One-week prevalence of depressive symptoms and psychotropic drug treatments among old people with different levels of cognitive impairment living in institutional care: changes between 1982 and 2000

2010 ◽  
Vol 22 (7) ◽  
pp. 1154-1160 ◽  
Author(s):  
Hugo Lövheim ◽  
Ellinor Bergdahl ◽  
Per-Olof Sandman ◽  
Stig Karlsson ◽  
Yngve Gustafson

ABSTRACTBackground: Dementia and depression are common in advanced age, and often co-exist. There are indications of a decreased prevalence of depressive symptoms among old people in recent years, supposedly because of the manifold increase in antidepressant treatment. Whether the prevalence of depressive symptoms has decreased among people in different stages of dementia disorders has not yet been investigated.Methods: A comparison was undertaken of two cross-sectional studies, conducted in 1982 and 2000, comprising 6864 participants living in geriatric care units in the county of Västerbotten, Sweden. Depressive symptoms were measured using the Multi-Dimensional Dementia Assessment Scale (MDDAS), and the cognitive score was measured with Gottfries’ cognitive scale. Drug data were obtained from prescription records.Results: There was a significant decrease in depressive symptom score between 1982 and 2000 in all cognitive function groups except for the group with moderate cognitive impairment. Antidepressant drug use increased in all cognitive function groups.Conclusion: The prevalence of depressive symptoms decreased between 1982 and 2000, in all levels of cognitive impairment except moderate cognitive impairment. This might possibly be explained by the depressive symptoms having different etiologies in different stages of a dementia disorder, which in turn might not be equally susceptible to antidepressant treatment.

2020 ◽  
Vol 26 (7) ◽  
pp. 679-689
Author(s):  
Chang Hyun Lee ◽  
Do Hoon Kim

AbstractObjective:The aim of this study was to model the relationships among white matter hyperintensities (WMHs), depressive symptoms, and cognitive function and to examine the mediating effect of depressive symptoms on the relationship between WMHs and cognitive impairment.Methods:We performed structural equation modeling using cross-sectional data from 1158 patients from the Clinical Research for Dementia of South Korea (CREDOS) registry who were diagnosed with mild-to-moderate dementia. Periventricular white matter hyperintensities (PWMHs) and deep white matter hyperintensities (DWMHs) were obtained separately on the protocol of magnetic resonance imaging (MRI). Depression and cognitive function were assessed using the Korean Form of the Geriatric Depression Scale (KGDS) and the Seoul Neuropsychological Screening Battery (SNSB), respectively.Results:The model that best reflected the relationships among the variables was the model in which DWMHs affected cognitive function directly and indirectly through the depressive symptoms; on the other hand, PWMHs only directly affected cognitive function.Conclusions:This study presents the mediation model including the developmental pathway from DWMHs to cognitive impairment through depressive symptoms and suggests that the two types of WMHs may affect cognitive impairment through different pathways.


2019 ◽  
Vol 5 (2) ◽  
pp. 185-192
Author(s):  
Abigail Asfas Tandilangi ◽  
Regina Makawimbang

Elderly is a life process that is characterized by a decline in cognitive function that can cause the inability to carry out activities, especially for the elderly who are undergoing treatment. The purpose of this study was to determine whether there is a relationship between cognitive function and compliance with the use of medication in the elderly in Girian Permai Village. The methods used were observational analytic and cross-sectional. Data were collected using a Mini-Mental State Examination (MMSE) questionnaire for cognitive function and the Morisky Medication Adherence Scale (MMAS) for compliance with medication use. The results showed 26 (52%) elderly experienced moderate cognitive impairment, and 38 (76%) elderly had low adherence to the use of medication, while the results of the correlation test between cognitive function and compliance with the use of medication showed significant values ​​p = (0.008). Researchers' recommendations for the community is to pay more attention and provide support to the elderly who are around the neighborhood, especially specifically for the elderly who are undergoing treatment, so that they can use the drug obediently.


BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e032679 ◽  
Author(s):  
Min Ji Kim ◽  
Kota Tsutsumimoto ◽  
Takehiko Doi ◽  
Sho Nakakubo ◽  
Satoshi Kurita ◽  
...  

