Baseline Depressive Symptoms Research Articles

Bidirectional associations between dietary diversity and depressive symptoms in Chinese adult women: A retrospective cohort study

ObjectiveThis study aimed to examine the bidirectional associations between dietary diversity and clinical depressive symptoms in adult women, and influencing factors of clinical depressive symptoms. MethodsThis longitudinal study included a total of 22,385 participants, each of whom underwent at least two data collections. We used convenience sampling to recruit women from a health management center of a general hospital in southern China from April 2015 to December 2021. They completed an online self-reported health questionnaire, which included demographic characteristics, lifestyle information, the Dietary Diversity Scale (DDS), and the Patient Health Questionnaire-9. ResultsNew-onset depressive symptoms and low dietary diversity were observed in this study among 1285 and 3223 participants, respectively. Negative associations were observed between baseline low dietary diversity and new-onset depressive symptoms (P < 0.05) and between baseline depressive symptoms and low dietary diversity (P < 0.001). Cross-lagged panel analysis indicated that dietary diversity negatively and prospectively predicted depressive symptoms, but vice versa (P < 0.05). Strong evidence of a nonlinear association between DDS scores and incident depressive symptoms was found (P nonlinear < 0.05) regardless of whether the variables were adjusted. Besides, age, menarche age, physical activity, sleep duration, longer sedentary behavior and other lifestyle factors were influencing factors of depressive symptoms (P < 0.05). ConclusionsThe present study identified bidirectional associations between dietary diversity and depressive symptoms, and the associations were found to have a non-linear pattern. Adherence to dietary diversity and a healthy lifestyle could be effective non-pharmacological preventive measures to reduce the incidence of depressive symptoms.

Association between type 2 diabetes and depressive symptoms after a 1-year follow-up in an older adult Mediterranean population

ObjectivesTo examine the cross-sectional association between baseline depressive symptoms and the presence of type 2 diabetes (T2D), and its association with glycated hemoglobin (HbA1c) and other metabolic variables, and the prospective association of depressive symptoms and HbA1c after 1 year of follow-up.Methodsn = 6224 Mediterranean older adults with overweight/obesity and metabolic syndrome (48% females, mean age 64.9 ± 4.9 years) were evaluated in the framework of the PREDIMED-Plus study cohort. Depressive symptoms were assessed using the Beck Depression Inventory-II and HbA1c was used to measure metabolic control.ResultsThe presence of T2D increased the likelihood of higher levels of depressive symptoms (χ2 = 15.84, p = 0.001). Polynomial contrast revealed a positive linear relationship (χ2 = 13.49, p = 0.001), the higher the depressive symptoms levels, the higher the prevalence of T2D. Longitudinal analyses showed that the higher baseline depressive symptoms levels, the higher the likelihood of being within the HbA1c ≥ 7% at 1-year level (Wald-χ2 = 24.06, df = 3, p < .001, for the full adjusted model). Additionally, depressive levels at baseline and duration of T2D predicted higher HbA1c and body mass index, and lower physical activity and adherence to Mediterranean Diet at 1 year of follow-up.ConclusionsThis study supports an association between T2D and the severity of depressive symptoms, suggesting a worse metabolic control from mild severity levels in the short–medium term, influenced by lifestyle habits related to diabetes care. Screening for depressive symptoms and a multidisciplinary integrative therapeutic approach should be ensured in patients with T2D.

Poor mobility and lower limb weakness are associated with three distinct depressive symptom trajectories over 6 years in older people.

Physical decline can be associated with the onset of depressive symptoms in later life. This study aimed to identify physical and lifestyle risk factors for depressive symptom trajectories in community-dwelling older adults. Participants were 553 people aged 70-90 years who underwent baseline physical, psychological and lifestyle assessments. Group-based trajectory analysis was used to identify patterns of depressive symptom development over 6 years of follow-up. Strengths of associations between baseline functional test performances and depressive symptom trajectories were evaluated with univariable ordinal models. Subsequently, the adjusted cumulative odds ratio for the association between identified risk factors, demographic factors and baseline anti-depressant use were measured using multivariable ordinal logistic regression. Three distinct depressive symptom trajectories were identified: a low-and-stable course (10% of participants), a low-and-increasing course (81%) and a moderate-and-increasing course (9%). Timed Up and Go test time was the strongest risk factor of depressive symptom trajectory, followed by Five Times Sit-to-Stand test performance, planned physical activity levels, and knee extension strength (adjusted standardised ORs 1.65, 95% CI 1.34-2.04; 1.44, 95% CI 1.16-1.77; 1.44, 95% CI 1.17-1.76 and 1.41, 95% CI 1.15-1.73 respectively). After adjusting for age, sex, body mass index and baseline anti-depressant use, Timed Up and Go test performance and knee extension strength were independently and significantly associated with depressive trajectories. Timed Up and Go test times, Five Times Sit-to-Stand test performance, planned physical activity levels and knee extension strength are associated with three discrete depressive symptom trajectories. These clinical tests may help identify older adults aged 70-90 years at risk of developing depressive symptoms and help guide subsequent strength and mobility interventions.

