Diagnosis and treatment of depression and cognitive impairment in late life

Morimoto, Sarah Shizuko; Kanellopoulos, Dora; Manning, Kevin J.; Alexopoulos, George S.

doi:10.1111/nyas.12669

Cited by 108 publications

(91 citation statements)

References 78 publications

(161 reference statements)

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“…This is consistent with evidence showing the vast majority of older adults with major depression do not experience global cognitive impairment (Morimoto et al , 2015). Instead, the cognitive profile of late-life depression is usually characterized by mild deficits in executive functioning and processing speed (Sheline et al , 2006; Lockwood et al , 2002).…”

Section: Discussionsupporting

confidence: 91%

Methodology and preliminary results from the neurobiology of late-life depression study

Steffens

Manning

et al. 2015

Int. Psychogeriatr.

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Background We sought to investigate the relationship between neuroticism and depression in an elderly cohort. In this paper, we describe the methods of an NIMH-supported study and present findings among the cohort enrolled to date. Methods We used the NEO Personality Inventory to assess neuroticism, and we employed several cognitive neuroscience-based measures to examine emotional control. Results Compared with a group of 27 non-depressed older control subjects, 33 older depressed subjects scored higher on measures of state and trait anxiety and neuroticism. On our experimental neuroscience-based measures, depressed subjects endorsed more negative words compared with controls on an emotional characterization test. In addition, we found a significant group-by-congruency effect on an emotional interference test where subjects were asked to identify the face’s emotional expression while ignoring the words “fear” or “happy” labeled across the face. Conclusion Thus, in this preliminary work, we found significant differences in measures of neuroticism and emotional controls among older adults with and without depression.

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Section: Discussionsupporting

confidence: 91%

Methodology and preliminary results from the neurobiology of late-life depression study

Steffens

Manning

et al. 2015

Int. Psychogeriatr.

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“…In fact, the largest ever and most recent worldwide meta-analysis of cortical thickness reductions in depressed patients relative to controls reported the largest effect sizes in medial orbitofrontal cortices (55). Cognitive decline in the elderly is frequently accompanied by depressed mood (56, 57), and neurodegeneration appears to play an important role in the pathogenesis of depression associated with cognitive complaints (58). Here, we examined predictors of mood scores and found that the only two variables significantly associated with depressive symptoms were medial orbitofrontal atrophy and cognitive impairment.…”

Section: Discussionmentioning

confidence: 99%

The C677T Variant in MTHFR Modulates Associations Between Brain Integrity, Mood, and Cognitive Functioning in Old Age

Roussotte

Hou

Narr

et al. 2017

Biological Psychiatry: Cognitive Neuroscience and Neuroimaging

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Introduction The C677T functional variant in the methylene-tetrahydrofolate reductase (MTHFR) gene leads to reduced enzymatic activity and elevated blood levels of homocysteine. Hyperhomocysteinemia has been linked with higher rates of cardiovascular diseases, cognitive decline, and late-life depression. Methods and Materials Here, 3D magnetic resonance imaging data was analyzed from 738 individuals (age: 75.5 ± 6.8 years; 438 men/300 women) including 173 Alzheimer's patients, 359 subjects with mild cognitive impairment, and 206 healthy older adults, scanned as part of the Alzheimer's Disease Neuroimaging Initiative (ADNI). Results We found that this variant associates with localized brain atrophy, after controlling for age, sex, and dementia status, in brain regions implicated in both intellectual and emotional functioning, notably the medial orbitofrontal cortices. The medial orbitofrontal cortex is involved in the cognitive modulation of emotional processes, and localized atrophy in this region was previously linked with both cognitive impairment and depressive symptoms. Here, we report that increased plasma homocysteine mediates the association between MTHFR genotype and lower medial orbitofrontal volumes, and that these volumes mediate the association between cognitive decline and depressed mood in this elderly cohort. We additionally show that vitamin B12 deficiency interacts with the C677T variant in the etiology of hyperhomocysteinemia. Conclusion This study sheds light on important relationships between vascular risk factors, age-related cognitive decline, and late-life depression, and represents a significant advance in our understanding of clinically relevant associations relating to MTHFR genotype.

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“…The depression accompanied by cognitive impairment (predominantly deficits in information processing, memory, and executive dysfunction), which is more likely occur in older people with major depression, can be confused with dementia at advanced ages [35,36]. This comorbidity is just named as dementia syndrome of depression, which is previously known as "pseudodementia" [35].…”

Section: Discussionmentioning

confidence: 99%

Effect of anticholinergic burden on the development of dementia in older adults with subjective cognitive decline

Naharci

Cintosun

Öztürk

et al. 2017

Psychiatry and Clinical Psychopharmacology

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OBJECTIVE: Data on the effect of anticholinergic cognitive burden (ACB) in older adults with subjective cognitive decline (SCD) are limited. We aimed to study whether ACB increases the future risk of dementia in older adults with SCD. METHODS: The retrospective cohort analysis was carried out on 1496 older adults. Out of those, 109 older patients with SCD followed up over 36 months were studied. They were divided into two groups according to cognitive status at last visit: group I included the subjects with SCD who did not progress to dementia and group II included those who progressed to dementia. The drugs with anticholinergic effects that were received by subjects three months or more were identified from records. The drugs were categorized as having absent (ACB = 0), possible (ACB = 1), and definite (ACB = 2) anticholinergic properties based on an ACB scale. ACB was calculated for each subject by adding the score of each drug and classified as no or low ACB (ACB ≤ 2) and high ACB (ACB ≥ 3). RESULTS: The mean age of all subjects was 72.5 ± 6.3 years and 66.1% of the sample was female. The median follow-up time for all subjects was 75 months (range, 36-185). Fifteen (13.8%) of 109 participants with baseline SCD developed dementia. High ACB was present in 12 subjects (12.8%) in group I and 7 subjects (46.7%) in group II (p = .001). The 75-84 and 85 + age groups (hazard ratio (HR)

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Diagnosis and treatment of depression and cognitive impairment in late life

Cited by 108 publications

References 78 publications

Methodology and preliminary results from the neurobiology of late-life depression study

Methodology and preliminary results from the neurobiology of late-life depression study

The C677T Variant in MTHFR Modulates Associations Between Brain Integrity, Mood, and Cognitive Functioning in Old Age

Effect of anticholinergic burden on the development of dementia in older adults with subjective cognitive decline

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