Cognitive performance in depressed older persons: the impact of vascular burden and remission. A two‐year follow‐up study

Zuidersma, Marij; Comijs, Hannie C.; Naarding, Paul; Voshaar, Richard C. Oude

doi:10.1002/gps.4416

Cited by 5 publications

(4 citation statements)

References 43 publications

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“…Recent longitudinal studies, with up 10 years of follow-up, demonstrated that persistently high levels or increasing levels of depressive symptoms are the most important predictors of dementia in LLD [77, 78]. The association with depressive symptoms is stronger for the MCI subtype with memory impairment [79], but this was independent of underlying vascular disease [80–82]. Some studies suggested an association between white matter microstructural damage and depressive symptoms in MCI patients with small vessel disease [74, 83], whereas others showed no association between depressive symptoms and the rate of incident MCI [84].…”

Section: Resultsmentioning

confidence: 99%

Vascular depression consensus report – a critical update

Aizenstein

Baskys

Boldrini

et al. 2016

BMC Med

187

145

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BackgroundVascular depression is regarded as a subtype of late-life depression characterized by a distinct clinical presentation and an association with cerebrovascular damage. Although the term is commonly used in research settings, widely accepted diagnostic criteria are lacking and vascular depression is absent from formal psychiatric manuals such as the Diagnostic and Statistical Manual of Mental Disorders, 5th edition – a fact that limits its use in clinical settings. Magnetic resonance imaging (MRI) techniques, showing a variety of cerebrovascular lesions, including extensive white matter hyperintensities, subcortical microvascular lesions, lacunes, and microinfarcts, in patients with late life depression, led to the introduction of the term “MRI-defined vascular depression”.DiscussionThis diagnosis, based on clinical and MRI findings, suggests that vascular lesions lead to depression by disruption of frontal–subcortical–limbic networks involved in mood regulation. However, despite multiple MRI approaches to shed light on the spatiotemporal structural changes associated with late life depression, the causal relationship between brain changes, related lesions, and late life depression remains controversial. While postmortem studies of elderly persons who died from suicide revealed lacunes, small vessel, and Alzheimer-related pathologies, recent autopsy data challenged the role of these lesions in the pathogenesis of vascular depression. Current data propose that the vascular depression connotation should be reserved for depressed older patients with vascular pathology and evident cerebral involvement. Based on current knowledge, the correlations between intra vitam neuroimaging findings and their postmortem validity as well as the role of peripheral markers of vascular disease in late life depression are discussed.ConclusionThe multifold pathogenesis of vascular depression as a possible subtype of late life depression needs further elucidation. There is a need for correlative clinical, intra vitam structural and functional MRI as well as postmortem MRI and neuropathological studies in order to confirm the relationship between clinical symptomatology and changes in specific brain regions related to depression. To elucidate the causal relationship between regional vascular brain changes and vascular depression, animal models could be helpful. Current treatment options include a combination of vasoactive drugs and antidepressants, but the outcomes are still unsatisfying.

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Section: Resultsmentioning

confidence: 99%

Vascular depression consensus report – a critical update

Aizenstein

Baskys

Boldrini

et al. 2016

BMC Med

187

145

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“…On the other hand, in the case of MDD, relative to HC, WM performance has sometimes been reported to be impaired (Chen et al, 2018; Christopher & MacDonald, 2005; Egeland et al, 2003; Liu et al, 2019; Noort et al, 2016; Pu et al, 2011; Pu et al, 2018; Schwert, Stohrer, Aschenbrenner, Weisbrod, & Schröder, 2019) or sometimes not (Channon, Baker, & Robertson, 1993; Murphy et al, 2019; Trapp et al, 2017; Yuksel et al, 2018). Furthermore, WM deficits have been reported to increase over time in SZ (Fu, Czajkowski, & Torgalsboen, 2018; Jimenez‐Lopez et al, 2019; Park, Püschel, Sauter, Rentsch, & Hell, 1999; Strugstad, Lau, & Glenne Oie, 2018), but not in MDD (Nuninga et al, 2018; Sankar, Adams, Costafreda, Marangell, & Fu, 2017; Vasavada et al, 2017; Zuidersma, Comijs, Naarding, & Oude Voshaar, 2016). WM is also more impaired in SZ than in MDD (Egeland et al, 2003; Mahmood, Burton, Vella, & Twamley, 2018; Yamashita et al, 2018), and measurement of WM deficit may represent a promising endophenotype for studying the disorders (Glahn et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Shared and distinct brain fMRI response during performance of working memory tasks in adult patients with schizophrenia and major depressive disorder

