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Shusharina N, Yukhnenko D, Botman S, Sapunov V, Savinov V, Kamyshov G, Sayapin D, Voznyuk I. Modern Methods of Diagnostics and Treatment of Neurodegenerative Diseases and Depression. Diagnostics (Basel) 2023; 13:diagnostics13030573. [PMID: 36766678 PMCID: PMC9914271 DOI: 10.3390/diagnostics13030573] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/09/2023] Open
Abstract
This paper discusses the promising areas of research into machine learning applications for the prevention and correction of neurodegenerative and depressive disorders. These two groups of disorders are among the leading causes of decline in the quality of life in the world when estimated using disability-adjusted years. Despite decades of research, the development of new approaches for the assessment (especially pre-clinical) and correction of neurodegenerative diseases and depressive disorders remains among the priority areas of research in neurophysiology, psychology, genetics, and interdisciplinary medicine. Contemporary machine learning technologies and medical data infrastructure create new research opportunities. However, reaching a consensus on the application of new machine learning methods and their integration with the existing standards of care and assessment is still a challenge to overcome before the innovations could be widely introduced to clinics. The research on the development of clinical predictions and classification algorithms contributes towards creating a unified approach to the use of growing clinical data. This unified approach should integrate the requirements of medical professionals, researchers, and governmental regulators. In the current paper, the current state of research into neurodegenerative and depressive disorders is presented.
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Affiliation(s)
- Natalia Shusharina
- Baltic Center for Neurotechnologies and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236041 Kaliningrad, Russia
- Correspondence:
| | - Denis Yukhnenko
- Department of Social Security and Humanitarian Technologies, N. I. Lobachevsky State University of Nizhny Novgorod, 603022 Nizhny Novgorod, Russia
| | - Stepan Botman
- Baltic Center for Neurotechnologies and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236041 Kaliningrad, Russia
| | - Viktor Sapunov
- Baltic Center for Neurotechnologies and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236041 Kaliningrad, Russia
| | - Vladimir Savinov
- Baltic Center for Neurotechnologies and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236041 Kaliningrad, Russia
| | - Gleb Kamyshov
- Baltic Center for Neurotechnologies and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236041 Kaliningrad, Russia
| | - Dmitry Sayapin
- Baltic Center for Neurotechnologies and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236041 Kaliningrad, Russia
| | - Igor Voznyuk
- Baltic Center for Neurotechnologies and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236041 Kaliningrad, Russia
- Department of Neurology, Pavlov First Saint Petersburg State Medical University, 197022 Saint Petersburg, Russia
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Černotová D, Hrůzová K, Levčík D, Svoboda J, Stuchlík A. Linking Social Cognition, Parvalbumin Interneurons, and Oxytocin in Alzheimer's Disease: An Update. J Alzheimers Dis 2023; 96:861-875. [PMID: 37980658 PMCID: PMC10741376 DOI: 10.3233/jad-230333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 11/21/2023]
Abstract
Finding a cure for Alzheimer's disease (AD) has been notoriously challenging for many decades. Therefore, the current focus is mainly on prevention, timely intervention, and slowing the progression in the earliest stages. A better understanding of underlying mechanisms at the beginning of the disease could aid in early diagnosis and intervention, including alleviating symptoms or slowing down the disease progression. Changes in social cognition and progressive parvalbumin (PV) interneuron dysfunction are among the earliest observable effects of AD. Various AD rodent models mimic these early alterations, but only a narrow field of study has considered their mutual relationship. In this review, we discuss current knowledge about PV interneuron dysfunction in AD and emphasize their importance in social cognition and memory. Next, we propose oxytocin (OT) as a potent modulator of PV interneurons and as a promising treatment for managing some of the early symptoms. We further discuss the supporting evidence on its beneficial effects on AD-related pathology. Clinical trials have employed the use of OT in various neuropsychiatric diseases with promising results, but little is known about its prospective impacts on AD. On the other hand, the modulatory effects of OT in specific structures and local circuits need to be clarified in future studies. This review highlights the connection between PV interneurons and social cognition impairment in the early stages of AD and considers OT as a promising therapeutic agent for addressing these early deficits.
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Affiliation(s)
- Daniela Černotová
- Laboratory of Neurophysiology of Memory, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Karolína Hrůzová
- Laboratory of Neurophysiology of Memory, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - David Levčík
- Laboratory of Neurophysiology of Memory, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Jan Svoboda
- Laboratory of Neurophysiology of Memory, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Aleš Stuchlík
- Laboratory of Neurophysiology of Memory, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
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Bai W, Zhang J, Smith RD, Cheung T, Su Z, Ng CH, Zhang Q, Xiang YT. Inter-relationship between cognitive performance and depressive symptoms and their association with quality of life in older adults: A network analysis based on the 2017-2018 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS). J Affect Disord 2023; 320:621-627. [PMID: 36206885 DOI: 10.1016/j.jad.2022.09.159] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/25/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Depressive symptoms and cognitive impairment are common psychiatric conditions and often co-occur in older adults. Network analysis has been widely used in exploring the inter-connections between psychiatric symptoms. The aim of this study was to explore the network model of depressive symptoms and cognitive performance, and their association with quality of life in people aged 65 years or above based on the 2017-2018 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS). METHOD Global cognitive performance, depressive symptoms, and global quality of life (QoL) were measured using the validated Chinese version of the Mini Mental State Examination (MMSE), the 10-item Center for Epidemiologic Studies Short Depression Scale (CES-D), and the World Health Organization Quality of Life-brief version (WHOQOL-BREF), respectively. Central symptoms and bridge symptoms were identified via strength and bridge strength, respectively. The flow network was used to identify symptoms directly related to QoL. Network stability was examined using the case dropping bootstrap method. RESULTS A total of 9023 participants were included in the network analysis. CESD3 "Feeling blue/depressed", CESD4 "Everything was an effort", and At_C "Attention and Calculation" were the central (influential) symptoms that had the highest strength value. Three bridge symptoms (i.e., Nam "Naming", CESD2 "Difficulty with concentrating", and Lan "Language") were also identified. CESD10 "Sleep disturbances" had the strongest direct connection to QoL. CONCLUSIONS This exploratory study highlights the inter-relationships between cognitive performance and depressive symptoms in older adults in the general population. Interventions targeting bridge symptoms have the potential to alleviate depressive and cognitive symptoms in this population. Furthermore, improving sleep quality in older adults may reduce the negative impact of depression and cognition decline on QoL.
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Affiliation(s)
- Wei Bai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Juan Zhang
- Faculty of Education, University of Macau, Macao SAR, China
| | - Robert D Smith
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Zhaohui Su
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, TX, USA
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia.
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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Luo W, Pryzbyl KJ, Bigio EH, Weintraub S, Mesulam MM, Redei EE. Reduced Hippocampal and Anterior Cingulate Expression of Antioxidant Enzymes and Membrane Progesterone Receptors in Alzheimer's Disease with Depression. J Alzheimers Dis 2022; 89:309-321. [PMID: 35871353 PMCID: PMC10041688 DOI: 10.3233/jad-220574] [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: 11/15/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a risk factor for dementia including that caused by Alzheimer's disease (AD). Both MDD and AD have a higher prevalence in women than men, and estrogen-related processes have been implicated in this sex difference. OBJECTIVE To identify if enhanced oxidative stress and decreased expression of the memory enhancer insulin-like growth factor 2 (IGF2), each implicated separately in MDD and AD, are exaggerated in individuals with both AD and MDD compared to those with AD. METHODS Expression of target genes are determined by qPCR in postmortem hippocampus (Hip) and anterior cingulate cortex (ACC) of individuals with dementia and autopsy confirmed AD and those of AD+MDD. RESULTS Transcript levels of the antioxidant enzymes catalase (CAT) and superoxide dismutase 1 (SOD1), as well as IGF2 and its receptor (IGF2R) were significantly lower in the Hip and ACC of individuals with both AD and MDD compared to those with AD and no MDD. Expressions of Progestin and AdipoQ Receptor Family Member 7 (PAQR7, alias progesterone receptor alpha, mPRa) and PAQR8 (mPRβ), receptors that bind neurosteroids, were also lower in the Hip and ACC of AD+MDD samples compared to those of AD without MDD. Correlations among these transcripts revealed that estrogen receptor 2 (ESR2) and mPR β are direct or indirect regulators of the expression of the antioxidant enzymes and IGF2R. CONCLUSION Reduced levels of antioxidant enzymes, decreased IGF2 expression, and diminished estrogen or membrane progesterone receptor-dependent processes might be more pronounced in the subpopulation of individuals with AD and MDD than without MDD.
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Affiliation(s)
- Wendy Luo
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Katherine J Pryzbyl
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Eileen H Bigio
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Sandra Weintraub
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - M-Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Eva E Redei
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Wagner M, Guimond AJ, Kubzansky LD, Zhang Y, Bennett DA, Barnes LL, Grodstein F. Negative and Positive Psychosocial Factors in Relation to Cognitive Health in Older African Americans. Innov Aging 2022; 6:igac019. [PMID: 35677344 PMCID: PMC9169895 DOI: 10.1093/geroni/igac019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Indexed: 11/14/2022] Open
Abstract
Background and Objectives Identifying potential intervention strategies to reduce cognitive decline, particularly among older African Americans at high risk for Alzheimer’s dementia, is critical. This study aimed to investigate whether depressive symptoms, purpose in life, and their interrelations are associated with cognitive decline in older African Americans. Research Design and Methods We included older African Americans from the Minority Aging Research Study (n = 748) and Rush Memory and Aging Project (n = 109), without dementia at baseline. We assessed associations of depressive symptoms, purpose in life, and their interrelations, with baseline levels and change in global cognition using linear mixed-effects models. Results At baseline, each unit increment in depressive symptoms was related to worse initial global cognition (mean difference = −0.03 standard unit; p = .003), while higher purpose in life was related to better cognition (mean difference = 0.12; p = .002). Further, participants with ≥1 depressive symptom who had a purpose in life score above the median appeared to have better global cognition (mean difference = 0.10; p = .01), compared to those with depressive symptoms but lower levels of purpose in life. However, we did not find relations of depressive symptoms or purpose in life with rates of cognitive decline over time, likely due to the modest follow-up. Discussion and Implications In older African Americans, we found that lower depressive symptoms and greater purpose in life were independently related to higher initial levels of global cognition, but not cognitive decline. Preliminary findings of higher global cognition in individuals with depressive symptoms but greater purpose in life merit further investigation if purpose may eventually be considered as an intervention.
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Affiliation(s)
- Maude Wagner
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- University of Bordeaux, Bordeaux, France
| | - Anne-Josée Guimond
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Yingzhe Zhang
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - David A Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush Medical College, Chicago, IL, USA
| | - Lisa L Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush Medical College, Chicago, IL, USA
| | - Francine Grodstein
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Internal Medicine, Rush Medical College, Chicago, IL, USA
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Robinson AC, Roncaroli F, Davidson YS, Minshull J, Heal C, Montaldi D, Payton A, Horan MA, Pendleton N, Mann DM. Mid to late-life scores of depression in the cognitively healthy are associated with cognitive status and Alzheimer's disease pathology at death. Int J Geriatr Psychiatry 2021; 36:713-721. [PMID: 33176024 PMCID: PMC8048934 DOI: 10.1002/gps.5470] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 11/07/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Early diagnosis of Alzheimer's disease (AD) is essential for early interventions. Symptoms of depression could represent a prodromal stage of AD. Very early mood alterations may help to stratify those at highest risk of late-life AD. We aim to investigate associations between baseline/longitudinal scores for depression, presence of cognitive impairment and/or AD pathology at death. METHODS/DESIGN Between 1991 and 2015, participants from The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age underwent 10 waves of assessment using the Geriatric Depression Scale (GDS). AD pathology at death was evaluated in 106 eligible cases. Analyses aimed to examine associations between GDS scores, cognitive status and AD pathology (as measured by Braak stage, Thal phase and CERAD). RESULTS Baseline GDS scores were significantly higher for those cognitively impaired at death than those cognitively normal. Significantly higher baseline GDS scores were found for those with greater Consortium to Establish a Registry for Alzheimer's Disease (CERAD) scores than those with lower CERAD scores. Similarly, significantly higher baseline GDS scores were found for those with a greater Braak stage than those with lower tau burden. These correlations remained after controlling for age at death, education and APOE ε4, but were less robust. Mean longitudinal GDS scores associated with cognition but not pathology. CONCLUSIONS GDS scores collected approximately 20 years before death were associated with cognitive status and AD pathology at death. We postulate that early AD-related pathological change produces raised GDS scores due to an overlapping neural basis with depression, and that this may be considered as an early diagnostic marker for AD.
