Correlation Between Depression and Cognitive Decline in Elderly Outpatients: A Preliminary Study

2017 ◽  
Vol 41 (S1) ◽  
pp. S651-S651 ◽  
Author(s):  
A. Gogos ◽  
G. Papageorgiou ◽  
E. Kavourgia ◽  
E. Papakyrgiaki ◽  
A. Mitsokali
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptomatology ◽  
Symptomatic Relief ◽  
Psychiatric Morbidity ◽  
Depression Scale ◽  
Cognitive Disorders ◽  
The Elderly ◽  
Bipolar Patient ◽  
Hamilton Depression Scale ◽  
Elderly Outpatients

IntroductionDepressive disorder is common psychiatric morbidity among the elderly outpatients. It is also evident that cognitive disorders, ranging from mild cognitive impairment to severe dementia, are widely prevalent in the elderly coexistence of the above is quite common. Treatment for both conditions is quite challenging, aiming at symptomatic relief and improvement in functional status.ObjectivesTo investigate the coexistence of depression and cognitive impairment in aged depressive outpatients, 65 years or older. Correlation of cognitive level and depressive symptomatology was measured.MethodWe used hamilton depression scale (HAM-D) and MMSE in 35 (mean age 68.2 years) depressed outpatients over 65-year-old. We excluded depressed schizophrenics and bipolar patient.Results.On a preliminary basis, a correlation between low MMSe and HAM-D (P < 0.05) was found. An interesting finding, though not measured primarily, was that low MMSE was accompanied with a low compliance with medication.ConclusionsThe mental deterioration that accompanies cognitive impairment is being widely studied and it is real complex. In our ongoing study previous findings are confirmed and can be interpreted both ways, i.e. depression is a risk factor for dementia and also the fact that existing dementia is positively correlated with a low HAM-D.Compliance to medication is affected, among other variables, by the patients’ mental state.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Elderly patients with cognitive impairments on an ambulance care

2021 ◽  
Vol 25 (2) ◽  
pp. 19-27
Author(s):  
Tatiana Andreevna Bogdanova ◽  
Anna V. Turusheva ◽  
Elena V. Frolova ◽  
Dmitriy L. Logunov
Keyword(s):  
Cognitive Impairment ◽  
Memory Impairment ◽  
Complete Blood Count ◽  
Beta Blockers ◽  
Blood Pressure Measurement ◽  
Depression Scale ◽  
Cognitive Disorders ◽  
The Elderly ◽  
Cross Sectional ◽  
Global Cognition

BACKGROUND: Cognitive impairment is one of the most common geriatric syndromes that occur in the elderly. Dementia is a severe cognitive disorder that results in the professional, social, and functional impairment and gradual loss of independence. However, in most cases, the stage of dementia is preceded by a long period of non-dementia cognitive impairment. In this regard, one of the priorities of public health is to identify potentially reversible forms of dementia and cognitive impairment in the early stages. AIM: To assess demographic characteristics, co-morbidities and factors that are associated with cognitive impairment in adults aged 65 years and over and to determine the prevalence of cognitive disorders in aging population. MATERIALS AND METHODS: cross-sectional study included all patients aged 65 years and older who attended the ambulance care from 24.10.2019 to 15.12.2019 in Saint Petersburg. Measurements: the Montreal cognitive assessment test, the 15-item Geriatric Depression Scale. Data collection included a full medical history, blood pressure measurement, a medication review and blood tests (complete blood count, lipids, hormones, glucose, ALT, AST and creatinine). RESULTS: The prevalence of mild cognitive impairment was 62.9 % (95 % CI 56-70), severe cognitive impairment 8.2 %. We detected that hypertension, stroke, sleep disorders, subjective memory complaints and symptoms of depression were identified as factors associated with CI after adjustment for covariates. Hypertension and depression were related with cognitive impairment (p 0.05). Also patients with depression scored worse in global cognition and attention function (p 0.05). Patients with diabetes had association with a decrease in abstraction function (p = 0.02). Low hemoglobin levels were related with poor global cognition and memory impairment (p 0.01). Beta-blocker use was significantly associated with poor global cognition and memory impairment (p 0.01). CONCLUSIONS: We found that elders have a high prevalence of cognitive disorders. We also demonstrated association between co-morbidities and factors as hypertension, anemia, diabetes, depression and administration of beta-blockers with poor cognitive performance in the elderly.

