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Young KWD, Kwok CYT, Ng YNP, Ng SM, Chen QRJ. Multicomponent Intervention on Improving the Cognitive Ability of Older Adults with Mild Cognitive Impairment: A Pilot Randomized Controlled Trial. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024; 67:492-514. [PMID: 38590208 DOI: 10.1080/01634372.2024.2338066] [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: 07/26/2023] [Accepted: 03/15/2024] [Indexed: 04/10/2024]
Abstract
This pilot randomized controlled trial aimed to evaluate the feasibility and potential outcomes of an innovative 16-session multicomponent intervention model to improve cognitive abilities in older adults with mild cognitive impairment (MCI) by promoting healthy lifestyle, cognitive skills, tai chi and mindfulness practices. This study was a multicentre, randomized controlled, two-arm, parallel-group, unblinded trial in Hong Kong. 57 Chinese older adults with MCI recruited from three local elderly centers were randomly assigned to either the control or intervention group. The study results support the feasibility and efficacy of the multicomponent intervention, and recommend future larger-scale randomized control trials.
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Affiliation(s)
- Kim-Wan Daniel Young
- Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong, China
| | - Chi-Yui Timothy Kwok
- Department of Medicine/Geriatric Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Yat-Nam Petrus Ng
- Department of Social Work, Hong Kong Baptist University, Hong Kong, China
| | - Siu-Man Ng
- Department of Social Work & Social Administration, University of Hong Kong, Hong Kong, China
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Belfiori M, Salis F, Demelas G, Mandas A. Association between Depressive Mood, Antidepressant Therapy and Neuropsychological Performances: Results from a Cross-Sectional Study on Elderly Patients. Brain Sci 2024; 14:54. [PMID: 38248269 PMCID: PMC10813455 DOI: 10.3390/brainsci14010054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Currently, the global demographic landscape is undergoing a transformative shift towards an increasingly aging population. This leads to an increase in chronic pathologies, including depression and cognitive impairment. This study aimed to evaluate the association between depressive mood, whether in treatment or not, and cognitive capacities, assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). METHODS This study included 259 subjects, aged 65 years or older, evaluated at the Geriatric Outpatient Service of the University Hospital of Monserrato, Cagliari, between July 2018 and May 2022, who experienced subjective depressive mood and/or cognitive deficits. RESULTS Only 25.1% of the sample showed no cognitive impairment on the RBANS. Education was a significant regressor of the RBANS Total Scale scores (p < 0.0001) and was negatively associated with mood deflection (r = -0.15, p = 0.0161). Subjects with depressive mood had more impaired attention and visuospatial/constructional abilities compared to untreated euthymic patients. Post-hoc analysis, conducted with the Conover test, showed that untreated euthymic patients (GDS-15 ≤ 5, group 2) had a higher score on the RBANS total scale than patients with mood deflection (GDS-15 > 5, group 1), and treated euthymic patients (GDS-15 ≤ 5, group 3). Finally, different logistic regression analyses revealed a significant negative coefficient for GDS as a regressor of the RBANS total scale (coefficient: -0.04, p = 0.0089), visuospatial/constructional abilities (coefficient: -0.03, p = 0.0009), language (coefficient: -0.05, p = 0.0140), and attention (coefficient: -0.05, p < 0.0001). CONCLUSIONS Our analysis demonstrated that "naturally" euthymic people show better cognitive performances than people with depressive mood and subjects with acceptable mood due to antidepressants. Furthermore, the gender-based difference observed in the language domain suggests the potential utility of incorporating an alternative category for male patients in the Semantic Fluency test.
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Affiliation(s)
- Maristella Belfiori
- Department of Medical Sciences, and Public Health, University of Cagliari, SS 554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy; (F.S.); (G.D.); (A.M.)
| | - Francesco Salis
- Department of Medical Sciences, and Public Health, University of Cagliari, SS 554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy; (F.S.); (G.D.); (A.M.)
- Department of Biomedical Sciences, University of Cagliari, 09042 Cagliari, Italy
| | - Giorgia Demelas
- Department of Medical Sciences, and Public Health, University of Cagliari, SS 554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy; (F.S.); (G.D.); (A.M.)
| | - Antonella Mandas
- Department of Medical Sciences, and Public Health, University of Cagliari, SS 554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy; (F.S.); (G.D.); (A.M.)
