Relationship Between Depressive Symptoms and Cognition in Older, Non-demented African Americans

AbstractKnowledge of the relationship between depressive symptoms and cognition in older adults has primarily come from studies of clinically depressed, functionally impaired or cognitively impaired individuals, and in predominately White samples. Limited minority representation in depression research exposes the need to examine these associations in more ethnic/racially diverse populations. We sought to examine the relationship between depressive symptoms and cognition in a sample of non-demented older African Americans recruited from surrounding U.S. cities of New York, Greensboro, Miami, and Nashville (N=944). Depressive symptoms were evaluated with the Geriatric Depression Scale (GDS). Cognition was evaluated with a comprehensive neuropsychological battery. Test scores were summarized into attention, executive function, memory, language, and processing speed composites. Controlling for age, education, reading level, and sex, African American older adults who endorsed more symptoms obtained significantly lower scores on measures of memory, language, processing speed, and executive functioning. Further investigation of the causal pathway underlying this association, as well as potential mediators of the relationship between depressive symptoms and cognitive test performance among older African Americans, such as cardiovascular and cerebrovascular disease, may offer potential avenues for intervention. (JINS, 2014, 20, 1–8)

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Relationship Between Frailty and Depression Among Community-Dwelling Older Adults: The Mediating and Moderating Role of Social Support

The Gerontologist ◽

10.1093/geront/gnaa072 ◽

2020 ◽

Vol 60 (8) ◽

pp. 1466-1475 ◽

Cited By ~ 1

Author(s):

Yaru Jin ◽

Huaxin Si ◽

Xiaoxia Qiao ◽

Xiaoyu Tian ◽

Xinyi Liu ◽

...

Keyword(s):

Social Support ◽

Older Adults ◽

Depressive Symptoms ◽

Rating Scale ◽

Depression Scale ◽

Community Dwelling ◽

Linear Regression Models ◽

Frailty Phenotype ◽

Community Dwelling Older Adults ◽

The Relationship

Abstract Background and Objectives Frailty is associated with depression in older adults and reduces their social support. However, the mechanism underlying such relationship remains unclear. We aim to examine whether social support acts as a mediator or moderator in the relationship between frailty and depression. Research Design and Methods This cross-sectional study was conducted among 1,779 community-dwelling older adults aged 60 and older. Frailty, social support, and depressive symptoms were measured by the Physical Frailty Phenotype, Social Support Rating Scale, and five-item Geriatric Depression Scale, respectively. Data were also collected on age, gender, years of schooling, monthly income, cognitive function, number of chronic diseases, physical function, and pain. Results Linear regression models showed that subjective support and support utilization, but not objective support, mediated and moderated the relationship between frailty and depressive symptoms. The Johnson–Neyman technique determined a threshold of 30 for subjective support, but not for support utilization, beyond which the detrimental effect of frailty on depressive symptoms was offset. Discussion and Implications Social support underlies the association of frailty with depression, and its protective role varies by type. Interventions on depression should address improving perceptions and utilization of social support among frail older adults rather than simply providing them with objective support.

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Depressive Symptoms and Loneliness Among Black and White Older Adults: The Moderating Effects of Race

Innovation in Aging ◽

10.1093/geroni/igaa048 ◽

2020 ◽

Vol 4 (5) ◽

Cited By ~ 1

Author(s):

Harry O Taylor ◽

Ann W Nguyen

Keyword(s):