ObjectivesThe current study aimed to elucidate the associations between cognitive leisure activities and cognitive function in an older population stratified by having or not having depressive symptoms.DesignA retrospective cross-sectional study based on a self-report questionnaire.SettingAnnual health check-ups in a rural community in Japan.ParticipantsA total of 11 010 community-dwelling older adults aged ≥65 years (mean age: 74.0±5.4 years) was examined. Participants with missing data for the main outcome (n=1630) were excluded.Outcome measuresCognitive impairment was defined as at least 1.5 SD below the reference threshold (age-adjusted and education-adjusted score) on two of more of the tests in the National Center for Geriatrics and Gerontology-Functional Assessment Tool. Depressive symptoms were defined by a 15-item Geriatric Depression Scale score ≥6. We assessed the frequency of participation in cognitive leisure activities using the validated scale (score: 0–42). A score of ≥8 points was defined as frequent participation in cognitive leisure activities.ResultsA total of 12.6% (n=1186) of the participants had depressive symptoms. There was a significant association between cognitive leisure activities and cognitive impairment in older adults (adjusted OR=0.77, 95% CI=0.65 to 0.94). In older adults with depressive symptoms, a higher frequency of cognitive leisure activities was negatively associated with cognitive impairment (adjusted OR=0.45, 95% CI=0.28 to 0.70). In contrast, there was no significant association in older adults without depressive symptoms (adjusted OR=0.85, 95% CI=0.70 to 1.02).ConclusionsEngaging in cognitive leisure activities in late life is associated with better cognitive function in older adults with depressive symptoms.


2015 ◽  
Vol 100 (8) ◽  
pp. 3090-3096 ◽  
Author(s):  
Kenji Obayashi ◽  
Keigo Saeki ◽  
Junko Iwamoto ◽  
Nobuhiro Tone ◽  
Kunihiko Tanaka ◽  
...  

Context: In contrast with randomized controlled trials, observational studies have suggested that physiological levels of melatonin are reduced in patients with dementia or depression, but the relationship has not been evaluated in large populations. Objective: The objective was to determine the relationships between physiological levels of melatonin and cognitive function and depressive symptoms. Design and Participants: A cohort of 1105 community-dwelling elderly individuals was enrolled in this cross-sectional study (mean age, 71.8 ± 7.1 y). Measures: Urinary 6-sulfatoxymelatonin excretion (UME) and Mini-Mental State Examination (MMSE; n = 935) and Geriatric Depression Scale (GDS; n = 1097) scores were measured as indices of physiological melatonin levels, cognitive function, and depressive symptoms, respectively. Results: With increases in UME quartiles, the prevalence of cognitive impairment (MMSE score ≤ 26) and depressed mood (GDS score ≥ 6) significantly decreased (P for trend = .003 and .012, respectively). In multivariate logistic regression models, after adjusting for confounders such as age, gender, socioeconomic status, physical activity, and sleep/wake cycles, higher UME levels were significantly associated with lower odds ratios (ORs) for cognitive impairment and depressed mood (ORs: Q1 = 1.00; Q2 = 0.88 and 0.76; Q3 = 0.66 and 0.85; Q4 = 0.67 and 0.53; P for trend = .023 and .033, respectively). In addition, the highest UME group showed a significantly lower OR for depressed mood than the lowest UME group (Q4 vs Q1: OR, 0.53; 95% confidence interval, 0.32–0.89; P = .033). UME levels above the median value were significantly associated with a lower OR for cognitive impairment, even after further adjustment for depressive symptoms (OR = 0.74; 95% confidence interval, 0.55–0.99; P = .043). Conclusions: Significant associations of higher physiological melatonin levels with lower prevalence of cognitive impairment and depressed mood were revealed in a large general elderly population. The association between physiological melatonin levels and cognitive function was independent of depressive symptoms.


2020 ◽  
Vol 17 (6) ◽  
pp. 556-565
Author(s):  
Yujie Guo ◽  
Pengfei Li ◽  
Xiaojun Ma ◽  
Xiaochen Huang ◽  
Zhuoheng Liu ◽  
...  

