Depression is more strongly associated with cognition in elderly women than men with type 2 diabetes

Objective: Depression is highly frequent in older adults with Type 2 Diabetes and is associated with cognitive impairment. Yet, little is known about how various depression dimensions differentially affect cognition. We investigated longitudinal associations of specific depression dimensions with cognitive decline. Research Design and Methods: Participants (N=1002) were from the Israel Diabetes and Cognitive Decline study, 65+ years of age with Type 2 Diabetes, not demented at baseline. Participants underwent comprehensive neuropsychological battery at baseline and every 18 months thereafter including domains of Episodic Memory, Attention/Working Memory, Semantic Categorization/Language, Executive Function and Z scores of each domain were averaged and further normalized to calculate Global Cognition. Depression items from Geriatric Depression Scale- 15 items (GDS-15) was measured at each visit and subcategorized to five dimensions: Dysphoric Mood, Withdrawal Apathy-Vigor (entitled apathy), Anxiety, Hopelessness and Memory complaint. Random coefficients models examined association of depression dimensions with baseline and longitudinal cognitive functioning adjusting for socio-demographics and baseline characteristics, including cardiovascular risk factors, physical activity and use of diabetic medications. Result: In the fully adjusted model, at baseline, all dimensions of depression, except for anxiety, were associated with some aspects of cognition (p-values from .01 to <.001). Longitudinally, greater apathy scores were associated with faster decline in executive functions (p=.004), a results that withstood adjustment for multiple comparisons. Associations of other depression dimensions with cognitive decline were not significant (p>0.01). Conclusion: Apathy was associated with a faster cognitive decline in executive functions. These findings highlight the heterogeneity of depression as a clinical construct rather than a single entity and point to apathy as a specific risk factor for cognitive decline among older adults with Type 2 Diabetes.

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Specific Dimensions of Depression Have Different Associations With Cognitive Decline in Older Adults With Type 2 Diabetes

10.2337/figshare.13286318 ◽

2021 ◽

Author(s):

Laili Soleimani ◽

Ramit Ravona-Springer ◽

Hung-Mo Lin ◽

Xiaoyu Liu ◽

Mary Sano ◽

...

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Executive Functions ◽

Cognitive Decline ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Random Coefficients ◽

Neuropsychological Battery ◽

Five Dimensions

Objective: Depression is highly frequent in older adults with Type 2 Diabetes and is associated with cognitive impairment. Yet, little is known about how various depression dimensions differentially affect cognition. We investigated longitudinal associations of specific depression dimensions with cognitive decline. Research Design and Methods: Participants (N=1002) were from the Israel Diabetes and Cognitive Decline study, 65+ years of age with Type 2 Diabetes, not demented at baseline. Participants underwent comprehensive neuropsychological battery at baseline and every 18 months thereafter including domains of Episodic Memory, Attention/Working Memory, Semantic Categorization/Language, Executive Function and Z scores of each domain were averaged and further normalized to calculate Global Cognition. Depression items from Geriatric Depression Scale- 15 items (GDS-15) was measured at each visit and subcategorized to five dimensions: Dysphoric Mood, Withdrawal Apathy-Vigor (entitled apathy), Anxiety, Hopelessness and Memory complaint. Random coefficients models examined association of depression dimensions with baseline and longitudinal cognitive functioning adjusting for socio-demographics and baseline characteristics, including cardiovascular risk factors, physical activity and use of diabetic medications. Result: In the fully adjusted model, at baseline, all dimensions of depression, except for anxiety, were associated with some aspects of cognition (p-values from .01 to <.001). Longitudinally, greater apathy scores were associated with faster decline in executive functions (p=.004), a results that withstood adjustment for multiple comparisons. Associations of other depression dimensions with cognitive decline were not significant (p>0.01). Conclusion: Apathy was associated with a faster cognitive decline in executive functions. These findings highlight the heterogeneity of depression as a clinical construct rather than a single entity and point to apathy as a specific risk factor for cognitive decline among older adults with Type 2 Diabetes.

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Specific Dimensions of Depression Have Different Associations With Cognitive Decline in Older Adults With Type 2 Diabetes

10.2337/figshare.13286318.v1 ◽

2021 ◽

Author(s):

Laili Soleimani ◽

Ramit Ravona-Springer ◽

Hung-Mo Lin ◽

Xiaoyu Liu ◽

Mary Sano ◽

...

