Cardiovascular diseases and related risk factors accelerated cognitive deterioration in patients with late-life depression: a one-year prospective study

ABSTRACTObjectives:Cognitive impairment in late-life depression is common and associated with a higher risk of all-cause dementia. Late-life depression patients with comorbid cardiovascular diseases (CVDs) or related risk factors may experience higher risks of cognitive deterioration in the short term. We aim to investigate the effect of CVDs and their related risk factors on the cognitive function of patients with late-life depression.Methods:A total of 148 participants were recruited (67 individuals with late-life depression and 81 normal controls). The presence of hypertension, coronary heart disease, diabetes mellitus, or hyperlipidemia was defined as the presence of comorbid CVDs or related risk factors. Global cognitive functions were assessed at baseline and after a one-year follow-up by the Mini-Mental State Examination (MMSE). Global cognitive deterioration was defined by the reliable change index (RCI) of the MMSE.Results:Late-life depression patients with CVDs or related risk factors were associated with 6.8 times higher risk of global cognitive deterioration than those without any of these comorbidities at a one-year follow-up. This result remained robust after adjusting for age, gender, and changes in the Hamilton Depression Rating Scale (HAMD) scores.Conclusions:This study suggests that late-life depression patients with comorbid CVDs or their related risk factors showed a higher risk of cognitive deterioration in the short-term (one-year follow up). Given that CVDs and their related risk factors are currently modifiable, active treatment of these comorbidities may delay rapid cognitive deterioration in patients with late-life depression.

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Vascular risk factors and incident late-life depression in a Korean population

The British Journal of Psychiatry ◽

10.1192/bjp.bp.105.015032 ◽

2006 ◽

Vol 189 (1) ◽

pp. 26-30 ◽

Cited By ~ 61

Author(s):

Jae-Min Kim ◽

Robert Stewart ◽

Sung-Wan Kim ◽

Su-Jin Yang ◽

Il-Seon Shin ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Function ◽

Density Lipoprotein ◽

Late Life ◽

Diagnostic Interview ◽

Affective States ◽

Late Life Depression ◽

Lower Baseline ◽

Vascular Status

BackgroundCausal relationships between vascular factors and late-life depression are controversial.AimsTo investigate prospective associations between risk factors for vascular disease and incidence of late-life depression.MethodOf 661 community participants aged 65 years or over, without depression at baseline, 521 (79%) were re-evaluated 2 years later. At baseline and follow-up, a diagnostic interview for depression was carried out and information on vascular status, disability and cognitive function was gathered.ResultsPre-existing heart disease, incident stroke and lower baseline high-density lipoprotein cholesterol level were significantly associated with incidence of late-life depression, independently of disability and cognitive function.ConclusionsThese results provide some support for a vascular aetiology of late-life depression. However, important risk factors for cerebrovascular disease such as hypertension and diabetes were not implicated, and the associations with lipid levels might still be explained by affective states earlier in life.

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Late-Life Depression as a Possible Predictor of Dementia Cross-Sectional and Short-Term Follow-Up Results

American Journal of Geriatric Psychiatry ◽

10.1097/00019442-199921720-00009 ◽

1999 ◽

Vol 7 (2) ◽

pp. 151-159

Author(s):

Robert van Reekum ◽

Martine Simard ◽

Diana Clarke ◽

Malcolm A. Binns ◽

David Conn

Keyword(s):

Late Life ◽

Late Life Depression ◽

Short Term ◽

Cross Sectional

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Long-term effectiveness and prediction of treatment outcome in cognitive behavioral therapy and sertraline for late-life anxiety disorders

International Psychogeriatrics ◽

10.1017/s1041610209990536 ◽

2009 ◽

Vol 21 (6) ◽

pp. 1148-1159 ◽

Cited By ~ 22

Author(s):

Josien Schuurmans ◽

Hannie Comijs ◽

Paul M. G. Emmelkamp ◽

Ingrid J. C. Weijnen ◽

Marcel van den Hout ◽

...

