Disability in older adults across the continuum of cognitive decline: unique contributions of depression, sleep disturbance, cognitive deficits and medical burden

2019 ◽  
Vol 31 (11) ◽  
pp. 1611-1625 ◽  
Author(s):  
Haley M. LaMonica ◽  
Ian B. Hickie ◽  
Jerome Ip ◽  
Catriona Ireland ◽  
Loren Mowszowski ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Sleep Quality ◽  
Cognitive Decline ◽  
Clinical Sample ◽  
Self Report ◽  
World Health ◽  
Early Dementia ◽  
Medical Burden ◽  
The Continuum

ABSTRACTObjectives:Disability in older adults is associated with a need for support in work, education, and community activities, reduced independence, and poorer quality of life. This study examines potential determinants of disability in a clinical sample of older adults across the continuum of cognitive decline, including sociodemographic, medical, psychiatric, and cognitive factors.Design:This is a cross-sectional study.Setting:Participants were recruited from a specialty clinic for adults “at risk” of or with early dementia (including subjective cognitive complaints, mild cognitive impairment, and early dementia).Participants:Four hundred forty-two older adults (mean age = 67.11, SD = 9.33) underwent comprehensive medical, neuropsychological, and mood assessments.Measurements:Disability was assessed via the self-report World Health Organization Disability Assessment Schedule 2.0. A stepwise (forward) linear regression model was computed to determine factors that contribute to disability within this group.Results:Depressive symptoms were the largest predictor, uniquely explaining 31.8% of the variance. Other contributing factors in the model included younger age, medical burden, and sleep quality, with all factors together accounting for a total of 50.4% of the variance in disability. Cognitive variables did not contribute to the model.Conclusions:Depressive symptoms account for a significant portion of the variance in disability, but other factors such as age, medical burden and sleep quality are also important contributors in older adults across the continuum of cognitive decline. The relative association of these variables with disability appears to differ for older (≥65 years) relative to younger (<65 years) participants. Given the relationship between disability and these risk factors, an integrative and multidisciplinary approach to risk reduction will likely be most effective, with potential carry over effects for physical and mental health.

scholarly journals Self-Reported Disability: Association With Lower Extremity Performance and Other Determinants in Older Adults Attending Primary Care

2015 ◽  
Vol 95 (12) ◽  
pp. 1628-1637 ◽  
Author(s):  
Anabela G. Silva ◽  
Alexandra Queirós ◽  
Pedro Sa-Couto ◽  
Nelson P. Rocha
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Primary Care ◽  
Depressive Symptoms ◽  
Lower Extremity ◽  
Self Report ◽  
World Health ◽  
Cross Sectional ◽  
Whodas 2.0 ◽  
Lower Extremity Performance

Background Measurement of function usually involves the use of both performance-based and self-report instruments. However, the relationship between both types of measures is not yet completely understood, in particular for older adults attending primary care. Objective The main objective of the study was to investigate the association between the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and the Short Physical Performance Battery (SPPB) for older adults at primary care. A secondary objective was to determine the influence of sociodemographic and health-related variables on this relationship. Design This was a cross-sectional study. Methods A total of 504 participants aged 60 years and older from 18 different primary care centers underwent a one-session assessment including: sociodemographic variables, comorbidities, performance, self-reported disability, pain, depressive symptoms, and physical activity. Performance was assessed using the SPPB, and self-reported disability was assessed using the WHODAS 2.0. Results The correlation between WHODAS 2.0 and SPPB scores was strong (r=.65). Regression analysis showed that the SPPB total score explained 41.7% of the variance in WHODAS 2.0 scores (adjusted R2=41.6%). A second model including the SPPB subtests (balance, gait, and sit-to-stand), depressive symptoms, number of pain sites, pain intensity, and level of physical activity explained 61.7% of the variance in WHODAS 2.0 scores (adjusted R2=60.4%). No model improvement was found when considering the 6 WHODAS 2.0 individual domains. Limitations The cross-sectional nature of the study does not allow inferences on causal relationships. Conclusions This study's findings confirm that self-report and performance-based measures relate to different aspects of functioning. Further study is needed to determine if primary care interventions targeting lower extremity performance and depressive symptoms improve self-reported disability.

