Geriatric Depression Scale Score Research Articles

Habitual tea consumption was associated with lower levels of depressive symptoms among older Chinese: Guangzhou Biobank Cohort Study

Previous studies showed that some components in tea had potential beneficial effects on depression. However, population-based studies examining the potential benefits of tea on depression are limited. We hypothesized that older Chinese with habitual tea consumption had lower levels of depressive symptoms than those without habitual tea consumption. A cross-sectional analysis of baseline data from the Guangzhou Biobank Cohort Study was conducted. Depressive symptoms were measured by the 15-item Geriatric Depression Scale (GDS) score (continuous), with the presence defined by a GDS ≥ 8. Of 10,014 participants, 421 (4.20%) had depressive symptoms. After adjusting for potential confounders, compared with never-consumers, occasional and regular consumers had lower GDS scores (β [95% confidence interval]: -0.29 [-0.46, -0.11] and -0.60 [-0.78, -0.42], respectively), and regular consumers showed lower odds of depressive symptoms (odds ratio [95% CI]: 0.51 (0.35-0.72). In regular tea consumers, greater frequency, amount per occasion and per week, and higher amount-years showed lower GDS score (all P for trend <0.001) and lower odds of depressive symptoms (all P for trend < .05) than nonconsumers. The results were similar by different types of tea (green tea, black tea, and oolong tea) consumed. Further adjustment for social characteristics of tea consumption attenuated the association slightly but not fully. In conclusion, habitual tea consumption was associated with lower levels of depressive symptoms among older Chinese, which might be partly explained by social interaction during consumption. Further investigation on causation and mechanisms, including mechanistic randomized controlled trials is warranted.

Learning about the Experience of Amyloid imaging and early RecogNition of Alzheimer's Disease in Veterans and Their Caregivers: Overview of the LEARN-AD Study

Learning about the Experience of Amyloid imaging and early RecogNition of Alzheimer's Disease in Veterans and Their Caregivers: Overview of the LEARN-AD Study

The Association between Cognitive Reserve and Depressive Mood in Older Inpatients: Gender and Age Differences

ABSTRACT Cognitive Reserve (CR) plays a protective role in neurological and acute/chronic diseases. Its effect on mood, however, is still unclear, although it may be relevant in a hospital setting. We aimed to explore the relationship between CR and depressive mood in older inpatients, evaluating possible gender- and age-related differences. This study involved 86 inpatients aged ≥65 years with an MMSE ≥15. Participants underwent a multidimensional evaluation that included the assessment of CR with the Cognitive Reserve Index questionnaire, divided into three sections (Education, Working Activity, and Leisure Time). Depressive mood was assessed with the 15-item Geriatric Depression Scale (GDS). The relationship between CR and GDS was evaluated by multivariable linear regressions. Significant inverse associations between CR and GDS scores emerged in the total sample (β = −0.03 [SD = 0.02], p = .047), especially in men (β = −0.05 [SD = 0.02], p = .005) and in individuals aged <85 years (β = −0.07 [SD = 0.03], p = .01). Among the single CRI sections, CRI-Leisure Time was significantly associated with GDS in the total sample, in men, and participants <85 years. CR seems to be inversely associated with depressive mood in older inpatients. This relationship is particularly marked for CR related to Leisure Time, which may be modifiable even in older age through social support and interaction.

Lifetime pathogen burden, inflammatory markers, and depression in community-dwelling older adults