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Affiliation(s)
- Andrew C. Robinson
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterSalford Royal HospitalSalfordUK
- Geoffrey Jefferson Brain Research CentreManchester Academic Health Science Centre (MAHSC)ManchesterUK
| | - Federico Roncaroli
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterSalford Royal HospitalSalfordUK
- Geoffrey Jefferson Brain Research CentreManchester Academic Health Science Centre (MAHSC)ManchesterUK
| | - Yvonne S. Davidson
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterSalford Royal HospitalSalfordUK
| | - James Minshull
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterSalford Royal HospitalSalfordUK
| | - Calvin Heal
- Centre for BiostatisticsFaculty of Biology, Medicine and HealthSchool of Health SciencesThe University of ManchesterManchesterUK
| | - Daniela Montaldi
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterManchesterUK
| | - Antony Payton
- Division of Informatics, Imaging & Data SciencesFaculty of Biology, Medicine and HealthSchool of Health SciencesThe University of ManchesterManchesterUK
| | - Michael A. Horan
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterSalford Royal HospitalSalfordUK
| | - Neil Pendleton
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterSalford Royal HospitalSalfordUK
| | - David M.A. Mann
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterSalford Royal HospitalSalfordUK
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The effect of electroconvulsive therapy on neuroinflammation, behavior and amyloid plaques in the 5xFAD mouse model of Alzheimer's disease. Sci Rep 2021; 11:4910. [PMID: 33649346 PMCID: PMC7921388 DOI: 10.1038/s41598-021-83998-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 02/09/2021] [Indexed: 12/17/2022] Open
Abstract
Microglial cells are affected in Alzheimer’s disease (AD) and interact with amyloid-beta (Aβ) plaques. Apart from memory loss, depression is common in patients with AD. Electroconvulsive therapy (ECT) is an anti-depressive treatment that may stimulate microglia, induce neuroinflammation and alter the levels of soluble Aβ, but the effects of ECT on microglia and Aβ aggregation in AD are not known. We investigated the short- and long-term effects of ECT on neuroinflammation and Aβ accumulation. 5xFAD mice received either electroconvulsive stimulation (ECS n = 26) or sham treatment (n = 25) for 3 weeks. Microglia and Aβ were analyzed in samples collected 24 h, 5 weeks, or 9 weeks after the last treatment. Aβ plaques and microglia were quantified using immunohistochemistry. The concentration of soluble Aβ and cytokines was quantified using ELISA and levels of Aβ aggregates were measured with Western Blot. Microglial phagocytosis of Aβ in the hippocampus was evaluated by flow cytometry in Methoxy-X04 injected mice 24 h following the last ECS treatment. Y-maze and Elevated plus maze were performed to study behavior after 5 weeks. We could not detect any significant short- or long-term effects of ECS on Aβ pathology or neuroinflammation, but ECS reduced abnormal behavior in the Elevated Plus maze.
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Heun R, Hein S. Risk factors of major depression in the elderly. Eur Psychiatry 2020; 20:199-204. [PMID: 15935417 DOI: 10.1016/j.eurpsy.2004.09.036] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2004] [Accepted: 09/24/2004] [Indexed: 11/25/2022] Open
Abstract
AbstractBackgroundSeveral risk factors of depression have been identified in retrospective as well as some prospective studies in the elderly. Confirmation in independent samples is needed. The present follow-up study prospectively investigated risk factors of depression in an elderly German sample.MethodsOne thousand four hundred and thirty-one subjects from a family study were re-investigated after 4.7 ± 2.5 years. Bivariate and multivariate forward logistic regression analyses were used to identify risk factors of the development of new depression in the elderly.ResultsRisk factors of a new depressive episode in 1408 elderly without current depression were age, female gender, a previous depression, subjective memory impairment, previous anxiety and somatoform disorders. The presence of dementia or mild cognitive impairment were significant risk factors in bivariate, but not multivariate analysis controlling for possible confounding. Risk factors of a first geriatric depressive episode were age, gender and subjective memory impairment; age remained the only significant risk factor in multivariate analysis.ConclusionsThis investigation confirms previous studies from other countries concerning the relevance of risk factors for depression in the elderly. The knowledge of risk factors might help identify subjects at increased risk of depression for early intervention approaches. Elderly with a history of previous depression carry the highest risk.
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Affiliation(s)
- Reinhard Heun
- Department of Psychiatry, University of Bonn, Venusberg, 53105 Bonn, Germany.
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Lanza CE, Sejunaite K, Steindel C, Scholz I, Riepe MW. On the conundrum of cognitive impairment due to depressive disorder in older patients. PLoS One 2020; 15:e0231111. [PMID: 32240257 PMCID: PMC7117703 DOI: 10.1371/journal.pone.0231111] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 03/16/2020] [Indexed: 11/19/2022] Open
Abstract
Objectives Depressive symptoms and cognitive impairment often concur in older persons. Differentiating the cause of cognitive impairment in older persons with Depressive Disorder (DD) from other diseases such as Alzheimer’s Disease (AD) is challenging. The goal of this study was to characterize cognitive impairment in older persons with DD. Design Cross-sectional retrospective observational clinical cohort study using patient records from 2014 to 2018. Setting Gerontopsychiatric services of Ulm University at Bezirkskrankenhaus Günzburg serving as primary psychiatric care institution and tertiary referral center for psychiatric care for older persons. Partcipants DD was diagnosed according to ICD-10 criteria. When indicated by the medical history or neuropsychological assessment further diagnostic procedures were initiated. Cerebrospinal fluid (CSF) tap was routinely the first additional procedure. If patients did not consent to CSF tap or contraindications were present, 18F-fluordesoxyglucose-PET (FDG-PET) or Amyloid-PET (Am-PET) were performed. Materials and methods Extensive neuropsychological test battery to assess cognitive profile. Results 457 subjects were diagnosed with DD (DD-all; age 50–94; 159 males, 298 females). Biomarkers were assessed in 176 persons; in 90 of these subjects AD-biomarkers were negative (DD-BM-; age 54–89; 40 males, 50 females), and in 86 subjects at least one biomarker was compatible with AD (DD-BM+; age 60–90; 31 males, 55 females). Cognitive performance was below healthy controls (HC; n = 56; age 50–80; 30 males, 26 females) for all groups of patients with DD. With case-control matching of HC and DD-BM- we find that executive functions are impaired in about one out of three and delayed recall in about two out of three patients with DD. Conclusion Cognitive impairment is frequent in older persons with DD. Cognitive profile in older patients with DD without and with biomarkers of AD is not distinguishable. Therefore, cognitive impairment due to DD should be diagnosed after exclusion of comorbid AD.
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Affiliation(s)
- Claudia E. Lanza
- Department of Psychiatry and Psychotherapy II, Mental Health & Old Age Psychiatry, Ulm University, Ulm, Germany
| | - Karolina Sejunaite
- Department of Psychiatry and Psychotherapy II, Mental Health & Old Age Psychiatry, Ulm University, Ulm, Germany
| | - Charlotte Steindel
- Department of Psychiatry and Psychotherapy II, Mental Health & Old Age Psychiatry, Ulm University, Ulm, Germany
| | - Ingo Scholz
- Department of Psychiatry and Psychotherapy II, Mental Health & Old Age Psychiatry, Ulm University, Ulm, Germany
| | - Matthias W. Riepe
- Department of Psychiatry and Psychotherapy II, Mental Health & Old Age Psychiatry, Ulm University, Ulm, Germany
- * E-mail:
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Shared genetic etiology underlying Alzheimer's disease and major depressive disorder. Transl Psychiatry 2020; 10:88. [PMID: 32152295 PMCID: PMC7062839 DOI: 10.1038/s41398-020-0769-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/14/2020] [Accepted: 02/25/2020] [Indexed: 01/22/2023] Open
Abstract
Patients with late-onset Alzheimer's disease (LOAD) frequently manifest comorbid neuropsychiatric symptoms with depression and anxiety being most frequent, and individuals with major depressive disorder (MDD) have an increased prevalence of LOAD. This suggests shared etiologies and intersecting pathways between LOAD and MDD. We performed pleiotropy analyses using LOAD and MDD GWAS data sets from the International Genomics of Alzheimer's Project (IGAP) and the Psychiatric Genomics Consortium (PGC), respectively. We found a moderate enrichment for SNPs associated with LOAD across increasingly stringent levels of significance with the MDD GWAS association (LOAD|MDD), of maximum four and eightfolds, including and excluding the APOE-region, respectively. Association analysis excluding the APOE-region identified numerous SNPs corresponding to 40 genes, 9 of which are known LOAD-risk loci primarily in chromosome 11 regions that contain the SPI1 gene and MS4A genes cluster, and others were novel pleiotropic risk-loci for LOAD conditional with MDD. The most significant associated SNPs on chromosome 11 overlapped with eQTLs found in whole-blood and monocytes, suggesting functional roles in gene regulation. The reverse conditional association analysis (MDD|LOAD) showed a moderate level, ~sevenfold, of polygenic overlap, however, no SNP showed significant association. Pathway analyses replicated previously reported LOAD biological pathways related to immune response and regulation of endocytosis. In conclusion, we provide insights into the overlapping genetic signatures underpinning the common phenotypic manifestations and inter-relationship between LOAD and MDD. This knowledge is crucial to the development of actionable targets for novel therapies to treat depression preceding dementia, in an effort to delay or ultimately prevent the onset of LOAD.
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Lee JR, Suh SW, Han JW, Byun S, Kwon SJ, Lee KH, Kwak KP, Kim BJ, Kim SG, Kim JL, Kim TH, Ryu SH, Moon SW, Park JH, Lee DW, Youn JC, Lee DY, Lee SB, Lee JJ, Jhoo JH, Kim KW. Anhedonia and Dysphoria Are Differentially Associated with the Risk of Dementia in the Cognitively Normal Elderly Individuals: A Prospective Cohort Study. Psychiatry Investig 2019; 16:575-580. [PMID: 31446685 PMCID: PMC6710416 DOI: 10.30773/pi.2019.06.07] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/07/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE We investigated the impact of depressed mood (dysphoria) and loss of interest or pleasure (anhedonia)on the risk of dementia in cognitively-normal elderly individuals. METHODS This study included 2,685 cognitively-normal elderly individuals who completed the baseline and 4-year follow-up assessments of the Korean Longitudinal Study on Cognitive Aging and Dementia. We ascertained the presence of dysphoria and anhedonia using the Mini International Neuropsychiatric Inventory. We defined subjective cognitive decline as the presence of subjective cognitive complaints without objective cognitive impairments. We analyzed the association of dysphoria and anhedonia with the risk of cognitive disorders using multinomial logistic regression analysis adjusted for age, sex, education, Cumulative Illness Rating Scale score, Apolipoprotein E genotype, and neuropsychological test performance. RESULTS During the 4-year follow-up period, anhedonia was associated with an approximately twofold higher risk of mild cognitive impairment (OR=2.09, 95% CI=1.20-3.64, p=0.008) and fivefold higher risk of dementia (OR=5.07, 95% CI=1.44-17.92, p=0.012) but was not associated with the risk of subjective cognitive decline. In contrast, dysphoria was associated with an approximately twofold higher risk of subjective cognitive decline (OR=2.06, 95% CI=1.33-3.19, p=0.001) and 1.7-fold higher risk of mild cognitive impairment (OR=1.75, 95% CI=1.00-3.05, p=0.048) but was not associated with the risk of dementia. CONCLUSION Anhedonia, but not dysphoria, is a risk factor of dementia in cognitively-normal elderly individuals.
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Affiliation(s)
- Ju Ri Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seung Wan Suh
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seonjeong Byun
- Department of Neuropsychiatry, National Medical Center, Seoul, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soon Jai Kwon
- Department of Psychiatry, Mediplex Sejong Hospital, Incheon, Republic of Korea
| | - Kyoung Hwan Lee
- Department of Psychiatry, Bongseng Memorial Hospital, Busan, Republic of Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Republic of Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Republic of Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Republic of Korea
| | - Dong-Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Republic of Korea
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.,National Institute of Dementia, Seongnam, Republic of Korea
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12
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Szymkowicz SM, Woods AJ, Dotson VM, Porges EC, Nissim NR, O’Shea A, Cohen RA, Ebner NC. Associations between subclinical depressive symptoms and reduced brain volume in middle-aged to older adults. Aging Ment Health 2019; 23:819-830. [PMID: 29381390 PMCID: PMC6066456 DOI: 10.1080/13607863.2018.1432030] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The associations between subclinical depressive symptoms, as well specific symptom subscales, on brain structure in aging are not completely elucidated. This study investigated the extent to which depressive symptoms were related to brain volumes in fronto-limbic structures in a sample of middle-aged to older adults. METHOD Eighty participants underwent structural neuroimaging and completed the Beck Depression Inventory, 2nd Edition (BDI-II), which comprises separate affective, cognitive, and somatic subscales. Gray matter volumes were extracted from the caudal and rostral anterior cingulate, posterior cingulate, hippocampus, and amygdala. Hierarchical regression models examined the relationship between brain volumes and (i) total depressive symptoms and (ii) BDI-II subscales were conducted. RESULTS After adjusting for total intracranial volume, race, and age, higher total depressive symptoms were associated with smaller hippocampal volume (p = 0.005). For the symptom subscales, after controlling for the abovementioned covariates and the influence of the other symptom subscales, more somatic symptoms were related to smaller posterior cingulate (p = 0.025) and hippocampal (p < 0.001) volumes. In contrast, the affective and cognitive subscales were not associated with brain volumes in any regions of interest. CONCLUSION Our data showed that greater symptomatology was associated with smaller volume in limbic brain regions. These findings provide evidence for preclinical biological markers of major depression and specifically advance knowledge of the relationship between subclinical depressive symptoms and brain volume. Importantly, we observed variations by specific depressive symptom subscales, suggesting a symptom-differential relationship between subclinical depression and brain volume alterations in middle-aged and older individuals.