P2-607: DEPRESSIVE SYMPTOMS PREDICT COGNITIVE DECLINE IN OLDER ADULTS

2006 ◽  
Vol 14 (7S_Part_18) ◽  
pp. P972-P972
Author(s):  
Elizabeth Guerrero-Berroa ◽  
James Schmeidler ◽  
Vahram Haroutunian ◽  
Joshua Arneson ◽  
Rebecca West ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Cognitive Decline

scholarly journals Longitudinal Relationships Between Subjective Cognitive Decline and Objective Memory: Depressive Symptoms Mediate Between-Person Associations

2021 ◽  
pp. 1-14
Author(s):  
Nikki L. Hill ◽  
Sakshi Bhargava ◽  
Emily Bratlee-Whitaker ◽  
Jennifer R. Turner ◽  
Monique J. Brown ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Cognitive Decline ◽  
Structural Equation ◽  
Disease Risk ◽  
Well Being ◽  
Equation Modeling ◽  
Subjective Cognitive Decline ◽  
Future Research ◽  
Over Time

Background: Subjective cognitive decline (SCD) may be an early indicator of cognitive impairment, but depressive symptoms can confound this relationship. Associations may be influenced by differences between individuals (i.e., between-persons) or how each individual changes in their experiences over time (i.e., within-persons). Objective: We examined depressive symptoms as a mediator of the between- and within-person associations of SCD and objective memory in older adults. Methods: Coordinated analyses were conducted across four datasets drawn from large longitudinal studies. Samples (range: n = 1,889 to n = 15,841) included participants 65 years of age or older with no dementia at baseline. We used multilevel structural equation modeling to examine the mediation of SCD and objective memory through depressive symptoms, as well as direct relationships among SCD, objective memory, and depressive symptoms. Results: Older adults who were more likely to report SCD had lower objective memory on average (between-person associations), and depressive symptoms partially mediated this relationship in three of four datasets. However, changes in depressive symptoms did not mediate the relationship between reports of SCD and declines in objective memory in three of four datasets (within-person associations). Conclusion: Individual differences in depressive symptoms, and not changes in an individual’s depressive symptoms over time, partially explain the link between SCD and objective memory. Older adults with SCD and depressive symptoms may be at greater risk for poor cognitive outcomes. Future research should explore how perceived changes in memory affect other aspects of psychological well-being, and how these relationships influence cognitive decline and Alzheimer’s disease risk.

IC-P-139: LONGITUDINAL DEPRESSIVE SYMPTOMS AND CORTICAL AMYLOID ARE ASSOCIATED WITH COGNITIVE DECLINE IN OLDER ADULTS

2006 ◽  
Vol 14 (7S_Part_2) ◽  
pp. P116-P117
Author(s):  
Jennifer R. Gatchel ◽  
Jennifer S. Rabin ◽  
Rachel F. Buckley ◽  
Joseph J. Locascio ◽  
Yakeel T. Quiroz ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Cognitive Decline

Edentulism and Trajectories of Cognitive Functioning Among Older Adults: The Role of Dental Care Service Utilization

2019 ◽  
Vol 32 (7-8) ◽  
pp. 744-752 ◽  
Author(s):  
Sae Hwang Han ◽  
Bei Wu ◽  
Jeffrey A. Burr
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Cognitive Functioning ◽  
Service Utilization ◽  
Dental Care ◽  
Care Service ◽  
Health Care Expenditures ◽  
Self Report ◽  
Dental Services

Objective: This study examined the associations between edentulism, dental care service utilization, and cognitive functioning trajectories among older adults. Method: Longitudinal data from the Health and Retirement Study (2006-2014) were employed to examine individuals aged 51 and older who were identified as having normal cognition at baseline ( N = 12,405). Cognitive functioning was measured with a modified version of the Telephone Interview for Cognition Status. Edentulism was self-reported as total tooth loss at baseline. Dental care service utilization was measured by self-report of having visited a dentist at least once during the previous 2 years. Results: The results indicated that edentulism and dental care service utilization were independently associated with cognitive decline during the observation period. Findings also showed that dental care service utilization moderated the association between edentulism and cognitive decline. Discussion: The findings suggested that providing access to dental services may promote cognitive health and potentially reduce health care expenditures.

scholarly journals THE MODERATING EFFECT OF RAISING ONE’S GRANDCHILDREN ON THE RELATION BETWEEN SLEEP AND DEPRESSION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S678-S678
Author(s):  
Melanie Stearns ◽  
Danielle K Nadorff
Keyword(s):  
Older Adults ◽  
Risk Factor ◽  
Depressive Symptoms ◽  
Sleep Quality ◽  
Sleep Problems ◽  
Depression Scale ◽  
Poor Sleep ◽  
Older Individuals ◽  
Poor Sleep Quality ◽  
Custodial Grandparents

