Geriatric Depression Scale Score Research Articles

Depression in Older Adults: May Be the Mass Under the Tip of the Iceberg?

Aims: Our aim was to investigate the relationship between common geriatric syndromes and depression. Methods: 515 patients over 65 years old admitted to a university hospital participated in this cross-sectional study. The Beck Anxiety Inventory (BAI), the European Quality of Life (EQ-5D), and the Pittsburgh Sleep Quality Index (PSQI) were administered to the participants in addition to the Comprehensive Geriatric Assessment. The Geriatric Depression Scale (GDS) was used to assess depressive symptoms in persons 65 years and older. Results: The mean age of the participants was 72.26.3 years, and 133 (24.8%) of them scored high on the GDS for depression. The non-depressed group had lower rates of sarcopenia, fewer medications, lower BAI and PSQI scores, and higher EQ-5D and Instrumental Activities of Daily Living (IADL) scores. Correlation analysis showed that the GDS score was moderately positively associated with the number of medications (r = 0.351, p = <0.001), the BAI score (r = 0.638, p = <0.001), and moderately negatively associated with the IADL score (r = -0.355, p = <0.001) and the Mini Nutritional Assessment (MNA) score (r = -0.316, p = <0.001). After multivariate logistic regression analysis, IADL, MNA, and BAI scores were independently associated with depression (p = 0.026, OR = 0.72, p = 0.026, OR = 0.94, and p = <0.001, OR = 1.11, respectively). Conclusions: Interventions aimed at alleviating depressive symptoms may be an effective strategy for preventing the adverse consequences of depression that lead to deterioration in quality of life. Therefore, focusing on factors that are independently associated with depression, such as dependency in activities of daily living, anxiety symptoms, and poor nutritional status, may be a useful method in the management of older patients with depression.

The Relationship between Degree of Hearing Loss and Geriatric Depression Scale Scores in Geriatric Patients

Backgrounds: Hearing loss occurs in a third of the elderly population worldwide but is often overlooked. Studies have shown that hearing loss increases the risk of depression in the elderly population and reduces the quality of life. Objective: The objective of this study is to prove the relationship between hearing loss and depression in geriatrics and to assess the effect of physical illness in geriatric patients that may cause depression. Methods: This type of research is observational-analytic with a cross-sectional approach. The study was conducted at the geriatrics polyclinic, Dr. Soetomo Hospital. Results: There are 47 participants in this study who are outpatients of the geriatrics polyclinic that carried out by consecutive sampling. Data are retrieved from medical records and Geriatric Depression Scale (GDS) questionnaire interviews. The effect of physical illness was assessed as a confounding variable in this study. Data analysis used multiple linear regression, one-sample Kolmogorov–Smirnov test, and Spearman correlation test. Conclusion: This research found hearing loss in most geriatric patients, but the prevalence of depression in the study participants was low. The degree of hearing loss was not related to the GDS questionnaire score. Diabetes is a confounding factor in the onset of depression in study participants.

Increased depressive symptoms in Parkinson’s disease during the COVID‐19 pandemic: Preliminary findings from longitudinal analysis of the PHASE study

IntroductionThe cumulative number of patients has increased through the four waves of the pandemic in Japan. Many people experienced mental stress due to the fear of infection, and restrictions of leaving the house and leisure activities. No longitudinal study has assessed the fluctuation of neuropsychiatric symptoms during the COVID-19 pandemic using the same scale. We examined changes in non-motor symptoms, and the scores of a Parkinson’s Disease (PD)-specific questionnaire between the early and later periods during the COVID-19 pandemic. MethodsWe conducted a questionnaire survey during the first wave (from February to April 2020) and the fourth wave of the COVID-19 pandemic (from March to April 2021). We compared the number of symptoms from the two periods. ResultsCompared with the first wave, the Geriatric Depression Scale score was significantly higher in the fourth wave of the pandemic (median score of GDS: 4.00 vs. 5.50, p = 0.022). Consistently, the scores of symptoms on MDS-UPDRS part 1 in the fourth wave were significantly higher in hygiene (p = 0.033), handwriting (p = 0.033), performing hobbies and other activities (p = 0.035), and turning in bed (p = 0.046) than in the first wave. ConclusionsOur observation over a year between the early and later phases of the COVID-19 pandemic showed an increase in the severity of depression in patients with PD.