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Affiliation(s)
- Sarah M. Szymkowicz
- Sarah M. Szymkowicz, M.S., 1Department of Clinical & Health Psychology, University of Florida, P.O. Box 100165, Gainesville, FL, 32610-0165. Phone: +1 (352) 273-6058.
| | - Adam J. Woods
- Adam J. Woods, Ph.D., 1Department of Clinical & Health Psychology, University of Florida, 2Center for Cognitive Aging & Memory, McKnight Brain Institute, University of Florida, P.O. Box 100015, Gainesville, FL, 32610-0015, 3Department of Neuroscience, University of Florida, P.O. Box 100244, Gainesville, FL, 32610-0244. Phone: +1 (352) 294-5842.
| | - Vonetta M. Dotson
- Vonetta M. Dotson, Ph.D., 4Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010. Phone: +1 (404) 413-6207.
| | - Eric C. Porges
- Eric C. Porges, Ph.D., 1Department of Clinical & Health Psychology, University of Florida, 2Center for Cognitive Aging & Memory, McKnight Brain Institute, University of Florida. Phone: +1 (352) 294-5838.
| | - Nicole R. Nissim
- Nicole R. Nissim, M.S., 2Center for Cognitive Aging & Memory, McKnight Brain Institute, University of Florida, 3Department of Neuroscience, University of Florida. Phone: +1 (352) 294-5742.
| | - Andrew O’Shea
- Andrew O’Shea, M.S., 1Department of Clinical & Health Psychology, University of Florida, 2Center for Cognitive Aging & Memory, McKnight Brain Institute, University of Florida. Phone: +1 (352) 294-5827.
| | - Ronald A. Cohen
- Ronald A. Cohen, Ph.D., 1Department of Clinical & Health Psychology, University of Florida, 2Center for Cognitive Aging & Memory, McKnight Brain Institute, University of Florida. Phone: +1 (352) 294-5840.
| | - Natalie C. Ebner
- Natalie C. Ebner, Ph.D., 2Center for Cognitive Aging & Memory, McKnight Brain Institute, University of Florida, 5Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611, 6Department of Aging & Geriatric Research, University of Florida, 2004 Mowry Road, Gainesville, FL, 32611. Phone: +1 (203) 691-0371.
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13
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Tan EY, Köhler S, Hamel RE, Muñoz-Sánchez JL, Verhey FR, Ramakers IH. Depressive Symptoms in Mild Cognitive Impairment and the Risk of Dementia: A Systematic Review and Comparative Meta-Analysis of Clinical and Community-Based Studies. J Alzheimers Dis 2019; 67:1319-1329. [DOI: 10.3233/jad-180513] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Eva Y.L. Tan
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University, The Netherlands
- Geestelijk Gezondheidszorg Eindhoven en de Kempen (GGzE), The Netherlands
| | - Sebastian Köhler
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University, The Netherlands
| | | | | | - Frans R.J. Verhey
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University, The Netherlands
| | - Inez H.G.B. Ramakers
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University, The Netherlands
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14
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Zuidersma M, Sjöberg L, Pantzar A, Fratiglioni L, Wang HX. A bi-factor model of the Montgomery Åsberg depression rating scale and future cognitive impairments in older adults: A 6-year follow-up study. J Psychiatr Res 2019; 109:1-9. [PMID: 30453181 DOI: 10.1016/j.jpsychires.2018.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 10/15/2018] [Accepted: 11/09/2018] [Indexed: 11/15/2022]
Abstract
Depression has been found to be associated with cognitive decline. This study evaluated the association of general depressive symptoms and motivational-related symptoms with cognitive impairment 6 years later and to explore the role of potential underlying mechanisms. In 2690 cognitively healthy persons aged ≥60 from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) depressive symptoms were derived from the Montgomery Åsberg Depression Rating Scale (MADRS). Cognitive performance was assessed at baseline and 6 years later in 1810 persons with the Mini Mental State Examination (global cognition), Digit Span Forward (short-term memory), Digit Span Backward (working memory), Clock-test (visuospatial construction), and the 5-item test (immediate and delayed recall). Bi-factor analysis on the MADRS yielded a General Depression factor and an unrelated Motivational factor. After adjusting for demographics, the General Depression factor was only associated with 6-year impairment in delayed recall (OR (95% CI): 1.18 (1.04-1.34)). This association was no longer significant after adjusting for demographics, cardiovascular risk, lifestyle factors and medication use. The Motivational factor was not significantly associated with future cognitive impairments after adjusting for demographics. Concluding, almost all associations of general depressive symptoms and motivational-related symptoms with future cognitive impairments appeared to be confounded by demographics. Only the association of general depressive symptoms with future memory impairments appeared to be explained by a combination of demographics, cardiovascular risk, lifestyle and medication use.
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Affiliation(s)
- Marij Zuidersma
- University Center of Psychiatry & Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Linnea Sjöberg
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | | | - Laura Fratiglioni
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Hui-Xin Wang
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stress Research Institute, Stockholm University, Sweden.
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15
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Elhusein B, Radwan A, Khairi A, Ahmed M. Atypical presentation of progressive young onset dementia. BMJ Case Rep 2018; 11:11/1/bcr-2018-225754. [PMID: 30567158 DOI: 10.1136/bcr-2018-225754] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present the case of a 34-year-old Jordanian woman who was referred to mainstream mental health services because of irritability, agitation, loss of appetite, withdrawal from family activities and sleeping difficulties. She was initially diagnosed with major depressive disorder but subsequently showed very poor response to antidepressant therapy. Her presentation gradually and dramatically progressed into full blown dementia within couple of years. Brain MRI showed atrophic cortical changes and subcortical white matter alterations consistent with Alzheimer's dementia. Brain PET scan revealed reduction in cerebral glucose metabolism in temporoparietal areas bilaterally most consistent with Alzheimer's dementia. There was a strong family history of early-onset dementia. A final diagnosis of young onset dementia was made, and unfortunately, she passed away at the age of 44 years.
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Affiliation(s)
- Bushra Elhusein
- Mental Health Services, Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Radwan
- Mental Health Services, Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Abdalla Khairi
- Mental Health Services, Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Ahmed
- Mental Health Services, Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
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16
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Hypertension and obesity moderate the relationship between β-amyloid and cognitive decline in midlife. Alzheimers Dement 2018; 15:418-428. [PMID: 30367828 DOI: 10.1016/j.jalz.2018.09.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/14/2018] [Accepted: 09/09/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND This study tested if central obesity, hypertension, or depressive symptoms moderated the relationship between β-amyloid (Aβ) and longitudinal cognitive performance in late middle-aged adults enriched for Alzheimer's disease (AD) risk. METHODS Participants (n = 207; ages = 40-70 years; 73% parental AD) in the Wisconsin Registry for Alzheimer's Prevention study completed 3+ neuropsychological evaluations and a [11C]PiB positron emission tomography scan or lumbar puncture. Linear mixed-effects regression models tested interactions of risk factor × Aβ × visit age on longitudinal Verbal Learning & Memory and Speed & Flexibility factor scores. RESULTS The relationship between Aβ and Verbal Learning & Memory decline was moderated by hypertension (χ2(1) = 3.85, P = .04) and obesity (χ2(1) = 6.12, P = .01); those with both elevated Aβ and the risk factor declined at faster rates than those with only elevated Aβ or elevated risk factors. CONCLUSION In this cohort, hypertension and obesity moderated the relationship between Aβ and cognitive decline.
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17
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Wetsman N. When the golden years turn blue. Nat Med 2018; 24:1294-1296. [PMID: 30139957 DOI: 10.1038/s41591-018-0174-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Nicole Wetsman
- Nicole Wetsman is a freelance science and health reporter based in, New York, USA.
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18
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Hsu DC, Mormino EC, Schultz AP, Amariglio RE, Donovan NJ, Rentz DM, Johnson KA, Sperling RA, Marshall GA. Lower Late-Life Body-Mass Index is Associated with Higher Cortical Amyloid Burden in Clinically Normal Elderly. J Alzheimers Dis 2018; 53:1097-105. [PMID: 27340843 DOI: 10.3233/jad-150987] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Lower body-mass index (BMI) in late life has been associated with an increased risk of dementia, and weight loss has been associated with more rapid decline in Alzheimer's disease (AD) dementia. OBJECTIVE To explore the association between BMI and cortical amyloid burden in clinically normal (CN) elderly at risk for AD dementia. METHODS Cross-sectional analyses were completed using baseline data from the Harvard Aging Brain Study, consisting of 280 community-dwelling CN older adults aged 62-90. Assessments included medical histories and physical exam, Pittsburgh compound B (PiB) positron emission tomography (PET) amyloid imaging, and apolipoprotein E ɛ4 (APOE4) genotyping. For the primary analysis, a general linear regression model was used to evaluate the association of BMI with PiB retention. Covariates included age, sex, years of education, and APOE4 carrier status. Secondary analyses were performed for BMI subdivisions (normal, overweight, obese), APOE4 carriers, and BMI×APOE4 interaction. RESULTS In the primary analysis, greater PiB retention was associated with lower BMI (β = -0.14, p = 0.02). In the secondary analyses, APOE4 carrier status (β= -0.27, p = 0.02) and normal BMI (β= -0.25, p = 0.01), as opposed to overweight or obese BMI, were associated with greater PiB retention. The BMI×APOE4 interaction was also significant (β= -0.14, p = 0.04). CONCLUSIONS This finding offers new insight into the role of BMI at the preclinical stage of AD, wherein lower BMI late in life is associated with greater cortical amyloid burden. Future studies are needed to elucidate the mechanism behind this association, especially in those with lower BMI who are APOE4 carriers.
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Affiliation(s)
- David C Hsu
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Mercy Medical Group, Sacramento, CA, USA
| | - Elizabeth C Mormino
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Aaron P Schultz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rebecca E Amariglio
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Nancy J Donovan
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Dorene M Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Keith A Johnson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Gad A Marshall
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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19
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Chiu PY, Wang CW, Tsai CT, Li SH, Lin CL, Lai TJ. Depression in dementia with Lewy bodies: A comparison with Alzheimer's disease. PLoS One 2017; 12:e0179399. [PMID: 28617831 PMCID: PMC5472293 DOI: 10.1371/journal.pone.0179399] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 05/30/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Depression is highly associated with dementia, and this study will compare the frequencies, severity, and symptoms of depression between dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). METHODS Frequency of depression was determined according to the DSM-IV criteria for major depression or the National Institute of Mental Health criteria for depression in AD (NIMH-dAD). Severity of depression were assessed using the Hamilton Depression Rating Scale, the Cornell Scale for Depression in Dementia, and the depression subscale in Neuropsychiatric Inventory. The rates of depressive symptoms were compared between AD and DLB. RESULTS A total of 312 patients were investigated (AD/DLB = 241/71). The frequency of major depression was significantly higher (p = 0.017) in DLB (19.7%) than in AD (8.7%). The higher frequency of depression in DLB was not reproduced by using the NIMH-dAD criteria (DLB: AD = 43.7%: 33.2%; p = 0.105). The severity of depression was higher in DLB than in AD according to the Hamilton Depression Rating Scale (p < 0.001) and the Cornell Scale for Depression in Dementia (p < 0.001). Among depressive symptoms, pervasive anhedonia had the highest odds ratio in DLB compared with AD. CONCLUSION This is the first study using the NIMH-dAD criteria to investigate the frequency of depression in DLB. Our study shows that co-morbid major depression is more frequent in DLB than in AD. Pervasive anhedonia had the greatest value for the differential diagnosis of depression between DLB and AD.
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Affiliation(s)
- Pai-Yi Chiu
- Department of Neurology, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Chein-Wei Wang
- Department of Neurology, Taichung Lin-Shin Hospital, Taichung, Taiwan
| | - Chun-Tang Tsai
- Department of Guidance and Counseling, National Changhua University of Education, Changhua, Taiwan
| | - Shin-Hua Li
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chih-Li Lin
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Te-Jen Lai
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
- * E-mail: ,
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20
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Banerjee A, Khemka VK, Roy D, Dhar A, Sinha Roy TK, Biswas A, Mukhopadhyay B, Chakrabarti S. Role of Pro-Inflammatory Cytokines and Vitamin D in Probable Alzheimer's Disease with Depression. Aging Dis 2017; 8:267-276. [PMID: 28580183 PMCID: PMC5440107 DOI: 10.14336/ad.2016.1017] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 10/17/2016] [Indexed: 12/26/2022] Open
Abstract
Symptoms of depression are present in a significant proportion of Alzheimer's disease (AD) patients. While epidemiological studies have shown a strong association between depression and AD, it has not been established whether depression is a risk factor or merely a co-morbidity of AD. It is also uncertain if depression affects the pathogenesis of AD. In this paper, we address these questions by measuring the serum levels of two common metabolic risk factors of AD and depression, inflammatory cytokines (IL 6 and TNF alpha) and serum 25-hydroxyvitamin D, in a case-control study. We measured the serum levels of IL 6, TNF α and 25-hydroxyvitamin D in age-matched healthy controls (n= 60) and in AD patients without depression (n=26) or AD patients with depression (n=34), and statistically analyzed the changes in these parameters among different groups under this study. Our results show that in AD there is a significant increase in IL 6 and TNF α and a marked decrease in 25-hydroxyvitamin D in the peripheral circulation compared to age-matched healthy controls. Furthermore, AD patients with depression have even significantly higher levels of IL 6 or TNF α and a lower level of 25-hydroxyvitamin D in circulation than in AD patients without depression. We also found a strong statistical correlation between the disease severity and the serum levels of IL 6, TNF α and 25-hydroxyvitamin D in AD patients with depression. These results suggest that altered circulating levels of common metabolic risk factors lead to the co-existence of depression with AD in many patients, and when they co-exist, the depression presumably affects the severity of AD presentations through more aggravated changes in these risk factors.
