Prevalence of clinically significant depressive symptoms in an epidemiologic sample of community-dwelling elders with milder forms of cognitive impairment in Hong Kong SAR

2008 ◽  
Vol 23 (6) ◽  
pp. 611-617 ◽  
Author(s):  
Sandra S. M. Chan ◽  
Linda C. W. Lam ◽  
Cindy W. C. Tam ◽  
Victor W. C. Lui ◽  
W. C. Chan ◽  
...  
2018 ◽  
Vol 33 (3) ◽  
pp. 439-449 ◽  
Author(s):  
Chandra da Silveira Langoni ◽  
Thais de Lima Resende ◽  
Andressa Bombardi Barcellos ◽  
Betina Cecchele ◽  
Juliana Nunes da Rosa ◽  
...  

Objective: To determine the effects of group exercises on balance, mobility, and depressive symptoms in community-dwelling older adults with mild cognitive impairment. Design: Single blinded, randomized, matched pairs clinical trial. Setting: Four primary healthcare units. Subjects: Fifty-two sedentary subjects with mild cognitive impairment were paired (age, sex, body mass index, and Addenbrooke’s Cognitive Examination Revised score), tested, and then randomized into an intervention group ( n = 26) and a control group ( n = 26). Intervention: The intervention group performed strength (ankle weights, elastic bands, and dumbbells) and aerobic exercises (walking) in their communities’ public spaces, twice a week (60 minutes each), during 24 weeks. The control group maintained its usual routine. Main measures: Balance (Berg Balance Scale (BBS)), mobility (Timed Up and Go Test (TUG)), and depressive symptoms (Geriatric Depression Scale-15) were assessed before and after the intervention. Results: Before the intervention, the two groups did not differ statistically. After, the intervention group showed significant improvement ( P < 0.05) in balance (before: 53 ± 3; after: 55.1 ± 1.1 points), mobility (before: 10.7 ± 2.9 seconds; after: 8.3 ± 2 seconds), and depressive symptoms (median punctuation (interquartile range) before: 4 (1.8–6); after: 2.5 (1–4)). The control group presented a significant increase in their depressive symptoms (median before: 3.5 (2–7.3); after: 4 (2–5.3)), while their balance and mobility showed no significant modification. Small effect sizes were observed in the intervention group and control group depressive symptoms, as well as in the control group’s mobility and balance. Large effect sizes were observed the intervention group’s mobility and balance. Conclusion: Group exercises improved balance, mobility, and depressive symptoms in community-dwelling older adults with mild cognitive impairment.


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.


1997 ◽  
Vol 9 (4) ◽  
pp. 449-457 ◽  
Author(s):  
Lisa L. Onega ◽  
Ivo L. Abraham

We examined the factor structure of the 28-item Dementia Mood Assessment Scale (DMAS), an instrument to assess depressive symptoms in older adults with cognitive impairment, in a cohort of 165 community-dwelling elderly with varying degrees of cognitive impairment. Factor analysis using principal components analysis and varimax rotation was performed to explore the presence of subscales and examine construct validity. A five-factor structure involving all 28 items accounting for 63.2% of the variance in the DMAS scores was derived. Factors were named: Depressed Affect, Environmental Interaction, Diurnal Patterns, Agitation/Suspicion, and Somatic Indicators. This factor structure reflects the often differing presentations of depressive symptoms in older adults with varying degrees of cognitive function and established the construct validity of the DMAS in this population. We conclude that the DMAS may be used for differentiated clinical assessment of depressive symptoms along major dimensions of depressive illness in this cohort of elderly.


2007 ◽  
Vol 13 (8) ◽  
pp. 1046-1053 ◽  
Author(s):  
K. Cetin ◽  
K.L. Johnson ◽  
D.M. Ehde ◽  
C.M. Kuehn ◽  
D. Amtmann ◽  
...  

Depressive symptoms and disorders among individuals with multiple sclerosis (MS) are more common when compared to other chronic illnesses and the general population, but relatively little is known about the use of antidepressant medication in this population. In this cross-sectional study of 542 community-dwelling adults with MS, we examined the prevalence of antidepressant use and employed multivariate logistic regression modeling to identify factors significantly associated with antidepressant use. Thirty-five percent of the sample reported currently using at least one antidepressant medication. Gender, marital status, insurance status, fatigue, and use of disease modifying therapies were all significantly associated with antidepressant use. Just over half of the sample endorsed a clinically significant level of depressive symptoms, and the majority of this group was not currently taking an antidepressant. Conversely, 41% of those with depressive symptoms reported taking at least one antidepressant medication. More research is needed to better understand why people with MS and depressive symptoms use or do not use antidepressant medications and to further explore the possibility of an under-treatment of depressive disorder in this population. Rigorous studies testing the feasibility, acceptability, and efficacy of currently available therapies for depression in the MS population should also be conducted. Multiple Sclerosis 2007; 13: 1046—1053. http://msj.sagepub.com