POLYPHARMACY IN ADULTS WITH CHRONIC DISEASE – CHARACTERISTICS AND ASSOCIATION WITH COGNITIVE DISORDERS

Polypharmacy in the elderly with multimorbidity in particular results in drug interactions and manifestation of cognitive impairments and functional deficits. To analyze the characteristics of polypharmacy, predictors affecting its variability and its impact on possible cognitive impairment in adults over 60 years of age with a diagnosed chronic disease at risk for dementia. A national prospective multicenter study started in 2022 in 46 outpatient clinics of family medicine specialists in primary care. Participants older than 60 years of age with a confirmed minimum of one chronic disease and at risk for dementia were included. A general and clinical information questionnaire and 3 standardized questionnaires were used – Mini-cog test, IADL test and Geriatric Depression Scale (GDS). Eight hundred fifty-eight participants were analyzed, with female predominance (57.69%). Sex and age as independent predictors significantly affected the variability of polypharmacy consistently 0.7% vs. 0.5%. Elevated cholesterol [OR=1.449 (1.09 – 1.92) 99% CI] and obesity [OR=1.695 (1.30 – 3.30) 99% CI] were associated with female sex. Four hundred ninety-seven participants (57.92%) received ≤2 groups of medications for treatment of chronic diseases. There was no significant association between the obtained Mini-cog test scores and the number of medication groups participants received (p=0.12). The higher GDS score was significantly associated with polypharmacy (p=0.03). A non-significant negative correlation was found between the IADL score and the number of medication groups used for therapy of chronic diseases (p=0.38).

Different metabolic and clinical profiles between patients with pure Alzheimer dementia and epileptic Alzheimer dementia: a metabolic study

Aim: To investigate the clinical characteristics and cerebral FDG PET metabolisms of dementia patients who were also diagnosed with epilepsy and compare the differences with pure Alzheimer dementia patients.Methods: In this case-control study, a total of 14 patients, 7 patients with pure Alzheimer disease as a control group and 7 age and gender-matched patients with Alzheimer disease and concomitant epilepsy as a study group, were included. Detailed neurocognitive battery and brain fludeoxyglucose positron emission tomography (FDG PET-CT) were performed for all subjects.Results: In comparison of neurocognitive test scores, there was no significant difference between the study and control groups. However, geriatric depression scale scores were significantly lower in study group than the controls (p= 0.026). In cerebral FDG-PET CT profiles of subjects we detected significantly lower metabolism in left and right cerebellum, left lentiform nucleus, right thalamus and vermis in the study group (p=0.008, p=0.023, p=0.003, p=0.002, p=0.002, respectively). In the right parietotemporal cortex and right and left associative visual cortex, we found higher metabolism in the study group than controls (p=0.023, p=0.012, p=0.003, respectively).Conclusion: Epileptic patients with Alzheimer’s dementia may have distinct clinical and metabolic profiles, than pure Alzheimer’s disease patients. Even if there is no difference in the neurocognitive clinical scores of the patients, depression and related functional abnormalities may be a biomarker of epileptic AD.

EFFECT OF THE RESIDENTIAL AREAS OF GERIATRICS LIVING IN TURKEY ON PHYSICAL ACTIVITY, DEPRESSION, AND QUALITY OF LIFE DURING THE COVID-19 PANDEMIC

Objective: The quarantine precautions implemented during the new type of coronavirus epidemic caused some changes in the daily lives of geriatric individuals. This study aimed to examine whether living in rural or urban areas affects physical activity, depression, and quality of life (QoL) in Turkish geriatrics during pandemic.
 Method: One hundred three geriatrics were assessed with the videoconferencing method, which was performed once. Participants were divided into two groups according to the area where they lived as rural (n:41) or urban (n:62). In addition, physical activity, presence of depression, and QoL of individuals were assessed with the Physical Activity Scale for the Elderly (PASE), Geriatric Depression Scale (GDS), and Short Form-36 (SF-36), respectively.
 Results: According to the results, PASE (p=0.677), GDS (p=0.742), and all sub-dimensions of SF-36 (p>0.05 for all) except pain (p=0.033) of geriatrics were similar in both groups. Also, while there is a low-level relationship between the GDS scores of those living in rural areas and the sub-dimensions of SF-36 physical function (r=-0.381), mental health (r=-0.381), and social functionality (r=-0.395), there was a moderate correlation between the vitality (r=-0.529) and pain (r=-0.536) sub-dimensions. In addition, a strong correlation was found between GDS and the general health perception sub-dimension of SF-36 (r=-0.611).
 Conclusion: The pandemic-induced quarantine precautions, which were put into effect throughout Turkey, negatively affected the daily life of all people, especially elderly individuals. Because of these precautions, the similarity of daily living activities of the elderly living in rural and urban areas may have caused similar physical activity, depression, and QoL scores.