The link between pathogen exposure and mental health has long been hypothesized, but evidence remains limited. We investigated the association of seropositivity to common pathogens and total pathogen burden with depression and mental health and explored the role of mediating inflammatory cytokines. We profiled in 884 participants in the Singapore Longitudinal Ageing Studies, mean (SD) age: 67.9 (8.1) years, their seropositivities for 11 pathogens (CMV, HSV 1, HSV 2, HHV-6, EBV, VZV, RSV, Dengue, Chikungunya, H. Pylori and Plasmodium) and pathogen burden, Geriatric Depression Scale (GDS) score at baseline and 3–4 and 6–8 years follow-up, and baseline Mental Component Score (MCS) of 12-Item Short Form Survey (SF-12). Inflammatory markers included CRP, TNF-α, IL-6, MIP-1α, sgp130, sTNF-RI, sTNF-RII, C3a, and MCP-2. Controlling for age, sex, ethnicity, education, marital status, living alone, and smoking status, high pathogen burden (7 + cumulative infections) compared to low pathogen burden (1–5 cumulative infections) was significantly associated with period prevalence (the highest GDS score from baseline and follow-up measurements) of depressive symptoms (OR = 2.36, 95% CI = 1.05–5.33) and impaired mental health (OR = 2.25, 95% CI = 1.18–4.30). CMV seropositivity and HSV1 seropositivity, which are highly prevalent and most widely studied, were associated with estimated 2-fold increased odds of depression, but only HSV1 seropositivity was significantly associated with depression after adjusting for confounders. Notably, adjusted for confounders, RSV, H. pylori and Plasmodium seropositivity were significantly associated with increased odds, and Dengue seropositivity was associated with unexpectedly deceased odds of depressive symptoms and impaired mental health. The association of pathogen exposure with depression and mental health were at least in parts explained by inflammatory markers. Adding certain inflammatory markers to the models attenuated or weakened the association. Bootstrap method showed that MIP-1α significantly mediated the association between pathogen burden and mental health. In conclusion, lifelong pathogen burden and specific infections are associated with depression and impaired mental health in older adults.

Muscle Strength Moderates the Relationship between Nutritional Health Risk and Depression in Korean Older Adults.

Background: Little is known about the relationships between muscle strength and nutritional health risk with late-in-life depression. This study aimed to investigate the moderating effect of lower-extremity muscle strength on the relationship between nutritional health risk and depression in Korean older adults. Methods: Data obtained from 5949 women and 3971 men aged ≥ 65 years in the 2020 Korea Longitudinal Study on Aging were used in this study. Exposures included lower-extremity muscle strength and nutritional health risk. Lower-extremity muscle strength was measured with a modified sit-to-stand test. The nutritional health risk was assessed using a screening tool. Depression was defined as a score ≥ 8 points on the Geriatric Depression Scale (GDS). Results: Logistic regression analyses showed that depression was positively associated with nutritional health risk (p < 0.001) and inversely associated with lower-extremity muscle strength (p < 0.001). A moderation analysis with Andrew Hayes’ PROCESS macro showed a significant moderating effect of lower-extremity muscle strength (β = −0.119; 95% confidence interval, −0.172 to −0.066; p < 0.001) on the relationship between nutritional health risk and depression; the weaker was the muscle strength, the steeper was the slope of the GDS score for nutritional health risk. Conclusions: The current findings suggest the need for an intervention targeting both high nutritional risk and weak muscle strength as a therapeutic strategy against depression in Korean older adults.

Factors influencing changes in daily life due to the state of emergency among older adults living in Akita Prefecture

The present study is assessed the effects of COVID-19 on the mental and physical function after the declaration of an emergency situation, which included the request that residents refrain from going out, in order to prevent the spread of COVID-19 infection. The investigation was conducted from 2019 to 2020. Our samples consisted of 506 older adults (332 people in 2019 and 174 people in 2020), whose physical, cognitive, depression, and independence in daily and social activities were measured annually. Furthermore, a questionnaire survey (COVID-19 questionnaire) on the impact of the spread of COVID-19 infection on respondents' daily lives (reduction in social interaction, going out, exercise, and sleep time) was conducted among participants in 2020. According to a statistical analysis, the UWS (Usual Walking Speed) was significantly faster in 2020 than it had been in 2019 (p<0.000). However, no significant differences were found in other items. A correlation analysis, revealed a significant association between the reduction in sleep time and GDS-15 (Geriatric Depression Scale) score (r=0.200, p=0.019) and between the COVID-19 questionnaire total score and body mass index (r=0.282, p=0.001).These results suggest that the decline in the physical and mental function might not have been evident in older adults in Akita Prefecture, where the number of infected people is small, although a more detailed long-term follow-up is needed. Even in such areas, there might be a significant relationship between depression and sleep or between changes in daily life due to self-imposed restraint and obesity as an effect of self-imposed restraint among older adults.