2021 ◽  
Author(s):  
Hui Foh Foong ◽  
Tengku Aizan Hamid ◽  
Rahimah Ibrahim ◽  
Sharifah Azizah Haron

Abstract Background: Ethnicity/race and poverty are among determinants of health in older persons. However, studies involving intersectional effects of ethnicity/race and poverty on health of older adults within multi-ethnic Asian populace is limited. Hence, this study aimed to examine the intersectional effects of ethnicity/race and poverty on cognitive function, depressive symptoms, and multimorbidity among community-dwelling older adults in Malaysia.Methods: Data were obtained from the first wave of a Peninsular Malaysia national survey - “Identifying Psychosocial and Identifying Economic Risk Factor of Cognitive Impairment among Elderly”. Multivariate logistic regression was used to identify intersectional effects and associations between control variables and health outcomes. A comparison between Malay and non-Malay older adults within the same poverty group, as well as hardcore poor and non-hardcore poor older people within the same ethnicity groups, were conducted to understand the intersectional effects of ethnicity/race and poverty on health. Results: Prevalence of cognitive impairment was highest among the hardcore poor group while risk of depression and multimorbidity were highest among non-Malays. Malay older adults were more prone to developing cognitive impairment regardless of their poverty status whereas non-Malay from the hardcore poor group had higher tendency for risk of depression and multimorbidity. Hardcore poor older adults residing alone were associated with higher depressive symptoms. But fewer older adults currently working reported multimorbidity. Conclusions: Health outcomes of Malaysian older adults differ according to ethnicity and socioeconomic status. Given the importance of demographic characteristics on health outcomes, design of interventions targeting older adults within multi-ethnic settings must address specific characteristics, especially that of ethnicity and sociodemographic status so as to fulfil their needs. Several implications for future practice were discussed.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Alcibiades E. Villarreal ◽  
Shantal Grajales ◽  
Lineth Lopez ◽  
Gabrielle B. Britton ◽  
Panama Aging Research Initiative

Cognitive impairment and depression are common mental health problems among the elderly, although few studies have examined their cooccurrence in older adults in Latin America. The purpose of this study was to examine cognitive impairment, depression, and cooccurrence of the two conditions and associated factors in a sample of older adults in Panama. This study included 304 community-dwelling elderly (≥65 years) individuals. Participants underwent a clinical interview and assessments of cognitive function by the Minimental State Examination and depressive symptoms by the Geriatric Depression Scale. Limitations in basic (BADL) and instrumental (IADL) activities in daily living and the presence of chronic illnesses were recorded. Multinomial regression analysis revealed that cooccurrence of cognitive impairment and depressive symptoms was explained by increasing age (OR: 3.2, 95% CI: 1.20, 8.30), low education (OR: 3.3, 95% CI: 1.33, 8.38), having four or more chronic conditions (OR: 11.5, 95% CI: 2.84, 46.63), and BADL limitations (OR: 5.0, 95% CI: 1.26, 19.68). Less education and limitations in BADL and IADL increased the odds of cognitive impairment alone, while less education and three or more chronic conditions increased the odds of depression alone. These findings underscore the relevance of assessing cognitive impairment in the elderly as part of a long-term approach to managing depression and vice versa.


Author(s):  
Isabella Khoo ◽  
Jacqueline C.T. Close ◽  
Stephen R. Lord ◽  
Kim Delbaere ◽  
Morag E. Taylor

<b><i>Introduction:</i></b> Dementia and depression often coexist. Understanding how concomitant comorbidities affect function can improve assessment and management strategies. We examined the relationship between cognitive, psychological, and physical function and depressive symptoms in people with cognitive impairment. <b><i>Methods:</i></b> Cross-sectional study using baseline data from the iFOCIS randomized controlled trial involving 309 participants with mild-moderate cognitive impairment. The association between cognitive (Addenbrooke’s Cognitive Examination-III [ACE-III], Frontal Assessment Battery), psychological (Goldberg Anxiety Scale; Iconographical Falls Efficacy Scale), and physical (Physiological Profile Assessment; Short Physical Performance Battery [SPPB]) function, and quality of life (QoL), physical activity levels and activities of daily living, and depressive symptoms (15-item Geriatric Depression Scale [GDS]) were assessed (adjusted for age, sex, education, and ACE-III as appropriate). <b><i>Results:</i></b> Participants with depressive symptoms (GDS ≥4) had significantly more falls in the previous year and a higher number of comorbidities than people without depressive symptoms (GDS &#x3c;4). Each point increase in the GDS was associated with better memory, higher levels of anxiety and concern about falling, poorer balance, slower gait speed, and reduced QoL. The relationship between the GDS and poor balance and QoL withstood additional adjustment for comorbidity tertiles. The relationship between GDS and concern about falls withstood additional adjustment for previous falls (12 months) and SPPB scores. <b><i>Conclusions:</i></b> Depressive symptomatology is associated with poorer physical and psychological function and reduced QoL in people with cognitive impairment. These factors should be considered when assessing and intervening in this group. Future research could examine these relationships longitudinally to establish causality and examine intervention efficacy in this group.