Resilience buffers the association between psychotic-like experiences and suicide risk: a prospective study from a non-clinical sample

BackgroundSeveral studies have reported that psychotic-like experiences are associated with low levels of resilience and increased suicide risk. However, it remains unknown as to whether resilience mediates or moderates the association between psychotic-like experiences and suicide risk. Therefore, in this study, we aimed to explore the moderating and mediating effect of resilience in the association between psychotic-like experiences and suicide risk.MethodsA total of 1100 non-clinical, young adults (aged 18 – 35 years) with a negative history of psychiatric treatment were enrolled. Participants were recruited by the snowball sampling methodology through advertisements posted in the online platform. They were followed-up for about 7 months. Variables of interest were recorded using self-reports. Psychopathological assessment was conducted using the Prodromal Questionnaire-16, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Traumatic Experience Checklist, the Childhood Experience of Care and Abuse Questionnaire, the Cannabis Problems Questionnaire, the Connor-Davidson Resilience Scale-10, and the Mini-International Neuropsychiatric Interview. The STROBE statement guidelines were followed.ResultsThe moderation analysis revealed that higher levels of psychotic-like experiences and related distress at baseline were associated with significantly higher suicide risk at the follow-up after adjustment for baseline sociodemographic characteristics, depressive and anxiety symptoms, a history of childhood trauma, and problematic cannabis use. The interaction between follow-up resilience and distress related to baseline psychotic-like experiences was significantly and negatively associated with suicide risk at the follow-up. Specifically, the correlation between the level of distress related to psychotic-like experiences and suicide risk was significant and positive only in participants with lower levels of resilience. This interaction did not reach statistical significance for the baseline level of psychotic-like experiences. No significant mediating effect of the follow-up resilience level in the association between baseline psychotic-like experiences and the follow-up suicide risk was found.ConclusionsFindings from the present study indicate that resilience might protect against suicide risk in people with psychotic-like experiences. These findings could be applied in the formulation of early intervention strategies aimed at mitigating the risk of suicide. Future studies need to explore the effects of interventions targeting resilience for individuals with psychotic-like experiences.

Prospective Bidirectional Relationship Between Sleep Duration and Posttraumatic Stress Disorder Symptoms After Suspected Acute Coronary Syndrome.

Sleep disturbance is a "hallmark" symptom of posttraumatic stress disorder (PTSD). Poor sleep (including short sleep) after combat-related trauma can also predict subsequent PTSD. Less is known about the association between sleep duration and PTSD symptoms when PTSD is induced by acute coronary syndrome (ACS). We examined the bidirectional relationship between sleep duration and PTSD symptoms over the year after hospital evaluation for ACS. Participants were enrolled in this observational study after emergency department evaluation for ACS. Sleep duration ("During the past month, how many hours of actual sleep did you get at night?") and cardiac event or hospitalization-induced PTSD symptoms (PTSD Checklist) were assessed at 1, 6, and 12 months after hospital discharge. Cross-lagged path analysis was used to model the effects of sleep duration and PTSD symptoms on each other. Covariates included age, sex, race/ethnicity, cardiac severity, baseline depression symptoms, and early acute stress disorder symptoms. The sample included 1145 participants; 16% screened positive for probable PTSD (PTSD Checklist score ≥33). Mean sleep duration across time points was 6.1 hours. Higher PTSD symptoms predicted shorter sleep duration at the next time point (i.e., 1-6 and 6-12 months; B = -0.14 hours/10-point difference, SE = 0.03, p < .001). Shorter sleep duration was associated with higher PTSD symptoms at the next time point (B = -0.25 points/hour, SE = 0.12, p = .04). Short sleep duration and PTSD symptoms are mutually reinforcing across the first year after ACS evaluation. Findings suggest that sleep, PTSD symptoms, and their relationship should be considered in the post-ACS period.

