The moderation of multimorbidity and depressive symptoms on cognition

Araujo, Jacyra Azevedo Paiva de; Xavier, Érika Fialho Morais; Rodrigues, Elisângela da Silva; Machado, Daiane Borges; Barreto, Marcos Ennes; Kanaan, Richard A A; Castro-de-Araujo, Luís Fernando Silva

doi:10.47626/1516-4446-2022-2601

Cited by 4 publications

(5 citation statements)

References 31 publications

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“…When we examined the association of multimorbidity patterns in diabetes patients with cognitive function, we found a “multisystem morbidity” class that consists of several chronic conditions, particularly depressive symptoms, is associated with declines in global cognitive function, which aligns with previous results ( de Araujo et al, 2022 ). In addition, we found that all patterns of multimorbidity in diabetes patients were associated with memory decline.…”

Section: Discussionsupporting

confidence: 87%

The effect of multimorbidity patterns on physical and cognitive function in diabetes patients: a longitudinal cohort of middle-aged and older adults in China

Zhou,

Qin,

et al. 2024

Front. Aging Neurosci.

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BackgroundThe prevalence of diabetes has increased rapidly, and comorbid chronic conditions are common among diabetes patients. However, little is known about the pattern of multimorbidity in diabetes patients and the effect on physical and cognitive function. This study aimed to assess the disease clusters and patterns of multimorbidity in diabetes patients using a novel latent class analysis (LCA) approach in middle-aged and older adults and explore the association between different clusters of multimorbidity in diabetes and the effect on physical and cognitive function.MethodsThis national observational study included 1,985 diabetes patients from the four waves of the China Health and Retirement Longitudinal Study (CHARLS) in 2011 to 2018. Thirteen chronic diseases were used in latent class analysis to identify the patterns of multimorbidity in diabetes, which span the cardiovascular, physical, psychological, and metabolic systems. Cognitive function is assessed via a structured questionnaire in three domains: memory, executive function, and orientation. We combined activities of daily living (ADL) with instrumental activities of daily living (IADL) to measure physical function. Linear mixed models and negative binomial regression models were used to analyze the association between patterns of multimorbidity in diabetes and the effect on cognitive function and disability, respectively.ResultsA sample of 1,985 diabetic patients was identified, of which 1,889 (95.2%) had multimorbidity; their average age was 60.6 years (standard deviation (SD) = 9.5), and 53.1% were women. Three clusters were identified: “cardio-metabolic” (n = 972, 51.5%), “mental-dyslipidemia-arthritis” (n = 584, 30.9%), and “multisystem morbidity” (n = 333, 17.6%). Compared with diabetes alone, the “multisystem morbidity” class had an increased association with global cognitive decline. All patterns of multimorbidity were associated with an increased risk of memory decline and disability; however, the “multisystem morbidity” group also had the strongest association and presented a higher ADL-IADL disability (ratio = 4.22, 95% CI = 2.52, 7.08) and decline in memory Z scores (β = −0.322, 95% CI = −0.550, −0.095, p = 0.0058).ConclusionSignificant longitudinal associations between different patterns of multimorbidity in diabetes patients and memory decline and disability were observed in this study. Future studies are needed to understand the underlying mechanisms and common risk factors for multimorbidity in diabetes patients and to propose treatments that are more effective.

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Section: Discussionsupporting

confidence: 87%

The effect of multimorbidity patterns on physical and cognitive function in diabetes patients: a longitudinal cohort of middle-aged and older adults in China

Zhou,

Qin,

et al. 2024

Front. Aging Neurosci.

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“…Zhang et al (2022) found that multimorbidity was associated with increased odds of having depressive symptoms (adjusted odds ratio of 1.51), and developing depressive symptoms (adjusted odds ratio of 1.65). Depression worsens the outcomes of people living with multimorbidity increasing disability, accelerating cognitive decay and also increasing costs in older individuals 5,7,29 . Moreover, depression was associated with a higher incidence of somatic disease, cardiometabolic disease, musculoskeletal diseases and digestive diseases in a 6-year follow-up cohort in the Netherlands 30 .…”