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Affiliation(s)
- Anindita Banerjee
- 1Department of Biochemistry, ICARE Institute of Medical Sciences and Research, Haldia, India.,2Department of Biochemistry, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Vineet Kumar Khemka
- 1Department of Biochemistry, ICARE Institute of Medical Sciences and Research, Haldia, India.,2Department of Biochemistry, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Debashree Roy
- 2Department of Biochemistry, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Aparajita Dhar
- 2Department of Biochemistry, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Tapan Kumar Sinha Roy
- 2Department of Biochemistry, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Atanu Biswas
- 3Department of Neurology, Bangur Institute of Neurosciences, Kolkata, India
| | - Barun Mukhopadhyay
- 4Biological Anthropology Unit, Indian Statistical Institute, Kolkata, India
| | - Sasanka Chakrabarti
- 1Department of Biochemistry, ICARE Institute of Medical Sciences and Research, Haldia, India
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21
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Ryu SH, Jung HY, Lee KJ, Moon SW, Lee DW, Hong N, Kee BS, Kim DH, Han C, Lee CU. Incidence and Course of Depression in Patients with Alzheimer's Disease. Psychiatry Investig 2017; 14:271-280. [PMID: 28539945 PMCID: PMC5440429 DOI: 10.4306/pi.2017.14.3.271] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 05/26/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Depressive symptoms are common in Alzheimer's disease (AD) and they might influence the course and prognosis of AD. Depression could appear anytime in the course of the disease, and could either last considerably long or disappear easily. This study is intended to investigate the occurrence of depression in the course of AD and the risk factors of incidence. METHODS This study targeted 1,272 AD patients without depressive symptoms at the start of this study in Korea. A total of 775 subjects completed the study, and the occurrence of depression was assessed after 12 months. Demographic information of subjects was collected and cognitive functions, overall functions, and depression severity were assessed at the start of this study and after 12 months. RESULTS Among the 775 subjects, 103 subjects (13.29%) developed depression 12 months later. The MMSE-KC scores showed significant changes in both groups that developed depression and did not. In the univariate analysis, significant differences in the incidence of depression were found in terms of gender, the administration of the antidepressant at the baseline, the SGDS-K score, and the GDS score. The multiple logistic regression analysis showed that the increase in the incidence of depression was associated with a female, in the increase in SGDS-K score and the GDS score. CONCLUSION The incidence of depression in the subjects who completed the 12-month follow-up observation was 13.29%. Moreover, in the multivariate analysis, a female gender and the severity of dementia, including the overall functions, seemed associated with the occurrence of depression.
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Affiliation(s)
- Seung-Ho Ryu
- Department of Psychiatry, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Han-Yong Jung
- Department of Psychiatry, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea
| | - Kang Joon Lee
- Department of Psychiatry, College of Medicine, Inje University, Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Seok Woo Moon
- Department of Konkuk University Chungju Hospital, School of Medicine, Konkuk University, Chungju, Republic of Korea
| | - Dong Woo Lee
- Department of Psychiatry, College of Medicine, Inje University, Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Narei Hong
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Baik Seok Kee
- Department of Psychiatry, Chung-Ang University, College of Medicine, Seoul, Republic of Korea
| | - Do Hoon Kim
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Changsu Han
- Department of Neuropsychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
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Risk analysis of use of different classes of antidepressants on subsequent dementia: A nationwide cohort study in Taiwan. PLoS One 2017; 12:e0175187. [PMID: 28384235 PMCID: PMC5383251 DOI: 10.1371/journal.pone.0175187] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 03/22/2017] [Indexed: 01/27/2023] Open
Abstract
Depression and dementia are common mental health problems and are associated in several ways. Early-life depression is associated with increased risk of later life dementia, and depression can present as a preclinical symptom or consequence of dementia. Despite the plausible relationship between these two clinical entities, the potential association between antidepressant medication and dementia has rarely been investigated. We conducted a 9-year retrospective analysis of Taiwan’s National Health Insurance Research Database (NHIRD), enrolling 5819 cases who had received prescriptions of antidepressants between 2003 and 2006, and 23,276 (with ratio of 1:4) age, sex, and index date-matched controls. The hazard ratio (HR) of dementia among antidepressant users with depression was 2.42 (95% confidence interval (CI): 1.15–5.10), for those without depression was 4.05 (95% CI: 3.19–5.15), compared to antidepressant non-users respectively. Among the 6 classes of common antidepressants used in Taiwan, the adjusted HRs were 3.66 (95% CI: 2.62–5.09) for SSRIs, 4.73 (95% CI: 2.54–8.80) for SNRI, 3.26 (95% CI: 2.30–4.63) for TCAs, 6.62 (95% CI: 3.34–13.13) for TeCA, 4.94 (95% CI: 2.17–11.24) for MAOI, and 4.48 (95% CI: 3.13–6.40) for SARI. Furthermore, the multivariate analysis result showed that the adjusted HRs of cumulative defined daily doses (cDDDs) were 3.74 (95% CI: 2.91–4.82), 3.73 (95% CI: 2.39–5.80) and 5.22 (95% CI: 3.35–8.14) for those who had cDDDs of <90, 90–180 and >180 compared to those who had taken no antidepressant medication. This is a retrospective study based on secondary data, hence, we could not claim causality between antidepressant medication and dementia. However, a potential association between antidepressant and occurrence of dementia after controlling for the status of depression was observed. Lack of patients’ data about smoking status and body mass index in NHIRD, which are considered related to dementia, was also a limitation in this study. In this study, we concluded that antidepressant medication is a potential risk factor for dementia, independent from any effect of depression itself.
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Assessing the presence of shared genetic architecture between Alzheimer's disease and major depressive disorder using genome-wide association data. Transl Psychiatry 2017; 7:e1094. [PMID: 28418403 PMCID: PMC5416691 DOI: 10.1038/tp.2017.49] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 01/24/2017] [Accepted: 01/25/2017] [Indexed: 01/03/2023] Open
Abstract
Major depressive disorder (MDD) and Alzheimer's disease (AD) are both common in older age and frequently co-occur. Numerous phenotypic studies based on clinical diagnoses suggest that a history of depression increases risk of subsequent AD, although the basis of this relationship is uncertain. Both illnesses are polygenic, and shared genetic risk factors could explain some of the observed association. We used genotype data to test whether MDD and AD have an overlapping polygenic architecture in two large population-based cohorts, Generation Scotland's Scottish Family Health Study (GS:SFHS; N=19 889) and UK Biobank (N=25 118), and whether age of depression onset influences any relationship. Using two complementary techniques, we found no evidence that the disorders are influenced by common genetic variants. Using linkage disequilibrium score regression with genome-wide association study (GWAS) summary statistics from the International Genomics of Alzheimer's Project, we report no significant genetic correlation between AD and MDD (rG=-0.103, P=0.59). Polygenic risk scores (PRS) generated using summary data from International Genomics of Alzheimer's Project (IGAP) and the Psychiatric Genomics Consortium were used to assess potential pleiotropy between the disorders. PRS for MDD were nominally associated with participant-recalled AD family history in GS:SFHS, although this association did not survive multiple comparison testing. AD PRS were not associated with depression status or late-onset depression, and a survival analysis showed no association between age of depression onset and genetic risk for AD. This study found no evidence to support a common polygenic structure for AD and MDD, suggesting that the comorbidity of these disorders is not explained by common genetic variants.
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Brailean A, Aartsen MJ, Muniz-Terrera G, Prince M, Prina AM, Comijs HC, Huisman M, Beekman A. Longitudinal associations between late-life depression dimensions and cognitive functioning: a cross-domain latent growth curve analysis. Psychol Med 2017; 47:690-702. [PMID: 27834162 PMCID: PMC5426346 DOI: 10.1017/s003329171600297x] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 10/16/2016] [Accepted: 10/17/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cognitive impairment and depression often co-occur in older adults, but it is not clear whether depression is a risk factor for cognitive decline, a psychological reaction to cognitive decline, or whether changes in depressive symptoms correlate with changes in cognitive performance over time. The co-morbid manifestation of depression and cognitive impairment may reflect either a causal effect or a common cause, depending on the specific symptoms experienced and the cognitive functions affected. METHOD The study sample comprised 1506 community-dwelling older adults aged ⩾65 years from the Longitudinal Aging Study Amsterdam (LASA). We conducted cross-domain latent growth curve analyses to examine longitudinal associations between late-life depression dimensions (i.e. depressed affect, positive affect, and somatic symptoms) and specific domains of cognitive functioning (i.e. processing speed, inductive reasoning, immediate recall, and delayed recall). RESULTS Poorer delayed recall performance at baseline predicted a steeper increase in depressed affect over time. Steeper decline in processing speed correlated with a steeper increase in somatic symptoms of depression over time. CONCLUSIONS Our findings suggest a prospective association between memory function and depressed affect, whereby older adults may experience an increase in depressed affect in reaction to poor memory function. Somatic symptoms of depression increased concurrently with declining processing speed, which may reflect common neurodegenerative processes. Our findings do not support the hypothesis that depression symptoms may be a risk factor for cognitive decline in the general population. These findings have potential implications for the treatment of late-life depression and for the prognosis of cognitive outcomes.
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Affiliation(s)
- A. Brailean
- Department of Health Service and Population
Research, King's College London, Institute of Psychiatry,
Psychology and Neuroscience, Centre for Global Mental Health,
London, UK
| | - M. J. Aartsen
- NOVA - Norwegian Social Research, Center for
Welfare and Labor Research, Oslo,
Norway
| | | | - M. Prince
- Department of Health Service and Population
Research, King's College London, Institute of Psychiatry,
Psychology and Neuroscience, Centre for Global Mental Health,
London, UK
| | - A. M. Prina
- Department of Health Service and Population
Research, King's College London, Institute of Psychiatry,
Psychology and Neuroscience, Centre for Global Mental Health,
London, UK
| | - H. C. Comijs
- VU University Medical Centre, Department of
Psychiatry and the EMGO Institute for Health and Care Research,
Amsterdam, The Netherlands
| | - M. Huisman
- VU University Medical Center, Department of
Epidemiology and Biostatistics and the EMGO Institute for Health and Care
Research, Amsterdam, The Netherlands
- Department of Sociology, VU
University, Amsterdam, The
Netherlands
| | - A. Beekman
- VU University Medical Centre, Department of
Psychiatry and the EMGO Institute for Health and Care Research,
Amsterdam, The Netherlands
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25
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Spauwen PJJ, Murphy RA, Jónsson PV, Sigurdsson S, Garcia ME, Eiriksdottir G, van Boxtel MPJ, Lopez OL, Gudnason V, Harris TB, Launer LJ. Associations of fat and muscle tissue with cognitive status in older adults: the AGES-Reykjavik Study. Age Ageing 2017; 46:250-257. [PMID: 28399220 DOI: 10.1093/ageing/afw219] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Indexed: 11/14/2022] Open
Abstract
Background/Objective studies on the association of dementia with specific body composition (BC) components are scarce. Our aim was to investigate associations of BC measures with different levels of cognitive function in late-life. Methods we studied 5,169 participants (mean age 76 years, 42.9% men) in the AGES-Reykjavik Study of whom 485 (9.4%) were diagnosed with mild cognitive impairment (MCI) and 307 (5.9%) with dementia. Visceral fat, abdominal and thigh subcutaneous fat, and thigh muscle were assessed by computed tomography. MCI and dementia were based on clinical assessment and a consensus meeting; those without MCI or dementia were categorised as normal. Multinomial regression models assessed the associations stratified by sex and in additional analyses by midlife body mass index (BMI). Results among women, there was a decreased likelihood of dementia per SD increase in abdominal subcutaneous fat (OR 0.72; 95% CI: 0.59-0.88), thigh subcutaneous fat (0.81; 0.67-0.98) and thigh muscle (0.63; 0.52-0.76), but not visceral fat, adjusting for demographics, vascular risk factors, stroke and depression. Inverse associations of fat with dementia were attenuated by weight change from midlife and were strongest in women with midlife BMI <25. In men, one SD increase in thigh muscle was associated with a decreased likelihood of dementia (0.75; 0.61-0.92). BC was not associated with MCI in men or women. Conclusion a higher amount of abdominal and thigh subcutaneous fat were associated with a lower likelihood of dementia in women only, while more thigh muscle was associated with a lower likelihood of dementia in men and women.