The effectiveness of yoga therapy to reduce the level of depression among elderly in the community

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; : Depression is one of the most common diseases among the elderly. Depression indicates disturbances in mood, physical and cognitive symptoms. Depression symptoms related to mood disorders include sadness, loss of interest in activities, worthlessness, and death, and suicidal thoughts. Early detection of depression in elderly can be noticed if the elderly have been known to possess factors that may cause depression. Yoga is a non-pharmacological therapy used to treat depression. Yoga movements consist of three stages, pranayama (breath control), asana (body temperature), and meditation (relaxation of the mind), these movements are very important to overcome stress and depression problems. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Objectives&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; : To purpose the effectiveness of yoga therapy in reducing depression in the elderly in the community. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Methods&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; : This research uses the quantitative research method with quasi-experimental with pre-test post-test design without control. The research site was in Gedongan Village, Baki Sub district, Sukoharjo, Central Java, in March-May 2021, with a total of 47 elderly using the purposive sampling method. Inclusion criteria include 60 years old, GDS score minimum 5, no extremity disorders, and Muslim. Screening for depression employed the Geriatric Depression Scale (GDS). The media used were videos and booklets, using Islamic religious classical music and data analysis used the Wilcoxon test. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Results&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; : The average depression level of respondents during the pre-test was 8.40 while the post-test decreased to 4.77 or a mean difference of 3.63 with a p-value of 0.001 (p &amp;lt;0.05). Yoga therapy and breathing program have a remarkable and refreshing effect. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Conclusion&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; : The conclusion is that the level of depression in the elderly resulted in a higher pre-test average value than the post-test value, which means that the level of depression after yoga therapy has decreased.&lt;/em&gt;&lt;/p&gt;

Relationship between Eating Alone and Poor Appetite Using the Simplified Nutritional Appetite Questionnaire.

One prominent factor associated with malnutrition is poor appetite. In Japan, the number of older adults living alone has increased annually. Those living alone tended to eat alone, which may lead to poor appetite. This study aimed to investigate the association between eating alone and poor appetite using an index called the Simplified Nutritional Appetite Questionnaire (SNAQ). We surveyed 818 people aged 70 and over in Takashimadaira, Itabashi-ku, Tokyo, Japan, in 2016. Comparisons were made between two groups, a poor appetite group (n = 295) and a good appetite group (n = 523), and results indicate that the poor appetite group had a higher rate of eating alone than the good appetite group (38.0% vs. 20. 1%: p < 0.001). Multivariable logistic regression (OR; 95%CI) was performed and poor appetite was significantly associated with the Geriatric Depression Scale (GDS) score (1.707; 1.200–2.427), the number of medications (1.061; 1.007–1.118), JST score (0.894; 0.841–0.950), the indication of “very healthy” on a self-rated health scale (0.343; 0.152–0.774), and reports of eating alone (1.751; 1.130–2.712). Our results suggest that eating alone is associated with a poor appetite.

Effects of Sodium Benzoate, a D-Amino Acid Oxidase Inhibitor, on Perceived Stress and Cognitive Function Among Patients With Late-Life Depression: A Randomized, Double-Blind, Sertraline- and Placebo-Controlled Trial.

