Low-grade inflammation differentiates between symptoms of apathy and depression in community-dwelling older individuals

ABSTRACTBackground:Systemic low-grade inflammation has repeatedly been associated with depression in old age, but the relationship with apathy is less clear. The present study assessed whether C-reactive protein (CRP) is differentially associated with symptoms of apathy and depression.Methods:A population-based cohort study was carried-out. At baseline and after two and four years of follow-up, CRP levels were assessed and symptoms of apathy and depression were measured using the 15-item Geriatric Depression Scale. Logistic regression analysis was used to investigate the cross-sectional and longitudinal associations of CRP with symptoms of apathy and depression.Results:Two thousand forty-seven community-dwelling participants (70–78 years) without a history of cardiovascular disease or stroke were studied. A cross-sectional association was found between CRP and apathy symptoms at three time points (odds ratio (OR) per natural log unit increase in CRP: baseline visit = 1.40, 95% CI = 1.12–1.75; two-year follow-up visit = 1.62, 95% CI = 1.17–2.25; four-year follow-up visit = 1.51, 95% CI = 1.03–2.21). This did not change after adjustment for demographics and depressive symptoms, and was slightly attenuated after adjustment for cardiovascular risk factors. No cross-sectional association was found with depressive symptoms. Baseline CRP did not predict incident apathy or depressive symptoms during four years of follow-up.Conclusions:Increased CRP levels are associated with apathy symptoms but not with depressive symptoms. This suggests a differential effect of inflammation on apathy and depression. In older persons, symptoms of apathy may be a behavioral manifestation of concurrent low-grade inflammation.

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Physical activity and depressive symptoms in community-dwelling elders from southern Brazil

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462011005000006 ◽

2011 ◽

Vol 33 (2) ◽

pp. 165-170 ◽

Cited By ~ 16

Author(s):

César L. Reichert ◽

César L. Diogo ◽

José L. Vieira ◽

Roberta R. Dalacorte

Keyword(s):

Physical Activity ◽

Depressive Symptoms ◽

Linear Trend ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Population Based ◽

Community Dwelling ◽

Active Group ◽

Lower Prevalence ◽

Cross Sectional

OBJECTIVE: To determine the existence of a relationship between physical activity and depressive symptoms in community-dwelling elders. METHOD: This is a cross-sectional, population-based study, which included 379 community-dwelling elders from Novo Hamburgo, state of RS, Brazil. The level of physical activity was estimated using the International Physical Activity Questionnaire and depressive symptoms were diagnosed according to the Yesavage Geriatric Depression Scale. The association between the level of physical activity and depressive symptoms was analyzed by logistic regression. RESULTS: A tendency towards a lower prevalence of depressive symptoms was observed in individuals with higher levels of physical activity, both in the sample as a whole as well as among men, but not among women (p for linear trend 0.04, 0.03 and 0.36, respectively). The odds ratio of the presence of depressive symptoms in the very active group, as compared against that of the insufficiently active group was 0.32 (95% CI: 0.12-0.86) for men and 0.76 (95% CI: 0.39-1.46) for women. CONCLUSION: In this population of aged individuals, more intense physical activity is related to a lower prevalence of depressive symptoms. As shown by gender stratification, physical activity is inversely related to depressive symptoms in men, albeit not in women.

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Identifying the Factors Related to Depressive Symptoms Amongst Community-Dwelling Older Adults with Mild Cognitive Impairment

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16183449 ◽

2019 ◽

Vol 16 (18) ◽

pp. 3449 ◽

Cited By ~ 1

Author(s):

Dan Song ◽

Doris S.F. Yu ◽

Polly W.C. Li ◽

Qiuhua Sun

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Depressive Symptoms ◽

Mild Cognitive Impairment ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Community Dwelling ◽

Cross Sectional ◽

Increased Risk ◽

Community Dwelling Older Adults

High-level depressive symptoms have been reported in individuals with mild cognitive impairment (MCI), resulting in increased risk of progression to dementia. However, studies investigating the correlates of depressive symptoms among this population are scarce. This study aimed to investigate the significant socio-demographic, lifestyle-related and disease-related correlates of depressive symptoms among this cohort. Cross-sectional data were obtained from a sample of 154 Chinese community-dwelling older adults with MCI. MCI subjects were screened by the Montreal Cognitive Assessment. Depressive symptoms were measured by the Geriatric Depression Scale. Possible correlates of depressive symptoms in individuals with MCI were explored by multiple linear regressions. The prevalence of depressive symptoms among Chinese older adults with MCI was 31.8%. In multiple regression analysis, poor perceived positive social interaction, small social network, low level of physical activity, poor functional status, subjective memory complaint, and poor health perception were correlated with depressive symptoms. The findings highlight that depressive symptoms are sufficient to warrant evaluation and management in older adults with MCI. Addressing social isolation, assisting this vulnerable group in functional and physical activities, and cultivating a positive perception towards cognitive and physical health are highly prioritized treatment targets among individuals with MCI.