Section: Discussionmentioning

confidence: 99%

“…There is evidence that depression is associated with multimorbidity, the occurrence of two or more chronic diseases. It has been shown that the direction of this association seems to run from multimorbidity to depression 4,5 . As individuals age, they tend to become alone, losing friends and family members, which renders them susceptible to depressive symptoms 6 .…”

Section: Introductionmentioning

confidence: 99%

Evidence of depression affecting multimorbidity in survey data from the Brazilian population

Araújo

Araujo²,

Rodrigues

et al. 2023

Preprint

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Objectives: Depression is associated with multimorbidity, the occurrence of two or more chronic diseases. Although the effect of multimorbidity on depression is relatively well known, the opposite effect is less well studied. We aimed to examine the effect of depression on multimorbidity using data from a nationally representative Brazilian survey. Methods: We used information from all respondents above 15 years of age of the Brazilian National Survey on Access, Use, and Promotion of the Rational Use of Medicines (PNAUM) from 2014. A structural equation model was fit to the data with a specification that included the relationship between depressive syndrome and multimorbidity, controlled by age and body mass index. Results: The data set comprised 28,382 subjects. The model presented fit the data well, and revealed a statistically significant, positive, moderate-size effect (0.355) of depression on multimorbidity. Conclusion: Depression appears to make a moderate contribution to the development of multimorbidity.

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“…This could be due to most chronic diseases sharing the same pathologic pathways 43 , 44 . Regardless, patients with mental health disorders have a higher risk of chronic disease development 48 such as dyslipidemia, obesity, and cardiovascular diseases 49 . Our finding emphasizes the need for a proper definition of multimorbidity which is not only the existence of two or more chronic diseases but also the clinically related pattern that connects one chronic disease to other diseases.…”

Section: Discussionmentioning

confidence: 99%

Findings from the Indonesian family life survey on patterns and factors associated with multimorbidity

Griselda,

Alfian,

Wicaksono

et al. 2023

Sci Rep

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The prevalence of multimorbidity tends to increase with age, but it is now also reported in the middle-aged population, which has a negative impact on healthcare systems and health outcomes. This study aims to analyze the patterns and factors associated with multimorbidity in Indonesia. This national cross-sectional population-based survey used publicly available data from the Indonesian Family Life Survey (IFLS-5) for 2014 among middle-aged (40–59 years old) and elderly (≥ 60 years old) respondents. Information on all chronic diseases was assessed using a self-reported questionnaire. Sociodemographic and health-related behavioral factors were obtained from self-reported data. Binary logistic regression analysis was used to identify the factors associated with multimorbidity. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. The study recruited 11,867 respondents. The prevalence of multimorbidity was 18.6% (95% CI 17.9–19.3) with which 15.6% among middle age (95% CI 14.95–16.25) and 24.9% among the elderly (95% CI 24.12–25.68). Hypertension was the most commonly reported disease (23.2%) in all combinations of multimorbidity and among all age groups. Socio-demographic factors: elderly (AOR: 1.66; 95% CI 1.46–1.89), female (AOR: 1.42; 95% CI 1.20–1.69), living in the urban area (AOR: 1.22; 95% CI 1.09–1.38), higher educational level (AOR: 2.49; 95% CI 1.91–3.26), unemployed (AOR: 1.63; 95% CI 1.44–1.84), and higher economic level (AOR: 1.41; 95% CI 1.18–1.68) were associated with multimorbidity. Poor health behavior factors: being former smokers (AOR: 2.03; 95% CI 1.65–2.51) and obesity (AOR: 1.53; 95% CI 1.35–1.75) were also associated with multimorbidity. The prevalence of multimorbidity in the middle-aged and elderly population in Indonesia is relatively high, particularly in populations with poor health behaviors. Therefore, healthcare professionals should integrate more patient-specific factors when designing and implementing tailored interventions to manage multimorbidity in Indonesia.

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The moderation of multimorbidity and depressive symptoms on cognition

Cited by 4 publications

References 31 publications

The effect of multimorbidity patterns on physical and cognitive function in diabetes patients: a longitudinal cohort of middle-aged and older adults in China

The effect of multimorbidity patterns on physical and cognitive function in diabetes patients: a longitudinal cohort of middle-aged and older adults in China

Evidence of depression affecting multimorbidity in survey data from the Brazilian population

Findings from the Indonesian family life survey on patterns and factors associated with multimorbidity

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