scholarly journals Demographic Factors and Cognitive Function Assessments Associated with Mild Cognitive Impairment Progression for the Elderly

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Hong-yun Qin ◽  
Xu-dong Zhao ◽  
Bing-gen Zhu ◽  
Cheng-ping Hu
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Demographic Data ◽  
Depression Scale ◽  
Demographic Factors ◽  
The Elderly ◽  
Income Level ◽  
Hamilton Depression Scale ◽  
Clinical Dementia Rating

Objectives. In this study, we aimed to conduct a 6-year follow-up and acquire a large sample dataset to analyze the most important demographic factors and cognitive function scale variables associated with mild cognitive impairment (MCI) progression for an elderly cohort (age ≥ 60 years old). Patients and Methods. We analyzed the subjects who had participated in a survey in 2011 and were successfully contacted in the later survey in 2017. For each subject, the basic demographic information was recorded, including sex, age, education level, marital status, working status, income level, and physical mental illness history. Cognitive assessments were performed using the following scales if possible: (1) the mini-mental state examination (MMSE) scale, (2) Montreal cognitive assessment (MoCA), (3) the clinical dementia rating (CDR) scale, and (4) Hamilton Depression Scale (HAMD-17). Results. The progression outcomes were different between sexes, among age brackets, education degrees, occupations types, and income levels; different progression groups had distinct children numbers (p<0.001), heights (p<0.05), and body weights (p<0.01); the positive ends six years later were positively related to better performance in the MoCA and MMSE scales (progressed vs stable p<0.01). Moreover, we constructed some indicators using age, MoCA, and MMSE scores, which showed an efficiency in predicting the progression outcomes. Conclusions. In conclusion, the MCI progression outcomes were associated with sex, age, education degrees, occupations types, income level, children number, height, and weight. MoCA and MMSE scales are supporting tools to predict the progression outcomes, especially combined with the demographic data.

Depressive Mixed States: Symptomatology, Prevalence and Principles of Treatment

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
W. Drozdz ◽  
A. Borkowska
Keyword(s):  
Affective Disorders ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Assessment Tools ◽  
The Other ◽  
Mood Stabilizers ◽  
Hamilton Depression Scale ◽  
Principles Of Treatment ◽  
Bipolar Patients

Current diagnostic systems (DSM-IV-TR and ICD-10) do not include depressive mixed state (DMS) as a separate category. However, both historical descriptions and data from recent research clearly indicate that cooccurrence of (hypo)maniacal and depressive symptoms is standard in clinical picture of affective disorders. Most frequently employed criterion for DMS is the presence of at least three symptoms of (hypo)mania for 7 days during a major depressive episode. Not only formal diagnostic criteria for DMS are lacking but also psychometric assessment tools (for example the Hamilton Depression Scale or the MADRS) were designed around the features of “classical” depression. The other obstacles to recognize DMS could be lack of insight into the (hypo)maniacal symptoms in patients and cognitive dysfunctions present during an episode. On the other hand, newly created instrument, the Bipolar Depression Rating Scale, may assist clinical evaluation of DMS. Despite predominating depressive symptomatology, the principles of treatment of DMS suggest avoidance of antidepressant monotherapy in favor of mood stabilizers' administration. Actually DMS may emerge as a complication of antidepressant monotherapy in some bipolar patients or may be induced with interferon-alpha treatment in some chronic hepatitis C patients. Important consequences of both spontaneous and drug-induced DMS could be the roughening of affective symptomatology, resistance to antidepressants and the increase of suicidality. Thorough appraisal of symptoms seen in patients with affective disorders for indicators of DMS could have critical consequences for functional outcomes.