Motivated information avoidance in an mHealth weight loss intervention: Associations between unmet behavioral goals and likelihood of viewing program messages.

Program engagement is positively associated with improved outcomes in mobile health (mHealth) interventions, but little is known about which factors may increase or decrease the likelihood of participants viewing program messages. This study examined the association between daily behavioral goal achievement and likelihood of reading daily messages, and if this relationship is moderated by baseline depressive symptoms in an mHealth weight loss intervention. Data come from a 12-week microrandomized pilot mHealth weight management trial that tested the effects of daily messages on behavioral goals among 52 young adults (78.8% female, 61.5% white, ages 21-35). Conditional growth curve modeling was used to regress message viewing indicators onto the number of daily behavioral goals that participants had not met at the time of message receipt, with testing for moderation by depressive symptoms and controlling for covariates clustered within participants over time. For each additional goal not met at the time of message receipt, participants were 34.8% less likely to read any message sent (p < 0.0001), and this relationship did not appear to be related to depressive symptoms (p = 0.1). Participants may tend to avoid reading program messages when they know they are not meeting goals in a program, possibly due to motivated information avoidance to prevent negative emotional reactions from anticipated negative feedback messages. Future interventions may want to consider ways to contact participants who may be struggling in programs and also avoiding viewing standard message pushes in order to reduce the risk of disengagement.

The association between raw garlic consumption and the risk of depressive symptoms: the TCLSIH cohort study.

Background: Garlic has antioxidant, anti-inflammatory, cardiovascular improvement and other beneficial effects on human health. However, few studies have evaluated the association of garlic intake with the risk of depressive symptoms. The aim of this prospective cohort was to examine the association between the frequency of raw garlic consumption and depressive symptoms in the general adult population. Methods: A total of 7427 participants (mean ± standard deviation: 39.7 ± 10.5 years) without baseline depressive symptoms were included in the cohort study. Garlic consumption was assessed using a validated food frequency questionnaire, and depressive symptoms were assessed by a Chinese version of the Self-rating Depression Scale score (SDS score ≥ 45). Multivariable Cox proportional hazards models were used to determine the association between garlic consumption and the risk of depressive symptoms. Results: This study identified 1070 cases of depressive symptoms during a median follow-up of 2.0 years, with a depression prevalence of 73.4 cases per 1000 person-years. After multivariate adjustment, the hazard ratios (95% confidence intervals) for depressive symptoms in males were 1.00 (reference) for almost never, 1.05 (0.84, 1.32) for ≤1 time per week, 1.16 (0.90, 1.49) for 2-3 times per week, and 1.31 (0.97, 1.78) for ≥4 times per week, and in females, they were 1.00 (reference) for almost never, 0.85 (0.69, 1.06) for ≤1 time per week, 0.72 (0.54, 0.97) for 2-3 times per week, and 0.78 (0.53, 1.13) for ≥4 times per week. Conclusion: In a large general population, we demonstrate for the first time that moderate raw garlic consumption is associated with a reduced risk of depressive symptoms in females, but not in males. Additional prospective studies with long-term follow-up and randomized controlled trials are necessary to confirm the preliminary results of the current study.

Food insecurity and perinatal depression among pregnant women in BUNMAP cohort in Ethiopia: a structural equation modelling.

To assess the effect of food insecurity on perinatal depression in rural Ethiopia. We used a prospective cohort in which food insecurity was considered as primary exposure and perinatal depression as an outcome. Food insecurity at baseline (in the period of 8-24 weeks of pregnancy) was measured using the Household Food Insecurity Access Scale (HFIAS), and perinatal depression at follow-up (in 32-36 weeks of pregnancy) was measured using a Patient Health Questionnaire (PHQ-9). We used multivariable regression to assess the effect of food insecurity on the prevalence of perinatal depression. We explored food insecurity's direct and indirect impacts on perinatal depression using structural equation modelling (SEM). This paper used data from the Butajira Nutrition, Mental Health and Pregnancy (BUNMAP) cohort established under the Butajira Health and Demographic Surveillance Site (BHDSS). Seven hundred and fifty-five pregnant women. Among the study participants, 50 % were food-insecure, and about one-third were depressed at 32-36 follow-up. In SEM, higher values of baseline food insecurity, depressive symptoms and state-trait anxiety (STA) were positively and significantly associated with perinatal depression. The direct impact of food insecurity on perinatal depression accounts for 42 % of the total effect, and the rest accounted for the indirect effect through baseline depression (42 %) and STA (16 %). The significant effect of food insecurity at baseline on perinatal depression and the indirect effect of baseline food insecurity through baseline anxiety and depression in the current study implies the importance of tailored interventions for pregnant women that consider food insecurity and psychosocial problems.