Abstract Recent evidence has shown that poor quality sleep is associated with depression, particularly among older individuals (Bao et al., 2017; Nadorff, Fiske, Sperry, & Petts, 2012). Moreover, given the high prevalence of depressive symptoms among older adults, it is important to identify possible risk factors of poor sleep quality. One possible risk factor is being a custodial grandparent (raising one’s grandchildren), as increased caregiving responsivities are associated with increased depressive symptoms (Brand-Winterstein, Edelstein, & Bachner, 2018). Based upon these previous findings, the current study examines the effect of custodial status on the relation between sleep quality and depressive symptoms. The sample (N = 466) was a subset of individuals recruited in the second wave of the MIDUS biomarkers project completed in 2009 who answered the sleep, caregiving, and depressive symptoms variables of interest. Measures included the Center for Epidemiological Studies Depression Scale (CESD), the Pittsburgh Sleep Quality Index (PSQI), and a question regarding custodial grandparent status. The current study aimed to examine whether poor sleep quality might serve as a risk factor for experiencing depressive symptoms and how custodial grandparents might differ from other older adults. Moderation analyses were conducted using SPSS’ Process macro on the sample. The interaction between global sleep quality and custodial grandparent status was significant in predicting depressive symptoms, t (1, 465) = 3.90, p = .04, such that custodial grandparents reported a stronger positive correlation between greater global sleep problems and depressive symptoms than non-custodial grandparents. Implications, future directions, and limitations are discussed.

scholarly journals Effects of Mind–Body Interventions Involving Meditative Movements on Quality of Life, Depressive Symptoms, Fear of Falling and Sleep Quality in Older Adults: A Systematic Review with Meta-Analysis

2020 ◽  
Vol 17 (18) ◽  
pp. 6556
Author(s):  
Manuel Weber ◽  
Thiemo Schnorr ◽  
Mareike Morat ◽  
Tobias Morat ◽  
Lars Donath
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Mental Disorders ◽  
Sleep Quality ◽  
Health Outcomes ◽  
Psychological Health ◽  
Fear Of Falling ◽  
Randomized Controlled

Background: The aim of the present systematic meta-analytical review was to quantify the effects of different mind–body interventions (MBI) involving meditative movements on relevant psychological health outcomes (i.e., quality of life (QoL), depressive symptoms, fear of falling (FoF) and sleep quality) in older adults without mental disorders. Methods: A structured literature search was conducted in five databases (Ovid, PsycINFO, PubMed, SPORTDiscus, Web of Science). Inclusion criteria were: (i) the study was a (cluster) randomized controlled trial, (ii) the subjects were aged ≥59 years without mental illnesses, (iii) an intervention arm performing MBI compared to a non-exercise control group (e.g., wait-list or usual care), (iv) psychological health outcomes related to QoL, depressive symptoms, FoF or sleep quality were assessed and (v) a PEDro score of ≥5. The interventions of the included studies were sub-grouped into Tai Chi/Qigong (TCQ) and Yoga/Pilates (YP). Statistical analyses were conducted using a random-effects inverse-variance model. Results: Thirty-seven randomized controlled trials (RCTs) (comprising 3224 participants) were included. Small to moderate-but-significant overall effect sizes favoring experimental groups (Hedges’ g: 0.25 to 0.71) compared to non-exercise control groups were observed in all outcomes (all p values ≤ 0.007), apart from one subdomain of quality of life (i.e., social functioning, p = 0.15). Interestingly, a significant larger effect on QoL and depressive symptoms with increasing training frequency was found for TCQ (p = 0.03; p = 0.004). Conclusions: MBI involving meditative movements may serve as a promising opportunity to improve psychological health domains such as QoL, depressive symptoms, FoF and sleep quality in older adults. Hence, these forms of exercise may represent potential preventive measures regarding the increase of late-life mental disorders, which need to be further confirmed by future research.

scholarly journals Depressive symptoms and sleep problems as risk factors for heart disease: a prospective community study

