The depressive symptoms are moderators of cognitive and functional performances in normal and pathological aging?

Abstract

Depression (DEP) is usually associated with cognitive and functional impairment in the elderly. The present study aimed at validating a neuropsychological assessment protocol for low-educated elderly patients and at investigating the role of DEP as a moderator of cognitive impairment in participants (n=274) without dementia, amnestic mild cognitive impairment (MCI), and mild Alzheimer's disease (AD). Through an integrative review of the literature and subsequent validation, the Geriatric Depression Scale (GDS-15) was selected as a DEP measure. A multidimensional neuropsychological exam protocol composed by tests adapted or created for the assessment of executive functions, language, memory, visuospatial abilities, and functionality in low-educated elderly patients was validated by different methods in this study. DEP showed a moderating effect on cognitive performance of elderly people without dementia, with larger effect sizes on memory and executive functions and it was related to functional impairment. However, the phenomenon is less expressive in AD and MCI. A secondary analysis suggested that executive dysfunction mediates the deficit in other cognitive functions. The study validated a neuropsychological exam protocol for the low-educated Brazilian elderly population. The result suggests that DEP moderated cognitive performance and this effect may be mediated by executive dysfunction.

Executive functions as predictors of functional performance in mild Alzheimer's dementia and mild cognitive impairment elderly

“…The depressive symptoms influence functional performance on different levels: it can be mediated either by cognitive impairment or by the behavioral and emotional manifestations of the disorder. Recent studies however suggest that the moderating role of depression on functional performance may be milder on pathological cognitive aging, as the dementias, and may be secondary to the impairment of Executive Functions (de Paula et al, 2012d;Sexton et al, 2011), which may explain the results found on the current study.…”

Psychometric properties of the Brazilian version of Pfeffer's Functional Activities Questionnaire

“…Although the association was weak, depressive symptoms were independently associated with cognitive and socio-demographic aspects. Such symptoms are important determinants of functional decline in older adults (Hoffmann et al, 2010 ; de Paula, 2012 ; de Paula et al, 2013c ), but can be understood as either a cause or consequence of functional decline, which is an aspect that should be analyzed further in future studies.…”