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Affiliation(s)
- Peggy J J Spauwen
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center and School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Rachel A Murphy
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Pálmi V Jónsson
- Department of Geriatrics, Landspitali National University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Melissa E Garcia
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | | | - Martin P J van Boxtel
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center and School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Oscar L Lopez
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
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Qiu WQ, Himali JJ, Wolf PA, DeCarli DC, Beiser A, Au R. Effects of white matter integrity and brain volumes on late life depression in the Framingham Heart Study. Int J Geriatr Psychiatry 2017; 32:214-221. [PMID: 27059548 PMCID: PMC5052093 DOI: 10.1002/gps.4469] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 02/20/2016] [Accepted: 02/23/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND It is unclear whether brain white matter hyperintensities (WMHI) causes or is a result of late life depression. We used the Framingham Heart Study offspring to examine whether indices of brain aging are related to incident depression in the elderly. METHODS The Center for Epidemiologic Studies Depression Scale (CES-D) was administered along with a brain MRI scan at baseline and was re-administered (n = 1212) at an average 6.6 + 0.6 year follow-up. The outcomes (i) change in CES-D scores from baseline; (ii) depression defined as CES-D ≥16; (iii) severe depression defined as CES-D ≥21; and (iv) CES-D cutoff scores and/or on antidepressant were used. RESULTS Among those who did not have depression at baseline, 9.1% (n = 110) developed depression, 4.0% (n = 48) developed severe depressive symptoms, and 11.1% (n = 135) were put on antidepressants. When depressive symptoms only was the outcome, we found that baseline WMHI was positively associated with change in CES-D scores and that those with an extensive WMHI at baseline had a high risk of developing severe depressive symptoms; the relationship was strengthened in the absence of cardiovascular diseases. In contrast, when depressive symptoms or taking antidepressant was the outcome, larger total cerebral brain volume and temporal lobe brain volume, but not WMHI, were negatively associated with the development of depression. CONCLUSIONS Brain WMHI is a probable risk factor for vascular depression in the elderly. The depression outcomes with and without antidepressant were related to different brain pathologies. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Wei Qiao Qiu
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA,Department of Pharmacology, Boston University School of Medicine, Boston, MA, USA,Alzheimer’s Disease Center, Boston University School of Medicine, Boston, MA, USA
| | - Jayandra J. Himali
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA,Framingham Heart Study, Boston University School of Public Health, Boston, MA, USA
| | - Philip A. Wolf
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA,Framingham Heart Study, Boston University School of Public Health, Boston, MA, USA
| | - D. Charles DeCarli
- Alzheimer’s Disease Center, University of California Davis Medical Center, Sacramento, CA, USA
| | - Alexa Beiser
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA,Framingham Heart Study, Boston University School of Public Health, Boston, MA, USA,Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Rhoda Au
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA,Framingham Heart Study, Boston University School of Public Health, Boston, MA, USA
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27
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Choi WH, Jung WS, Um YH, Lee CU, Park YH, Lim HK. Cerebral vascular burden on hippocampal subfields in first-onset drug-naïve subjects with late-onset depression. J Affect Disord 2017; 208:47-53. [PMID: 27744126 DOI: 10.1016/j.jad.2016.08.070] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 08/24/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although there is substantial evidence of associations between frontal-striatal circuits and cerebral vascular burden in late-onset depression (LOD), relationships between vascular burden and hippocampal subfields are not clear. The purpose of this study was to investigate relationships between cerebral vascular burden and hippocampal subfield volume in LOD patients. METHODS Fifty subjects with LOD and 50 group-matched healthy control subjects underwent magnetic resonance imaging scanning. Hippocampal subfields volumes were measured and compared between the groups. In addition, association patterns between white matter hyperintensity (WMH) volumes, clinical measures and hippocampal subfield volumes were investigated in the LOD group. RESULTS Subjects with LOD exhibited significant hippocampal volume reductions in the total hippocampus, cornu ammonis (CA) 1 and 3 and dentate gyrus (DG) areas compared with healthy subjects. Total WMH volume was negatively correlated with left total hippocampal volume and CA1 in the LOD group. In addition, depression severity was negatively associated with left and right CA3 volumes in the LOD group. LIMITATION Our findings of distinctive relationships between WMH and hippocampal subfields demonstrate a simple correlation, but do not prove causation CONCLUSION: This study is the first to elaborate distinctive association patterns between hippocampal subfield volumes and cerebral vascular burden in LOD. These structural changes in the hippocampal CA1, CA3 and DG areas might be at the core of the underlying neurobiological mechanisms of hippocampal dysfunction in LOD. However, longitudinal studies will be needed to identify the mechanisms of these structural changes.
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Affiliation(s)
- Woo Hee Choi
- Department of Radiology, Division of Nuclear Medicine The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Won Sang Jung
- Department of Radiology The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, The Seoul St. Mary's Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Young Ha Park
- Department of Radiology, Division of Nuclear Medicine The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea.
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Babulal GM, Ghoshal N, Head D, Vernon EK, Holtzman DM, Benzinger TLS, Fagan AM, Morris JC, Roe CM. Mood Changes in Cognitively Normal Older Adults are Linked to Alzheimer Disease Biomarker Levels. Am J Geriatr Psychiatry 2016; 24:1095-1104. [PMID: 27426238 PMCID: PMC5069099 DOI: 10.1016/j.jagp.2016.04.004] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 04/13/2016] [Accepted: 04/14/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To evaluate whether cerebrospinal fluid (CSF) and PET Pittsburgh Compound B (PiB) biomarkers of underlying Alzheimer disease (AD) pathology (β-amyloid42 [Aβ42], tau, phosphorylated tau181 [ptau181], tau/Aβ42, ptau181/Aβ42 and mean cortical binding potential [MCBP] for PET-PiB) predict changes in mood in cognitively normal older adults. SETTING Knight Alzheimer's Disease Research Center (ADRC) at Washington University (WU). PARTICIPANTS Participants, 65 years of age or older, were enrolled from longitudinal studies at the WU Knight ADRC. MEASUREMENTS CSF, PET-PiB biomarkers, Clinical Dementia Rating (CDR), Mini-Mental State Examination (MMSE), Profile of Mood States-Short Form (POMS-SF), the Geriatric Depression Scale (GDS), and Neuropsychiatric Inventory Questionnaire (NPI-Q). RESULTS Data from 118 participants at baseline and 66 participants at one-year follow-up were analyzed. CSF and PET biomarkers were not associated cross-sectionally with any mood disturbances at baseline (p > 0.05). Changes in mood as indicated by the total mood disturbance score on the POMS-SF, selected POMS-SF subscales, GDS, and NPI-Q scores from baseline to one-year follow-up were associated with (p < 0.05) CSF and PET-PiB biomarkers. There was no statistically significant decline in cognitive functioning. CONCLUSIONS Generally, higher values of CSF and PET-PiB biomarkers are associated with more changes in mood in cognitively normal older adults. Further work is needed to understand the temporal development of mood changes over several years during the phase of preclinical AD. Evaluating mood as a noncognitive outcome may provide further insight into the development of preclinical AD in cognitively normal older adults.
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Affiliation(s)
- Ganesh M. Babulal
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine,Department of Neurology, Washington University School of Medicine
| | - Nupur Ghoshal
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine,Department of Neurology, Washington University School of Medicine
| | - Denise Head
- Department of Neurology, Washington University School of Medicine,Department of Hope Center for Neurological Disorders, Washington University School of Medicine,Department of Psychology, Washington University School of Medicine
| | - Elizabeth K. Vernon
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine
| | - David M. Holtzman
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine,Department of Neurology, Washington University School of Medicine,Department of Hope Center for Neurological Disorders, Washington University School of Medicine
| | - Tammie L. S. Benzinger
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine,Department of Radiology, Washington University School of Medicine,Department of Neurosurgery, Washington University School of Medicine
| | - Anne M. Fagan
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine,Department of Neurology, Washington University School of Medicine,Department of Hope Center for Neurological Disorders, Washington University School of Medicine
| | - John C. Morris
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine,Department of Neurology, Washington University School of Medicine,Department of Pathology and Immunology, Washington University School of Medicine,Department of Physical Therapy, Washington University School of Medicine,Department of Occupational Therapy, Washington University School of Medicine
| | - Catherine M. Roe
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine,Department of Neurology, Washington University School of Medicine
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29
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Byun MS, Choe YM, Sohn BK, Yi D, Han JY, Park J, Choi HJ, Baek H, Lee JH, Kim HJ, Kim YK, Yoon EJ, Sohn CH, Woo JI, Lee DY. Association of Cerebral Amyloidosis, Blood Pressure, and Neuronal Injury with Late-Life Onset Depression. Front Aging Neurosci 2016; 8:236. [PMID: 27790137 PMCID: PMC5061734 DOI: 10.3389/fnagi.2016.00236] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/23/2016] [Indexed: 01/14/2023] Open
Abstract
Previous literature suggests that Alzheimer's disease (AD) process may contribute to late-life onset depression (LLOD). Therefore, we investigated the association of LLOD with cerebral amyloidosis and neuronal injury, the two key brain changes in AD, along with vascular risks. Twenty nine non-demented individuals who first experienced major depressive disorder (MDD) after age of 60 years were included as LLOD subjects, and 27 non-demented elderly individuals without lifetime experience of MDD were included as normal controls (NC). Comorbid mild cognitive impairment (MCI) was diagnosed in 48% of LLOD subjects and in 0% of NC. LLOD, irrespective of comorbid MCI diagnosis, was associated with prominent prefrontal cortical atrophy. Compared to NC, LLOD subjects with comorbid MCI (LLODMCI) showed increased cerebral 11C-Pittsburg compound B (PiB) retention and plasma beta-amyloid 1–40 and 1–42 peptides, as measures of cerebral amyloidosis; and, such relationship was not observed in overall LLOD or LLOD without MCI (LLODwoMCI). LLOD subjects, particularly the LLODwoMCI, had higher systolic blood pressure (SBP) than NC. When analyzed in the same multiple logistic regression model that included prefrontal gray matter (GM) density, cerebral amyloidosis, and SBP as independent variables, only prefrontal GM density showed a significant independent association with LLOD regardless of MCI comorbidity status. Our findings suggest AD process might be related to LLOD via prefrontal neuronal injury in the MCI stage, whereas vascular processes—SBP elevation, in particular—are associated with LLOD via prefrontal neuronal injury even in cognitively intact or less impaired individuals.
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Affiliation(s)
- Min Soo Byun
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University Seoul, South Korea
| | - Young Min Choe
- Department of Neuropsychiatry, Ulsan University Hospital Ulsan, South Korea
| | - Bo Kyung Sohn
- Department of Neuropsychiatry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center Seoul, South Korea
| | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University Seoul, South Korea
| | - Ji Young Han
- Department of Neuropsychiatry, Seoul National University Hospital Seoul, South Korea
| | - Jinsick Park
- Department of Biomedical Engineering, Hanyang University Seoul, South Korea
| | - Hyo Jung Choi
- Department of Neuropsychiatry, Seoul National University Hospital Seoul, South Korea
| | - Hyewon Baek
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly Yongin, South Korea
| | - Jun Ho Lee
- Department of Neuropsychiatry, Seoul National University Hospital Seoul, South Korea
| | - Hyun Jung Kim
- Department of Neuropsychiatry, Changsan Convalescent Hospital Changwon, South Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center Seoul, South Korea
| | - Eun Jin Yoon
- Department of Nuclear Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center Seoul, South Korea
| | - Chul-Ho Sohn
- Department of Radiology, Seoul National University Hospital Seoul, South Korea
| | - Jong Inn Woo
- Department of Psychiatry, Seoul National University College of Medicine Seoul, South Korea
| | - Dong Young Lee
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National UniversitySeoul, South Korea; Department of Neuropsychiatry, Seoul National University HospitalSeoul, South Korea; Department of Psychiatry, Seoul National University College of MedicineSeoul, South Korea
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30
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Ortner M, Pasquini L, Barat M, Alexopoulos P, Grimmer T, Förster S, Diehl-Schmid J, Kurz A, Förstl H, Zimmer C, Wohlschläger A, Sorg C, Peters H. Progressively Disrupted Intrinsic Functional Connectivity of Basolateral Amygdala in Very Early Alzheimer's Disease. Front Neurol 2016; 7:132. [PMID: 27698649 PMCID: PMC5027206 DOI: 10.3389/fneur.2016.00132] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 07/29/2016] [Indexed: 01/24/2023] Open
Abstract
Very early Alzheimer’s disease (AD) – i.e., AD at stages of mild cognitive impairment (MCI) and mild dementia – is characterized by progressive structural and neuropathologic changes, such as atrophy or tangle deposition in medial temporal lobes, including hippocampus and entorhinal cortex and also adjacent amygdala. While progressively disrupted intrinsic connectivity of hippocampus with other brain areas has been demonstrated by many studies, amygdala connectivity was rarely investigated in AD, notwithstanding its known relevance for emotion processing and mood disturbances, which are both important in early AD. Intrinsic functional connectivity (iFC) patterns of hippocampus and amygdala overlap in healthy persons. Thus, we hypothesized that increased alteration of iFC patterns along AD is not limited to the hippocampus but also concerns the amygdala, independent from atrophy. To address this hypothesis, we applied structural and functional resting-state MRI in healthy controls (CON, n = 33) and patients with AD in the stages of MCI (AD-MCI, n = 38) and mild dementia (AD-D, n = 36). Outcome measures were voxel-based morphometry (VBM) values and region-of-interest-based iFC maps of basolateral amygdala, which has extended cortical connectivity. Amygdala VBM values were progressively reduced in patients (CON > AD-MCI and AD-D). Amygdala iFC was progressively reduced along impairment severity (CON > AD-MCI > AD-D), particularly for hippocampus, temporal lobes, and fronto-parietal areas. Notably, decreased iFC was independent of amygdala atrophy. Results demonstrate progressively impaired amygdala intrinsic connectivity in temporal and fronto-parietal lobes independent from increasing amygdala atrophy in very early AD. Data suggest that early AD disrupts intrinsic connectivity of medial temporal lobe key regions, including that of amygdala.
