Depression Predicts Cognitive Disorders in Older Primary Care Patients

Boyle, Lisa L.; Porsteinsson, Anton P.; Cui, Xingjia; King, Deborah A.; Lyness, Jeffrey M.

doi:10.4088/jcp.08m04724gry

Cited by 36 publications

(20 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This activity restriction may manifest as depression 17–20. Depression is thought to increase the likelihood of cognitive decline 10,11,47. However, caution should be used while prescribing antidepressants to patients who have fallen as studies have shown that these medications cause an increased risk in falling equal to that of untreated depression 16,48.…”

Section: Discussionmentioning

confidence: 99%

Falls and cognitive decline in Mexican Americans 75 years and older

Padubidri¹,

snih²,

Samper‐Ternent³

et al. 2014

CIA

View full text Add to dashboard Cite

BackgroundLittle is known about long-term emotional and cognitive consequences of falls. We examined the association between falls and subsequent cognitive decline, and tested the hypothesis that depression would mediate any falls–cognition association among cognitively intact Hispanic Elders.MethodsWe used data from the Hispanic Established Population for the Epidemiological Study of the Elderly to examine change in Mini Mental State Examination (MMSE) scores over the 6-year period according to number of falls. All participants (N=1,119) had MMSE scores ≥21 and complete data on Center for Epidemiologic Studies of Depression Scale, social and demographic factors, medical conditions (diabetes, heart attack, stroke, and hypertension), and hand grip muscle strength.ResultsAt baseline, participants’ mean age was 80.8 years (range, 74–109), mean education was 6.3 years (range, 0–17), and mean MMSE was 25.2 (range, 21–30). Of the 1,119 participants, 15.8% experienced one fall and 14.4% had two or more falls. In mixed model analyses, having two or more falls was associated with greater decline in MMSE score (estimate =−0.81, standard error =0.19, P<0.0001) compared to having no fall, after adjusting for age, sex, marital status, and education. The magnitude of the association decreased (estimate =−0.65, standard error =0.19, P=0.0007) when adjustment was made for high depressive symptoms, suggesting a possible mediating effect of depression on the falls–cognition association. Female sex, high level of education, and high performance in hand grip muscle strength were associated with a slower decline in MMSE scores.ConclusionHaving two or more falls was independently associated with steeper decline in cognition over 6 years, with a possible mediating effect of depression on the falls–cognition association.

show abstract

Section: Discussionmentioning

confidence: 99%

Falls and cognitive decline in Mexican Americans 75 years and older

Padubidri¹,

snih²,

Samper‐Ternent³

et al. 2014

CIA

View full text Add to dashboard Cite

show abstract

“…The symptoms include cognitive impairment and loss of memory, implicating synaptic dysfunction in the pathophysiology of MDD 4–6 . This possibility is supported by studies demonstrating a reduction of dendritic spine number and function of neurons in PFC in animal models of depression 7,8 .…”

mentioning

confidence: 99%

Decreased expression of synapse-related genes and loss of synapses in major depressive disorder

Kang

Voleti

Hajszán

et al. 2012

Nat Med

658

448

View full text Add to dashboard Cite

Previous imaging and postmortem studies have reported a reduction in brain volume and a decrease in the size and density of neurons in the dorsolateral prefrontal cortex (dlPFC, area 9) of subjects with major depressive disorder (MDD).1,2 These findings suggest that synapse number and function are decreased in dlPFC of depressed patients. However, there has been no direct evidence for synapse loss in MDD and the gene expression alterations underlying these effects have not been identified. Here we use microarray gene profiling and electron microscopic stereology to reveal decreased expression of synaptic function-related genes in dlPFC of MDD subjects and a corresponding reduction in the number of synapses. We also identify a transcriptional repressor that is increased in MDD, and that when expressed in PFC neurons is sufficient to decrease expression of synapse-related genes, cause loss of spines and dendrites, and produce depressive behavior in rodent models of depression.

show abstract

“…62 Depressed adults with executive dysfunction have a greater risk for relapse, are less responsive to pharmacologic interventions, and have poorer functional status. 63-65 Because late-life depression is associated with persisting cognitive impairment 8 and may be a sign of prodromal dementia, 66 prevention and early treatment of both vascular conditions and depression are important. Treating modifiable risk factors, such as hypertension, hyperlipidemia, obesity, and diabetes, and implementing health behaviors, such as increasing exercise, are key primary prevention strategies.…”

Section: Discussionmentioning

confidence: 99%

Vascular Burden and Cognitive Functioning in Depressed Older Adults

Schneider¹,

Ercoli²,

Siddarth³

et al. 2012

The American Journal of Geriatric Psychiatry

View full text Add to dashboard Cite

Background Vascular burden is known to contribute to geriatric depression and cognitive impairment. The objective of our study was to evaluate the relationship between vascular burden and pattern of cognitive impairment in older adults with depression. Methods Ninety-four community-dwelling older adults (mean age = 70.8 years; SD = 7.63) diagnosed with major depression were recruited to participate in the tai chi complementary use study aimed to improve antidepressant response to an antidepressant medication. All participants received comprehensive evaluations of depression, apathy, and vascular risk factors, and completed a battery of cognitive measures of memory, cognitive control, verbal fluency, and attention. Results The severity of vascular burden was significantly correlated with depression severity and impaired performance on measures of cognitive control (i.e., inhibition/mental flexibility), and attention, but not memory or verbal fluency. Neither the severity of comorbid apathy nor medical illness burden was related to cognitive impairment. Conclusions Vascular burden in older depressed adults contributes to cognitive impairment, particularly in domains of attention and cognitive control. Our findings suggest that aggressive treatment of vascular risk factors may reduce risk for further cognitive decline in depressed older adults.

show abstract

Depression Predicts Cognitive Disorders in Older Primary Care Patients

Abstract: Depressive disorders pose increased risk of incident dementia or cognitive disorder NOS in older primary care patients. Clinicians treating depressed older adults should monitor for development of cognitive disorders.

Cited by 36 publications

References 0 publications

Falls and cognitive decline in Mexican Americans 75 years and older

Falls and cognitive decline in Mexican Americans 75 years and older

Decreased expression of synapse-related genes and loss of synapses in major depressive disorder

Vascular Burden and Cognitive Functioning in Depressed Older Adults

Contact Info

Product

Resources

About