- University Hospital “Azienda Ospedaliero-Universitaria” of Cagliari, 09127 Cagliari, Italy
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Ricciardi E, Spano G, Tinella L, Lopez A, Clemente C, Bosco A, Caffò AO. Perceived Social Support Mediates the Relationship between Use of Greenspace and Geriatric Depression: A Cross-Sectional Study in a Sample of South-Italian Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085540. [PMID: 37107822 PMCID: PMC10138493 DOI: 10.3390/ijerph20085540] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/09/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
A growing body of evidence is suggestive for the beneficial role of contact with greenspace (e.g., use of greenspace, visual access to greenspace, etc.) on mental health (e.g., depression, anxiety, etc.). In addition, several studies have pointed out the benefits of social support and social interaction on psychological wellbeing. Even if evidence on the association between contact with greenspace and perceived social support were mixed, it was supposed that the use of greenspace could enhance social interactions and perceived social support, especially among older adults. The present study aims to explore the effect of use of greenspace on geriatric depression in a sample of South-Italian older adults and the mediating role of perceived social support in this association. A structural equation model was tested in a sample of 454 older adults (60-90 years old) residing in the Metropolitan Area of Bari, Apulia. The fit indices revealed the goodness of fit of the model (CFI = 0.934; TLI = 0.900; IFI = 0.911; NFI = 0.935; RMSEA = 0.074; SRMR = 0.056). Results showed that the use of greenspace was inversely associated with geriatric depression through perceived social support. These findings underlined the relevance of perceived social support on the pathway linking use of greenspace and geriatric depressive symptoms. This evidence may be useful to policymakers to plan interventions for promoting physical access to greenspace and social participation in an age-friendly city framework.
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Affiliation(s)
- Elisabetta Ricciardi
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy; (E.R.); (G.S.); (L.T.); (A.L.); (C.C.); (A.B.)
| | - Giuseppina Spano
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy; (E.R.); (G.S.); (L.T.); (A.L.); (C.C.); (A.B.)
| | - Luigi Tinella
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy; (E.R.); (G.S.); (L.T.); (A.L.); (C.C.); (A.B.)
| | - Antonella Lopez
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy; (E.R.); (G.S.); (L.T.); (A.L.); (C.C.); (A.B.)
- Faculty of Law, Giustino Fortunato University, 82100 Benevento, Italy
| | - Carmine Clemente
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy; (E.R.); (G.S.); (L.T.); (A.L.); (C.C.); (A.B.)
| | - Andrea Bosco
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy; (E.R.); (G.S.); (L.T.); (A.L.); (C.C.); (A.B.)
| | - Alessandro Oronzo Caffò
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy; (E.R.); (G.S.); (L.T.); (A.L.); (C.C.); (A.B.)
- Correspondence:
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Polese JC, da Silva SLA, Lacerda CSA, Roza EA, Torriani-Pasin C. Community ambulation after chronic stroke: A cross-sectional study. J Bodyw Mov Ther 2022. [DOI: 10.1016/j.jbmt.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Schutter N, Holwerda TJ, Kuipers H, Van RHL, Stek ML, Comijs HC, Peen J, Dekker JJM. The Association Between Loneliness and Psychiatric Symptomatology in Older Psychiatric Outpatients. J Geriatr Psychiatry Neurol 2022; 35:778-788. [PMID: 34937438 DOI: 10.1177/08919887211060022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Loneliness in adults increases with age. Although loneliness has been found to be associated with psychiatric disorders and dementia, no information is available on prevalence of loneliness in older psychiatric patients. The aims of this study were to examine prevalence of loneliness in older psychiatric outpatients, including gender differences and associations with psychiatric disorders and social isolation. METHODS Cross-sectional study in an outpatient clinic for geriatric psychiatry between September 2013 and February 2018. Interviews were done in 181 patients. RESULTS 80% of participants were lonely. Loneliness was associated with having contacts in less social network domains, in women but not in men. There were no associations with DSM-IV-TR-classifications. However, loneliness was associated with higher scores on questionnaires for depression and cognitive function. Intensity of treatment did not differ significantly between lonely and non-lonely participants. CONCLUSION Loneliness is highly prevalent in older psychiatric outpatients, with men and women equally affected. Loneliness should be assessed in all older psychiatric patients, especially when they show high scores on symptom checklists or have a restricted social network.