Keyword(s):

Treatment Outcome ◽

Anxiety Disorders ◽

Behavioral Therapy ◽

Late Life ◽

Term Treatment ◽

Short Term ◽

Long Term Treatment ◽

One Year

ABSTRACTBackground: Although anxiety disorders are prevalent in older adults, randomized controlled trials of treatment effectiveness for late-life anxiety are scarce and have focused primarily on the effectiveness of psychotherapeutic interventions. However, recent findings suggest that in some cases, pharmacological treatment may be more beneficial for late-life anxiety disorders. As yet, there have been no systematic studies investigating prognostic factors for the outcome of cognitive behavioral therapy (CBT) and pharmacotherapy for late-life anxiety. The objective of the present study was to study long-term treatment outcomes and to explore differential predictors for both short-term and long-term treatment outcomes of sertraline and CBT for late-life anxiety disorders.Methods: Participants of a randomized controlled trial (RCT) comparing sertraline and CBT for the treatment of late-life anxiety were contacted one year after completing their treatment, so that predictors for both short-term and long-term treatment outcome could be established.Results: Sertraline showed a greater reduction of symptoms than CBT on anxiety (Hamilton Anxiety Rating Scale; HARS) and worry (Worry Domain Questionnaire) ratings at one-year follow-up. The strongest predictor for short-term CBT outcome was poor perceived health, explaining 40% of the variance in post-treatment residual gain scores on the HARS. The strongest predictor for long-term CBT outcome was neuroticism, explaining 20% of the variance in residual gain scores at one-year follow-up. Analyses revealed no significant predictors for treatment outcome in sertraline participants.Conclusions: Our study suggests that long-term use of sertraline might be more beneficial for late-life anxiety than a 15-week CBT program. Poor perceived health and neuroticism are predictive of less improvement after CBT in anxious older adults. Implications of these findings are discussed.

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Late-Life Depression as a Possible Predictor of Dementia: Cross-Sectional and Short-Term Follow-Up Results

American Journal of Geriatric Psychiatry ◽

10.1097/00019442-199905000-00009 ◽

1999 ◽

Vol 7 (2) ◽

pp. 151-159 ◽

Cited By ~ 1

Author(s):

Robert van Reekum ◽

Martine Simard ◽

Diana Clarke ◽

Malcolm A. Binns ◽

David Conn

Keyword(s):

Late Life ◽

Late Life Depression ◽

Short Term ◽

Cross Sectional

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Disability but not social support predicts cognitive deterioration in late-life depression

International Psychogeriatrics ◽

10.1017/s1041610214002543 ◽

2014 ◽

Vol 27 (5) ◽

pp. 707-714 ◽

Cited By ~ 12

Author(s):

Meghan Riddle ◽

Douglas R. McQuoid ◽

Guy G. Potter ◽

David C. Steffens ◽

Warren D. Taylor

Keyword(s):

Social Support ◽

Cognitive Decline ◽

Antidepressant Treatment ◽

Late Life ◽

Cognitive Diagnosis ◽

Cognitive Deterioration ◽

Late Life Depression ◽

Cognitively Normal ◽

Increased Risk ◽

One Year

ABSTRACTBackground:Depression in late life is a risk factor for cognitive decline. Depression is also associated with increased disability and social support deficits; these may precede conversion to dementia and inform risk. In this study, we examined if baseline or one-year change in disability and social support predicted later cognitive deterioration.Methods:299 cognitively intact depressed older adults were followed for an average of approximately seven years. Participants received antidepressant treatment according to a standardized algorithm. Neuropsychological testing and assessment of disability and social support were assessed annually. Cognitive diagnosis was reviewed annually at a consensus conference to determine if participants remained cognitively normal, or if they progressed to either dementia or cognitively impaired, no dementia (CIND).Results:During study participation, 167 individuals remained cognitively normal (56%), 83 progressed to CIND (28%), and 49 progressed to dementia (16%). Greater baseline instrumental activities of daily living (IADL) deficits predicted subsequent conversion to a cognitive diagnosis (CIND or dementia). However, neither baseline measures nor one-year change in basic ADLs (BADLs) and social support predicted cognitive conversion. In post hoc analyses, two IADL measures (managing finances, preparing meals) significantly increased the odds of cognitive conversion.Conclusions:Greater IADL deficits predicted increased risk of cognitive conversion. Assessment of IADL deficits may provide clues about risk of later cognitive decline.