scholarly journals Description of suicide ideation among older adults and a psychological profile: a cross-sectional study in Turkey

2019 ◽  
Vol 24 (5) ◽  
pp. 1865-1874 ◽  
Author(s):  
Murat Aslan ◽  
Cicek Hocaoglu ◽  
Bulent Bahceci
Keyword(s):  
Suicidal Ideation ◽  
Suicide Ideation ◽  
Psychiatric Morbidity ◽  
Depression Scale ◽  
The Elderly ◽  
Elderly Subjects ◽  
Reasons For Living ◽  
Low Level ◽  
Significant Difference ◽  
The Mean

Abstract This study investigates the suicidal ideation and the possible causes for suicidal behaviour in the elderly. Subjects were 150 patients aged 65 and older who were evaluated using the sociodemographic data collection forms, Geriatric Depression Scale (GDS), Suicidal Ideation Scale (SIS), Reasons for Living Inventory (RLI), and Beck Hopelessness Scale (BHS). Of 150 patients, 72.7% were women and 27.3% were men, ages ranged from 65 to 88 years. Suicidal ideation was noted in 30.7% of patients. When the mean of BHS total score between patients with and without suicidal ideation and the mean of BHS subscale’s feelings and expectations regarding the future and loss of motivation and hope in terms of subscales were evaluated between the groups with and without suicidal ideation, the scores had a significant difference. When RLI was evaluated in terms of total scores, the suicidal ideation mean score was 243.74 ± 32.28, while the non-suicidal ideation mean score was 267.27 ± 24.36. There was a significant relationship between the two groups. We found low level of education, low level of reasons for living and higher psychiatric morbidity (generalized anxiety disorder and comorbid depressive disorder) in with suicidal ideation in the elderly.

Cognitive Function in Older Euthymic Bipolar Patients

2017 ◽  
Vol 41 (S1) ◽  
pp. S116-S117
Author(s):  
K. Hajbi ◽  
I. Baati ◽  
S. Ellouze ◽  
S. Mkaouar ◽  
I. Abida ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Low Income ◽  
Cognitive Rehabilitation ◽  
Depression Scale ◽  
Cognitive Disorders ◽  
Hamilton Depression Scale ◽  
Affective Symptoms ◽  
Bipolar Patients ◽  
Psychotic Features

ObjectivesTo assess cognitive function in older euthymic bipolar patients. To investigate the relationship between cognitive disorders and clinical features in this population.MethodsWe conducted a cross-sectional study during the period from August to November 2015. It included 34 stable bipolar outpatients, aged at least 65 years. We used the Montreal Cognitive Assessment (MoCA) to screen for cognitive disorders. Our patients were clinically euthymic, as checked by the Hamilton depression scale and the Young mania scale.ResultsThe sex ratio was 1. The mean age of our patients was 68.2 years. Most of them were married (82.4%), unemployed (55.8%), living in urban area (82.4%), had low educational level (58.8%) and low income (64.7%).The majority was bipolar type 1 (67.6%). The most recent episode was manic in 55.9% of cases, including psychotic features in 50% of cases. Subsyndromal affective symptoms were noted between episodes in 23.5% of them. The average MoCA score was 23.6. Cognitive disorders were found in 61.5% of patients, who showed impairments across all cognitive domains. The most frequent deficits were found in attention (100%) and executive functions (85.3%).Cognitive dysfunction correlated to psychotic features during the last episode (P = 0.005), subsyndromal affective symptoms between episodes (P = 0.13), high number of mood episodes (P = 0.007) and hospitalisations (P = 0.014).ConclusionOur study confirmed that cognitive dysfunction was frequent in older bipolar patients in Tunisia. Preventing mood episodes, screening for addictive and somatic comorbidities, as well as cognitive rehabilitation, are suitable strategies for improving cognitive functioning among these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Direct costs associated with depressive symptoms in late life: a 4.5-year prospective study