BackgroundCompared with adults with depression in the general population, elderly depressive patients are prone to poor treatment response, more side effects, and early withdrawal with current antidepressants (which principally modulate monoamines). Whether N-methyl-D-aspartate receptor enhancement can benefit treatment of late-life depression deserves study. This study aims to compare sodium benzoate (a D-amino acid oxidase inhibitor and an indirect N-methyl-D-aspartate receptor enhancer), sertraline (a selective serotonin reuptake inhibitor), and placebo in the treatment of late-life depression.MethodsIn this randomized, double-blind trial, 117 patients with major depressive disorder aged 55 years or older received 8-week treatment of 250–1500 mg/d of sodium benzoate, 25–150 mg/d of sertraline, or placebo in 2 medical centers. The primary outcome measures were Hamilton Depression Rating Scale and Perceived Stress Scale scores.ResultsThree treatments similarly decreased clinicians-rated Hamilton Depression Rating Scale scores. Compared with placebo, sodium benzoate but not sertraline substantially improved Perceived Stress Scale scores and cognitive function. Sertraline, but not benzoate, significantly reduced self-report Geriatric Depression Scale scores. Benzoate and placebo showed similar safety profiles, while sertraline was more likely to raise low-density lipoprotein than benzoate and placebo. Benzoate-treated patients were less likely to drop out than sertraline or placebo recipients.ConclusionsSertraline can reduce subjective depressive symptoms, while benzoate can decrease perceived stress, improve cognitive function, and enhance treatment adherence in late-life depression patients. The results show promise for D-amino acid oxidase inhibition as a novel approach for perceived stress and cognitive decline among patients with late-life depression.Trial RegistrationClinicalTrials.gov Identifier: NCT03414931. Registered January 2016.

Characteristics of Dysregulated Proinflammatory Cytokines and Cognitive Dysfunction in Late-Life Depression and Amnestic Mild Cognitive Impairment.

BackgroundLate-life depression (LLD) and amnestic mild cognitive impairment (aMCI) are two different diseases associated with a high risk of developing Alzheimer’s disease (AD). Both diseases are accompanied by dysregulation of inflammation. However, the differences and similarities of peripheral inflammatory parameters in these two diseases are not well understood.MethodsWe used Luminex assays to measure 29 cytokines simultaneously in the plasma of two large cohorts of subjects at high risk for AD (23 LLD and 23 aMCI) and 23 normal controls (NCs) in the community. Demographics and lifestyle factors were also collected. Cognitive function was evaluated with the Chinese versions of the Montreal Cognitive Assessment (C-MoCA) and neuropsychological test battery (NTB).ResultsWe observed a remarkably increased level of IL-6 in the plasma and reduced levels of chemokines (CXCL11 and CCL13) in the LLD group compared with the aMCI group. The LLD group also showed lower levels of CXCL16 than the NC group. Furthermore, altered cytokine levels were associated with abnormal results in neuropsychological testing and Geriatric Depression Scale scores in both the LLD and aMCI groups. Notably, combinations of cytokines (IL-6 and CCL13) and two subitems of C-MoCA (orientation and short-term memory) generated the best area under the receiver operating characteristic curve (AUROC = 0.974).ConclusionA novel model based on proinflammatory cytokines and brief screening tests performs with fair accuracy in the discrimination between LLD and aMCI. These findings will give clues to provide new therapeutic targets for interventions or markers for two diseases with similar predementia syndromes.

Prevalence and associated factors of depression among elderly patients attending the primary health clinic in Prince Mansour Military Hospital in Taif, Saudi Arabia.

Depression in the elderly is a common, debilitating, and costly condition. Little is known about the prevalence and correlates of geriatric depression in Saudi Arabia. This study evaluates the prevalence of depression among the elderly and its associated risk factors. A cross-sectional, questionnaire-based descriptive study was conducted on 259 elderly patients attending the Prince Mansour Military Hospital emergency department family medicine clinic in Taif city. Geriatric Depression Scale (GDS) was used. The mean score was 4.4 (standard deviation [SD] = 2.56), ranging between 0 and 13. The median GDS score was 4. According to the results of this study, Cronbach's alpha for the GDS was 0.61 (95% confidence interval: 0.54-0.68). The prevalence of depression among the study participants was 43.2%. According to the GDS score categorization, 36.3% were mildly depressed, 4.2% were moderately depressed, and 2.7% were severely depressed. The adjusted effect was statistically significant for male gender (odds = 0.39, P < 0.001), older age (odds = 1.11, P = 0.007), diabetes mellitus (odds = 3.04, P = 0.02), asthma (odds = 25.94, P < 0.001), and renal failure (odds = 114.27, P = 0.03). Identification and treatment of geriatric depression should be prioritized by the family physicians in Saudi Arabia. Further research should focus on designing better culture-friendly geriatric depression screening tools.