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Executive Functions ◽

Cognitive Decline ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Random Coefficients ◽

Neuropsychological Battery ◽

Five Dimensions

Objective: Depression is highly frequent in older adults with Type 2 Diabetes and is associated with cognitive impairment. Yet, little is known about how various depression dimensions differentially affect cognition. We investigated longitudinal associations of specific depression dimensions with cognitive decline. Research Design and Methods: Participants (N=1002) were from the Israel Diabetes and Cognitive Decline study, 65+ years of age with Type 2 Diabetes, not demented at baseline. Participants underwent comprehensive neuropsychological battery at baseline and every 18 months thereafter including domains of Episodic Memory, Attention/Working Memory, Semantic Categorization/Language, Executive Function and Z scores of each domain were averaged and further normalized to calculate Global Cognition. Depression items from Geriatric Depression Scale- 15 items (GDS-15) was measured at each visit and subcategorized to five dimensions: Dysphoric Mood, Withdrawal Apathy-Vigor (entitled apathy), Anxiety, Hopelessness and Memory complaint. Random coefficients models examined association of depression dimensions with baseline and longitudinal cognitive functioning adjusting for socio-demographics and baseline characteristics, including cardiovascular risk factors, physical activity and use of diabetic medications. Result: In the fully adjusted model, at baseline, all dimensions of depression, except for anxiety, were associated with some aspects of cognition (p-values from .01 to <.001). Longitudinally, greater apathy scores were associated with faster decline in executive functions (p=.004), a results that withstood adjustment for multiple comparisons. Associations of other depression dimensions with cognitive decline were not significant (p>0.01). Conclusion: Apathy was associated with a faster cognitive decline in executive functions. These findings highlight the heterogeneity of depression as a clinical construct rather than a single entity and point to apathy as a specific risk factor for cognitive decline among older adults with Type 2 Diabetes.

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P1-266: Trajectories of glycemic control are associated with depressive symptoms beyond cognitive function in nondemented very elderly with type 2 diabetes

Alzheimer s & Dementia ◽

10.1016/j.jalz.2015.06.467 ◽

2015 ◽

Vol 11 (7S_Part_10) ◽

pp. P457-P457

Author(s):

Ramit Ravona-Springer ◽

Anthony Heymann ◽

Erin Moshier ◽

James Schmeidler ◽

Michael Davidson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Depressive Symptoms ◽

Cognitive Function ◽

Glycemic Control ◽

Very Elderly

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The Diabetic Person Beyond a Foot Ulcer

Journal of the American Podiatric Medical Association ◽

10.7547/0980130 ◽

2008 ◽

Vol 98 (2) ◽

pp. 130-136 ◽

Cited By ~ 52

Author(s):

Matteo Monami ◽

Rosella Longo ◽

Carla Maria Desideri ◽

Giulio Masotti ◽

Niccolò Marchionni ◽

...

Keyword(s):

Depressive Symptoms ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Foot Ulcers ◽

Diabetic Patients ◽

Geriatric Depression ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

Background: Several studies have shown a significant relationship between depressive symptoms and wound healing, but these studies have not assessed the effects of depressive symptoms on diabetic foot prognosis. We specifically designed our study to assess the role of depressive symptoms in healing and recurrence of diabetic foot ulcers. Methods: A consecutive series of 80 type 2 diabetic patients aged 60 years and older with foot ulcers was enrolled in a cohort observational study with a 6-month follow-up. Patients who healed within 6 months of enrollment were included in a 12-month follow-up study for assessment of ulcer recurrence. Depressive symptoms were assessed with the geriatric depression scale. Results: Healing was associated with a smaller ulcer area, shorter delay between ulcer onset and treatment, lower glycosylated hemoglobin, and higher ankle-brachial index. Both smoking status and Texas and Wagner scores also had a significant impact on healing. Patients who healed had significantly lower scores on the geriatric depression scale, and those with scores = 10 had a significantly higher risk of not healing at 6 months (relative risk, 3.57; 95% confidence interval, 1.05–12.2). Patients with a recurrent ulcer (59.3%) showed significantly higher total cholesterol levels, higher scores on the Greenfield index of disease severity and geriatric depression scale, and a higher prevalence of cerebrovascular disease. Depressive symptoms maintained a significant association with persistence and recurrence of ulcer even after adjustment for confounders. Conclusions: Depressive symptoms are associated with impaired healing and recurrence of ulcers in elderly type 2 diabetic patients. (J Am Podiatr Med Assoc 98(2): 130–136, 2008)

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5-Cog Study: Cross-Cultural Comparison of Subjective Cognitive Complaints in a Diverse Primary Care Population

Innovation in Aging ◽

10.1093/geroni/igaa057.1162 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 361-361

Author(s):

Emmeline Ayers ◽

Erica F Weiss ◽

Joe Verghese

Keyword(s):

Primary Care ◽

Depressive Symptoms ◽

Cognitive Function ◽

Verbal Learning ◽

Primary Care Clinic ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Cognitive Complaints ◽