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Affiliation(s)
- Natasja Schutter
- Department of Geriatric Psychiatry, 120662Arkin Mental Health Care, Amsterdam, Netherlands
| | - Tjalling J Holwerda
- Department of Psychiatry, 120662Arkin Mental Health Care, Amsterdam, Netherlands
| | - Hanna Kuipers
- Department of Psychiatry, Amici Zorgt, Heerhugowaard, Netherlands
| | - Rien H L Van
- Department of General Psychiatry Residency Training/Netherlands Psychoanalytical Institute, 120662Arkin Mental Health Care, Amsterdam, Netherlands
| | - Max L Stek
- GGZ InGeest/Department of Psychiatry and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
| | - Hannie C Comijs
- GGZ InGeest/Department of Psychiatry and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
| | - Jaap Peen
- Department of Clinical Research, 120662Arkin Mental Health Care, Amsterdam, Netherlands
| | - Jack J M Dekker
- Department of Clinical Research, 120662Arkin Mental Health Care, Amsterdam, Netherlands.,Department of Psychology, VU University, Amsterdam, Netherlands
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Acosta Quiroz CO, García-Flores R, Echeverría-Castro SB. The Geriatric Depression Scale (GDS-15): Validation in Mexico and Disorder in the State of Knowledge. Int J Aging Hum Dev 2021; 93:854-863. [PMID: 32960071 PMCID: PMC8392767 DOI: 10.1177/0091415020957387] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/28/2020] [Indexed: 11/17/2022]
Abstract
The objective of this study was to evaluate the reliability and validity of the Geriatric Depression Scale in its 15-item version (GDS-15) in Mexican older adults. Participants included 1178 older adults between the ages of 60 and 94 (M = 69.16, SD = 7.69); 53.9% were women and 55.8% were married or with a partner. They completed the GDS-15, a subjective well-being scale, and a quality-of-life questionnaire. A Kuder-Richardson coefficient of .80 was obtained, which indicates an acceptable internal consistency of the GDS-15, as well as evidence of divergent validity with significant correlations of -.783 with subjective well-being and -.569 with quality of life, in addition to concurrent validity when discriminating between participants with low scores from those with high scores of depressive symptoms. The need for a simple screening tool such as the GDS-15 that helps in the identification of depressive symptoms in Mexican older adults is underlined.
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Lee HY, Rhee Y, Choi KS. Urinary incontinence and the association with depression, stress, and self-esteem in older Korean Women. Sci Rep 2021; 11:9054. [PMID: 33907278 PMCID: PMC8079410 DOI: 10.1038/s41598-021-88740-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 04/15/2021] [Indexed: 11/09/2022] Open
Abstract
The objectives were to investigate the prevalence of urinary incontinence (UI) and its relationships with depression, stress, and self-esteem in older Korean women from the Korean Study of Women's Health Related Issues (K-Stori), a nationally representative cross-sectional survey. A total of 3000 women between 65 and 79 years were the final study subjects. We applied multiple linear regression models to analyze associations with depression, stress, and self-esteem levels in relation to UI types. Types of urinary incontinence included stress, urge, and mixed UI. UI affects at least one in two older Korean women (52.2%). The prevalences of SUI, UUI, and MUI were 45.7%, 39.6%, and 33.1%, respectively. UI was found to be adversely associated with depression, stress, and self-esteem: women with UI reported significantly higher levels of depression and stress and lower levels of self-esteem than those without UI. Women with MUI reported significantly greater impairment than the women with SUI or UUI. Our results provide an evidence base for the evaluation of mental health in older women with incontinence. The prioritization of UI detection and the identification of psychological factors may help improve the diagnosis and management of UI and potentially yield significant economic and psychosocial benefits.
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Affiliation(s)
- Hoo-Yeon Lee
- Department of Social Medicine, College of Medicine, Dankook University, Chungnam, South Korea
| | - Yumie Rhee
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, South Korea.