Social Support ◽

Older Adults ◽

Depressive Symptoms ◽

Multivariable Analysis ◽

Depression Scale ◽

Religious Service ◽

Religious Service Attendance ◽

Black And White ◽

The Relationship ◽

Service Attendance

Abstract Background and Objectives Loneliness is consistently linked to worse depression/depressive symptoms; however, there are few studies that have examined whether the relationship between loneliness and depressive symptoms varies by race. The purpose of this study was to determine whether race moderated the relationship between loneliness and depressive symptoms. Research Design and Methods Data come from the 2014 wave of the Health and Retirement Study (HRS) Core survey and Psychosocial Leave-Behind Questionnaire; only black and white older adults were included in the analysis (N = 6,469). Depressive symptoms were operationalized by the eight-item Center for Epidemiological Studies—Depression scale; however, the “felt lonely” item was removed given concerns with collinearity. Loneliness was operationalized using the Hughes 3-Item Loneliness Scale. Sociodemographic variables included gender, age, education, household income, employment status, marital status, and living alone or with others. Furthermore, social support and negative interactions from family members and friends, and religious service attendance were included in the analysis. Lastly, we created an interaction term between race and loneliness. All analyses used survey weights to account for the complex multistage sampling design of the HRS. Missing data were multiply imputed. Results In multivariable analysis, we found race significantly moderated the relationship between loneliness and depressive symptoms while controlling for sociodemographic covariates, social support and negative interaction variables, and religious service attendance. Discussion and Implications Our findings demonstrate a differential racial effect for loneliness and depressive symptoms. For both blacks and whites, greater loneliness affected depressive symptoms; however, the effect was stronger among whites than it was for blacks. Given this is one of the first studies to examine the differential effects of race on loneliness and depressive symptoms, more research is necessary to determine the consistency of these results.

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HEARING IMPAIRMENT, DEPRESSION, AND THE ROLE OF SOCIAL ACTIVITY AMONG CHINESE OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.595 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S166-S167

Author(s):

Shu Xu ◽

Haowei Wang ◽

Caitlin Connelly

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Hearing Impairment ◽

Social Engagement ◽

Depression Scale ◽

The United States ◽

Social Activities ◽

Chinese Older Adults ◽

Hearing Status ◽

The Relationship

Abstract Studies suggest that depression is closely linked to hearing impairment, which is highly prevalent among older adults in the United States. There is evidence that social engagement may be impacted by hearing impairment in older adults. However, there is relatively little research on these associations among Chinese older adults. This study examines the relationships between hearing impairment, social activities, and depressive symptoms among older adults in China. Using nationally representative data from the China Health and Retirement Longitudinal Study 2011, we conducted cross-sectional analysis on adults age 60 years and older (n=10,994). Depressive symptoms were assessed by the 10-item Center for Epidemiologic Studies Depression scale and we considered self-reported hearing status (if participants wear a hearing aid and how they would rate their hearing), and social activities (i.e., volunteering, dancing, attending courses, etc.). Models were controlled for age, gender, education, and other covariates. Descriptive analysis showed that 9% of older adults experienced hearing impairment. Multiple linear regression analyses revealed that hearing impairment was positively associated with depressive symptoms among older Chinese adults (β=1.32, p<.001). Social activities were found to partially mediate the relationship between hearing status and depressive symptoms. Respondents with hearing impairment were less likely to engage in social activities (OR=.78, p<.01) and those who did not participate in social activities reported more depressive symptoms (β=1.28, p<.001). These findings suggest that Chinese older adults experiencing hearing loss are at greater risk of depression and that social activities play an important role in the relationship between hearing status and depression.

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Perceived Discrimination and Cognition in Older African Americans

Journal of the International Neuropsychological Society ◽

10.1017/s1355617712000628 ◽

2012 ◽

Vol 18 (5) ◽

pp. 856-865 ◽

Cited By ~ 47

Author(s):

L.L. Barnes ◽

T.T. Lewis ◽

C.T. Begeny ◽

L. Yu ◽

D.A. Bennett ◽

...

Keyword(s):

Depressive Symptoms ◽

African Americans ◽

Episodic Memory ◽

Test Performance ◽

Perceived Discrimination ◽

Cognitive Test ◽

Perceptual Speed ◽

Physical Health Outcomes ◽

Older African Americans ◽

Cognitive Test Performance

AbstractExisting evidence suggests that psychosocial stress is associated with cognitive impairment in older adults. Perceived discrimination is a persistent stressor in African Americans that has been associated with several adverse mental and physical health outcomes. To our knowledge, the association of discrimination with cognition in older African Americans has not been examined. In a cohort of 407 older African Americans without dementia (mean age = 72.9; SD = 6.4), we found that a higher level of perceived discrimination was related to poorer cognitive test performance, particularly episodic memory (estimate = −0.03; SE = .013; p < .05) and perceptual speed tests (estimate = −0.04; SE = .015; p < .05). The associations were unchanged after adjusting for demographics and vascular risk factors, but were attenuated after adjustment for depressive symptoms (Episodic memory estimate = −0.02; SE = 0.01; Perceptual speed estimate = −0.03; SE = 0.02; both p's = .06). The association between discrimination and several cognitive domains was modified by level of neuroticism. The results suggest that perceived discrimination may be associated with poorer cognitive function, but does not appear to be independent of depressive symptoms. (JINS, 2012, 18, 1–10)