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Affiliation(s)
- Marion Ortner
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München , Munich , Germany
| | - Lorenzo Pasquini
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar der Technischen Universität München , Munich , Germany
| | - Martina Barat
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar der Technischen Universität München , Munich , Germany
| | - Panagiotis Alexopoulos
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany; Department of Psychiatry, University Hospital of Rion, University of Patras, Rion Patras, Greece
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München , Munich , Germany
| | - Stefan Förster
- Department of Nuclear Medicine, Klinikum Bayreuth , Bayreuth , Germany
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München , Munich , Germany
| | - Alexander Kurz
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München , Munich , Germany
| | - Hans Förstl
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München , Munich , Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar der Technischen Universität München , Munich , Germany
| | - Afra Wohlschläger
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar der Technischen Universität München , Munich , Germany
| | - Christian Sorg
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany; Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - Henning Peters
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
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Brailean A, Comijs HC, Aartsen MJ, Prince M, Prina AM, Beekman A, Huisman M. Late-life depression symptom dimensions and cognitive functioning in the Longitudinal Aging Study Amsterdam (LASA). J Affect Disord 2016; 201:171-8. [PMID: 27235820 PMCID: PMC4914607 DOI: 10.1016/j.jad.2016.05.027] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/18/2016] [Indexed: 12/03/2022]
Abstract
BACKGROUND Depression often co-occurs in late-life in the context of declining cognitive functions, but it is not clear whether specific depression symptom dimensions are differentially associated with cognitive abilities. METHODS The study sample comprised 3107 community-dwelling older adults from the Longitudinal Aging Study Amsterdam (LASA). We applied a Multiple Indicators Multiple Causes (MIMIC) model to examine the association between cognitive abilities and latent dimensions of the Center for Epidemiologic Studies Depression Scale (CES-D), while accounting for differential item functioning (DIF) due to age, gender and cognitive function levels. RESULTS A factor structure consisting of somatic symptoms, positive affect, depressed affect, and interpersonal difficulties fitted the data well. Higher levels of inductive reasoning were significantly associated with lower levels of depressed affect and somatic symptoms, whereas faster processing speed was significantly associated with lower levels of somatic symptoms. DIF due to age and gender was found, but the magnitude of the effects was small and did not alter substantive conclusions. LIMITATIONS Due to the cross-sectional context of this investigation, the direction of influence between depression symptom levels and cognitive function levels cannot be established. Furthermore, findings are relevant to non-clinical populations, and they do not clarify whether certain DIF effects may be found only at high or low levels of depression. CONCLUSIONS Our findings suggest differential associations between late-life depression dimensions and cognitive abilities in old age, and point towards potential etiological mechanisms that may underline these associations. These findings carry implications for the prognosis of cognitive outcomes in depressed older adults.
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Affiliation(s)
- Anamaria Brailean
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Health Service and Population Research, Centre for Global Mental Health, London, UK.
| | - Hannie C. Comijs
- VU University Medical Centre, Department of Psychiatry and the EMGO Institute for Health and Care Research, Amsterdam, the Netherlands
| | - Marja J. Aartsen
- NOVA - Norwegian Social Research, Center for Welfare and Labor Research, Oslo, Norway
| | - Martin Prince
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Health Service and Population Research, Centre for Global Mental Health, London, UK
| | - A. Matthew Prina
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Health Service and Population Research, Centre for Global Mental Health, London, UK
| | - Aartjan Beekman
- VU University Medical Centre, Department of Psychiatry and the EMGO Institute for Health and Care Research, Amsterdam, the Netherlands
| | - Martijn Huisman
- VU University, Department of Sociology, Amsterdam, the Netherlands,VU University Medical Center, Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, Department of Sociology, Amsterdam, the Netherlands
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Grigsby J, Brega AG, Bennett RE, Bourgeois JA, Seritan AL, Goodrich GK, Hagerman RJ. Clinically significant psychiatric symptoms among male carriers of the fragile X premutation, with and without FXTAS, and the mediating influence of executive functioning. Clin Neuropsychol 2016; 30:944-59. [PMID: 27355103 PMCID: PMC5011752 DOI: 10.1080/13854046.2016.1185100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 04/26/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To clarify the neuropsychiatric phenotype of fragile X-associated tremor/ataxia syndrome (FXTAS), and assess the extent to which it is mediated by the dysexecutive syndrome that is a major feature of the disorder. METHODS We examined the prevalence of clinically meaningful psychiatric symptoms among male carriers of the fragile X premutation, with and without FXTAS, in comparison with men with a normal allele. Measures included the Neuropsychiatric Inventory (NPI), Symptom Checklist-90-R (SCL-90-R), and the Behavioral Dyscontrol Scale, a measure of executive functioning. Between-group differences were evaluated using logistic regression, followed by a mediation analysis with ordinary least squares regression to assess the contribution of dysexecutive syndrome to the observed psychiatric domains. RESULTS Men with FXTAS showed higher rates of clinically significant symptoms overall and in specific domains: somatization, obsessive compulsive, depression, anxiety, psychoticism, agitation/aggression, apathy/indifference, irritability, and nighttime behavior problems. Post hoc analyses suggested that findings of psychoticism among men with FXTAS may be associated with participants' accurate acknowledgment of cognitive and physical dysfunction, rather than reflecting psychosis. Asymptomatic carriers showed no evidence of clinically significant psychiatric symptoms, but when all carriers were compared with men having a normal FMR1 allele, executive function deficits were found to mediate scores in several domains on both NPI and SCL-90-R. CONCLUSIONS Building on prior research, the results provide evidence that the psychiatric phenotype for men includes clinically meaningful depression, hostility, and irritability, in association with behavioral and attentional disinhibition. It is likely that these problems reflect the effects of impaired executive functioning.
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Affiliation(s)
- Jim Grigsby
- a Department of Psychology , University of Colorado Denver , Denver , CO , USA
- b Department of Medicine , University of Colorado Denver , Aurora , CO , USA
| | - Angela G Brega
- c Department of Community and Behavioral Health , Colorado School of Public Health, University of Colorado Denver , Aurora , CO , USA
| | - Rachael E Bennett
- b Department of Medicine , University of Colorado Denver , Aurora , CO , USA
| | - James A Bourgeois
- d Department of Psychiatry , University of California , San Francisco , CA , USA
- e Langley Porter Psychiatric Institute , University of California , San Francisco , CA , USA
| | - Andreea L Seritan
- d Department of Psychiatry , University of California , San Francisco , CA , USA
| | - Glenn K Goodrich
- f Kaiser Permanente Institute for Health Research , Denver , CO , USA
| | - Randi J Hagerman
- g M.I.N.D. Institute , University of California, Davis , Sacramento , CA , USA
- h Department of Pediatrics , University of California, Davis, Medical Center , Sacramento , CA , USA
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Qiu WQ, Zhu H, Dean M, Liu Z, Vu L, Fan G, Li H, Mwamburi M, Steffens DC, Au R. Amyloid-associated depression and ApoE4 allele: longitudinal follow-up for the development of Alzheimer's disease. Int J Geriatr Psychiatry 2016; 31:316-22. [PMID: 26250797 PMCID: PMC4840849 DOI: 10.1002/gps.4339] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 07/03/2015] [Accepted: 07/08/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Amyloid-associated depression is associated with cognitive impairment cross sectionally. This follow-up study was to determine the relationship between amyloid-associated depression and the development of Alzheimer's disease (AD). METHODS Two hundred and twenty three subjects who did not have dementia at baseline were given a repeat cognitive evaluation for incident AD. Depression was defined by having a Center for Epidemiological Studies Depression (CES-D) score ≥ 16, and non-amyloid vs. amyloid-associated depression by having a low vs. high plasma amyloid-β peptide 40 (Aβ40)/Aβ42 ratio. Apolipoprotein E (ApoE) genotype was determined, and antidepressant usage was documented. RESULTS Fifteen subjects developed AD (7%) after an average follow-up time of 6.2 years. While none of those with non-amyloid depression developed AD, 9% of those with amyloid-associated depression developed AD. Further, among those with amyloid-associated depression, ApoE4 carriers tended to have a higher risk of AD than ApoE4 non-carriers (40% vs. 4%, p = 0.06). In contrast, 8% of those who did not have depression at baseline developed AD, but ApoE4 carriers and non-carriers did not show a difference in the AD risk. After adjusting for age, the interaction between ApoE4 and amyloid-associated depression (β = +0.113, SE = 0.047, P = 0.02) and the interaction between ApoE4 and antidepressant use (β = +0.174, SE = 0.064, P = 0.007) were associated with the AD risk. CONCLUSIONS Amyloid-associated depression may be prodromal depression of AD especially in the presence of ApoE4. Future studies with a larger cohort and a longer follow-up are warranted to further confirm this conclusion.
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Affiliation(s)
- Wei Qiao Qiu
- Department of Psychiatry, Boston University, Boston, MA, USA
,Department of Pharmacology and Experimental Therapeutics, Boston University, Boston, MA, USA
,Alzheimer’s Disease Center, Boston University, Boston, MA, USA
| | - Haihao Zhu
- Department of Pharmacology and Experimental Therapeutics, Boston University, Boston, MA, USA
| | - Michael Dean
- Department of Pharmacology and Experimental Therapeutics, Boston University, Boston, MA, USA
| | - Zhiheng Liu
- Department of Pharmacology and Experimental Therapeutics, Boston University, Boston, MA, USA
,Departments of Anesthesiology, the Second People’s Hospital of Shenzhen, China
| | - Linh Vu
- Department of Pharmacology and Experimental Therapeutics, Boston University, Boston, MA, USA
| | - Guanguang Fan
- Department of Pharmacology and Experimental Therapeutics, Boston University, Boston, MA, USA
,Departments of Anesthesiology, the Second People’s Hospital of Shenzhen, China
| | - Huajie Li
- Department of Pharmacology and Experimental Therapeutics, Boston University, Boston, MA, USA
,Department of Neurology, the First People’s Hospital of Chang Zhou, China
| | - Mkaya Mwamburi
- Department of Public Health and Family Medicine, Tufts University, Boston, MA, USA
| | - David C. Steffens
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Rhoda Au
- Department of Neurology, Boston University, Boston, MA, USA
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Lugtenburg A, Zuidersma M, Oude Voshaar RC, Schoevers RA. Symptom Dimensions of Depression and 3-Year Incidence of Dementia: Results From the Amsterdam Study of the Elderly. J Geriatr Psychiatry Neurol 2016; 29:99-107. [PMID: 26404165 DOI: 10.1177/0891988715606235] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To evaluate the association between depressive symptom dimensions and incident dementia in a community sample of older persons. METHODS Depressive symptoms at baseline and incident dementia at 3-year follow-up were assessed with the Geriatric Mental State (GMS)-Automated Geriatric Examination for Computer Assisted Taxonomy in nondemented persons aged 65 years or older. Exploratory and confirmatory bifactor analysis on the depression items yielded a general depression factor characterized by all GMS items and a cognitive/motivational factor characterized by cognitive and motivational "depressive" symptoms and the absence of depressed mood. RESULTS Ninety-three of 1911 persons had developed dementia at follow-up. The general depression factor increased the risk of dementia after adjustment for covariates (odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.14-1.92), but the cognitive/motivational factor did not (OR: 1.05, 95% CI: 0.75-1.47). However, in 1725 nondepressed older persons, the cognitive/motivational factor significantly predicted dementia after adjustment for covariates (OR: 1.53, 95% CI: 1.03-2.28) but not anymore after additional adjustment for subjective memory complaints (OR: 1.41, 95% CI: 0.94-2.13). The general depression factor did not significantly predict dementia in nondepressed older persons (OR: 1.15, 95% CI: 0.80-1.66). CONCLUSION Our findings suggest that the increased risk of dementia associated with depressive symptoms in many previous studies appears to be heterogeneous, that is, it is likely due to different underlying pathways, including a pathway involving depression itself and a pathway in which cognitive and motivational symptoms reflect subjective cognitive complaints, particularly in the absence of depressed mood. These different pathways might warrant a different treatment approach.