Cognitive Evidence on EEG-P300 in Healthy Individuals with High Depression Scores

Background: Depression is common among elderly and middle-aged individuals and is a reason for decreased quality of life. Depression may lead to impairments in cognitive abilities. The P300 potential is one of the most used event-related potentials (ERPs) to evaluate cognition. This study investigated the P300 amplitude differences between individuals with depressive symptoms and nondepressed healthy elderly individuals. Materials and Methods: The current study included twenty individuals with high depression scores (high DS, age: 64.80 ± 7.22, 6 M/14 F) and twenty demographically matched participants with low depression scores (low DS, age: 64.20 ± 6.21, 7 M/13 F). The Geriatric Depression Scale (GDS) was used to evaluate whether participants have depressive symptoms. All of the participants were underwent a comprehensive neuropsychological battery. The ERPs were recorded with a visual classical oddball paradigm. The P300 amplitudes were measured in the 250–550 ms time window. Results: High DS group had lower P300 amplitudes than low DS individuals regardless of electrode location. Correlation analyses showed that there was a significant correlation between GDS scores and the P300 amplitudes recorded from the Fz electrode. Conclusion: The current study showed the reduced P300 amplitudes on individuals with high GDS scores. The P300 potential may be a useful tool to determine possible changes or impairments due to subthreshold depressive symptoms.

Assessment of nutritional status of community-dwelling older adults in rural North India using mini nutritional assessment-short form

Objective: challenges of geriatric populace are plentiful and vexing, malnutrition being a critical issue. We studied the burden of malnutrition and determined its association with socio-demographic factors, depression, and other health variables. Methods: A cross-sectional study was conducted among 162 community-dwelling older adults to screen for malnutrition using mini nutritional assessment short-form (MNA-SF). Pearson's Chi-square test, one-way analysis of variance, correlation, and Multinominal logistic regression were used for data analysis. Results: Four-point nine percent older adults were malnourished and 42.6% were at risk of malnutrition. Malnutrition was higher in 60–69 years of age group (5.95%) and females (6.9%), while risk of malnutrition was high among >80 years (59.1%) and widowed (66.7%). Weight loss, decrease in food intake, dementia, stress, decreased mobility, and depression were significantly associated with malnutrition. Geriatric Depression and MNA-SF scores showed a significant negative correlation (r = −0.434). Comparison of means of MNA-SF and geriatric depression scale scores among well-nourished, at risk, and malnourished subjects showed significant difference (P < 0.001). Multinominal regression revealed that it is highly likely (P < 0.01) that the subjects were malnourished if they had body mass index <19 kg/m2, reported weight loss >3 kg or suffered from acute disease or stress in the past 3 months while the likelihood of being “at risk” increased significantly only if subjects had acute disease or stress in preceding 3 months. Conclusions: Screening with MNA-SF can help identify at low cost a sizable proportion of elderly who are malnourished and “at risk.” Timely intervention can be instrumental in preventing the progression of infirmity and reducing its catastrophic consequences.

Anxiety and Depressive Symptoms and Cortical Amyloid-β Burden in Cognitively Unimpaired Older Adults.