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Explaining Differences in Episodic Memory Performance among Older African Americans and Whites: The Roles of Factors Related to Cognitive Reserve and Test Bias

Journal of the International Neuropsychological Society ◽

10.1017/s1355617711000476 ◽

2011 ◽

Vol 17 (4) ◽

pp. 625-638 ◽

Cited By ~ 19

Author(s):

Denise C. Fyffe ◽

Shubhabrata Mukherjee ◽

Lisa L. Barnes ◽

Jennifer J. Manly ◽

David A. Bennett ◽

...

Keyword(s):

Older Adults ◽

African Americans ◽

Episodic Memory ◽

Test Performance ◽

Cognitive Reserve ◽

Cognitive Activity ◽

Test Bias ◽

Reading Level ◽

Older African Americans ◽

Brain Resilience

AbstractOlder African Americans tend to perform poorly in comparison with older Whites on episodic memory tests. Observed group differences may reflect some combination of biological differences, measurement bias, and other confounding factors that differ across groups. Cognitive reserve refers to the hypothesis that factors, such as years of education, cognitive activity, and socioeconomic status, promote brain resilience in the face of pathological threats to brain integrity in late life. Educational quality, measured by reading test performance, has been postulated as an important aspect of cognitive reserve. Previous studies have not concurrently evaluated test bias and other explanations for observed differences between older African Americans and Whites. We combined data from two studies to address this question. We analyzed data from 273 African American and 720 White older adults. We assessed DIF using an item response theory/ordinal logistic regression approach. DIF and factors associated with cognitive reserve did not explain the relationship between race, and age- and sex-adjusted episodic memory test performance. However, reading level did explain this relationship. The results reinforce the importance of considering education quality, as measured by reading level, when assessing cognition among diverse older adults. (JINS, 2011, 17, 625–638)

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Changes in Depressive Symptoms and Metabolic Control over 3 Years among African Americans with Type 2 Diabetes

The International Journal of Psychiatry in Medicine ◽

10.2190/bq22-4hu0-p6ek-l7yx ◽

2005 ◽

Vol 35 (4) ◽

pp. 377-382 ◽

Cited By ~ 5

Author(s):

Tiffany L. Gary ◽

Kesha Baptiste-Roberts ◽

Rosa M. Crum ◽

Lisa A. Cooper ◽

Daniel E. Ford ◽

...

Keyword(s):

Type 2 Diabetes ◽

Depressive Symptoms ◽

African Americans ◽

Metabolic Control ◽

Statistical Power ◽

Depression Scale ◽

Cross Sectional ◽

Negative Finding ◽

The Relationship

Objective: It is established that individuals with diabetes have high rates of depression, but the longitudinal relationship between depression and glycemic control has not been well examined, particularly among African Americans. The objective of this study was to evaluate the longitudinal relationship between depressive symptoms and metabolic control. Method: We conducted an earlier cross-sectional study that demonstrated marginal and significant associations between depressive symptoms (using the Center for Epidemiologic Studies Depression Scale [CES-D]) and metabolic control (HbA1c, lipids, blood pressure) among 183 African Americans with type 2 diabetes. In this report, we present data on these individuals, followed for three years, and examine the relationship between change in depressive symptoms and change in metabolic control over that time period. Results: Results showed that that there were no statistically significant associations between baseline or change in depressive symptoms and metabolic control over three years. Limited statistical power may explain this negative finding. Conclusions: This study provides insight into the relationship between depression and metabolic control. Prospective observational studies are needed to further evaluate this relationship.