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Affiliation(s)
- Astrid Lugtenburg
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Marij Zuidersma
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Richard C Oude Voshaar
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Forstmeier S, Maercker A. Motivational processes in mild cognitive impairment and Alzheimer's disease: results from the Motivational Reserve in Alzheimer's (MoReA) study. BMC Psychiatry 2015; 15:293. [PMID: 26578083 PMCID: PMC4650956 DOI: 10.1186/s12888-015-0666-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 10/28/2015] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Brain reserve, i.e., the ability of the brain to tolerate age- and disease-related changes in a way that cognitive function is still maintained, is assumed to be based on the lifelong training of various abilities. The Motivational Reserve in Alzheimer's (MoReA) is a longitudinal study that aims to examine motivational processes as a protective factor in mild Alzheimer's dementia (AD) and mild cognitive impairment (MCI). This paper presents the results of motivational variables, frequency of diagnoses, and prediction of global cognition as well as depression in a one-year longitudinal study. METHODS The sample consists of 64 subjects with MCI and 47 subjects with mild AD at baseline. At baseline, the physical/neurological examinations, standard clinical assessment, neuropsychological testing, and assessment of motivational variables were performed. At follow-up (FU) one year later, neuropsychological testing including cognition, functional abilities, behavioral and affective symptoms, and global clinical assessments of severity have been repeated. RESULTS AD cases have lower motivational capacities as measured with a midlife motivation-related occupational score and informant-reported present motivational processes, but do not differ with regard to delay of gratification (DoG) and self-reported motivational processes. DoG and delay discounting (DD) were relatively stable during the measurement interval. However, 20 % of the MCI cases converted to mild AD at FU, and 17 % of the mild AD cases converted to moderate AD. The rate of depression of Alzheimer's disease was 9 at baseline and 21 % at FU, and the rate of apathy was 7 and 14 %, respectively. Global cognition at FU was mainly predicted by baseline global cognition but also by one of the motivational variables (scenario test). Depression at FU was predicted mainly by two motivational variables (self-reported and informant-reported motivational processes). CONCLUSIONS This research might inform motivation-related strategies for prevention and early intervention with older people or people at risk for AD.
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Affiliation(s)
- Simon Forstmeier
- Developmental Psychology, Faculty II, University of Siegen, Adolf-Reichwein-Str. 2, 57068, Siegen, Germany.
| | - Andreas Maercker
- Psychopathology and Clinical Interventions, Department of Psychology, University of Zurich, Binzmuehlestr. 14/17, 8050, Zurich, Switzerland.
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Chang TT, Lung FW, Yen YC. Depressive symptoms, cognitive impairment, and metabolic syndrome in community-dwelling elderly in Southern Taiwan. Psychogeriatrics 2015; 15:109-115. [PMID: 25521171 DOI: 10.1111/psyg.12080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 08/07/2014] [Accepted: 09/02/2014] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Metabolic syndrome and depression are both thought to be associated with cognitive impairment in the elderly. Metabolic syndrome is also correlated with depression. We examined their possible pathways in a population-based sample. METHODS We recruited 300 older community participants from Southern Taiwan. Demographics, medical history, severity of depressive symptoms, cognitive function, apolipoprotein genotyping, and lipid profile were collected. The presence of metabolic syndrome was confirmed with the Third Report of the National Cholesterol Education Program's Adult Treatment Panel. Possible relationships between metabolic syndrome, depressive symptoms, and cognitive dysfunction were explored using logistic regression and structured equation modelling. RESULTS When gender, age, education, marital status, and apolipoprotein genotype were adjusted for logistic regression, metabolic syndrome and depressive symptoms were independent and significant predictors of cognitive dysfunction for community-dwelling elderly. In structural equation modelling, metabolic syndrome and depressive symptoms were correlated to each other, and both contributed to the presence of cognitive dysfunction. CONCLUSIONS Depressive symptoms and metabolic syndrome are independently associated with cognitive impairment among community-dwelling elderly.
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Affiliation(s)
| | - For-Wey Lung
- Songde Branch, Taipei City Hospital, Taipei, Taiwan.,Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan.,Department of Neurology, Kaohsiung Medial University, Kaohsiung, Taiwan
| | - Yung-Chieh Yen
- Department of Psychiatry, E-Da Hospital, Taipei, Taiwan.,School of Medicine, I-Shou University, Taiwan
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Zilkens RR, Bruce DG, Duke J, Spilsbury K, Semmens JB. Severe psychiatric disorders in mid-life and risk of dementia in late- life (age 65-84 years): a population based case-control study. Curr Alzheimer Res 2015; 11:681-93. [PMID: 25115541 PMCID: PMC4153082 DOI: 10.2174/1567205011666140812115004] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 06/19/2014] [Accepted: 07/03/2014] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To examine the association of mid-life exposure to several psychiatric disorders with the development of late-life dementia. METHODS A matched case-control study using Western Australian state-wide hospital inpatient, outpatient mental health and emergency records linked to death records. Incident dementia cases (2000-2009) aged 65 to 84 years were sex- and age-matched to an electoral roll control. Records as far back as 1970 were used to assess exposure to medical risk factors before age 65 years. Candidate psychiatric risk factors were required to be present at least 10 years before dementia onset to ensure direction of potential causality. Odds ratios were estimated using conditional logistic regression. RESULTS 13, 568 dementia cases (median age 78.7 years, 43.4 % male) were matched to a control. Depression, bipolar disorder, schizophrenia, anxiety disorder and alcohol dependence were found to be significant and independent risk factors for late-life dementia after adjusting for diabetes, heart disease, cerebrovascular disease and smoking risk factors. The effect of a history of depression, schizophrenia and alcohol dependency on dementia risk varied with age, being strongest for earlier onset late-life dementia and waning at older ages. CONCLUSION Severe depression, anxiety disorder, bipolar disorder, schizophrenia and alcoholic dependency disorder treated by specialists in psychiatric facilities in mid-life are important risk factors for late-life dementia. These psychiatric conditions need to be considered in future studies of the risk and prevention of late-life dementia.
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Affiliation(s)
| | | | | | | | - James B Semmens
- Curtin University, Room 238, Building 400, GPO Box U1987, Perth Western Australia 6845.
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Ismail Z, Malick A, Smith EE, Schweizer T, Fischer C. Depression versus dementia: is this construct still relevant? Neurodegener Dis Manag 2014; 4:119-26. [PMID: 24832029 DOI: 10.2217/nmt.14.5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Cognitive impairment has long been identified as a component of late-life depression (LLD), and depressive symptoms are common in neurodegeneration. Depression may confer a greater risk of cognitive decline in a cognitively intact population and further cognitive decline in a mild cognitive impairment population compared with those without depression. Exploration of the link between cognitive impairment in LLD and the depressive features of neurodegeneration is an essential part of a diagnostic algorithm. In this review, we will discuss these links; we will address depressive symptoms as a risk factor for dementia and as a prodrome to dementia. We will review clinical subtypes and imaging markers as predictors of development of dementia in depressed patients and explore vascular etiologies. We will also explore LLD and dementia as a spectrum, rather than mutually exclusive diagnostic entities.
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Affiliation(s)
- Zahinoor Ismail
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
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Guerrero-Berroa E, Kluger A, Schmeidler J, Sailor K, Lizardi H, Golomb J, Ferris S, Reisberg B. Neuropsychological and neuropsychiatric prediction of global cognitive status among older Spanish-speaking Hispanics and English-speaking whites. J Geriatr Psychiatry Neurol 2014; 27:266-75. [PMID: 24759088 PMCID: PMC4465291 DOI: 10.1177/0891988714532020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Neuropsychological and depression measures have been found to predict cognitive functioning. We compared these associations among whites and Spanish-speaking Hispanics. METHODS Fifty-two pairs of whites and Hispanics were matched demographically and clinically in a cross-sectional study. Hierarchical regression analyses predicted Global Deterioration Scale (GDS) rating by baseline neuropsychological tests and depression symptoms. RESULTS Neuropsychological tests predicted GDS better in whites; depression symptoms--specifically retardation--predicted well in Hispanics but not whites. Immediate recall of the New York University (NYU)-Paragraph Test and the Retardation item of the Hamilton Depression Rating Scale were associated with GDS in Hispanics and delayed recall of the NYU-Paragraph Test and Wechsler Adult Intelligence Scale-Digit Symbol in whites. Neuropsychological tests and depression symptoms predicted GDS differently in Hispanics and whites. DISCUSSION These results suggest that other measures should be considered to increase the predictive accuracy of neuropsychological tests when assessing cognitive status in Spanish-speaking Hispanics. Additional studies of specific ethnic/racial and sociodemographic subgroups are warranted.
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Affiliation(s)
| | - Alan Kluger
- Department of Psychology, Lehman College/City University of New York, New York, NY, USA, Alzheimer's Disease Center, Comprehensive Center on Brain Aging, New York University Langone Medical Center, New York, NY, USA
| | - James Schmeidler
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kevin Sailor
- Department of Psychology, Lehman College/City University of New York, New York, NY, USA
| | - Humberto Lizardi
- Department of Psychology, Lehman College/City University of New York, New York, NY, USA
| | - James Golomb
- Alzheimer's Disease Center, Comprehensive Center on Brain Aging, New York University Langone Medical Center, New York, NY, USA
| | - Steven Ferris
- Alzheimer's Disease Center, Comprehensive Center on Brain Aging, New York University Langone Medical Center, New York, NY, USA
| | - Barry Reisberg
- Alzheimer's Disease Center, Comprehensive Center on Brain Aging, New York University Langone Medical Center, New York, NY, USA
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Shimada H, Park H, Makizako H, Doi T, Lee S, Suzuki T. Depressive symptoms and cognitive performance in older adults. J Psychiatr Res 2014; 57:149-56. [PMID: 25023083 DOI: 10.1016/j.jpsychires.2014.06.004] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 05/21/2014] [Accepted: 06/06/2014] [Indexed: 12/22/2022]
Abstract
Many longitudinal studies have found that older adults with depressive symptoms or depression have increased risk of cognitive impairment. We investigated the relationships between depressive symptoms or depression, cognitive function, serum brain-derived neurotrophic factor (BDNF), and volumetric MRI measurements in older adults. A total of 4352 individuals aged 65 years or older (mean age 72 years) participated in the study. We investigated medical history and geriatric depression scale-15 (GDS-15) items to determine depression and depressive symptoms. Cognitive tests included the mini-mental state examination (MMSE), story memory, word list memory, trail-making tests, and the symbol digit substitution task. Of the 4352 participants, 570 (13%) fulfilled the criteria for depressive symptoms (GDS-15: 6 + points) and 87 (2%) were diagnosed with depression. All cognitive tests showed significant differences between the 'no depressive symptoms', 'depressive symptoms', and 'depression' groups. The 'depressive symptoms' and 'depression' groups showed lower serum BDNF (p < 0.001) concentrations than the 'no depressive symptoms' group. The 'depressive symptoms' group exhibited greater atrophy of the right medial temporal lobe than did the 'no depressive symptoms' group (p = 0.023). These results suggest that memory, executive function, and processing speed examinations are useful to identify cognitive decline in older adults who have depressive symptoms and depression. Serum BDNF concentration and atrophy of the right medial temporal lobe may in part mediate the relationships between depressive symptoms and cognitive decline.
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Affiliation(s)
- Hiroyuki Shimada
- Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 35 Gengo, Morioka-machi, Obu, Aichi 474-8511, Japan.
| | - Hyuntae Park
- Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hyuma Makizako
- Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 35 Gengo, Morioka-machi, Obu, Aichi 474-8511, Japan
| | - Takehiko Doi
- Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 35 Gengo, Morioka-machi, Obu, Aichi 474-8511, Japan
| | - Sangyoon Lee
- Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 35 Gengo, Morioka-machi, Obu, Aichi 474-8511, Japan
| | - Takao Suzuki
- Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
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Pantzar A, Laukka EJ, Atti AR, Fastbom J, Fratiglioni L, Bäckman L. Cognitive deficits in unipolar old-age depression: a population-based study. Psychol Med 2014; 44:937-947. [PMID: 23842200 DOI: 10.1017/s0033291713001736] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND There is substantial variability in the degree of cognitive impairment among older depressed persons. Inconsistencies in previous findings may be due to differences in clinical and demographic characteristics across study samples. We assessed the influence of unipolar depression and severity of depression on cognitive performance in a population-based sample of elderly persons aged ⩾60 years. METHOD Eighty-nine persons fulfilled ICD-10 criteria for unipolar depression (mild, n = 48; moderate, n = 38; severe, n = 3) after thorough screening for dementia (DSM-IV criteria), psychiatric co-morbidities and antidepressant pharmacotherapy. Participants (n = 2486) were administered an extensive cognitive test battery. RESULTS Moderate/severe unipolar depression was associated with poorer performance on tasks assessing processing speed, attention, executive function, verbal fluency, episodic memory and vocabulary. Mild depression was associated with poorer performance in processing speed, and few differences between mild and moderate/severe depression were observed. No association between depression and short-term memory, general knowledge or spatial ability was observed. Increasing age did not exacerbate the depression-related cognitive deficits, and the deficits remained largely unchanged after excluding persons in a preclinical phase of dementia. Furthermore, depression-related cognitive deficits were not associated with other pharmacological treatments that may affect cognitive performance. CONCLUSIONS Cognitive deficits in unipolar old-age depression involve a range of domains and the cognitive deficits seem to follow the spectrum of depression severity. The finding that mild depression was also associated with poorer cognitive functioning underscores the importance of detecting mild depression in elderly persons.
