Non-Hispanic Black = 15.9%. Covariate-adjusted multivariate analyses revealed no dementia/major impairment prevalence differences among White, Black, and Hispanic individuals, but impairment severity was greater among Hispanic participants (b = 0.22; p = 0.02). People with more than HS education had less severe impairment (b = -0.12; p <0.001) and lower likelihood of dementia/major impairment (AOR = 0.61; p <0.001). Dementia/major impairment likelihood and impairment severity were greater in less socially vulnerable neighborhoods. CONCLUSION Racial and ethnic group differences in cognitive impairment are less pronounced in Medicaid-funded HCBS cohorts than in other community-dwelling older adult cohorts. SVI results suggest that, among other possible explanations, older adults with dementia may move to lower social vulnerability neighborhoods where supportive family members reside.
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Affiliation(s)
- Richard H Fortinsky
- UConn Center on Aging, University of Connecticut School of Medicine, Farmington, CT.
| | - Julie Robison
- UConn Center on Aging, University of Connecticut School of Medicine, Farmington, CT
| | - David C Steffens
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT
| | - James Grady
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT
| | - Deborah Migneault
- UConn Center on Aging, University of Connecticut School of Medicine, Farmington, CT
| | - Dorothy Wakefield
- UConn Center on Aging, University of Connecticut School of Medicine, Farmington, CT
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Bartels C, Abdel-Hamid M, Wiltfang J, Schneider A, Belz M. Antidepressant Effects of a Multimodal Group Therapy Program for Mild Dementia: A Retrospective Evaluation of Clinical Routine Data. J Alzheimers Dis 2022; 90:1725-1737. [PMID: 36336930 DOI: 10.3233/jad-220578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The multimodal CORDIAL treatment concept for mild dementia, combining cognitive rehabilitation, cognitive behavioral and humanistic psychology interventions, has proven its feasibility and demonstrated a reduction of depressive symptoms in individual dyadic/triadic settings. OBJECTIVE We investigate antidepressant effects of an adapted group-based CORDIAL program in clinical routine care. METHODS During 2013 and 2017, 51 outpatients with mild dementia (45% female, mean age 72.4 years, 67% Alzheimer's dementia, mean MMST 24.8) periodically received a modified CORDIAL group treatment as part of our regular outpatient care. Treatment comprised 10 bi-weekly sessions, partly involving caregivers. Systematic pre- and post-treatment assessments of clinical routine data were evaluated retrospectively (median time-interval of 6.6 months). RESULTS Depressive symptoms as measured by the Geriatric Depression Scale significantly decreased over time (p = 0.007, Cohen's d = 0.39), and irrespective of gender. Patients with longer disease duration before treatment start showed significantly higher initial levels of depressive symptoms (p = 0.044), followed by a reduction to a level of those with shorter disease duration (ns). Most secondary outcomes (cognitive symptoms, disease severity, quality of life, caregiver burden) remained unchanged (ns), while competence in activities of daily living declined from pre- to post-measurement (p = 0.033). CONCLUSION A group-based CORDIAL treatment is feasible in a clinical routine setting and demonstrated antidepressant effects comparable to those of the individual treatment design, further suggesting its implementation in regular care. Future trials might also investigate its potentially preventive effects by reducing depressive symptoms in pre-dementia stages, even at a subsyndromal level.
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Affiliation(s)
- Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany
| | - Mona Abdel-Hamid
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany.,Department of Psychiatry and Psychotherapy, University of Duisburg-Essen, LVR-Hospital Essen, Essen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany.,Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Michael Belz
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany
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Kim IH, Kim CS. "Leisure Life Satisfaction:" Will It Have a Beneficial Impact on Depression Among Older Adults in Community Care Settings? J Prev Med Public Health 2022; 55:398-406. [PMID: 35940195 PMCID: PMC9371784 DOI: 10.3961/jpmph.22.160] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/27/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives While the risk of depression is expected to substantially increase among older adults receiving community care, leisure life satisfaction can be regarded as a key component in enhancing the mental health of those receiving community care. However, it is not yet known whether community care utilization increases the risk of depression, or what role is played by leisure life satisfaction in these settings. This study investigated the relationship between community care utilization and depression, as well as the main effect and the moderating role of leisure life satisfaction on the link between community care utilization and depression among older adults. Methods This study, using the 2019 Korean Welfare Panel Survey, conducted multiple regression analysis on data from 4494 elderly people aged 65 years or older. Results After controlling for potential covariates, older community care recipients were more likely to report symptoms of depression than those who did not receive community care. Meanwhile, leisure life satisfaction was negatively associated with depression in older adults. The test for interaction between community care utilization and leisure life satisfaction revealed that leisure life satisfaction significantly attenuated the link between depression and community care utilization. Conclusions The findings of this study imply that leisure life satisfaction could play a meaningful role in improving the mental health of older adults receiving community care. Welfare policies affecting older adults should consider leisure life satisfaction as an important resource for reducing depression in community care settings.