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Association of Mortality-Related Risk Factors in Patients with COVID-19: A Retrospective Cohort Study

Healthcare ◽

10.3390/healthcare9111468 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1468

Author(s):

Shazia Rehman ◽

Nadia Rehman ◽

Ayesha Mumtaz ◽

Jindong Jiang

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Cardiovascular Diseases ◽

Hospital Mortality ◽

Troponin I ◽

World Health ◽

Multivariate Logistic Regression Model ◽

Risk Of Death ◽

Related Risk

COVID-19 is a rapidly disseminating infectious disease conferred by the World Health Organization (WHO) as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics data have been identified for patients with COVID-19, but mortality-related risk factors and a comprehensive clinical course of disease in a developing country have not been specifically defined. This retrospective, single-center cohort study involved all successive inpatients having a positive COVID-19 polymerase chain reaction (PCR), with deceased or discharged clinical outcomes from 1 January to 10 May 2021. Data were extracted from electronic medical records on demographic, clinical, radiological, and laboratory findings as well as complications faced and treatment provided during follow-up, involving serial samples for viral RNA identification, and compared between the dead and survivors. To investigate the risk factors associated with in-hospital mortality, we employed the multivariate logistic regression model. In this study, 2048 patients were involved, 1458 of whom were discharged, and 590 died in hospital. More than half of patients were identified as male with old age being the potential risk factor of mortality. Exactly 94.8% of all patients presented with fever at the time of admission. Several comorbidities were present in the study population, with the most frequent comorbidity being cardiovascular diseases (1177 of 2048) and hypertension (975 of 2048) followed by cerebrovascular disease and diabetes mellitus. Mortality rates for infected patients were observed as higher in severe patients (46.3%) compared with non-severe cases (26.1%) during a follow-up. Multivariate regression analysis showed a significant association of in-hospital mortality of patients with older age, presence of hypertension and cardiovascular diseases as underlying comorbidities, increased level of cardiac troponin I and d-dimer concentration on admission, as well as septicemia and ARDS as a complication during illness. To minimize the risk of death in COVID19 patients, as well as the risk of severe complications, urgent public health measures should be properly planned and implemented on those vulnerable populations. To detect early manifestations of clinical problems, thorough and regular follow-up is warranted.

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A Study on the Short-Term Mortality and Related Risk Factors of Fragile Hip Fracture

10.21203/rs.3.rs-129838/v1 ◽

2020 ◽

Author(s):

Pei-Wen Wang ◽

Hua-Feng Zhuang ◽

Yi-Zhong Li ◽

Hao Xu ◽

Jin-Kuang Lin ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Hip Fractures ◽

Total Mortality ◽

Early Mortality ◽

Factors Affecting ◽

Related Risk ◽

Independent Risk Factors ◽

One Year

Abstract BackgroundThis study aimed to observe the mortality of patients with fragile hip fractures and assess the death-associated risk factors.MethodsSix hundred and ninety patients with osteoporotic hip fractures(aged 50-103-years-old) that were treated from January 2010 to December 2015 were enrolled in this study and followed-up and the clinical data were retrospectively examined. Three months, one year, and the total mortality during the follow-up time were measured. Mortality-related risk factors were assessed including age, gender, surgery, the duration from injury to operation, pulmonary infection, and the number and type of complications.ResultsThe 286 patients were followed up between 6 months and 42 months, with an average of 21.42±9.88 months. The three-month mortality was 7.69%, the number of patients who were followed up over one year was 231, the one-year mortality was 16.02%, and the total mortality of the follow-up time was 17.48%. The higher mortality was related to age over 75 years, associated cardio-respiratory diseases, male gender, non-operative treatment, surgery delayed over 5 days. Binary Logistic regression analysis showed that the independent risk factors affecting mortality included age (OR=5.385, P=0.003), surgery (OR=21.217, P=0.000), the number of complications (OR=9.038, P=0.000), and pre-injury cardiovascular disease (OR=3.201, P=0.041).ConclusionThe early mortality of fragile hip fractures was high and was also related to many risk factors. Age, surgery, the number of complications, and pre-injury cardiovascular disease were the independent risk factors affecting the mortality of patients with fragile hip fractures. Effective treatment without complications and early surgery can lower early mortality in patients with fragile hip fractures.