There is evidence of relationships between behavioral symptoms and increased risk for Alzheimer's Disease and/or Alzheimer's Disease biomarkers. However, the nature of this relationship is currently unknown. To evaluate the relationship between anxiety and depressive symptoms and amyloid-β deposition in cognitively unimpaired older adults, and to assess mediating effects of either objective or subjective cognitive skills. Cross-sectional analysis of screening data from participants enrolled in the Anti-Amyloid Treatment in Asymptomatic Alzheimer Disease (A4) Study (ClinicalTrials.gov Identifier: NCT02008357). Data analysis. 4492 cognitively unimpaired adults, age 65-85, enrolled in the Anti-Amyloid Treatment in Asymptomatic Alzheimer Disease (A4) Study. We used linear regression to estimate the associations between amyloid-β standard uptake value ratio (SUVR) and Geriatric Depression Scale (GDS) and State Trait Anxiety Inventory (STAI) scores while adjusting for potential confounding factors as well as for Cognitive Function Index (CFI) or Preclinical Alzheimer's Cognitive Composite (PACC) scores as possible mediational variables. 4399 subjects with complete covariates were included (mean age: 71.3, 59% female), GDS ranged 0-13 (mean: 1.0), and STAI ranged 6-24 (mean: 9.9). Amyloid-β SUVR was modestly associated with STAI; mean STAI score was estimated to be 0.275 points higher (95% CI: 0.038, 0.526; p-value = 0.023) for each 0.5-point increase in cortical amyloid-β SUVR. Subjective cognitive decline (CFI) attenuated the relationship between SUVR and STAI, while objective cognitive function (PACC) did not. No statistically significant relationship between SUVR and GDS was observed (p = 0.326). In cognitively unimpaired adults with low levels of depression and anxiety, cortical amyloid-β deposition is associated with anxiety but not depressive symptoms. Attenuation of this relationship by subjective cognitive difficulties suggests that anxiety may be partly due to such a perception resulting from cortical amyloid-β deposition.

Associations between age-related hearing loss, cognitive decline, and depression in Chinese centenarians and oldest-old adults.

Objective:Age-related hearing loss (ARHL) and age-related cognitive decline (ARCD) are leading causes of disability in older adults. ARHL may increase ARCD risk and cause depression development. This study aimed to explore the associations of ARHL with ARCD and depression in Chinese centenarians and oldest-old adults.Methods:A household survey was conducted on 859 centenarians and oldest-old adults residing in 16 cities and counties in China. Basic information was collected using interview questionnaires, physical examinations, and blood tests conducted by systematically trained local doctors and nurses.Results:In total, 501 (58.3%), 649 (75.6%), and 211 (24.6%) participants had ARHL, ARCD, and depression, respectively. The prevalence of ARCD and depression was significantly higher in participants with ARHL than in those without ARHL (all p < 0.05). Participants with ARHL had significantly lower Mini-Mental State Examination (MMSE) scores indicative of more cognitive decline, and significantly higher 15-item version of the Geriatric Depression Scale (GDS-15) scores suggesting greater levels of depression, than those without ARHL (all p < 0.05). Multivariate logistic regression analyses (Stepwise) indicated that ARHL was significantly and positively associated with ARCD [odds ratio (OR): 1.594, 95% confidence interval (CI): 1.132, 2.245] and depression (OR: 1.623, 95% CI: 1.139, 2.314; all p < 0.05). Multivariate linear regression analyses (Stepwise) indicated that ARHL was significantly and inversely associated with MMSE scores (B: −2.520, 95% CI: −3.356, −1.684) and significantly and positively associated with GDS-15 scores (B: 0.713, 95% CI: 0.328, 1.098; all p < 0.05).Conclusion:ARHL is independently associated with ARCD and depression in Chinese centenarians and oldest-old adults.