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Associations between Depressive Symptoms and Satisfaction with Meaningful Activities in Community-Dwelling Japanese Older Adults

Journal of Clinical Medicine ◽

10.3390/jcm9030795 ◽

2020 ◽

Vol 9 (3) ◽

pp. 795

Author(s):

Michio Maruta ◽

Hyuma Makizako ◽

Yuriko Ikeda ◽

Hironori Miyata ◽

Atsushi Nakamura ◽

...

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Cross Sectional Study ◽

Community Dwelling ◽

Cross Sectional ◽

Significant Difference ◽

Japanese Older Adults ◽

And Performance

The aim of this cross-sectional study was to investigate relationships between individuals’ ratings of satisfaction and performance of activities that they found meaningful and depressive symptoms. Data was obtained from 806 older adults (mean age 74.9 ± 6.3 years, women = 63.0%) who participated in a community-based health check survey (Tarumizu Study 2018). Participants selected meaningful activities from 95 activities using the Aid for Decision-Making in Occupation Choice and evaluated their satisfaction and performance. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS-15) and defined by a GDS-15 score of ≥5. Non-linear logistic regression analyses were used separately by gender to examine the association between satisfaction and performance of meaningful activities and depressive symptoms. The prevalence of depressive symptoms was 15.8%. We found no significant difference between meaningful activity choice between older adults with depressive symptoms and those without, in both men and women. After adjusting for potential covariates, satisfaction was associated with depressive symptoms in both men (OR 0.52, 95% CI 0.35–0.77) and women (OR 0.67, 95% CI 0.49–0.91), but performance was limited in women (OR 0.87, 95% CI 0.77–0.99). Our findings suggest that depressive symptoms are associated with satisfaction in meaningful activities regardless of activity categories.

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Association between Chronic Pain and Physical Frailty in Community-Dwelling Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16081330 ◽

2019 ◽

Vol 16 (8) ◽

pp. 1330 ◽

Cited By ~ 10

Author(s):

Yuki Nakai ◽

Hyuma Makizako ◽

Ryoji Kiyama ◽

Kazutoshi Tomioka ◽

Yoshiaki Taniguchi ◽

...

Keyword(s):

Older Adults ◽

Chronic Pain ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Cross Sectional Study ◽

Community Dwelling ◽

Older Individuals ◽

Physical Frailty ◽

Cross Sectional ◽

Community Dwelling Older Adults

This cross-sectional study investigated the association between chronic pain and physical frailty in community-dwelling older adults. We analyzed data obtained from 323 older adults (women: 74.6%) who participated in a community-based health check survey (the Tarumizu Study, 2017). Physical frailty was defined in terms of five parameters (exhaustion, slowness, weakness, low physical activity, and weight loss). We assessed the prevalence of chronic low back and knee pain using questionnaires. Participants whose pain had lasted ≥two months were considered to have chronic pain. Among all participants, 138 (42.7%) had chronic pain, and 171 (53.0%) were categorized as having physical frailty or pre-frailty. Logistic regression analysis showed that chronic pain was significantly associated with the group combining frailty and pre-frailty (odds ratio 1.68, 95% confidence interval 1.03–2.76, p = 0.040) after adjustment for age, sex, body mass index, score on the 15-item Geriatric Depression Scale, and medications. Comparing the proportions of chronic pain among participants who responded to the sub-items, exhaustion (yes: 65.9%, no: 39.4%) demonstrated a significant association (p < 0.001). Chronic pain could be associated with the group combining frailty and pre-frailty and is particularly associated with exhaustion in community-dwelling older adults. Therefore, there is a need for early intervention and consideration of the role of exhaustion when devising interventions for physical frailty in older individuals with chronic pain.