Loneliness Predicts Progression of Frailty in Married and Widowed, but Not Unmarried Community Dwelling Older Adults.

Loneliness is highly prevalent among older adults and is associated with frailty. Most studies consider loneliness in isolation without consideration for structural and functional measures of social relationships - and longitudinal studies are scarce. This study examined longitudinal associations between loneliness and frailty and analyzed how structural and functional social measures influence these associations. Linear mixed effects models examined longitudinal associations between loneliness and frailty assessed with the frailty index (scale 0-100). Models were adjusted for baseline age, gender, education, depressive symptoms, global cognition, and structural (e.g., social network, marital status), and functional social measures (e.g., social, cognitive, and physical activity, and social support). Loneliness and frailty data from 1,931 older adults without dementia at baseline from the Rush Memory and Aging Project were examined (mean age 79.6 ± 7.7 years, 74.9% female). Baseline loneliness assessed by the de Jong Gierveld Loneliness Scale was the predictor of interest. Frailty increased significantly over a mean follow-up period of 4.6 years. Effects of loneliness on frailty were modified by marital status. Loneliness predicted an additional accumulation of 0.37 and 0.34 deficits on the frailty index per year in married and widowed individuals respectively, compared to those who were not lonely (married: p=0.009, CI 0.09, 0.64; widowed: p=0.005, CI 0.1, 0.58). Loneliness did not predict frailty progression in unmarried individuals. Loneliness predicts frailty progression, highlighting the importance of social determinants on physical health in aging.

Bidirectional relationship between C-reactive protein and depressive symptoms considering cumulative effect among Chinese middle-aged and older adults.

Research examining the bidirectional relationship between C-reactive protein (CRP) and depressive symptoms, while accounting for cumulative effect of repeated episodes of CRP or depressive symptoms, is currently deficient in non-Western populations. A nationally representative population-based cohort data from the Chinese Health and Retirement Longitudinal Study (CHARLS) was utilized. In bi-directional analysis, we considered both single determinations and two successive determinations of CRP or depressive symptoms. Multivariate logistic regression assessed the association between elevated CRP levels at baseline or repeated episodes of CRP elevations over two successive determinations and subsequent elevated depressive symptoms, and vice versa. Although single determinations of CRP or depressive symptoms yielded non-significant results in both directions, full multivariate models, adjusting for baseline depressive symptoms, socio-demographic characteristics, health-related behaviors, metabolic measures, and health status, revealed a significantly positive association based on two successive determinations of CRP or depressive symptoms. This significant association was observed between cumulative effects of sustained CRP elevations over two successive determinations (2 vs. 0) and subsequent elevated depressive symptoms (OR=1.58; 95% CI: 1.15 to 2.17) and between cumulative effect of repeated episodes of depression (2 vs. 0) and later elevated CRP (OR=1.26; 95% CI: 1.02 to 1.56). Furthermore, sex-stratified analyses confirmed the robustness of these relationships. There are bidirectional associations between depressive symptoms and CRP, driven by the cumulative effect of repeated episodes of CRP or depressive symptoms among middle-aged and older Chinese adults. These findings hold significant clinical implications, highlighting the potential of both anti-inflammatory and anti-depression approaches.

Trajectories of insomnia following bereavement

BackgroundInsomnia symptoms are common following bereavement and may exacerbate severe and protracted grief reactions, such as prolonged grief disorder (PGD). However, typical trajectories of insomnia symptoms and risk factors for having a more chronic insomnia trajectory following bereavement are yet unknown. MethodIn the current investigation, 220 recently bereaved (≤6 months post-loss) participants, completed questionnaires assessing sociodemographic and loss-related characteristics, rumination, experiential avoidance and symptoms of (prolonged) grief and depression, on three time-points (6 months apart). We applied growth mixture models to investigate the typical trajectories of insomnia symptoms following bereavement. ResultsThree insomnia trajectory classes emerged, characterized by a resilient (47 %), recovering (43 %), and a chronic trajectory (10 %). Baseline depression symptoms best predicted the type of insomnia trajectory. At one-year follow-up, 9 %, 27 %, and 60 % of participants met the criteria for probable PGD within the resilient, recovering and chronic trajectory, respectively. A parallel process model showed that temporal changes in insomnia symptoms were strongly related to changes in prolonged grief symptoms. ConclusionThe results suggest, that targeting insomnia symptoms in the treatment of PGD, particularly with comorbid depression, may be a viable option.

