Abstract
This study evaluated the association between empty-nest-related psychological distress and the progression of white matter lesions (WMLs) and cognitive impairment in 219 elderly subjects aged 60 years or over. Psychological distress was assessed using the University of California at Los Angeles Loneliness Scale (UCLA-LS) and Geriatric Depression Scale (GDS) Short-Form. Cognitive function was evaluated using the MMSE and MoCA. White matter hyperintensities (WMH) were assessed using magnetic resonance imaging. After 5.2-year follow-up, the reductions in MMSE and MoCA scores and the increases in periventricular (P)WMH, deep (D)WMH, and total WMH volumes in the empty-nest elderly were greater than those in the non-empty-nest elderly (P < 0.05). The reduced MMSE and MoCA scores and increased volumes of PWMH and total WMH in the empty-nest elderly living alone were greater than those in the empty-nest elderly living with a spouse (P < 0.05). UCLA-LS and GDS scores were significantly and independently associated with reduced MMSE and MoCA scores and the increased volumes of PWMH, DWMH, and total WMH. The results indicate that empty-nest-related psychological distress is associated with progression of WMLs and cognitive impairment in the elderly.
Highlights
Loneliness and depressive symptoms are deemed unpleasant state experiences and serious problems among the elderly[1,7,8]
83 were non-empty-nest elderly, 70 were empty-nest elderly living with a spouse, and 66 were empty-nest elderly living alone
Empty-nest elderly living alone suffered more serious loneliness and depressive symptoms than empty-nest elderly living with a spouse
Summary
Loneliness and depressive symptoms are deemed unpleasant state experiences and serious problems among the elderly[1,7,8]. There is a mutually promoting function between loneliness and depressive symptoms[10] They exhibit deleterious effects on mental wellbeing as well as on physical health. Evidence indicates that both loneliness and depressive symptoms are significant risk factors for hypertension[11], vascular stiffness[12,13], metabolic syndrome[14], and dementia[10,15]. The association of empty-nest-related psychological distress with progression of cognitive impairment and WMLs has not been explored in depth in the elderly. We performed a 5-year follow-up study to investigate and elucidate the association between empty-nest-related psychological distress and the progression of WMLs and cognitive impairment in the elderly
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