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Depressive symptoms in institutionalized older adults

Revista de Saúde Pública ◽

10.1590/s0034-8910.2014048004965 ◽

2014 ◽

Vol 48 (2) ◽

pp. 216-224 ◽

Cited By ~ 10

Author(s):

Lívia Maria Santiago ◽

Inês Echenique Mattos

Keyword(s):

Social Support ◽

Factor Analysis ◽

Depressive Symptoms ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Cross Sectional Study ◽

Health Conditions ◽

Older Individuals ◽

Cross Sectional ◽

High Prevalence

OBJECTIVE To estimate the prevalence of depressive symptoms among institutionalized elderly individuals and to analyze factors associated with this condition. METHODS This was a cross-sectional study involving 462 individuals aged 60 or older, residents in long stay institutions in four Brazilian municipalities. The dependent variable was assessed using the 15-item Geriatric Depression Scale. Poisson’s regression was used to evaluate associations with co-variables. We investigated which variables were most relevant in terms of presence of depressive symptoms within the studied context through factor analysis. RESULTS Prevalence of depressive symptoms was 48.7%. The variables associated with depressive symptoms were: regular/bad/very bad self-rated health; comorbidities; hospitalizations; and lack of friends in the institution. Five components accounted for 49.2% of total variance of the sample: functioning, social support, sensory deficiency, institutionalization and health conditions. In the factor analysis, functionality and social support were the components which explained a large part of observed variance. CONCLUSIONS A high prevalence of depressive symptoms, with significant variation in distribution, was observed. Such results emphasize the importance of health conditions and functioning for institutionalized older individuals developing depression. They also point to the importance of providing opportunities for interaction among institutionalized individuals.

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Physical activity and depression in older adults with and without cognitive impairment

Dementia & Neuropsychologia ◽

10.1590/1980-57642018dn12-010002 ◽

2018 ◽

Vol 12 (1) ◽

pp. 12-18 ◽

Cited By ~ 7

Author(s):

Kornanong Yuenyongchaiwat ◽

Khajonsak Pongpanit ◽

Somrudee Hanmanop

Keyword(s):

Physical Activity ◽

Older Adults ◽

Cognitive Impairment ◽

Depressive Symptoms ◽

Geriatric Depression Scale ◽

Depression Scale ◽

The Elderly ◽

Older Individuals ◽

Cross Sectional ◽

Increased Risk

ABSTRACT Low physical activity and depression may be related to cognitive impairment in the elderly. Objetive: To determine depression and physical activity (PA) among older adults with and without cognitive impairment. Methods: 156 older adults, both males and females, aged ≥60 years, were asked to complete the Thai Mini-Mental State Examination (Thai-MMSE), a global cognitive impairment screening tool. Seventy-eight older adults with cognitive impairment and 78 older adults without cognitive impairment were then separately administered two questionnaires (i.e., the Thai Geriatric Depression Scale; TGDS and Global Physical Activity Questionnaire; GPAQ). Logistic regression analysis was used to determine the risk of developing cognitive impairment in the groups of older individuals with and without cognitive impairment. Results: A cross-sectional study of elderly with a mean age of 74.47 ± 8.14 years was conducted. There were significant differences on the depression scale and in PA between older adults with and without cognitive impairment. Further, participants with low PA and high level of depressive symptoms had an increased risk of cognitive impairment (Odds ratio = 4.808 and 3.298, respectively). Conclusion: Significant differences were noted in PA and on depression scales between older adults with and without cognitive impairment. Therefore, increased PA and decreased depressive symptoms (i.e., having psychological support) are suggested to reduce the risks of cognitive impairment in older adults.

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The Association between Leisure and Physical Activity Level with Depressive Symptoms after 5-years of follow-up

Innovation in Aging ◽

10.1093/geroni/igab046.2886 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 788-788

Author(s):

Milan Chang ◽

Hrafnhildur Eymundsdottir ◽

Alfons Ramel ◽

Sigurveig Sigurdardottir ◽

Vilmundur Gudnasson ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Depressive Symptoms ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Leisure Activity ◽

Community Dwelling ◽

Activity Level ◽

Community Dwelling Older Adults

Abstract Background Depressive symptoms in older adults are associated with socioeconomic status (SES), medical care, and physical activity. However, there is little evidence on the longitudinal association between level of leisure activity (LA) and physical activity (PA) with depressive symptoms among community-dwelling older adults in Iceland. The study examined an association of LA and PA at baseline with high depressive symptoms (HGDS) assessed after 5 years of follow-up among community-dwelling older adults. Methods A large community-based population residing in Reykjavik, Iceland participated in a longitudinal study with 5 years of follow-up (n=2957, 58% women, 74.9±4.8 yrs). Those with HGDS or dementia at baseline were excluded from the analysis. The reported activity was categorized into 2 groups as no-activity versus any-activity. Depressive symptoms were assessed by the 15-item Geriatric Depression Scale (GDS) on average 5 years later. Results After adjusting for demographic and health-related risk factors, those who reported having any LA had significantly fewer HGDS after the follow-up of 5 years (6 or higher GDS scores, Odds Ratio (OR) = 0.46, 95% Confidence Interval (CI): 0.27 ~ 0.76, P = 0.003). However, reporting any PA at baseline was not significantly associated with HGDS (OR = 0.71, 95% CI: 0.51 ~ 1.00, P = 0.053). Conclusion Our study shows that any LA among older adults is associated with having less depressive symptoms 5 years later among community-dwelling older adults while having any PA was not associated with depressive symptoms after 5 years of follow-up.

