Abstract
BackgroundLate-life depression (LLD) is a risk factor for cognitive decline in older adults, and odor identification (OI) deficits are an early indicator of cognitive decline with LLD. However, neuropsychiatric symptoms (NPSs) are common in LLD and are associated with OI deficits. In subjects with LLD, when OI deficits forecast cognitive decline, whether and how NPS affects the relationship between OI and cognition still must be further explored.ObjectiveTo comprehensively explore the potential effects of various NPSs on the relationship between OI and cognition in participants with LLD.MethodsThere were 167 patients with LLD and 105 normal elderly (NE) participants. The odor identification test (Sniffin' Sticks), cognitive function assessments (global cognition, memory, executive function, attention, language, visual space), and an NPS assessment (the neuropsychiatric inventory questionnaire) were performed on the subjects. In patients with LLD, the relationship among OI, cognition and NPSs was examined using correlation analysis and moderation analysis.ResultsIn patients with LLD, OI was positively correlated with cognition (global cognition, memory, executive function, attention, language) and negatively associated with NPSs (agitation and aberrant motor behavior). In NE group, OI was correlated with executive function. Moderation analysis showed that there was an interactive effect of agitation and cognitive impairment (language deficit or attention deficit) on OI in patients with LLD.ConclusionThe coexistence of agitation and language or attention deficit was associated with worse OI in subjects with LLD. Agitation should be considered since OI predicts cognitive decline in patients with LLD.
Highlights
The current prevalence of late-life depression (LLD) is 20% among older adults in China [1]
Odor identification (OI) was correlated with neuropsychiatric inventory questionnaire (NPI) scores, including agitation (r = −0.18), dysphoria (r = −0.14), anxiety (r = −0.12), apathy (r = −0.14), and aberrant motor behavior (r = −0.16)
In the LLD group, OI was correlated with Mini-Mental State Examination (MMSE) (r = 0.37), Auditory Verbal Learning Test (AVLT) N1N5 total (r = 0.35), 1/TMTA-Time (r = 0.18), 1/TMTB-Time (r = 0.20), Verbal Fluency Test (VFT) (r = 0.29), and Digital Span Test (DST) (r = 0.22); OI was associated with NPI scores, including agitation (r = −0.20) and aberrant motor behavior (r = −0.17)
Summary
The current prevalence of late-life depression (LLD) is 20% among older adults in China [1]. Previous studies have shown that subjects with LLD were more likely than normal older adults to develop major neurocognitive disorders [3], and a follow-up study suggested that an increased risk of all-cause mortality was affiliated with cognitive impairment and neuropsychiatric symptoms (NPSs) with LLD [4]. Our previous studies suggested that OI deficits might act as a promising predictor of the development of major neurocognitive disorder in subjects with LLD, who with impaired OI exhibited poorer cognitive function, and had more functional and structural impairments in brain regions [11, 12]. Late-life depression (LLD) is a risk factor for cognitive decline in older adults, and odor identification (OI) deficits are an early indicator of cognitive decline with LLD. In subjects with LLD, when OI deficits forecast cognitive decline, whether and how NPS affects the relationship between OI and cognition still must be further explored
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