Incidence and psychiatric predictors of Long COVID beyond 3months in a city-wide community sample in Texas.

Studies have emerged about a syndrome of persistent symptoms of Coronavirus Disease-2019 (COVID-19) infection called 'Long COVID', which have mostly focused on the first 3months. This study examined rates and predictors of Long COVID symptoms lasting beyond 3months (termed Long2 COVID). A longitudinal cohort study using a population-based sample of 511 adults in San Antonio, Texas with laboratory-confirmed cases of COVID-19 were assessed for Long2 COVID. Inverse probability weighting was used. In the sample, 19.18-59.10% met criteria for Long2 COVID depending on the definition. In general, Long COVID symptoms decreased after 3months with the notable exception of an observed increase in loss of taste and smell. White Hispanic (adjusted odds ratio (aOR)=7.66; 95% confidence interval (CI)=1.78, 32.87) background and baseline depression symptoms (aOR=1.30; 95% CI=1.03, 1.65) were predictive of Long2 COVID. Long2 COVID was also associated with greater anxiety symptoms 6months after onset of COVID-19. A sizable proportion report COVID-19 symptoms lasting more than 3months and some symptoms even increased over time. Adults who are Hispanic white adults or have depression may be at greater risk for Long2 COVID. Further research is needed on why some adults experience Long COVID and how to reduce the duration of illness.

LONGITUDINAL ASSOCIATIONS OF LONELINESS AND FRAILTY IN COMMUNITY DWELLING OLDER ADULTS

Abstract Loneliness is highly prevalent among older adults and is associated with poor health outcomes. This study examined longitudinal associations between loneliness and frailty and the influence of other objective and subjective social measures on these associations. We analyzed data from 1,3111 older adults without dementia at baseline from the Rush Memory and Aging Project (mean age 78.3 ±7.5 years, 72.5% female). Loneliness was assessed using the de Jong Gierveld Loneliness Scale. Frailty was defined using a 39-item cumulative deficit frailty index. Linear mixed effects models were used to examine the association of baseline loneliness and change in frailty over time adjusted for baseline age, gender, education, depressive symptoms, global cognition, social network, marital status, social support, and social, cognitive, and physical activity. Loneliness and frailty both increased significantly over a mean follow-up period of 4.6 years. Baseline loneliness was associated with an additional increase in frailty by 0.3 deficits per year compared to those who were not lonely (p&amp;lt; 0.001, CI 0.2, 0.5). The 0.3 increase in frailty per 1-point increase in loneliness equaled a 27% increase in frailty per year. Loneliness is associated with accelerated frailty and should be considered in the design of interventions to prevent frailty and promote healthy aging.

RESIDENTIAL SEGREGATION AND DEPRESSIVE SYMPTOMS IN OLDER CHINESE IMMIGRANTS: MEDIATING ROLE OF SOCIAL PROCESSES

Abstract Older Chinese immigrants are particularly at risk for depression due to acculturative stress and language barriers. Residential segregation with respect to language use may play an important role in mental health of historically marginalized immigrant populations. Previous research provided mixed evidence about the segregation effect among older Latino and Asian immigrants. Guided by a model of social processes, we examined the direct and indirect effects of residential segregation on depressive symptoms via multiple mechanisms of acculturation, discrimination, social network, social support, social strain, and social engagement. Four waves of depressive symptoms were assessed in the Population Study of Chinese Elderly (2011-2019, N=1,970), and linked to the 2010-2014 American Community Survey estimates of neighborhood context. Residential segregation was measured by the Index of Concentrations at the Extremes that simultaneously assesses Chinese and English language use within a given census tract. Latent growth curve models with adjusted cluster robust standard errors were estimated after controlling for individual-level factors. Residents of segregated Chinese-speaking neighborhoods had fewer baseline depressive symptoms but a slower decline rate than those living in segregated toward English-only speaking neighborhoods. Racial discrimination, social strain, and social engagement partially mediated the association between segregation and initial level; social strain and social engagement also partially mediated the association with decline in depressive symptoms. This study demonstrates the importance of residential segregation and social processes in shaping mental well-being among older Chinese immigrants and suggests potential mechanisms to alleviate mental health risks.