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Affiliation(s)
- Il-Ho Kim
- Center for Collaborative Research on Population and Society, Dongguk University, Seoul,
Korea
| | - Cheong-Seok Kim
- Department of Sociology and Center for Collaborative Research on Population and Society, Dongguk University, Seoul,
Korea
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Soleimani L, Schnaider Beeri M, Grossman H, Sano M, Zhu CW. Specific depression dimensions are associated with a faster rate of cognitive decline in older adults. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12268. [PMID: 35317432 PMCID: PMC8923346 DOI: 10.1002/dad2.12268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/02/2022] [Accepted: 10/22/2021] [Indexed: 06/14/2023]
Abstract
Introduction Understanding the relationship between different depression presentations and cognitive outcome may elucidate high-risk sub-groups for cognitive decline. Methods In this study we utilized longitudinal data from the National Alzheimer's Coordinating Center (NACC) on 16,743 initially not demented older adults followed every 12 months for an average of 5 years. Depression dimensions were defined based on the 15-item Geriatric Depression Scale (GDS-15), that is, dysphoric mood, Withdrawal-Apathy-Vigor (WAV), anxiety, hopelessness, and subjective memory complaint (SMC). Results After adjustment for sociodemographic and clinical covariates, SMC and hopelessness were associated with faster decline in global cognition and all cognitive domains and WAV with decline executive function. Dysphoric mood and anxiety were not associated with a faster cognitive decline in any of the cognitive domains. Discussion Different depression dimensions had different associations with the rate of cognitive decline, suggesting distinct pathophysiology and the need for more targeted interventions.
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Affiliation(s)
- Laili Soleimani
- Department of PsychiatryThe Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Michal Schnaider Beeri
- Department of PsychiatryThe Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- The Joseph Sagol Neuroscience CenterSheba Medical CenterTel‐HashomerIsrael
| | - Hillel Grossman
- Department of PsychiatryThe Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- James J Peters VAMCBronxNew YorkUSA
| | - Mary Sano
- Department of PsychiatryThe Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- James J Peters VAMCBronxNew YorkUSA
| | - Carolyn W. Zhu
- Department of PsychiatryThe Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- James J Peters VAMCBronxNew YorkUSA
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Merizzi A, Biasi R, Zamudio JFÁ, Spagnuolo Lobb M, Di Rosa M, Santini S. A Single-Case Design Investigation for Measuring the Efficacy of Gestalt Therapy to Treat Depression in Older Adults with Dementia in Italy and in Mexico: A Research Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063260. [PMID: 35328948 PMCID: PMC8950193 DOI: 10.3390/ijerph19063260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023]
Abstract
Psychotherapy is one of the evidence-based clinical interventions for the treatment of depression in older adults with dementia. Randomised controlled trials are often the first methodological choice to gain evidence, yet they are not applicable to a wide range of humanistic psychotherapies. Amongst all, the efficacy of the Gestalt therapy (GT) is under-investigated. The purpose of this paper is to present a research protocol, aiming to assess the effects of a GT-based intervention on people with dementia (PWD) and indirect influence on their family carers. The study implements the single-case experimental design with time series analysis that will be carried out in Italy and Mexico. Six people in each country, who received a diagnosis of dementia and present depressive symptoms, will be recruited. Eight or more GT sessions will be provided, whose fidelity will be assessed by the GT fidelity scale. Quantitative outcome measures are foreseen for monitoring participants' depression, anxiety, quality of life, loneliness, carers' burden, and the caregiving dyad mutuality at baseline and follow-up. The advantages and limitations of the research design are considered. If GT will effectively result in the treatment of depression in PWD, it could enrich the range of evidence-based interventions provided by healthcare services.