Care Clinic ◽

Subjective Cognitive Complaints

Abstract Subjective cognitive complaints (SCC) are risk factors for cognitive decline in older adults. A link between SCC and depressive symptoms has also been reported. These associations have not been much studied in non-White populations. We examined the relationship of SCC with cognitive function and depressive symptoms in adults aged 65 and older attending a primary care clinic in the Bronx. Five common SCC questions (four memory-related and one non-memory-related) were identified by literature review. Linear regressions, adjusted for age, sex and education years, were used to examine associations between individual SCC and cognitive function (Montreal Cognitive Assessment (MoCA) score and Hopkins Verbal Learning Test (HVLT) recall score) and depressive symptoms (Geriatric Depression Scale (GDS) score) for Hispanic (n=53) and non-Hispanic Black (n=47) adults. Mean number of SCC was similar for Blacks and Hispanics (2.3 vs. 2.4, p=0.752). Hispanics performed worse on the MoCA than Blacks (16.4 vs. 18.5, p=0.012), but education explained this difference. GDS and HVLT were similar across groups. For Hispanics only, a response of fair or poor to the question “how is your memory for a person your age?” was associated with worse MoCA scores (β -2.6; p=0.008). SCC were not associated with HVLT scores for either group. Four SCC for Blacks and two for Hispanics were associated with worse GDS scores. In an urban clinic population, SCC for Blacks and Hispanics were associated more with depressive symptoms than cognition. Further research is needed to identify SCC that better correlate with cognitive function in diverse populations.

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Depressive Symptoms Are Associated with Cognitive Function in the Elderly with Type 2 Diabetes

Journal of Alzheimer s Disease ◽

10.3233/jad-170778 ◽

2018 ◽

Vol 65 (2) ◽

pp. 683-692 ◽

Cited By ~ 4

Author(s):

Elizabeth Guerrero-Berroa ◽

Ramit Ravona-Springer ◽

James Schmeidler ◽

Anthony Heymann ◽

Laili Soleimani ◽

...

Keyword(s):

Type 2 Diabetes ◽

Depressive Symptoms ◽

Cognitive Function ◽

The Elderly

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P4-155: The Relationship of Depressive Symptoms with Cognitive Function is Different for Men and Women with Type 2 Diabetes

Alzheimer s & Dementia ◽

10.1016/j.jalz.2016.06.2247 ◽

2016 ◽

Vol 12 ◽

pp. P1074-P1074

Author(s):

Laili Soleimani ◽

Ramit Ravona-Springer ◽

Anthony Heymann ◽

James Schmeidler ◽

Mary Sano ◽

...

Keyword(s):

Type 2 Diabetes ◽

Depressive Symptoms ◽

Cognitive Function ◽

Men And Women ◽

Relationship Of ◽

The Relationship

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Depressive symptoms and quality of life after screening for cognitive impairment in patients with type 2 diabetes: observations from the Cog-ID cohort study

BMJ Open ◽

10.1136/bmjopen-2018-024696 ◽

2019 ◽

Vol 9 (1) ◽

pp. e024696 ◽

Cited By ~ 3

Author(s):

Jolien Janssen ◽

Paula S Koekkoek ◽

Geert-Jan Biessels ◽

Jaap L Kappelle ◽

Guy E H M Rutten

Keyword(s):

Quality Of Life ◽

Type 2 Diabetes ◽

Cohort Study ◽

Cognitive Impairment ◽

Depressive Symptoms ◽

Short Form ◽

Depression Scale ◽

Analysis Of Covariance

ObjectivesTo assess changes in depressive symptoms and health-related quality of life (HRQOL) after screening for cognitive impairment in people with type 2 diabetes.DesignA prospective cohort study, part of the Cognitive Impairment in Diabetes (Cog-ID) study.SettingParticipants were screened for cognitive impairment in primary care. People suspected of cognitive impairment (screen positives) received a standardised evaluation at a memory clinic.ParticipantsParticipants ≥70 years with type 2 diabetes were included in Cog-ID between August 2012 and September 2014, the current study includes 179 patients; 39 screen positives with cognitive impairment, 56 screen positives without cognitive impairment and 84 participants not suspected of cognitive impairment during screening (screen negatives).Outcome measuresDepressive symptoms and HRQOL assessed with the Center for Epidemiologic Studies Depression Scale (CES-D), 36-Item Short-Form Health Survey, European Quality of Life-5 Dimensions questionnaire and the EuroQol Visual Analogue Scale. Outcomes were assessed before the screening, and 6 and 24 months after screening. An analysis of covariance model was fitted to assess differences in score changes among people diagnosed with cognitive impairment, screen negatives and screen positives without cognitive impairment using a factor group and baseline score as a covariate.ResultsOf all participants, 60.3% was male, mean age was 76.3±5.0 years, mean diabetes duration 13.0±8.5 years. At screening, participants diagnosed with cognitive impairment had significantly more depressive symptoms and a worse HRQOL than screen negatives. Scores of both groups remained stable over time. Screen positives without cognitive impairment scored between the other two groups at screening, but their depressive symptoms decreased significantly during follow-up (mean CES-D: −3.1 after 6 and −2.1 after 24 months); their HRQOL also tended to improve.ConclusionsDepressive symptoms are common in older people with type 2 diabetes. Screening for and a subsequent diagnosis of cognitive impairment will not increase depressive symptoms.

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