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The relationship of Careers with People Interactions and Volunteering Between Gender-racial Groups in Late-life

Innovation in Aging ◽

10.1093/geroni/igab046.2588 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 695-695

Author(s):

Patrick Ho Lam Lai

Keyword(s):

Older Adults ◽

African Americans ◽

Late Life ◽

Older Men ◽

The United States ◽

Racial Groups ◽

Human Interactions ◽

Asian Men ◽

Older African Americans ◽

The Relationship

Abstract Prior research showed that ethnic minorities in late-life tended to participate less in volunteering, compared to Whites. Older women, in general, spent more time volunteering than older men in the United States. Previous studies showed that occupational statuses, but have not yet discussed occupation categories, affected older adults' volunteering. The Current Population Survey dataset was utilized in this study to explore the relationship between careers with or without people interactions and volunteering of Americans aged 50 to 85 in an intersectionality lens. Regarding races, older African Americans who worked in occupations requiring human interactions, had almost double volunteering rate than those occupations not requiring these interactions. In respect of genders, compared to older men who worked in jobs requiring human interactions, the volunteer rate of those not requiring human interactions was 81% less. Either older African Americans or older men had more associations between their human interactions in career and their volunteering rate, than other racial groups or gender groups individually. Considering races and genders together, comparing to older Asian men who worked in fields needed interactions with others, the volunteering rate of those who did not work in these fields was 52% less. The association of older Asian men between fields requiring human interactions and volunteering rate was the least, among various gender-racial subgroups. Older adults with different racial-gender identities may face varying experiences in different types of occupations. Social and cultural factors among these identities are discussed to better understand the relationships between careers and volunteering in late-life.

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Mediating Role of Trait Mindfulness on the Relationships Between Age and Both Depressive and Anxiety Symptomology

Innovation in Aging ◽

10.1093/geroni/igaa057.1195 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 371-371

Author(s):

Scotti Howard ◽

Eric Allard

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Trait Anxiety ◽

Depression Scale ◽

Well Being ◽

Epidemiological Studies ◽

Trait Mindfulness ◽

Depressive Symptomology ◽

Mediating Role ◽

The Relationship

Abstract Previous research has shown that despite experiencing more negative life events, older adults maintain relatively high levels of well-being compared to their younger counterparts. This effect appears to be at least partially mediated by trait mindfulness in older adults (Raes et al., 2013). The current study expanded into an investigation as to how trait mindfulness might intervene on the relationship between age and other well-being indicators: anxiety and depressive symptomology. Participants included 30 older adults (aged 60-83) and 41 young adults (aged 18-35). Trait mindfulness was examined using the Mindful Attention Awareness Scale (MAAS), while depressive symptoms and trait anxiety were measured using the Center for Epidemiological Studies Depression Scale (CES-D) and the State-Trait Anxiety Inventory (STAI), respectively. Two separate mediated multiple regression models were conducted using Hayes’ PROCESS Macro in SPSS. Trait mindfulness exhibited a significant indirect effect on the relationship between age and depressive symptoms (β = -2.27, p < .005), which was also seen for the relationship between age and trait anxiety (β = -4.17, p < .001). Older age predicted higher trait mindfulness, which in turn predicted diminished self-reported anxiety and depressive symptomology. Controlling for mindfulness in these models reduced the direct effect of age on depression and anxiety to non-significance. These findings imply that the relationship between age and trait mindfulness can be extended to alternative markers of well-being.

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Poor Acceptance of the Past is Related to Depressive Symptoms in Older Adults

GeroPsych ◽

10.1024/1662-9647/a000227 ◽

2020 ◽

Vol 33 (4) ◽

pp. 246-251

Author(s):

Gozde Cetinkol ◽

Gulbahar Bastug ◽

E. Tugba Ozel Kizil

Keyword(s):

Older Adults ◽

Regression Analysis ◽

Depressive Symptoms ◽

Death Anxiety ◽

Geriatric Depression ◽

Ego Integrity ◽

The Past ◽

Depressed Group ◽

Total Death ◽

The Relationship

Abstract. Depression in older adults can be explained by Erikson’s theory on the conflict of ego integrity versus hopelessness. The study investigated the relationship between past acceptance, hopelessness, death anxiety, and depressive symptoms in 100 older (≥50 years) adults. The total Beck Hopelessness (BHS), Geriatric Depression (GDS), and Accepting the Past (ACPAST) subscale scores of the depressed group were higher, while the total Death Anxiety (DAS) and Reminiscing the Past (REM) subscale scores of both groups were similar. A regression analysis revealed that the BHS, DAS, and ACPAST predicted the GDS. Past acceptance seems to be important for ego integrity in older adults.

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