Wang

Cheng

Roberts

et al. 2021

Human Brain Mapping

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Working memory (WM) impairments are common features of psychiatric disorders. A systematic meta‐analysis was performed to determine common and disorder‐specific brain fMRI response during performance of WM tasks in patients with SZ and patients with MDD relative to healthy controls (HC). Thirty‐four published fMRI studies of WM in patients with SZ and 18 published fMRI studies of WM in patients with MDD, including relevant HC, were included in the meta‐analysis. In both SZ and MDD there was common stronger fMRI response in right medial prefrontal cortex (MPFC) and bilateral anterior cingulate cortex (ACC), which are part of the default mode network (DMN). The effects were of greater magnitude in SZ than MDD, especially in prefrontal‐temporal‐cingulate‐striatal‐cerebellar regions. In addition, a disorder‐specific weaker fMRI response was observed in right middle frontal gyrus (MFG) in MDD, relative to HC. For both SZ and MDD a significant correlation was observed between the severity of clinical symptoms and lateralized fMRI response relative to HC. These findings indicate that there may be common and distinct anomalies in brain function underlying deficits in WM in SZ and MDD, which may serve as a potential functional neuroimaging‐based diagnostic biomarker with value in supporting clinical diagnosis, measuring illness severity and assessing the efficacy of treatments for SZ and MDD at the brain level.

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“…Likewise, depressive disorder is bidirectionally associated with deficits in multiple cognitive domains (18,19), comparable to aging-related cognitive decline. Moreover, cognitive deficits in late-life depression mainly persist after remission of depression (20,21), and in particular, low processing speed and executive dysfunction predict a protracted course of the depression (22,23).…”

mentioning

confidence: 99%

Subtypes of Late-Life Depression: A Data-Driven Approach on Cognitive Domains and Physical Frailty

Lugtenburg

Zuidersma

Wardenaar

et al. 2020

The Journals of Gerontology: Series A

Self Cite

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Background With increasing age, symptoms of depression may increasingly overlap with age-related physical frailty and cognitive decline. We aim to identify late-life-related subtypes of depression based on measures of depressive symptom dimensions, cognitive performance, and physical frailty. Methods A clinical cohort study of 375 depressed older patients with a DSM-IV depressive disorder (acronym NESDO). A latent profile analysis was applied on the three subscales of the Inventory of Depressive Symptomatology, as well as performance in five cognitive domains and two proxies for physical frailty. For each class, we investigated remission, dropout, and mortality at 2-year follow-up as well as change over time of depressive symptom severity, cognitive performance, and physical frailty. Results A latent profile analysis model with five classes best described the data, yielding two subgroups suffering from pure depression (“mild” and “severe” depression, 55% of all patients) and three subgroups characterized by a specific profile of cognitive and physical frailty features, labeled as “amnestic depression,” “frail-depressed, physically dominated,” and “frail-depressed, cognitively dominated.” The prospective analyses showed that patients in the subgroup of “mild depression” and “amnestic depression” had the highest remission rates, whereas patients in both frail-depressed subgroups had the highest mortality rates. Conclusions Late-life depression can be subtyped by specific combinations of age-related clinical features, which seems to have prospective relevance. Subtyping according to the cognitive profile and physical frailty may be relevant for studies examining underlying disease processes as well as to stratify treatment studies on the effectiveness of antidepressants, psychotherapy, and augmentation with geriatric rehabilitation.

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Cognitive performance in depressed older persons: the impact of vascular burden and remission. A two‐year follow‐up study

Abstract: Our findings suggest that cognitive deficits in depressed older persons are not just a manifestation of depression. In addition, vascular burden was not associated with worse cognitive decline in a sample of depressed older persons. Copyright © 2016 John Wiley & Sons, Ltd.

Cited by 5 publications

References 43 publications

Vascular depression consensus report – a critical update

Vascular depression consensus report – a critical update

Shared and distinct brain fMRI response during performance of working memory tasks in adult patients with schizophrenia and major depressive disorder

Subtypes of Late-Life Depression: A Data-Driven Approach on Cognitive Domains and Physical Frailty

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