Associations between Sensory Loss and Depressive Symptoms in a Longitudinal National Study of Ageing Adults in Thailand

Introduction: Sensory loss and depressive symptoms (DS) may be an increasing concern in ageing adults. Some previous studies in China found bidirectional associations between sensory loss and DS, but we lack information on this relationship in Southeast Asia. The purpose of this study was to assess the bidirectional association between sensory loss and DS in a longitudinal study in Thailand.&#x0D; &#x0D; Methods: The responses of participants (≥ 45 years) of two consecutive waves (2015 and 2017) of the Health, Aging and Retirement in Thailand (HART) study were analysed. Sensory loss was assessed with self-reported questions and DS with the Center for Epidemiological Studies Depression scale.&#x0D; &#x0D; Results: The analytic baseline sample included 3708 participants (median = 66 years) who responded to the 2015 and 2017 survey. The prevalence of vision, hearing and dual sensory loss were 25.4%, 13.3% and 7.9%, respectively, and the prevalence of DS was 12.3%. In the final model, adjusted for relevant confounders, vision, hearing, and sensory loss at baseline were positively associated with incident DS (AOR: 1.34, 95% CI: 1.01 to 1.74; AOR: 1.71, 95% CI: 1.23 to 2.38; and AOR: 1.80, 95% CI: 1.20 to 2.69, respectively). DS at baseline was not significantly associated with incident vision, hearing or dual sensory loss.&#x0D; &#x0D; Conclusion: Baseline vision, hearing, and dual sensory loss increase the odds of incident DS, but baseline DS did not significantly increase the odds of incident vision, hearing, or dual sensory loss among ageing adults in Thailand.

The Role of Daily Steps in the Treatment of Major Depressive Disorder: Secondary Analysis of a Randomized Controlled Trial of a 6-Month Internet-Based, Mindfulness-Based Cognitive Behavioral Therapy Intervention for Youth.

Current evidence supports physical activity (PA) as an adjunctive treatment for major depressive disorder (MDD). Few studies, however, have examined the relationship between objectively measured PA and MDD treatment outcomes using prospective data. This study is a secondary analysis of data from a 24-week internet-based, mindfulness-based cognitive behavioral therapy program for MDD. The purpose of this analysis was twofold: (1) to examine average daily step counts in relation to MDD symptom improvement, and whether pain moderated this relationship; and (2) to examine whether changes in step activity (ie, step trajectories) during treatment were associated with baseline symptoms and symptom improvement. Patients from the Centre for Addiction and Mental Health were part of a randomized controlled trial evaluating the effects of internet-based, mindfulness-based cognitive behavioral therapy for young adults (aged 18-30 years old) with MDD. Data from 20 participants who had completed the intervention were analyzed. PA, in the form of objectively measured steps, was measured using the Fitbit-HR Charge 2 (Fitbit Inc), and self-reported depression severity was measured with the Beck Depression Inventory-II (BDI-II). Linear regression analysis was used to test PA's relationship with depression improvement and the moderating effect of pain severity and pain interference. Growth curve and multivariable regression models were used to test longitudinal associations. Participants walked an average of 8269 steps per day, and each additional +1000-step difference between participants was significantly associated with a 2.66-point greater improvement (reduction) in BDI-II, controlling for anxiety, pain interference, and adherence to Fitbit monitoring (P=.02). Pain severity appeared to moderate (reduce) the positive effect of average daily steps on BDI-II improvement (P=.03). Higher baseline depression and anxiety symptoms predicted less positive step trajectories throughout treatment (Ps≤.001), and more positive step trajectories early in the trial predicted greater MDD improvement at the end of the trial (Ps<.04). However, step trajectories across the full duration of the trial did not significantly predict MDD improvement (Ps=.40). This study used objective measurements to demonstrate positive associations between PA and depression improvement in the context of cognitive behavioral treatment. Pain appeared to moderate this relationship, and baseline symptoms of anxiety and depression predicted PA trajectories. The findings inform future interventions for major depression. Future research with larger samples should consider additional moderators of PA-related treatment success and the extent to which outcomes are related to PA change in multimodal interventions. Clinical Trials.gov NCT03406052; https://www.clinicaltrials.gov/ct2/show/NCT03406052. RR2-10.2196/11591.