2012 ◽  
Vol 25 (2) ◽  
pp. 292-302 ◽  
Author(s):  
Melanie Luppa ◽  
Hans-Helmut König ◽  
Dirk Heider ◽  
Hanna Leicht ◽  
Tom Motzek ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Home Care ◽  
Old Age ◽  
Service Use ◽  
Depressive Symptomatology ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Direct Costs ◽  
Cross Sectional

ABSTRACTBackground: Depression in old age is common. Only few studies examined the association of depressive symptoms and direct costs in the elderly in a cross-sectional way. This study aims to investigate prospectively health service use and direct costs over a course of 4.5 years considering also different courses of depressive symptomatology.Methods: 305 primary care patients aged 75+ were assessed face-to-face regarding depressive symptoms (Geriatric Depression Scale), and service use and costs at baseline and 4.5 years later. Resource utilization was monetarily valued using 2004/2005 prices. The association of baseline factors and direct costs after 4.5 years was analyzed by multivariate linear regression.Results: Mean annual direct costs of depressed individuals at baseline and follow-up were almost one-third higher than of non-depressed, and highest for individuals with chronic depressive symptoms. Most relevant cost drivers were costs for inpatient care, pharmaceuticals, and home care. Costs for home care increased at most in individuals with chronic depressive symptoms. Baseline variables that were associated with direct costs after 4.5 years were number of medications as a measure of comorbidity, age, gender, and depressive symptoms.Conclusions: Presence and persistence of depressive symptoms in old age seems to be associated with future direct costs even after adjustment for comorbidity. The findings deign a look to the potential economic consequences of depressive symptoms in the elderly for the healthcare system in the future.

scholarly journals Sexualidade e sintomatologia depressiva em idosos residentes no nordeste do Brasil

2021 ◽  
Vol 20 (4) ◽  
pp. 170-216
Author(s):  
Edison Vitório de Souza Júnior ◽  
Sterline Therrier ◽  
Cristiane dos Santos Silva ◽  
Bianca de Moura Peloso-Carvalho ◽  
Lais Reis Siqueira ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Depressive Symptomatology ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Spearman Correlation ◽  
Geriatric Depression ◽  
Sociodemographic Variables ◽  
Living Together ◽  
Moderate Magnitude