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Affiliation(s)
- Alessandra Merizzi
- Centre for Socio-Economic Research on Aging, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy;
- Correspondence:
| | - Rosanna Biasi
- Istituto di Gestalt HCC Human Communication Centre Italy, Via S. Sebastiano 38, 96100 Siracusa, Italy; (R.B.); (M.S.L.)
| | | | - Margherita Spagnuolo Lobb
- Istituto di Gestalt HCC Human Communication Centre Italy, Via S. Sebastiano 38, 96100 Siracusa, Italy; (R.B.); (M.S.L.)
| | - Mirko Di Rosa
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy;
| | - Sara Santini
- Centre for Socio-Economic Research on Aging, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy;
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Yang HW, Bae JB, Oh DJ, Moon DG, Lim E, Shin J, Kim BJ, Lee DW, Kim JL, Jhoo JH, Park JH, Lee JJ, Kwak KP, Lee SB, Moon SW, Ryu SH, Kim SG, Han JW, Kim KW. Exploration of Cognitive Outcomes and Risk Factors for Cognitive Decline Shared by Couples. JAMA Netw Open 2021; 4:e2139765. [PMID: 34928355 PMCID: PMC8689387 DOI: 10.1001/jamanetworkopen.2021.39765] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/20/2021] [Indexed: 11/14/2022] Open
Abstract
Importance Although couples could share many risk factors of cognitive disorders in their lifetime, whether shared risk factors mediate the shared risk of cognitive disorders has rarely been investigated. Objective To identify the risk factors of cognitive decline shared within couples and investigate their mediating roles in the shared risk of cognitive disorders and cognitive functions within couples. Design, Setting, and Participants A prospective cohort study was launched in November 1, 2010, and 784 participants were followed up every 2 years until December 31, 2020. This nationwide, multicenter, community-based study included older couples from the Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD) and a cohort of their spouses (KLOSCAD-S). Exposures The cognitive disorder of a spouse was defined as mild cognitive impairment or dementia. Main Outcomes and Measures The mediating roles of factors shared within couples on the association between one spouse's cognitive disorder and the other's risk of cognitive disorders was examined with structural equation modeling. Results Included were 784 KLOSCAD participants (307 women [39.2%] and 477 men [60.8%]; mean [SD] age, 74.8 [4.8] years) and their spouses (477 women [60.8%] and 307 men [39.2%]; mean [SD] age, 73.6 [6.2] years). The cognitive disorder of the KLOSCAD participants was associated with almost double the risk of cognitive disorder of their spouses in the KLOSCAD-S cohort (odds ratio, 1.74; 95% CI, 1.12-2.69; P = .01). History of head injury (β = 0.50; 95% CI, 0.09-0.90; P = .02) and age (β = 2.57; 95% CI, 1.37-3.76; P < .001) mediated the association between cognitive disorder in the KLOSCAD participants and their spouses' risk of cognitive disorder. Physical inactivity mediated the association through major depressive disorder (β = 0.33, 95% CI, 0.09-0.57, P = .006 for physical inactivity; β = 0.28, 95% CI, 0.13-0.44, P < .001 for major depressive disorder). These factors similarly mediated the association between spousal cognitive disorder and cognitive functions such as memory and executive function. Conclusions and Relevance These findings suggest that the risk factors shared within couples may mediate approximately three-quarters of the spousal risk of cognitive disorders. Identification of and intervention in the shared risk factors of dementia within couples may reduce the risk of cognitive disorders in the spouses of people with dementia.
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Affiliation(s)
- Hee Won Yang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Dae Jong Oh
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Dong Gyu Moon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Eunji Lim
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Jin Shin
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University, School of Medicine, Jinju, South Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea
| | - Jin Hyeong Jhoo
- Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon, South Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, South Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
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Rangarajan SK, Sivakumar PT, Manjunatha N, Kumar CN, Math SB. Public Health Perspectives of Geriatric Mental Health Care. Indian J Psychol Med 2021; 43:S1-S7. [PMID: 34732947 PMCID: PMC8543608 DOI: 10.1177/02537176211047963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In older adults (aged 60 years and above), mental health problems are gaining public health importance because of the increasing prevalence, disease burden, disability, morbidity, and mortality. Epidemiological studies on major mental health disorders such as depression and dementia in older adults have contributed to a better understanding of the distribution and determinants of these conditions. Identifying potential risk factors has stimulated interventional research on preventing these conditions under the public health framework towards their management. The increasing burden of geriatric mental health conditions like dementia in developing countries like India can contribute to significant challenges if there is no adequate strengthening of the public health response. This includes scaling up the measures of prevention, public awareness, early diagnosis, and quality health and social care equitably available to all sections of the population. The Decade of Healthy Ageing (2021-2030) provides the opportunity for concerted and coordinated initiatives to improve intrinsic capacity (physical and mental) and offer an age-friendly environment to enhance the functional ability of all older adults. METHODS This article reviews the critical public health issues related to geriatric mental health in India.
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Affiliation(s)
- Subhashini K. Rangarajan
- Dept. of Clinical Neurosciences, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Palanimuthu Thangaraju Sivakumar
- Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Dept. of Psychiatry, Tele Medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Channaveerachari Naveen Kumar
- Dept. of Psychiatry, Tele Medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Dept. of Psychiatry, Tele Medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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