The Association between Leisure and Physical Activity Level with Depressive Symptoms after 5-years of follow-up

BACKGROUND: Depressive symptoms in older adults are associated with socioeconomic status (SES), medical care, and physical activity. However, there is little evidence on the longitudinal association between level of leisure activity (LA) and physical activity (PA) with depressive symptoms among community-dwelling older adults in Iceland. The study examined an association of LA and PA at baseline with high depressive symptoms (HGDS) assessed after 5 years of follow-up among community-dwelling older adults. METHODS: A large community-based population residing in Reykjavik, Iceland participated in a longitudinal study with 5 years of follow-up (n=2957, 58% women, 74.9±4.8 yrs). Those with HGDS or dementia at baseline were excluded from the analysis. The reported activity was categorized into 2 groups as no-activity versus any-activity. Depressive symptoms were assessed by the 15-item Geriatric Depression Scale (GDS) on average 5 years later. RESULTS: After adjusting for demographic and health-related risk factors, those who reported having any LA had significantly fewer HGDS after the follow-up of 5 years (6 or higher GDS scores, Odds Ratio (OR) = 0.46, 95% Confidence Interval (CI): 0.27 ~ 0.76, P = 0.003). However, reporting any PA at baseline was not significantly associated with HGDS (OR = 0.71, 95% CI: 0.51 ~ 1.00, P = 0.053). CONCLUSION: Our study shows that any LA among older adults is associated with having less depressive symptoms 5 years later among community-dwelling older adults while having any PA was not associated with depressive symptoms after 5 years of follow-up.

The Association Between Midlife Education and Depressive Symptoms in Late Life: The AGES-Reykjavik Study

BACKGROUND: Disability and depression are associated with cumulative health adversities such as socioeconomic status (SES), nutrition, medical care, and education among older adults. However, there is little evidence on the longitudinal association between mid-life education level with a disability and depressive symptoms in older adults in Iceland. The aim of the study was to examine the association between mid-life education and prevalence of activity of daily living (ADL) dependency and high depressive symptoms in late-life. METHODS: A large community-based population residing in Reykjavik, Iceland (n=4991, 57.3% women, 76.9±5.8 yrs) participated in a longitudinal study with an average of 25 years of follow-up. Mid-life education was categorized into 4 groups (primary, secondary, college, and university). ADL dependency and high depressive symptoms were assessed on average 25 (±4) years later. The 5-item ADL dependency score ranged between 0 (no difficulty) and 18. Depressive symptoms were assessed by the 15-item Geriatric Depression Scale (GDS). RESULTS: After controlling for demographic and health-related risk factors, those with higher education at mid-life were significantly less likely to have high depressive symptomatology (6 or higher GDS scores, Odds Ratio (OR) = 0.65, 95% Confidence Interval (CI): 0.52 ~ 0.82, P < 0.0001). However, mid-life education was not associated with ADL dependency in later life. CONCLUSION: Our study shows that mid-life education is associated with depressive symptoms 25 years later, while no association found with ADL dependency among Icelandic older adults.

Neurodegeneration and Vascular Burden on Cognition After Midlife: A Plasma and Neuroimaging Biomarker Study.

Background and Objectives: Neurodegeneration and vascular burden are the two most common causes of post-stroke cognitive impairment. However, the interrelationship between the plasma beta-amyloid (Aβ) and tau protein, cortical atrophy and brain amyloid accumulation on PET imaging in stroke patients is undetermined. We aimed to explore: (1) the relationships of cortical thickness and amyloid burden on PET with plasma Aβ40, Aβ42, tau protein and their composite scores in stroke patients; and (2) the associations of post-stroke cognitive presentations with these plasma and neuroimaging biomarkers.Methods: The prospective project recruited first-ever ischemic stroke patients around 3 months after stroke onset. The plasma Aβ40, Aβ42, and total tau protein were measured with the immunomagnetic reduction method. Cortical thickness was evaluated on MRI, and cortical amyloid plaque deposition was evaluated by 18F-florbetapir PET. Cognition was evaluated with Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Dementia Rating Scale-2 (DRS-2).Results: The study recruited 24 stroke patients and 13 normal controls. The plasma tau and tau*Aβ42 levels were correlated with mean cortical thickness after age adjustment. The Aβ42/Aβ40 ratio was correlated with global cortical 18F-florbetapir uptake value. The DRS-2 and GDS scores were associated with mean cortical thickness and plasma biomarkers, including Aβ42/Aβ40, tau, tau*Aβ42, tau/Aβ42, and tau/Aβ40 levels, in stroke patients.Conclusion: Plasma Aβ, tau, and their composite scores were associated with cognitive performance 3 months after stroke, and these plasma biomarkers were correlated with corresponding imaging biomarkers of neurodegeneration. Further longitudinal studies with a larger sample size are warranted to replicate the study results.

