Abstract
BackgroundWhether depression or cardiovascular disease would have a greater effect on worsening cognitive impairment in the burgeoning older elderly population is uncertain. Which disorder causes greater cognitive impairment was investigated.MethodsA cross section of 207 cognitively impaired older elderly (≥75 years old) men was recruited from outpatient clinics in southern Taiwan between 2004 and 2008. Their medical charts were reviewed for their history of medical illnesses, and those undergoing a current major depressive episode were screened using the Mini-International Neuropsychiatric Interview. Four groups of men were enrolled: 33 healthy controls (HC), 101 cognitively impaired patients with cardiovascular comorbidities (CVCs), 34 patients with late-life depression (LLD), and 49 patients with LLD and cardiovascular comorbidities (LLD + CVC). Several neuropsychological tests (e.g., Mini-Mental State Examination (MMSE), WCST, and Trail Making Test (TMT) parts A and B) were used to assess the participants.ResultsCognitive function scores were highest in the HC group and lowest in the LLD + CVC group. There were no significant differences between the two groups with LLD comorbidity, and LLD was mostly associated with cognitive performance. LLD + CVC group members had the lowest recall memory, but their overall MMSE score was not significantly different. Moreover, this group had a higher but nonsignificantly different perseverative error than did the LLD group. Similarly, the LLD + CVC group was nonsignificantly slower at the TMT-A and TMT-B tasks than was the LLD group.ConclusionsLLD worsens neuropsychological function more than cardiovascular comorbidities do.
Highlights
Whether depression or cardiovascular disease would have a greater effect on worsening cognitive impairment in the burgeoning older elderly population is uncertain
There were no significant differences in age (F = 0.83, p = 0.48), education levels (F = 2.15, p = 0.10), and Mini-Mental State Examination (MMSE) scores (F = 0.86, p = 0.46) between groups
Inferiority, and disinterest were significantly associated with neurocognitive performance, especially on the Trail Making Test (TMT) tasks (Table 4)
Summary
Whether depression or cardiovascular disease would have a greater effect on worsening cognitive impairment in the burgeoning older elderly population is uncertain. The more medical disabilities the older elderly have, the more vulnerable they are to depression and the more social. Depression is the leading cause of geriatric psychiatric problems. It increased with age in a population of oldest elderly (≥80 years old) Han Chinese in Hong Kong [3]. The high prevalence of major depression seems to be a significant risk factor for suicide in the older elderly [4]. Some medical illnesses are associated with depression, such as cardiovascular comorbidities (CVCs) [5]. The management and prognosis of underlying medical illnesses can be affected by major depression
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