Baseline affective symptomatology moderates acute subjective effects of high potency THC and CBD cannabis concentrates.

Highly potent cannabis concentrates are widely available and associated with affective disturbance and cannabis use disorder. Little is known about the effects of concentrated Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) and their relationship to long-term affect. We explored how baseline affective symptoms (anxiety and depression) relate to acute (i.e., immediate or short-term) subjective mood and intoxication effects during naturalistic use of cannabis concentrates. Fifty-four cannabis users (48% female; Mage = 29.87) were assigned to ad libitum use of either a THC-dominant (84.99% THC and THCa, < 1% CBD) or CBD-dominant (74.7% CBD, 4.1% CBDa, 4.5% THC and THCa) concentrate. Individuals were assessed at baseline and before, immediately after, and 1 hr after naturalistic use of their assigned product. Models regressed each outcome on time, product condition, baseline affective symptoms, and their interactions. An interaction emerged between condition and baseline depression symptoms on positive mood (F = 9.47, p < .005); higher depression symptom level was associated with higher positive mood with THC-dominant product use. There was an interaction between condition, baseline depression symptoms, and time on negative mood (F = 5.55, p < .01); negative mood decreased with CBD-dominant product use for all depression symptom levels but increased with THC-dominant product use at high levels. Finally, there was an interaction between condition and time on intoxication (F = 3.72, p = .03); the THC-dominant condition was more intoxicated postuse than the CBD-dominant condition. This novel exploratory study suggests that baseline affect moderates the acute effects of ad libitum use of THC and CBD concentrates such that preexisting affective symptoms modulate the intensity of subjective drug experiences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Social health and subsequent cognitive capability: examining the potential mediating roles of depression symptoms and inflammatory biomarkers

AbstractBackgroundSocial health (SH) markers, including marital status, contact frequency, network size, and social support, have been linked with increased cognitive capability. However, the underlying mechanisms remain poorly understood. We aim to investigate whether depression symptoms and inflammatory biomarkers mediate associations between SH and cognitive outcomes.MethodWe used data from waves 1‐9 of the English Longitudinal Study of Ageing, involving 7,136 participants aged 50 or older at baseline. First, we examined associations between SH (wave 1) and depression and inflammatory biomarkers (C‐reactive protein (CRP) and fibrinogen) (wave 2) using linear regression models. Second, we tested associations between a) SH and b) depression and inflammation with subsequent standardised verbal fluency and memory in wave 3 and change between waves 3‐9, indexed using slopes derived from multilevel models. We adjusted for age, sex, socio‐economic position, cardiovascular disease, basic and instrumental activities of daily living, health behaviours, and baseline depression symptoms and cognition. We will also conduct causal mediation analysis.ResultAll SH markers, except contact frequency, were associated with lower subsequent depression, but not inflammatory biomarkers. Greater contact frequency (e.g. once‐twice a week vs &lt;once per year: β = 0.18 [0.01, 0.36]) and less negative support (β = 0.02 [0.00, 0.03]) were associated with higher verbal fluency. Larger network size (&gt;6 people vs none: β = 0.007SD/year [0.001, 0.012]), less negative (β = 0.001SD/year [0.001, 0.002]) and more positive support (β = 0.001SD/year [0.000, 0.001]) were linked with slower memory decline, and more positive support predicted slower verbal fluency decline (β = 0.001SD/year [0.000, 0.001]). Depression symptoms were associated with lower memory and verbal fluency, and faster memory decline (β = ‐0.001SD/year [‐0.001, ‐0.000]) and verbal fluency (β = ‐0.001SD/year [‐0.001, ‐0.000]). CRP was associated with lower verbal fluency (β = ‐0.02 [‐0.04, 0.00]), whereas fibrinogen was linked with faster memory decline (β = ‐0.001SD/year [‐0.003, ‐0.000]).ConclusionDepression symptoms and SH showed associations with subsequent cognitive capability and change. SH was linked with lower depression, but not inflammatory biomarkers. Findings highlight the potential for depression to underpin associations between SH and cognition, a pathway which we will test using causal mediation analysis. We will also examine whether findings replicate in the Swedish National Study of Aging and Care in Kungsholmen.

