Cognitive Reserve Moderates Effects of White Matter Hyperintensity on Depressive Symptoms and Cognitive Function in Late-Life Depression

Lin, Chia Wei; Huang, Chih-Mao; Yang, Fan; Liu, Ho Ling; Chen, Yao Liang; Aizenstein, Howard; Lee, Tatia Mei Chun; Lee, Shwu-Hua

doi:10.3389/fpsyt.2020.00249

Cited by 19 publications

(9 citation statements)

References 57 publications

(58 reference statements)

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“…On the other hand, the cognitive reserve has long been hypothesized to provide resilience and adaptability against age- and disease-related insults. In patients with VaD, a significant interactive effect in education on the association between WMH and depression severity and language domain has been observed, suggesting that cognitive reserve, for instance, due to an interactive effect of higher education, may exert a protective effect on neurocognitive functioning in people with LLD [ 182 ].…”

Section: Structural Brain Lesions In Vadmentioning

confidence: 99%

Pathomechanisms of Vascular Depression in Older Adults

Jellinger¹

2021

IJMS

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Depression in older individuals is a common complex mood disorder with high comorbidity of both psychiatric and physical diseases, associated with high disability, cognitive decline, and increased mortality The factors predicting the risk of late-life depression (LLD) are incompletely understood. The reciprocal relationship of depressive disorder and age- and disease-related processes has generated pathogenic hypotheses and provided various treatment options. The heterogeneity of depression complicates research into the underlying pathogenic cascade, and factors involved in LLD considerably differ from those involved in early life depression. Evidence suggests that a variety of vascular mechanisms, in particular cerebral small vessel disease, generalized microvascular, and endothelial dysfunction, as well as metabolic risk factors, including diabetes, and inflammation that may induce subcortical white and gray matter lesions by compromising fronto–limbic and other important neuronal networks, may contribute to the development of LLD. The “vascular depression” hypothesis postulates that cerebrovascular disease or vascular risk factors can predispose, precipitate, and perpetuate geriatric depression syndromes, based on their comorbidity with cerebrovascular lesions and the frequent development of depression after stroke. Vascular burden is associated with cognitive deficits and a specific form of LLD, vascular depression, which is marked by decreased white matter integrity, executive dysfunction, functional disability, and poorer response to antidepressive therapy than major depressive disorder without vascular risk factors. Other pathogenic factors of LLD, such as neurodegeneration or neuroimmune regulatory dysmechanisms, are briefly discussed. Treatment planning should consider a modest response of LLD to antidepressants, while vascular and metabolic factors may provide promising targets for its successful prevention and treatment. However, their effectiveness needs further investigation, and intervention studies are needed to assess which interventions are appropriate and effective in clinical practice.

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Section: Structural Brain Lesions In Vadmentioning

confidence: 99%

Pathomechanisms of Vascular Depression in Older Adults

Jellinger¹

2021

IJMS

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“…In contrast, this association tends to be weakened or disappear in subjects with high CR. [10][11][12] CR is commonly measured with proxies, and the Cognitive Reserve Index questionnaire (CRIq) evaluates CR from three aspects: education, working activity, and leisure time activity. 13 The three aspects contribute independently and differentially to CR.…”

Section: Introductionmentioning

confidence: 99%

“…A more significant burden of WMH links to poorer cognitive performance in subjects with low CR. In contrast, this association tends to be weakened or disappear in subjects with high CR 10–12 . CR is commonly measured with proxies, and the Cognitive Reserve Index questionnaire (CRIq) evaluates CR from three aspects: education, working activity, and leisure time activity 13 .…”

Section: Introductionmentioning

confidence: 99%

Effects of cognitive reserve proxies on cognitive function and frontoparietal control network in subjects with white matter hyperintensities: A cross‐sectional functional magnetic resonance imaging study

Zhu

Chen

et al. 2022

CNS Neurosci Ther

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Aims This study aimed to analyze the potential association between cognition reserve (CR) components, including education, working activity, and leisure time activity, and cognitive function in subjects with white matter hyperintensities (WMH). The study also explored the role of the frontoparietal control network (FPCN) in such association. Methods White matter hyperintensities subjects with and without cognitive impairment (CI) were evaluated with multimodal magnetic resonance imaging, neuropsychological testing, and CR survey. FPCN patterns were assessed with dorsolateral prefrontal cortex seed‐based functional connectivity analysis. Results Education was positively associated with cognitive function in WMH subjects with or without CI, whereas working activity and leisure time activity were positively associated with cognitive function only in those without CI. Similarly, education was associated with bilateral FPCN in both WMH groups, whereas working activity and leisure time activity were associated with bilateral FPCN mainly in the group without CI. Furthermore, FPCN partially mediated the association between education and cognitive function in both WMH groups. Conclusion Education showed a positive impact on cognitive function in WMH subjects regardless of their cognitive status, whereas working activity and leisure time activity exhibited beneficial effects only in those without CI. The FPCN mediated the beneficial effect of education on cognitive function.

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“…For most of the population, this global public health crisis has been an extremely stressful period ( Qiu et al, 2020 ; Zhang et al, 2020 ) and has affected many people's mental and psychological health both directly and indirectly. Research has reported the increased prevalence of psychological problems such as anxiety disorders ( Huang and Zhao, 2020 ), depression symptoms ( Elbay et al, 2020 ), insomnia ( Kokou-Kpolou et al, 2020 ; Voitsidis et al, 2020 ), and post-traumatic stress symptoms ( Lin et al, 2020 ) in both developing and developed countries. Hence, there is a need to update the treatment recommendations for mental disorders during such crises.…”

Section: Discussionmentioning

confidence: 99%