Gait speed is associated with changes in number of depression symptoms in older adults with type 2 diabetes

AbstractBackgroundWe examined the longitudinal relationships between motor function and number of depression symptoms, both important predictors of poor health‐related outcomes, including cognitive impairment, in old age. Analyses were based on initially cognitively normal older adults with type 2 diabetes (T2D) participating in the longitudinal Israel Diabetes and Cognitive Decline (IDCD) study.MethodSubjects [n=984; mean age 72 (SD=5); 40.4% female] underwent evaluations of motor functions‐ gait speed, measured by time to walk 3 meters (mean = 4.37 seconds; SD=2.35) and handgrip strength (mean 29 Kg; SD=10), and number of depression symptoms, assessed by the 15‐item version of the Geriatric Depression Scale (GDS) (mean=2, SD=2), at baseline and approximately every 18 months thereafter. Hierarchical Linear Mixed Models (HLMM), adjusting for demographic and cardiovascular risk factors as well as overall cognition, modeled the effects of motor function on repeated GDS scoresResultLower mean gait speed (based on all gait speed measurements) was associated with higher mean GDS scores (p=0.003) (based on all GDS measurements). A greater change in gait speed between measurements was associated with greater degree of change in GDS scores over the study period (p=0.034). Handgrip strength was not associated with number of depression symptoms or with their change over timeConclusionIn older adults with T2D, lower gait speed was associated with a greater number of depression symptoms. The degree of change in walking speed was associated with degree of change in GDS, such that greater increase in 3‐meters' walking time was associated with a greater increase in number of depression symptoms over time. Future studies should examine why gait speed, but not grip strength, was associated with depression. Slower gait speed due to depression, i.e. reverse causality, cannot be ruled out. Whether strategies for improvement of gait speed (e.g. physical activity) are effective in treatment or prevention of depressive symptoms in older adults with T2D merits investigation.

Prospective memory and depression symptoms in mild cognitive impairment

AbstractBackgroundProspective memory involves executing an intended action in the future. This cognitive ability declines in mild cognitive impairment (MCI) and Alzheimer’s disease and affects everyday functioning. Prospective memory is usually assessed by asking participants to execute a single action in the future. We developed a complex prospective memory test that involves selecting the correct action to execute based on the context of the situation. In this study, we examined both types of prospective memory and their relationships with depression symptoms. Prospective memory involves significant cognitive effort, which could be dampened by depression symptoms.MethodParticipants included healthy controls (n= 58) and persons with amnestic MCI (n= 28) and non‐amnestic MCI (n= 36). Before testing, all participants were informed that they should request a pill after completing each of 10 neuropsychological tests that would be administered. Simple prospective memory was assessed using the total number of correct requests. They were also told that if the most recent test involved memorization, they should request one pill, and if it did not, they should request two pills. The number of correct contingency‐based requests was used to assess complex prospective memory. The Geriatric Depression Scale (GDS) was used to measure depressive symptoms.ResultAnalyses of variance revealed that the amnestic MCI group performed significantly worse in simple prospective memory compared to both the controls and the non‐amnestic MCI group. The same pattern was found for complex prospective memory. We found that GDS scores did not predict prospective memory in any group.ConclusionOverall, we found that older adults with objective memory deficits (amnestic MCI) had difficulties with both simple and complex prospective memory, while those with no memory impairment (controls and non‐amnestic MCI) performed better on these tests. Importantly, depressive symptoms were not associated with performance on prospective memory tests for any of the groups. These findings suggest that prospective memory tests are useful for assessing MCI and are resistant to the impact of depressive symptoms.