FC40: Social health and subsequent cognitive capability: examining the potential mediating roles of depression symptoms and inflammatory biomarker

Objective:Social health (SH) markers, including marital status, contact frequency, network size, and social support, have been linked with increased cognitive capability. However, the underlying mechanisms remain poorly understood. We aim to investigate whether depression symptoms and inflammatory biomarkers mediate associations between SH and cognitive outcomes.Methods:We used data from waves 1-9 of the English Longitudinal Study of Ageing, involving 7,136 participants aged 50 or older at baseline. First, we examined associations between SH (wave 1) and depression and inflammatory biomarkers (C-reactive protein (CRP) and fibrinogen) (wave 2) using linear regression models. Second, we tested associations between a) SH and b) depression and inflammation with subsequent standardised verbal fluency and memory in wave 3 and change between waves 3-9, indexed using slopes derived from multilevel models. We adjusted for age, sex, socio-economic position, cardiovascular disease, basic and instrumental activities of daily living, health behaviours, and baseline depression symptoms and cognition. We will also conduct causal mediation analysis.Results:All SH markers, except contact frequency, were associated with lower subsequent depression, but not inflammatory biomarkers. Greater contact frequency (e.g. once-twice a week vs &lt;once per year: β=0.18 [0.01, 0.36]) and less negative support (β=0.02 [0.00, 0.03]) were associated with higher verbal fluency. Larger network size (&gt;6 people vs none: β=0.007SD/year [0.001, 0.012]), less negative (β=0.001SD/year [0.001, 0.002]) and more positive support (β=0.001SD/year [0.000, 0.001]) were linked with slower memory decline, and more positive support predicted slower verbal fluency decline (β=0.001SD/year [0.000, 0.001]). Depression symptoms were associated with lower memory and verbal fluency, and faster memory decline (β=-0.001SD/year [-0.001, -0.000]) and verbal fluency (β=-0.001SD/year [-0.001, -0.000]). CRP was associated with lower verbal fluency (β=-0.02 [-0.04, 0.00]), whereas fibrinogen was linked with faster memory decline (β=-0.001SD/year [-0.003, -0.000]).Conclusion:Depression symptoms and SH showed associations with subsequent cognitive capability and change. SH was linked with lower depression, but not inflammatory biomarkers. Findings highlight the potential for depression to underpin associations between SH and cognition, a pathway which we will test using causal mediation analysis. We will also examine whether findings replicate in the Swedish National Study of Aging and Care in Kungsholmen.

The RESIST Study: Do TNF Inhibitors Protect Against Cognitive Decline in Rheumatoid Arthritis Patients With Mild Cognitive Impairment?

AbstractBackgroundRheumatoid arthritis (RA) is an autoimmune disease characterised by chronic inflammation in the joint synovium. Considering growing research interest into the role that systemic inflammation might play in the pathogenesis of Alzheimer’s disease (AD), studying cognitive decline in RA patients can provide important insights into the potential effects of inflammation on cognitive health. Furthermore, evidence suggests that biological drugs used to treat RA, specifically TNF inhibitors (TNFi), may protect against AD progression by reducing systemic inflammation. The rheumatoid arthritis medication and memory study (RESIST) is a multicentre longitudinal observational study which aims to compare rates of cognitive decline in adults with both RA and mild cognitive impairment who are on either a conventional synthetic disease modifying anti‐rheumatic drug (csDMARD) or a TNFi.Method251 participants were recruited (160 on csDMARDs, 91 on TNFis). Participants completed assessments at six‐month intervals for eighteen months. The primary outcome was performance on the Free and Cued Selective Reminding Test (FCSRT). It was hypothesised that the rate of decline in FCSRT score would be lower among participants taking TNFis.ResultBetween‐groups ANCOVA was conducted to compare mean FCSRT scores at 12/18 months, adjusting for baseline score, age, disease activity, pain, wellbeing, depressive symptoms and physical function. Results showed that neither group declined in FCSRT free recall score on average over the 18 month follow‐up period, and that there was no significant difference between groups at 12 (mean difference = 0.59, 95% CI = ‐1.54, 2.72) or 18 months (mean difference = 1.24, 95% CI = ‐0.99, 3.47).ConclusionThe absence of decline in FCSRT performance in either group was unexpected. These findings raise the possibility that both csDMARDs and TNFis may protect against cognitive decline However, a major limitation of the study was attrition due to the COVID‐19 pandemic, which may have influenced results – those who experienced a greater degree of cognitive decline may have been more likely to withdraw from the study. Additional planned analyses will examine the potential moderating effect of APOE genotype, and the relationship between peripheral serum C reactive protein, cytokine levels and cognitive outcomes.