Background: The present study was designed to examine the association of circulating cholesterol with cognitive function in non-demented community aging adults. Methods: This was a cross-sectional study including 1754 Chinese adults aged 55-80 years. The association between serum cholesterol levels and cognitive function was examined. Participants were categorized into four groups according to the quartile of circulating TC (total cholesterol), High Density Lipoprotein Cholesterol (HDL-c), Low Density Lipoprotein Cholesterol (LDL-c) levels and HDLc/ LDL-c ratio. The difference in cognitive performance among the groups was compared. Logistic regression model was used to determine the association of circulating cholesterol level with the risk of Mild Cognitive Impairment (MCI). Results: Mild increase of serum LDL-c level correlated with better visual and executive, language, memory and delayed recall abilities. Higher circulating TC and HDL-c levels were found to be associated with poorer cognitive function, especially in aging female subjects. Higher circulating TC, HDL-c and HDL/LDL ratio indicated an increased risk of MCI, especially in female subjects. Conclusion: Slight increase in circulating LDL-c level might benefit cognitive function in aging adults. However, higher circulating TC and HDL-c levels might indicate a decline of cognitive function, especially in aging female subjects.


Author(s):  
Tran Dai Tri Han ◽  
Keiko Nakamura ◽  
Kaoruko Seino ◽  
Vo Nu Hong Duc ◽  
Thang Van Vo

This study examined the prevalence of cognitive impairment among older adults in central Vietnam and the roles of communication (with or without communication devices) in the association between cognitive impairment and hearing loss. This cross-sectional study was performed on 725 randomly selected community-dwelling older adults aged ≥60 years from Thua Thien Hue province, Vietnam. Participants attended a face-to-face survey. Sociodemographic characteristics, social interaction with or without communication devices, health status and cognitive function using the Mini-Mental State Examination were reported. Ordinal logistic regression analysis was performed to quantify the association between hearing loss and cognitive function by frequency of communication with and without devices. Mild and severe cognitive impairment had prevalence rates of 23.6% and 19.3%, respectively. Cognitive impairment was more prevalent among older adults with hearing-loss, vision loss and difficulties with instrumental activities of daily living (IADL). The association between hearing loss and cognitive impairment was not significant when older adults had frequent communication with others using devices. This study presented the relatively high prevalence of cognitive impairment in community-dwelling older adults in Vietnam. Frequent communication using devices attenuated the association between hearing loss and cognitive impairment.


2021 ◽  
pp. 1-10
Author(s):  
Yosuke Yamada ◽  
Hiroyuki Umegaki ◽  
Fumie Kinoshita ◽  
Chi Hsien Huang ◽  
Taiki Sugimoto ◽  
...  

Background: Homocysteine is a common risk factor for cognitive impairment and sarcopenia. However, very few studies have shown an association between sarcopenia and serum homocysteine levels after adjustment for cognitive function. Objective: The purpose of this study was to investigate the relationship between homocysteine and sarcopenia in memory clinic patients. Methods: This cross-sectional study investigated outpatients in a memory clinic. We enrolled 1,774 participants (≥65 years old) with measured skeletal muscle mass index (SMI), hand grip strength (HGS), and homocysteine. All participants had undergone cognitive assessments and were diagnosed with dementia, mild cognitive impairment, or normal cognition. Patient characteristics were compared according to sarcopenia presence, SMI level, or HGS. Multivariate logistic regression analysis was performed to determine the association of homocysteine with sarcopenia, low SMI, or low HGS. Next, linear regression analysis was performed using HGS as a continuous variable. Results: Logistic regression analysis showed that low HGS was significantly associated with homocysteine levels (p = 0.002), but sarcopenia and low SMI were not. In linear regression analysis, HGS was negatively associated with homocysteine levels after adjustment for Mini-Mental State Examination score (β= –2.790, p <  0.001) or clinical diagnosis of dementia (β= –3.145, p <  0.001). These results were similar for men and women. Conclusion: Our results showed a negative association between homocysteine and HGS after adjustment for cognitive function. Our findings strengthen the assumed association between homocysteine and HGS. Further research is needed to determine whether lower homocysteine levels lead to prevent muscle weakness.


2021 ◽  
pp. 1-8
Author(s):  
Xiao Liu ◽  
Ayiguli Abudukeremu ◽  
Yuan Jiang ◽  
Zhengyu Cao ◽  
Maoxiong Wu ◽  
...  