Objetivo: Analizar la asociación entre sexualidad y variables biosociodemográficas y síntomas depresivos en adultos mayores. Método: Se trata de un estudio seccional diseñado con 292 personas mayores. La recolección de datos se realizó entre agosto y octubre de 2020. Se utilizó la Escala de Experiencias Sexuales y Afectivas de Ancianos y la Escala de Depresión Geriátrica. Se utilizaron pruebas de Mann-Whitney, correlación de Spearman y pruebas de Kruskal-Wallis, adoptando un intervalo de confianza del 95% para todos los análisis estadísticos.Resultados: Predominaron los varones (52,1%) y entre 60 y 64 años (46,6%). La prevalencia de síntomas depresivos fue del 30,1% para los casos leves y del 8,6% para los graves. Los ancianos con síntomas depresivos experimentaron peor el acto sexual, las relaciones afectivas y las adversidades físicas y sociales relacionadas con la sexualidad. La única dimensión de la sexualidad que se asoció con las variables biosociodemográficas fue el acto sexual, mostrando que es mejor vivido por los ancianos en unión estable (p = 0.023) y entre quienes conviven con la pareja por un período ≤ 5 años, en comparación con los mayores de 20 años (p = 0,001). Además, solo la dimensión acto sexual se correlacionó negativamente y con magnitud moderada entre los síntomas depresivos graves (ρ = -0,442; p = 0,027), lo que indica que estas dos variables exhiben comportamientos inversamente proporcionales. Conclusión: La sexualidad se asocia con algunas variables biosociodemográficas y se correlaciona con síntomas depresivos severos en ancianos. Objective: To analyze the association of sexuality with the bio-sociodemographic variables and depressive symptomatology in the elderly. Method: This is a sectional study designed with 292 elderly people. Data were collected between August and October 2020. The Elderly Affective and Sexual Experiences Scale and the Geriatric Depression Scale were used. Mann-Whitney, Spearman correlation, and Kruskal-Wallis tests were used, adopting a 95% confidence interval for all statistical analyses.Results: The participants were predominantly male (52.1%) and aged between 60 and 64 years (46.6%). The prevalence of depressive symptoms was 30.1% for mild cases and 8.6% for severe cases. The elderly with depressive symptomatology experienced worse the sexual act, affective relationships, and physical and social adversities related to sexuality. The only dimension of sexuality that was associated with the bio-sociodemographic variables was the "sexual act," proving to be better experienced by the elderly in stable unions (p = 0.023) and among those who live with their partner for a period ≤ 5 years, when compared to those with living together for more than 20 years (p = 0.001). In addition, only the Sexual act dimension correlated negatively and with moderate magnitude with severe depressive symptoms (ρ = -0.442; p = 0.027), indicating that these two variables present inversely proportional behaviors.Conclusion: Sexuality is associated with some bio-sociodemographic variables and correlated with severe depressive symptoms among the elderly. Objetivo: Analisar a associação entre a sexualidade com as variáveis biosociodemográficas e sintomatologia depressiva em idosos. Método: Trata-se de um estudo seccional delineado com 292 idosos. Realizou-se a coleta de dados entre agosto e outubro de 2020. Foi utilizada a Escala de Vivências Afetivas e Sexuais do Idoso e a Escala de Depressão Geriátrica. Utilizou-se os testes de Mann-Whitney, correlação de Spearman e Kruskal-Wallis, adotando intervalo de confiança de 95% para todas as análises estatísticas.Resultados: Predominaram-se os participantes do sexo masculino (52,1%) e com idade entre 60 e 64 anos (46,6%). A prevalência de sintomatologia depressiva foi de 30,1% para os casos leves e 8,6% para os severos. Os idosos com sintomatologias depressivas pior vivenciaram o ato sexual, as relações afetivas e as adversidades física e social relacionadas à sexualidade. A única dimensão da sexualidade que se associou com as variáveis biosociodemográficas foi o ato sexual, demonstrando ser melhor vivenciada pelos idosos em união estável (p=0,023) e entre aqueles que convivem com o parceiro por um período ≤ 5 anos, quando comparados a aqueles com convivência superior a 20 anos (p=0,001). Além disso, somente a dimensão ato sexual se correlacionou de maneira negativa e com moderada magnitude entre os sintomas depressivos severos (ρ= -0,442; p=0,027), indicando que essas duas variáveis apresentam comportamentos inversamente proporcionais.Conclusão: A sexualidade está associada à algumas variáveis biosociodemográficas e correlacionada às sintomatologias depressivas severas entre os idosos.

scholarly journals Cognitive impairment is differentially associated with depression and anxiety at six-months post-stroke

2020 ◽  
Author(s):  
Owen A Williams ◽  
Nele Demeyere
Keyword(s):  
Cognitive Impairment ◽  
Spatial Attention ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Anxiety Symptoms ◽  
Cognitive Domain ◽  
Stroke Severity ◽  
Depression And Anxiety ◽  
Post Stroke ◽  
Post Stroke Depression