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Depressive Symptoms Predict Incident Dementia in a Community Sample of Older Adults: Results From the Einstein Aging Study

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988718824036 ◽

2019 ◽

Vol 32 (2) ◽

pp. 97-103 ◽

Cited By ~ 10

Author(s):

Ali Ezzati ◽

Mindy J. Katz ◽

Carol A. Derby ◽

Molly E. Zimmerman ◽

Richard B. Lipton

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Community Sample ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Community Dwelling ◽

Incident Dementia ◽

Increased Risk ◽

Aging Study

Background: There is increasing evidence that depressive symptoms are associated with increased risk of cognitive impairment and dementia in older adults. In current study, we aimed to investigate the effect of depressive symptoms on incident Alzheimer disease and all-cause dementia in a community sample of older adults. Methods: Participants were 1219 older adults from the Einstein Aging Study, a longitudinal cohort study of community-dwelling older adults in Bronx County, New York. The Geriatric Depression Scale (GDS, 15-item) was used as a measure of depressive symptoms. The primary outcome was incident dementia diagnosed using the Diagnostic and Statistical Manual, Fourth Edition, criteria. Cox proportional hazard models were used to estimate the risk of incident dementia as a function of GDS score for the whole population and also for 2 different time intervals, <3 years and ≥3 years after baseline assessment. Results: Among participants, 132 individuals developed dementia over an average 4.5 years (standard deviation [SD] = 3.5) of follow-up. Participants had an average age of 78.3 (SD = 5.4) at baseline, and 62% were women. Among all participants, after controlling for demographic variables and medical comorbidities, a 1-point increase in GDS was associated with higher incidence of dementia (hazard ratio [HR] = 1.11, P = .007). After up to 3 years of follow-up, depressive symptoms were not significantly associated with dementia incidence (HR = 1.09; P = .070). However, after more than 3 years, GDS score was a significant predictor of incident dementia (HR = 1.13, P = .028). Conclusions: Our results suggest that depressive symptoms are associated with an increased risk of incident dementia in older adults.

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Associations between depressive symptoms and geriatric syndromes in community-dwelling older adults in Japan: a cross-sectional study

10.21203/rs.3.rs-63598/v1 ◽

2020 ◽

Author(s):

Masakazu Imaoka ◽

Hidetoshi Nakao ◽

Misa Nakamura ◽

Fumie Tazaki ◽

Mitsumasa Hida ◽

...

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Cross Sectional Study ◽

Community Dwelling ◽

Geriatric Syndromes ◽

Sectional Study ◽

Cross Sectional ◽

Community Dwelling Older Adults

Abstract Background It is estimated that 7.2% of community-dwelling older adults in worldwide have major depression. This cross-sectional study aimed to investigate the relationship between geriatric syndromes and depressive symptoms. Methods Data were obtained from 363 older adults (mean age 73.6 ± 6.6 years; women = 75.8%) who participated in a community-based health check. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS-15). Depression was defined as a GDS-15 score of ≥ 5. Further, geriatric syndromes in participants—such as frailty, sarcopenia, and locomotive syndrome—were assessed. Results There was a 28.1% prevalence of depressive symptoms. In a logistic regression analysis with depressive symptoms as the dependent variable, both pre-frailty (odds ratio [OR] 1.85, 95% confidence interval [CI] 1.09–3.01) and frailty (OR 5.45, 95% CI 2.23–13.31) were found to be significantly higher in the depressive group. Conclusions Our findings suggest that depressive symptoms are associated with frailty and pre-frailty in community-dwelling older adults in Japan.

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Physiological Levels of Melatonin Relate to Cognitive Function and Depressive Symptoms: The HEIJO-KYO Cohort

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2015-1859 ◽

2015 ◽

Vol 100 (8) ◽

pp. 3090-3096 ◽

Cited By ~ 23

Author(s):

Kenji Obayashi ◽

Keigo Saeki ◽

Junko Iwamoto ◽

Nobuhiro Tone ◽

Kunihiko Tanaka ◽

...

Keyword(s):

Cognitive Impairment ◽

Depressive Symptoms ◽

Cognitive Function ◽

Confidence Interval ◽

Depressed Mood ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Cross Sectional Study ◽

Community Dwelling ◽

Cross Sectional

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.

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