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Late-life depression, subjective cognitive decline, and their additive risk in incidence of dementia: A nationwide longitudinal study

PLoS ONE ◽

10.1371/journal.pone.0254639 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0254639

Author(s):

Sheng-Min Wang ◽

Kyung-do Han ◽

Nak-Young Kim ◽

Yoo Hyun Um ◽

Dong-Woo Kang ◽

...

Keyword(s):

Risk Factors ◽

Depressive Disorder ◽

Cognitive Decline ◽

Screening Program ◽

Significant Risk ◽

Late Life ◽

Subjective Cognitive Decline ◽

Large Sample Size ◽

Late Life Depression

Objective Late-life depression and subjective cognitive decline (SCD) are significant risk factors for dementia. However, studies with a large sample size are needed to clarify their independent and combined risks for subsequent dementia. Methods This nationwide population-based cohort study included all individuals aged 66 years who participated in the National Screening Program between 2009 and 2013 (N = 939,099). Subjects were followed from the day they underwent screening to the diagnosis of dementia, death, or the last follow-up day (December 31, 2017). Results Depressive symptom presentation, recent depressive disorder, and SCD independently increased dementia incidence with adjusted hazard ratio (aHR) of 1.286 (95% CI:1.255–1.318), 1.697 (95% CI:1.621–1.776), and 1.748 (95% CI: 689–1.808) respectively. Subjects having both SCD and depression had a higher risk (aHR = 2.466, 95% CI:2.383–2.551) of dementia than having depression (aHR = 1.402, 95% CI:1.364–1.441) or SCD (aHR = 1.748, 95% CI:1.689–1.808) alone. Conclusions Depressive symptoms, depressive disorder, and SCD are independent risk factors for dementia. Co-occurring depression and SCD have an additive effect on the risk of dementia; thus, early intervention and close follow up are necessary for patients with co-occurring SCD and depression.

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Catheter-directed foam sclerotherapy treatment of saphenous vein incompetence

VASA ◽

10.1024/0301-1526/a000174 ◽

2012 ◽

Vol 41 (2) ◽

pp. 120-124 ◽

Cited By ~ 11

Author(s):

Asciutto ◽

Lindblad

Keyword(s):

Saphenous Vein ◽

Short Term ◽

Foam Sclerotherapy ◽

Results Of Treatment ◽

Ulcer Healing Rate ◽

Complete Obliteration ◽

Ceap Classification ◽

One Year ◽

The One

Background: The aim of this study is to report the short-term results of catheter-directed foam sclerotherapy (CDFS) in the treatment of axial saphenous vein incompetence. Patients and methods: Data of all patients undergoing CDFS for symptomatic primary incompetence of the great or small saphenous vein were prospectively collected. Treatment results in terms of occlusion rate and patients grade of satisfaction were analysed. All successfully treated patients underwent clinical and duplex follow-up examinations one year postoperatively. Results: Between September 2006 and September 2010, 357 limbs (337 patients) were treated with CDFS at our institution. Based on the CEAP classification, 64 were allocated to clinical class C3 , 128 to class C4, 102 to class C5 and 63 to class C6. Of the 188 patients who completed the one year follow up examination, 67 % had a complete and 14 % a near complete obliteration of the treated vessel. An ulcer-healing rate of 54 % was detected. 92 % of the patients were satisfied with the results of treatment. We registered six cases of thrombophlebitis and two cases of venous thromboembolism, all requiring treatment. Conclusions: The short-term results of CDFS in patients with axial vein incompetence are acceptable in terms of occlusion and complications rates.

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