Objective: This study investigated the associations between general cognitive impairment and domain specific cognitive impairment with post-stroke depression and anxiety at six-months post-stroke. Methods: Participants were a subset of 437 stroke patients from the OCS-CARE study who were followed up at a 6 months post-stroke assessment. Depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale sub-scales. General cognitive impairment was assessed using the Montreal Cognitive Assessment and stroke-specific cognitive domain impairments was assessed using the Oxford Cognitive Screen. Multivariable linear regression was used to examine the associations between cognition and depression/anxiety symptoms, controlling for acute stroke severity and ADL impairment, age, sex, education, and co-occurring post-stroke depression/anxiety. Results: Six-month post-stroke depression was associated with six-month impairment on the MoCA (beta [b] =0.96, standard error [SE] =0.31, p=0.006), and all individual domains assessed by the OCS including spatial attention (b=0.67, SE=0.33, p =0.041), executive function (b=1.37, SE=0.47, p=0.004), language processing (b=0.87, SE=0.38, p=0.028), memory (b=0.76, SE=0.37, p=0.040), number processing (b=1.13, SE=0.40, p=0.005), and praxis (b=1.16, SE =0.49, p=0.028). Post-stroke anxiety was associated with impairment on the MoCA (b=1.47, SE=0.42, p=0.001), and spatial attention (b=1.25, SE=0.45, p=0.006), but these associations did not remain significant after controlling for co-occurring post-stroke depression. Conclusion: The different profiles of associations between cognitive impairment and post-stroke depression and anxiety suggest that cognitive impairment is highly related to depressive symptomatology, but associations observed between cognitive impairment and anxiety may actually be the result of co-morbid post stroke depression.

The Office Assessment of Depression and Cognitive Impairment

2017 ◽  
Author(s):  
Martin Steinberg ◽  
Paul B. Rosenberg
Keyword(s):  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Clock Drawing Test ◽  
Atypical Symptoms ◽  
Cognitive Difficulties ◽  
Patient Health

Changes in mood and/or cognition are common complaints in the elderly population. This chapter uses case studies to illustrate insights to make clinical assessment more efficient. These include assessing for cognitive impairment when depression is present and vice versa, being mindful of assuming that patients reporting cognitive difficulties are “worried well,” avoiding overreaction to very mild symptoms, assessing the four key cortical cognitive domains (amnesia, aphasia, apraxia, agnosia), assessing for subcortical dysfunction, assessing Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), and understanding that depression in the elderly often presents with atypical symptoms. Brief cognitive instruments which can improve assessment include the Mini Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA), Patient Health Questionnaire (PHQ), Clock Drawing Test (CDT), and the Mini Cog. Brief depression instruments include the Geriatric Depression Scale (GDSS), and Cornell Scale for Depression in Dementia (CSDD).

scholarly journals Demographic and clinical variables as differentiating predictors of cognitive disorders in Parkinson’s disease

2019 ◽  
Vol 22 (1) ◽  
Author(s):  
Núbia Isabela Macêdo Martins ◽  
Nadja Maria Jorge Asano ◽  
Carla Cabral dos Santos Accioly Lins ◽  
Maria das Graças Wanderley de Sales Coriolano
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Elderly Patients ◽  
Executive Functions ◽  
Rating Scale ◽  
Depression Scale ◽  
Cognitive Disorders ◽  
Work Activity ◽  
Clinical Variables

Abstract Objective: to analyze demographic and clinical variables as predictors of cognitive disorders in Parkinson’s disease (PD). Method: a cross-sectional descriptive study was carried out at the Pro-Parkinson Program of the Hospital das Clínicas of the Federal University of Pernambuco. The instruments used were the Mini Mental State Examination (MMSE), Scales for Outcomes in Parkinson’s disease - Cognition (SCOPA-COG), the Hoehn & Yahr Staging Scale (HY), the Unified Parkinson’s Disease Rating Scale part 3 (UPDRS-III), and the 15-item Yesavage Geriatric Depression Scale (GDS-15). A multiple linear regression model was used for the predictive outcome and the Mann-Whitney test was used to compare the elderly and the non-elderly groups. Results: the sociodemographic data of 85 people were collected and the participants underwent a cognitive profile evaluation (MMSE and SCOPA-COG) and clinical evaluation (HY, UPDRS-III, GDS-15). Multiple regression analysis found significant results for age, work activity, and tremor index, explaining 59% of the variability of SCOPA-COG. There was an inverse correlation with age and work activity and a direct correlation with tremors. The SCOPA-COG and MEEM scores were significantly lower in elderly patients, with an emphasis on executive functions. Conclusion: the predictors of cognitive impairment were age, work activity, and tremors. Cognitive impairment was greater in elderly patients with PD, especially for executive functions.

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