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Lafont C, Chah Wakilian A, Lemogne C, Gouraud C, Fossey-Diaz V, Orvoen G, Lhuillier N, Paillaud E, Bastuji-Garin S, Zebachi S, Hanon O, Goldwasser F, Boudou-Rouquette P, Canouï-Poitrine F. Diagnostic Performance of the 4-Item Geriatric Depression Scale for Depression Screening in Older Patients with Cancer: The ELCAPA Cohort Study. Oncologist 2021; 26:e983-e991. [PMID: 33683759 DOI: 10.1002/onco.13746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/24/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND In older patients with cancer, depression is difficult to assess because of its heterogeneous clinical expression. The 4-item version of the Geriatric Depression Scale (GDS-4) is quick and easy to administer but has not been validated in this population. The present study was designed to test the diagnostic performance of the GDS-4 in a French cohort of older patients with cancer before treatment. MATERIALS AND METHODS Our cross-sectional analysis of data from the Elderly Cancer Patient cohort covered all patients with cancer aged ≥70 years and referred for geriatric assessment at two centers in France between 2007 and 2018. The GDS-4's psychometric properties were evaluated against three different measures of depression: the geriatrician's clinical diagnosis (based on a semistructured interview), the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, and a cluster analysis. The scale's sensitivity, specificity, positive and negative likelihood ratios, and area under the receiver operating characteristic curve (AUROC) were calculated. RESULTS In a sample of 2,293 patients (median age, 81 years; women, 46%), the GDS-4's sensitivity and specificity for detecting physician-diagnosed depression were, respectively, 90% and 89%. The positive and negative likelihood ratios were 8.2 and 0.11, and the AUROC was 92%. When considering the subset of patients with data on all measures of depression, the sensitivity and specificity values were, respectively, ≥90% and ≥72%, the positive and negative likelihood ratios were, respectively, ≥3.4 and ≤ 0.11, and the AUROC was ≥91%. CONCLUSION The GDS-4 appears to be a clinically relevant, easy-to-use tool for routine depression screening in older patients with cancer. IMPLICATIONS FOR PRACTICE Considering the overlap between symptoms of cancer and symptoms of depression, depression is particularly difficult to assess in older geriatric oncology and is associated with poor outcomes; there is a need for a routine psychological screening. Self-report instruments like the 4-item version of the Geriatric Depression Scale appears to be a clinically relevant, easy-to-use tool for routine depression screening in older patients with cancer. Asking four questions might enable physicians to screen older patients with cancer for depression and then guide them toward further clinical evaluation and appropriate care if required.
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Affiliation(s)
- Charlotte Lafont
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France.,AP-HP, Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, F-94010, Créteil, France
| | | | - Cédric Lemogne
- Université de Paris, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, INSERM, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, Paris, France
| | - Clément Gouraud
- AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, Paris, France
| | | | - Galdric Orvoen
- AP-HP, Hôpital Broca, Service de Gériatrie, F-75013, Paris, France
| | - Nathalie Lhuillier
- AP-HP, Hôpital Cochin, Service d'Oncologie Médicale, ARIANE, F-75014, Paris, France
| | - Elena Paillaud
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France.,AP-HP, HEGP, Service de Gériatrie, F-75015, Paris, France
| | - Sylvie Bastuji-Garin
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France.,AP-HP, Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, F-94010, Créteil, France
| | - Sonia Zebachi
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France
| | - Olivier Hanon
- AP-HP, Hôpital Broca, Service de Gériatrie, F-75013, Paris, France
| | - François Goldwasser
- AP-HP, Hôpital Cochin, Service d'Oncologie Médicale, ARIANE, F-75014, Paris, France
| | | | - Florence Canouï-Poitrine
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France.,AP-HP, Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, F-94010, Créteil, France
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Coventry PA, McMillan D, Clegg A, Brown L, van der Feltz-Cornelis C, Gilbody S, Ali S. Frailty and depression predict instrumental activities of daily living in older adults: A population-based longitudinal study using the CARE75+ cohort. PLoS One 2020; 15:e0243972. [PMID: 33320913 PMCID: PMC7737980 DOI: 10.1371/journal.pone.0243972] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 12/01/2020] [Indexed: 11/20/2022] Open
Abstract
