scholarly journals Apathy and the Risk of Predementia Syndromes in Community-Dwelling Older Adults

2020 ◽  
Vol 75 (7) ◽  
pp. 1443-1450
Author(s):  
Mirnova E Ceïde ◽  
Alana Warhit ◽  
Emmeline I Ayers ◽  
Gary Kennedy ◽  
Joe Verghese

Abstract Objectives Apathy is a potential predictor of dementia in older adults, but this investigation has been limited to older adults with a preexisting neurological illness like mild cognitive impairment (MCI), stroke or Parkinson’s disease. The objective of this study was to investigate the association between apathy at baseline and incident predementia syndromes, including MCI and motoric cognitive risk syndrome (MCR), subjective cognitive complaints and slow gait, in community-dwelling older adults. Method We prospectively studied the association between apathy (using the 3-item subscale of the Geriatric Depression Scale [GDS3A]) and incident cognitive disorders in 542 community-dwelling older adults enrolled in the Central Control of Mobility in Aging study using Cox proportional hazard models. Associations were reported as hazard ratio (HR) with 95% confidence intervals (CIs), adjusting for age, education, baseline cognitive performance, and depressive symptoms. Results Apathy was associated with incident MCR (HR 2.39, 95% CI: 1.10–5.20), but not predementia syndromes overall nor MCI. In sensitivity analyses of MCI subtypes, apathy was associated with nonamnestic MCI (HR 2.44, 95% CI: 1.14–5.22), but not amnestic MCI. Our study was limited by a short follow-up time (median 13.6 months; interquartile range 29.8) and a brief subscale measurement of apathy, GDS3A. Discussion In our study, apathy predicted MCR but not MCI in community-dwelling older adults. These results and the current literature suggest that apathy is an early risk factor for dementia. Additionally, apathy may be a novel treatment target that could forestall the disability of dementia.

Author(s):  
Dan Song ◽  
Doris S.F. Yu ◽  
Polly W.C. Li ◽  
Qiuhua Sun

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.


Author(s):  
Yonglin Liang ◽  
Francisco T.T. Lai ◽  
Joyce L.Y. Kwan ◽  
Wai Chan ◽  
Eng-Kiong Yeoh

Multimorbidity is associated with increased depression risks. Little research examines how physical exercise moderates this association. From an existing cohort of community-dwelling older adults in Hong Kong recruited in 2001–2003, the authors included participants who were successfully interviewed after 14 years (2015–2017). Geriatric depressive symptoms were used as the primary outcome and measured by the 15-item Geriatric Depression Scale, while multimorbidity was operationalized using a list of 19 conditions. Subscores of the Physical Activity Scale for the Elderly measuring light, moderate, and strenuous sport/recreational activities were included as moderators. In total, 1,056 participants were included, of whom 50.7% were multimorbid. Multimorbidity was associated with 12% more geriatric depressive symptoms, but strenuous physical activities were associated with a smaller risk elevation only among multimorbid patients (adjusted relative risk = 0.99, 95% confidence interval [0.98, 0.99]; p = .001). In conclusion, strenuous sport and recreational activities may attenuate the association between multimorbidity and geriatric depressive symptoms.


Author(s):  
Yuki Nakai ◽  
Hyuma Makizako ◽  
Ryoji Kiyama ◽  
Kazutoshi Tomioka ◽  
Yoshiaki Taniguchi ◽  
...  

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.


2014 ◽  
Vol 26 (9) ◽  
pp. 1511-1519 ◽  
Author(s):  
Sébastien Grenier ◽  
Marie-Christine Payette ◽  
Francis Langlois ◽  
Thien Tuong Minh Vu ◽  
Louis Bherer

ABSTRACTBackground:Falls and depression are two major public health problems that affect millions of older people each year. Several factors associated with falls are also related to depressive symptoms such as medical conditions, sleep quality, use of medications, cognitive functioning, and physical capacities. To date, studies that investigated the association between falls and depressive symptoms did not control for all these shared factors. The current study addresses this issue by examining the relationship between falls and depression symptoms after controlling for several confounders.Methods:Eighty-two community-dwelling older adults were enrolled in this study. The Geriatric Depression Scale (GDS-30) was used to evaluate the presence of depressive symptoms, and the following question was used to assess falls: “Did you fall in the last 12 months, and if so, how many times?”Results:Univariate analyses indicated that the number of falls was significantly correlated with gender (women), fractures, asthma, physical inactivity, presence of depressive symptoms, complaints about quality of sleep, use of antidepressant drugs, and low functional capacities. Multivariate analyses revealed that depressive symptoms were significantly and independently linked to recurrent falls after controlling for confounders.Conclusions:Results of the present study highlight the importance of assessing depressive symptoms during a fall risk assessment.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 788-788
Author(s):  
Milan Chang ◽  
Hrafnhildur Eymundsdottir ◽  
Alfons Ramel ◽  
Sigurveig Sigurdardottir ◽  
Vilmundur Gudnasson ◽  
...  

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.


2019 ◽  
Vol 32 (2) ◽  
pp. 97-103 ◽  
Author(s):  
Ali Ezzati ◽  
Mindy J. Katz ◽  
Carol A. Derby ◽  
Molly E. Zimmerman ◽  
Richard B. Lipton

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.


2020 ◽  
Author(s):  
Masakazu Imaoka ◽  
Hidetoshi Nakao ◽  
Misa Nakamura ◽  
Fumie Tazaki ◽  
Mitsumasa Hida ◽  
...  

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ki-Soo Park ◽  
Gyeong-Ye Lee ◽  
Young-Mi Seo ◽  
Sung-Hyo Seo ◽  
Jun-Il Yoo

Abstract Background The purpose of this study was to investigate the prevalence of osteosarcopenia in the over 60-year-old community and to evaluate whether osteosarcopenia is associated with disability, frailty and depression. Methods This study was performed using the baseline data of Namgaram-2, among the 1010 surveyed subjects, 885 study subjects who were 60 years or older and had all necessary tests performed were selected. The Kaigo-Yobo checklist (frailty), World Health Organization Disability Assessment Schedule (WHODAS) and Geriatric Depression Scale-Short Form-Korean (GDSSF-K) were used. The Asian Working Group for Sarcopenia (AWGS 2019) were applied in this study. Osteopenia was measured using data from dual energy X-ray absorptiometry (DEXA) and osteopenia was diagnosed when the T-score was less than − 1.0. The study subjects were divided into four groups: the normal group, in which both sarcopenia and osteopenia were undiagnosed, osteopenia only, sarcopenia only and the osteosarcopenia group, which was diagnosed with both sarcopenia and osteopenia. Results Of the 885 subjects over 60 years old evaluated, the normal group comprised 34.0%, the only osteopenia group 33.7%, the only sarcopenia group 13.1%, and the osteosarcopenia group 19.2%. WHODAS (17.5, 95% CI: 14.8-20.1), Kaigo-Yobo (3.0, 95% CI: 2.6-3.4), and GDSSF mean score (4.6, 95% CI: 3.9-5.4) were statistically significantly higher in the osteosarcopenia group compared the other groups. Partial eta squared (ηp2) of WHODAS (0.199) and Kaigo-Yobo (0.148) values ​​according to Osteosarcopenia were large, and GDSSF (0.096) was medium Conclusions Osteosarcopenia is a relatively common disease group in the older adults community that may cause deterioration of health outcomes. Therefore, when evaluating osteopenia or sarcopenia in the older adults, management of those in both disease groups should occur together.


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