2019 ◽  
Vol 29 ◽  
Author(s):  
S. S. Deschênes ◽  
R. J. Burns ◽  
E. Graham ◽  
N. Schmitz
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Depressive Symptoms ◽  
Sleep Disorders ◽  
Sleep Duration ◽  
Sleep Problems ◽  
Self Report ◽  
World Health ◽  
Diagnostic Codes ◽  
Long Sleep

Abstract Aims The goals of the present study were to examine the associations between depressive symptoms, sleep problems and the risk of developing heart disease in a Canadian community sample. Methods Baseline data were from the CARTaGENE study, a community health survey of adults aged 40–69 years in Quebec, Canada. Incidence of heart disease was examined in N = 33 455 participants by linking survey data with administrative health insurance data. Incident heart disease was identified using the World Health Organization's International Classification of Diseases, 9th or 10th edition (ICD-9 and ICD-10) diagnostic codes for heart disease. Sleep problems were assessed with diagnostic codes for sleep disorders within the 2 years preceding the baseline assessment. Average sleep duration was assessed by self-report. Depressive symptoms were assessed with the nine-item Patient Health Questionnaire. Results In total, 2448 (7.3%) participants developed heart disease over an average follow-up period of 4.6 years. Compared to those without depressive symptoms and with no sleep disorders, those with elevated depressive symptoms and a sleep disorder (HR = 2.60, 95% CI 1.83–3.69), those with depressive symptoms alone (HR = 1.40, 95% CI 1.25–1.57) and those with sleep disorders alone (HR = 1.33, 95% CI 1.03–1.73) were more likely to develop heart disease. Test of additive interaction suggested a synergistic interaction between depressive symptoms and sleep disorders (synergy index = 2.17 [95% CI 1.01–4.64]). When sleep duration was considered, those with long sleep duration and elevated depressive symptoms were more likely to develop heart disease than those with long sleep alone (HR = 1.77, 95% CI 1.37–2.28; and HR = 1.16, 95% CI 0.99–1.36, respectively). Conclusions Depression and diagnosed sleep disorders or long sleep duration are independent risk factors for heart disease and are associated with a stronger risk of heart disease when occurring together.

Sleep quality mediates the relationship between frailty and cognitive dysfunction in non-demented middle aged to older adults

2019 ◽  
Vol 31 (06) ◽  
pp. 779-788 ◽  
Author(s):  
Sonya Kaur ◽  
Nikhil Banerjee ◽  
Michelle Miranda ◽  
Mitchell Slugh ◽  
Ni Sun-Suslow ◽  
...  
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Sleep Quality ◽  
Cognitive Decline ◽  
Processing Speed ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Subjective Sleep Quality ◽  
Delayed Recall ◽  
The Relationship

ABSTRACTObjectives:Frailty is associated with cognitive decline in older adults. However, the mechanisms explaining this relationship are poorly understood. We hypothesized that sleep quality may mediate the relationship between frailty and cognition.Participants:154 participants aged between 50-90 years (mean = 69.1 years, SD = 9.2 years) from the McKnight Brain Registry were included.Measurements:Participants underwent a full neuropsychological evaluation, frailty and subjective sleep quality assessments. Direct relationships between frailty and cognitive function were assessed using linear regression models. Statistical mediation of these relationships by sleep quality was assessed using nonparametric bootstrapping procedures.Results:Frailty severity predicted weaker executive function (B = −2.77, β = −0.30, 95% CI = −4.05 – −1.29) and processing speed (B = −1.57, β = −0.17, 95% CI = −3.10 – −0.16). Poor sleep quality predicted poorer executive function (B = −0.47, β = −0.21, 95% CI = −0.79 – −0.08), processing speed (B = −0.64, β = −0.28, 95% CI = −0.98 – −0.31), learning (B = −0.42, β = −0.19, 95% CI = −0.76 – −0.05) and delayed recall (B = −0.41, β = −0.16, 95% CI = −0.80 – −0.31). Poor sleep quality mediated the relationships between frailty severity and executive function (B = −0.66, β = −0.07, 95% CI = −1.48 – −0.39), learning (B = −0.85, β = −0.07, 95% CI = −1.85 – −0.12), delayed recall (B = −0.47, β = −0.08, 95% CI = −2.12 – −0.39) and processing speed (B = −0.90, β = −0.09, 95% CI = −1.85 – −0.20).Conclusions:Relationships between frailty severity and several cognitive outcomes were significantly mediated by poor sleep quality. Interventions to improve sleep quality may be promising avenues to prevent cognitive decline in frail older adults.

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