Objectives To evaluate if depression contributes, independently and/or in interaction with frailty, to loss of independence in instrumental activities of daily living (ADL) in older adults with frailty. Methods Longitudinal cohort study of people aged ≥75 years living in the community. We used multi-level linear regression model to quantify the relationship between depression (≥5 Geriatric Depression Scale) and frailty (electronic frailty index), and instrumental activities of daily living (Nottingham Extended Activities of Daily Living scale; range: 0–66; higher score implies greater independence). The model was adjusted for known confounders (age; gender; ethnicity; education; living situation; medical comorbidity). Results 553 participants were included at baseline; 53% were female with a mean age of 81 (5.0 SD) years. Depression and frailty (moderate and severe levels) were independently associated with reduced instrumental activities of daily living scores. In the adjusted analysis, the regression coefficient was -6.4 (95% CI: -8.3 to -4.5, p<0.05) for depression, -1.5 (95% CI: -3.8 to 0.9, p = 0.22) for mild frailty, -6.1 (95% CI: -8.6 to -3.6, p<0.05) for moderate frailty, and -10.1 (95% CI: -13.5 to -6.8, p<0.05) for severe frailty. Moreover, depression interacted with frailty to further reduce instrumental activities of daily living score in individuals with mild or moderate frailty. These relationships remained significant after adjusting for confounders. Conclusion Frailty and depression are independently associated with reduced independence in instrumental activities of daily living. Also, depression interacts with frailty to further reduce independence for mild to moderately frail individuals, suggesting that clinical management of frailty should integrate physical and mental health care.
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Affiliation(s)
- Peter A. Coventry
- Department of Health Sciences, University of York, York, United Kingdom
- * E-mail:
| | - Dean McMillan
- Department of Health Sciences and Hull York Medical School, University of York, York, United Kingdom
| | - Andrew Clegg
- Academic Unit of Elderly Care and Rehabilitation, University of Leeds, Bradford, United Kingdom
| | - Lesley Brown
- Academic Unit of Elderly Care and Rehabilitation, Bradford, Institute for Health Research, Bradford, United Kingdom
| | | | - Simon Gilbody
- Department of Health Sciences and Hull York Medical School, University of York, York, United Kingdom
| | - Shehzad Ali
- Department of Health Sciences, University of York, York, United Kingdom
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
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Thompson LI, Jones RN. Depression screening in cognitively normal older adults: Measurement bias according to subjective memory decline, brain amyloid burden, cognitive function, and sex. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12107. [PMID: 33015310 PMCID: PMC7521597 DOI: 10.1002/dad2.12107] [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: 06/02/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Understanding the associations among depression, subjective cognitive decline, and prodromal Alzheimer's disease (AD) has important implications for both depression and dementia screening in older adults. The Geriatric Depression Scale (GDS) is a depression screening tool for older adults that queries memory concerns. To determine whether depression symptoms on the GDS (15-item version), including self-reported memory problems, differ by levels of brain amyloid beta (Aβ), a pathological hallmark of early stage AD, we investigated potential measurement bias with regard to Aβ level. We also examined measurement bias attributable to level of cognitive functioning and sex as positive controls. METHODS We examined 3961 cognitively normal older adults from the A4/LEARN Study. We used the MIMIC (multiple indicators, multiple causes) approach to detect measurement bias. RESULTS We found measurement bias with small-to-moderate range effect sizes in several GDS-15 items with respect to Aβ level, cognitive functioning, and sex. There was negligible impact of measurement bias attributable to Aβ level on overall depressive symptom level. DISCUSSION GDS-15 item responses are sensitive to Aβ burden, cognitive functioning, and sex over and above what would be expected given the effect of those factors on depressive symptom severity overall. However, these direct effects for GDS item measurement bias are of small magnitude and do not appreciably impact the validity of inferences about depression based on the GDS-15.
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Affiliation(s)
- Louisa I Thompson
- Department of Psychiatry, Alpert Medical School Brown University Providence Rhode Island USA
| | - Richard N Jones
- Department of Psychiatry, Alpert Medical School Brown University Providence Rhode Island USA
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