Background: Several kinds of motor dysfunction can predict future cognitive impairment in elderly individuals. However, the ability of the fine motor index (FINEA) and gross motor index (GROSSA) to predict the risk of cognitive impairment has not been assessed. Objective: We investigated the associations between FINEA/GROSSA and cognitive impairment. Methods: The data of 4,745 participants from The Irish Longitudinal Study on Ageing (TILDA) were analyzed. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). We first assessed the correlation between the FINEA GROSSA and MMSE in a cross-sectional study. Then, we further investigated the predictive role of the incidence of cognitive impairment in a prospective cohort study. Results: We found that both FINEA and GROSSA were negatively correlated with MMSE in both the unadjusted (FINEA: B = –1.00, 95%confidence intervals (CI): –1.17, –0.83, t = –11.53, p <  0.001; GROSSA: B = –0.85, 95%CI: –0.94, –0.76, t = –18.29, p <  0.001) and adjusted (FINEA: B = –0.63, 95%CI: –0.79, –0.47, t = –7.77, p <  0.001; GROSSA: B = –0.57, 95%CI: –0.66, –0.48, t = –12.61, p <  0.001) analyses in a cross-sectional study. In a prospective cohort study, both high FINEA and high GROSSA were associated with an increased incidence of cognitive function impairment (FINEA: adjusted odds ratios (OR) = 2.35, 95%CI: 1.05, 5.23, p = 0.036; GROSSA adjusted OR = 3.00, 95%CI: 1.49, 6.03, p = 0.002) after 2 years of follow-up. Conclusion: Higher FINEA and GROSSA scores were both associated with an increased incidence of cognitive impairment. FINEA or GROSSA might be a simple tool for identifying patients with cognitive impairment.


2010 ◽  
Vol 23 (4) ◽  
pp. 516-525 ◽  
Author(s):  
Chang-Quan Huang ◽  
Zheng-Rong Wang ◽  
Yong-Hong Li ◽  
Yi-Zhou Xie ◽  
Qing-Xiu Liu

ABSTRACTBackground: We assessed the relationship between cognitive impairment (including mild cognitive impairment with no signs of dementia, and dementia) and risk for depression in old age (60 years and older).Methods: MEDLINE, EMBASE and the Cochrane Library database were used to identify potential studies. All of the clinical studies that produced data on the association between cognitive function and risk of depression among individuals aged 55 years or older were identified and included in this review. The studies were classified into cross-sectional and longitudinal subsets. The quantitative meta-analysis of cross-sectional and longitudinal studies were performed. For prevalence and incidence rates of depression, odds risk (OR) and relative risk (RR) were calculated, respectively.Results: Since all but two studies found in the search were for individuals aged 60 years or over, we assessed and reported on results for this larger group only. In this review we included 13 cross-sectional and four prospective longitudinal studies. The quantitative meta-analysis showed that, in old age, individuals with non-dementia cognitive impairment had neither significant higher prevalence nor incidence rates of depression than those without (odds risk (OR): 1.48, 95% confidence intervals (95% CI): 0.87–2.52; relative risk (RR): 1.12, 95% CI: 0.62–2.01). In old age, individuals with dementia had both significant higher prevalence and incidence rates of depression than those without (OR: 1.82, 95% CI: 1.15–2.89; RR: 3.92, 95% CI: 1.93–7.99).Conclusions: Despite the methodological limitations of this meta-analysis, we found that in old age, there was no association between depression and cognitive impairment with no dementia; however, there was a definite association between depression and dementia and thus dementia might be a risk for depression.


2017 ◽  
Vol 30 (6) ◽  
pp. 843-862 ◽  
Author(s):  
Rosalba Hernandez ◽  
Elaine Cheung ◽  
Minli Liao ◽  
Seth W. Boughton ◽  
Lisett G. Tito ◽  
...  

Objective: We examined the association between depressive symptoms and cognitive functioning in older Hispanics/Latinos enrolled in an exercise intervention. Method: We analyzed baseline, 1-year, and 2-year in-person interview data collected from Hispanics/Latinos aged ≥60 years participating in an exercise intervention across 27 senior centers ( N = 572). Results: Mean age was 73.13 years; 77% female. At baseline, older adults screening positive for depression were 1.58 times more likely to experience cognitive impairment ( p = .04); controlling for demographics and comorbid chronic conditions. Compared to peers with little to no depressive symptoms, lower cognitive functioning scores were evident at each follow-up assessment point where elevated depressive symptoms were present, but baseline depression was not associated with cognitive function in longitudinal analyses. Discussion: In older Hispanics/Latinos enrolled in an exercise intervention, though baseline depression did not predict cognitive function over time, elevated symptoms of depression were associated with greater cognitive impairment at every point in this study.


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