2020 ◽  
pp. 1-11
Author(s):  
Minyoung Shin

ABSTRACT Objectives: Geriatric depression complicates cognitive health in older adults. This study aims to investigate the impact of depressive symptoms on cognitive impairment in community-dwelling older adults, depending on whether cognitive dysfunction accompanied. Design: A community-based longitudinal cohort study. Setting: This study analyzed data from the Korean Longitudinal Study of Aging (KLoSA) from 2006 to 2018. Participants: Among 10,254 individuals who were registered in the KLoSA study, a total of 9119 subjects met the criteria, and 4547 subjects were included in the final analysis. The subjects were grouped into 4 categories based on depressive symptoms and cognitive dysfunction at baseline assessment: “normal control” (NC, n = 3341), “depression only” (Dep-only, n = 652), “cognitive dysfunction only” (CD-only, n = 393), and “depression with cognitive dysfunction” (Dep-CD, n = 161). Measurements: Cognitive impairment 10 years later was defined as K-MMSE scores below two percentile on demographically adjusted norms. Results: Ten-year survival, that is, not experiencing cognitive impairment, was 80 $$ \pm \,$$ 1% in NC group, 72 $$ \pm $$ 2% in Dep-only group, 52 $$ \pm $$ 3% in CD-only group, and 44 $$ \pm $$ 5% in Dep-CD group. The hazard ratio (HR) of the Dep-only group (HR = 1.18, 95% CI, 0.97–1.43, n.s.) did not differ from that of the NC group, but the HR of the Dep-CD group was significantly higher (HR = 2.85, 95% CI, 2.23–3.66, p < 0.001) than the NC group. When the Dep-CD group was compared to the CD-only group, the HR was 1.13 (95% CI, 0.85–1.49, n.s.), which indicates that it did not significantly differ from the CD-only group. Conclusions: Our findings suggest that depressive symptoms with cognitive dysfunction are associated with a higher risk of cognitive impairment. Furthermore, cognitive dysfunction occurring with depressive symptoms is as much a risk for cognitive impairment as is pure cognitive dysfunction. Thus, healthcare providers should pay close attention to the community-dwelling elderly when depressive symptoms occur with cognitive dysfunction.


2019 ◽  
Vol 214 (4) ◽  
pp. 230-236 ◽  
Author(s):  
Robert Briggs ◽  
Daniel Carey ◽  
Paul Claffey ◽  
Triona McNicholas ◽  
Louise Newman ◽  
...  

BackgroundDeficits in frontal lobe perfusion have been demonstrated in late-life depression; however, studies to date have generally involved small numbers, used neuroimaging rather than bedside testing and have not controlled for important covariates.AimsWe aimed to examine the association between depressive symptoms and frontal lobe perfusion during standing, in a large cohort of community-dwelling older people.MethodParticipants aged ≥50 years underwent continuous measurement of orthostatic blood pressure by finometry, and frontal lobe perfusion by near-infrared spectroscopy. Depressive symptoms were assessed by the eight-item Centre for Epidemiological Studies Depression Scale. Real-time frontal lobe cerebral oxygenation was measured by the Portalite System, detecting changes in frontal lobe perfusion and reporting a tissue saturation index score.ResultsAlmost 8% (209 out of 2616) had clinically significant depressive symptoms. Multilevel models demonstrated a significantly lower tissue saturation index in participants with depressive symptoms at both 60 and 90 s post-stand, with coefficients of −0.43 (95% CI −0.63 to −0.22) and −0.37 (95% CI −0.57 to −0.16), respectively. Controlling for relevant covariates did not significantly attenuate these associations. After addition of systolic blood pressure this association was no longer significant, suggesting lower blood pressure may modify this relationship.ConclusionsThis study demonstrates that lower frontal lobe perfusion, related to lower values of baseline systolic blood pressure, is associated with clinically significant depressive symptoms in a cohort of community-dwelling older people. Given the recognised longitudinal association between lower blood pressure and depression in older people, this may represent a potential therapeutic target for prevention of incident depression.Declaration of interestNone.


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