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Affiliation(s)
- A Pantzar
- Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - E J Laukka
- Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - A R Atti
- Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - J Fastbom
- Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - L Fratiglioni
- Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - L Bäckman
- Aging Research Center, Karolinska Institutet, Stockholm University, Stockholm, Sweden
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Polyakova M, Sonnabend N, Sander C, Mergl R, Schroeter ML, Schroeder J, Schönknecht P. Prevalence of minor depression in elderly persons with and without mild cognitive impairment: a systematic review. J Affect Disord 2014; 152-154:28-38. [PMID: 24103852 DOI: 10.1016/j.jad.2013.09.016] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 08/08/2013] [Accepted: 09/17/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Minor depression (MinD) and mild cognitive impairment (MCI) are common disorders in late life that often coexist. The aim of the present review is to demonstrate prevalence rates of minor depression in older patients with and without MCI. METHODS Electronic database searches were performed through Medline, ISI Web of Knowledge, Psycinfo, and Cochrane library. Two independent reviewers extracted the original studies based on inclusion criteria: representative study population aged 55 and older, diagnostics of MinD according to DSM. Data on prevalence rates, risk factors, comorbidity and health care usage were analyzed. RESULTS Point prevalence for MinD is higher in medical settings (median 14.4%) than in the community-based settings (median 10.4%) and primary care patients (median 7.7%). Although minor depression is rarely investigated in elderly persons with MCI, nearly 20% of patients with MCI seem to suffer from MinD. No data was found on the prevalence of MCI in patients with MinD. Risk factors associated with MinD include female gender, history of cerebrovascular diseases, generalized anxiety disorder, loneliness, and long-term institutional care. LIMITATIONS Methodological differences of included studies resulted in a broad range of prevalence rates. No data is shown regarding the prevalence of MCI in MinD group due to insufficient evidence. CONCLUSIONS Our review indicates that MinD is frequent in elderly population. MCI among those subjects has not been sufficiently investigated. Future studies based on clinical structured interviews should be performed in longitudinal design in order to differentiate late-life depression from progressive MCI or early manifestation of Alzheimer's disease.
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Affiliation(s)
- M Polyakova
- Department of Psychiatry, University of Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany; Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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Varga J, Klausz B, Domokos Á, Kálmán S, Pákáski M, Szűcs S, Garab D, Zvara Á, Puskás L, Kálmán J, Tímár J, Bagdy G, Zelena D. Increase in Alzheimer's related markers preceeds memory disturbances: Studies in vasopressin-deficient Brattleboro rat. Brain Res Bull 2014; 100:6-13. [DOI: 10.1016/j.brainresbull.2013.10.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 10/18/2013] [Accepted: 10/21/2013] [Indexed: 11/25/2022]
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Abstract
OBJECTIVES This study examined correlates of cognitive functioning and possible cognitive impairment among older adults living in Da Nang, Vietnam and surrounding rural areas. METHODS The analytic sample consisted of 489 adults, 55 and older stratified by gender, age, and residence in a rural or urban area. The sample was 46% rural, 44% women, with a mean age of 69.04. Interviews were conducted in individuals' homes by trained interviewers. The dependent variable was a Vietnamese version of the mini mental status examination (MMSE). A multiple linear regression was run with the MMSE continuous scores reflecting cognitive functioning, while a binary logistic regression was conducted with an education-adjusted cut-off score reflecting possible cognitive impairment. Age, gender, education, material hardship, depressive symptoms Center for Epidemiologic Studies - Depression Scale, war injury, head trauma, diabetes, cardiovascular and cerebrovascular disease conditions served as correlates, controlling for marital status and rural/urban residence. RESULTS About 33% of the sample scored below the standard cutoff of 23 on the MMSE. However, only 12.9% of the sample would be considered impaired using the education-adjusted cut-off score. Cognitive functioning and possible cognitive impairment as indicated by MMSE scores were significantly associated with being older, completing fewer years of education, and material hardship. Gender, depressive symptoms, and cerebrovascular disease were associated with cognitive functioning, but not cognitive impairment. CONCLUSION These results show that social characteristics, physical illness, and mental health are associated with cognitive functioning. The study also raises questions about the need for standardization of screening measures on Vietnamese populations.
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Affiliation(s)
- Amanda Leggett
- a Human Development and Family Studies, State College , The Pennsylvania State University , PA , USA
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Shahnawaz Z, Reppermund S, Brodaty H, Crawford JD, Draper B, Trollor JN, Sachdev PS. Prevalence and characteristics of depression in mild cognitive impairment: the Sydney Memory and Ageing Study. Acta Psychiatr Scand 2013; 127:394-402. [PMID: 22943523 DOI: 10.1111/acps.12008] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Depression might be a risk factor for dementia. However, little is known about the prevalence of depressive symptoms in mild cognitive impairment (MCI) and whether mood or motivation-related symptoms are predominant. METHOD A total of 767 non-demented community-dwelling adults aged 70-90 years completed a comprehensive assessment, including neuropsychological testing, and a past psychiatric/medical history interview. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS) and Kessler Psychological Distress Scale (K10). Exploratory factor analysis was performed on the GDS and K10 to derive 'mood' and 'motivation' subscales. RESULTS A total of 290 participants were classified as having MCI and 468 as cognitively normal (CN). Participants with MCI reported more depressive symptoms, and more MCI participants met the cut-off for clinically significant symptoms, relative to CN participants. Those with amnestic MCI (aMCI), but not non-amnestic MCI, had more depressive symptoms and were more likely to meet the cut-off for clinically significant depressive symptoms, relative to CN participants. Participants with MCI reported more mood-related symptoms than CN participants, while there were no differences between groups on motivation-related symptoms. CONCLUSION Individuals with MCI, especially aMCI, endorse more depressive symptoms when compared with cognitively intact individuals. These findings highlight the importance of assessing and treating depressive symptoms in MCI.
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Affiliation(s)
- Z Shahnawaz
- Brain and Ageing Research Program, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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Balash Y, Mordechovich M, Shabtai H, Giladi N, Gurevich T, Korczyn AD. Subjective memory complaints in elders: depression, anxiety, or cognitive decline? Acta Neurol Scand 2013; 127:344-50. [PMID: 23215819 DOI: 10.1111/ane.12038] [Citation(s) in RCA: 194] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To study the association of subjective memory complaints (SMC) with affective state and cognitive performance in elders. MATERIALS AND METHODS We studied community dwelling elderly persons with normal physical examination. Participants completed questionnaires regarding memory difficulties and lifestyle habits, the Geriatric Depression Scale (GDS) and the Spielberger State-Trait Anxiety Inventory (STAI). Depending on their answers to the question about their memory condition, participants were divided into complainers and non-complainers and to five groups according to their MMSE scores. These data have been compared to objective cognitive performance according to Mindstreams - a computerized neuropsychological battery. A logistic regression was performed to evaluate odds ratios (OR) and 95% confidence intervals (CI) for those factors, which were associated with SMС (dependent variable). RESULTS Of 636 consecutive subjects (61% females), 507 participants (79.7%) had SMС. Presence of SMC was inversely correlated with MMSE scores, (r = -0.108; P for trend = 0.007). GDS and STAI scores were higher among subjects with SMC (OR = 1.23: CI 95%: 1.1-1.36 and OR = 1.03: CI 95%: 1.01-1.07, respectively). SMC did not correlate with objective cognitive performance measured by Mindstreams. CONCLUSIONS Subjective memory complaints are associated with sub-syndromal depression and anxiety in healthy cognitively normal elders.
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Affiliation(s)
| | | | - H. Shabtai
- Tel-Aviv Sourasky Medical Center; Tel Aviv; Israel
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Millán-Calenti JC, Sánchez A, Lorenzo-López L, Cao R, Maseda A. Influence of Social Support on Older Adults with Cognitive Impairment, Depressive Symptoms, or Both Coexisting. Int J Aging Hum Dev 2013; 76:199-214. [DOI: 10.2190/ag.76.3.b] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The influence of social support dimensions (the extent of contact with others, the satisfaction with contacts, and the availability of help if sick or disabled) in elderly people with cognitive impairment (COG), depressive symptoms (DEP), or the co-occurrence of these symptoms (COG-DEP) was assessed in a cross-sectional analysis of a representative sample of 579 individuals aged 65 years and older. A lower extent of contact was related to COG ( OR: 2.26). Fair satisfaction with contacts was related to DEP ( OR: 2.88) and COG-DEP (OR: 4.22). A low level of satisfaction with contacts was an important predictor for DEP ( OR: 7.99) and COG-DEP ( OR: 7.88). Therefore, different dimensions of social support were independently correlated with different aspects of mental health. Quantitative aspects of social support were significantly linked to the presence of cognitive impairment. Satisfaction with social support affected depressive symptoms both alone and when they co-occurred with cognitive impairment.
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Luppa M, Luck T, Ritschel F, Angermeyer MC, Villringer A, Riedel-Heller SG. Depression and incident dementia. An 8-year population-based prospective study. PLoS One 2013; 8:e59246. [PMID: 23527147 PMCID: PMC3602089 DOI: 10.1371/journal.pone.0059246] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 02/13/2013] [Indexed: 11/18/2022] Open
Abstract
Aims The aim of the study was to investigate the impact of depression (categorical diagnosis; major depression, MD) and depressive symptoms (dimensional diagnosis and symptom patterns) on incident dementia in the German general population. Methods Within the Leipzig Longitudinal Study of the Aged (LEILA 75+), a representative sample of 1,265 individuals aged 75 years and older were interviewed every 1.5 years over 8 years (mean observation time 4.3 years; mean number of visits 4.2). Cox proportional hazards and binary logistic regressions were used to estimate the effect of baseline depression and depressive symptoms on incident dementia. Results The incidence of dementia was 48 per 1,000 person-years (95% confidence interval (CI) 45–51). Depressive symptoms (Hazard ratio HR 1.03, 95% CI 1.01–1.05), and in particular mood-related symptoms (HR 1.08, 95% CI 1.03–1.14), showed a significant impact on the incidence of dementia only in univariate analysis, but not after adjustment for cognitive and functional impairment. MD showed only a significant impact on incidence of dementia in Cox proportional hazards regression, but not in binary logistic regression models. Discussion The present study using different diagnostic measures of depression on future dementia found no clear significant associations of depression and incident dementia. Further in-depth investigation would help to understand the nature of depression in the context of incident dementia.
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Affiliation(s)
- Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
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Brunnström H, Passant U, Englund E, Gustafson L. History of depression prior to Alzheimer's disease and vascular dementia verified post-mortem. Arch Gerontol Geriatr 2012; 56:80-4. [PMID: 23116976 DOI: 10.1016/j.archger.2012.10.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 10/05/2012] [Accepted: 10/08/2012] [Indexed: 10/27/2022]
Abstract
The aim of this study was to analyze the medical history, with regards to previous remote depression, in patients with neuropathologically verified Alzheimer's disease (AD), vascular dementia (VaD) and mixed AD/VaD. The 201 patients included (115 AD, 44 VaD and 42 mixed AD/VaD) had been referred to the Psychogeriatric/Psychiatric Department, Lund University Hospital, for psychogeriatric investigation and were followed-up with clinical records and detailed information on psychiatric history prior to the onset of dementia. Depression was considered to exist when the patient had consulted a psychiatrist or physician and had been diagnosed with a "depressive episode" or "depression" and when anti-depressants and/or other specific treatments had been prescribed. Twenty patients (10%) had suffered from depression earlier in life well before the onset of dementia. Eight of the 9 AD patients with a previous diagnosis of depression had suffered from only one depressive episode and all had responded well to treatment, with complete recovery. In the VaD group, 8 out of 9 patients suffered two or more depressive episodes and only two recovered completely. Events with a possible significant relationship to depression were seen in 8 of the 9 AD patients but in only 1 of the 9 VaD patients. Psychotic symptoms were more common in VaD than in the AD group. The treatment modality of depression was similar in the groups. In conclusion, a history of depression prior to dementia is more common and more therapy-resistant in VaD than in AD.
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Affiliation(s)
- Hans Brunnström
- Department of Pathology, Lund University and Regional Laboratories Region Skåne, Lund, Sweden.
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Depression in Taiwanese patients with Alzheimer's disease determined by the National Institutes of Mental Health Provisional Criteria. Int Psychogeriatr 2012; 24:1299-305. [PMID: 22333495 DOI: 10.1017/s1041610211002262] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Depression is a common behavioral and psychological symptom of Alzheimer's disease (AD). The aims of the present study were to determine the rate of depression in Taiwanese patients with AD using the National Institutes of Mental Health Provisional Criteria for Depression in AD (NIMH-dAD criteria) and to investigate the association of depression with other behavioral and psychological symptoms. METHODS A consecutive series of 302 AD patients registered in a dementia clinic were investigated in this study. All patients met the criteria of the National Institute of Neurological Disorders and Stroke-Alzheimer's Disease and Related Disorders Association for probable AD. The rates of depression were determined according to the criteria of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders for major depression (DSM-IV), the International Classification of Diseases-9-Clinical Modification (ICD-9-CM) for neurotic depression, the depression subscale of the Neuropsychiatric Inventory (NPI), and the NIMH-dAD criteria. Depression severity was assessed using the 17-item Hamilton Depression Rating Scale. The rates of depression determined by the NIMH-dAD criteria were compared with the rates derived from each of the other instruments. Other behavioral and psychological symptoms were assessed using NPI. A behavioral neurologist or a geriatric psychiatrist interviewed all the patients. RESULTS Using the NIMH-dAD criteria, it was found that 90 (29.8%) of the AD patients had depression, and all depressive symptoms in NIMH-dAD were significantly higher among depressed patients. Among other depression instruments, the frequency of depression was lowest using the DSM-IV major depression criteria (9.3%) and highest with the NPI depression subscale (54%). Behavioral and psychological symptoms determined with NPI were significantly higher among depressed patients in all domains except euphoria. CONCLUSIONS This is the first study of depression in Taiwanese patients with AD using the NIMH-dAD criteria. Our findings suggest that comorbid depression is high in Taiwanese patients with AD. It is clinically important to note the high frequency of most behavioral and psychological symptoms among depressed AD patients.
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