A formula for calculating 30-item Geriatric Depression Scale (GDS-30) scores from the 15-item version (GDS-15)

The Geriatric Depression Scale with 30 items (GDS-30) and with 15 items (GDS-15) are both valid tools for assessing depression in older adults, but their absolute values are not directly comparable. Here, we used a dataset (n = 431) with GDS-30 scores from a project concerning fall-risk assessment in older adults (FARAO) to develop and validate a formula which can be used to convert GDS-15 scores into GDS-30 scores. We found that the GDS-15 score cannot simply be multiplied by 2 to obtain the GDS-30 scores and that estimations of GDS-30 from GDS-15 are not affected by age, sex and MMSE. Therefore, the optimal formula to estimate the GDS-30 score from the GDS-15 score was: GDS-30_estimated = 1.57 + 1.95 × GDS-15. This formula yielded an estimate of GDS-30 with an explained variance of 79 %, compared to 63 % when GDS-15 was simply multiplied by 2. Researchers that have used the GDS-15 and want to compare their outcomes to other studies that reported only the GDS-30 are advised to use this formula.

Exploring factors that influence HRQoL for people living with Parkinson’s in one region of Ireland: A cross-sectional study

BackgroundThe diversity of symptoms associated with Parkinson’s and their impact on functioning have led to an increased interest in exploring factors that impact Health-Related Quality of Life (HRQoL). Although the experience of Parkinson’s is unique, some symptoms have a greater impact than others, e.g. depression. Moreover, as the risk of Parkinson’s increases with age, the financial and public health impact of this condition is likely to increase, particularly within the context of a globally ageing population. In Ireland, research is ongoing in the pursuit of causes and effective treatments for Parkinson’s; however, its impact on everyday living, functioning, and HRQoL is largely under-examined. This study aims to describe factors that influence HRQoL for people with Parkinson’s (PwP) in one region of Ireland.MethodsA cross-sectional postal survey was conducted among people living with Parkinson’s (n = 208) in one area of Ireland. This survey included socio-demographic questions, Nonmotor Symptoms Questionnaire for Parkinson’s disease (NMSQuest), the Geriatric Depression Scale (GDS-15), and the Parkinson’s disease Questionnaire (PDQ-39). Statistical analysis was conducted using SPSS, IBM version 25 (SPSS Inc., Chicago, II, USA).ResultsParticipants reflected a predominantly older population who were married, and lived in their own homes (91%). Participants diagnosed the longest reported poorer HRQoL regarding mobility, activities of daily living, emotional well-being, social support, cognition, communication domains and overall HRQoL. Lower HRQoL correlated with higher depression scores p < 0.001 and participants in the lower HRQoL cohort experienced 2.25 times more non-motor symptoms (NMSs) than participants with higher HRQoL. Hierarchical multiple linear regression analysis predicted Geriatric Depression Scale (GDS15) score, NMS burden, and years since diagnosis to negatively impact HRQoL. Principal component analysis (PCA) also indicated that for the population in this study, components measuring 1) independence/dependence 2) stigma 3) emotional well-being, and 4) pain were central to explaining core aspects of participants’ HRQoL.ConclusionsFindings highlighted the negative impact of longer disease duration, NMS burden, depression, mobility impairments, and perceived dependence on HRQoL for PwP. The positive influence of perceived independence, social engagement along with close supportive relationships were also identified as key components determining HRQoL. Findings emphasised the importance of long-term healthcare commitment to sustaining social and community supports and therapeutic, rehabilitative initiatives to augment HRQoL for PwP.

Hormones and depression in the advanced age.

In older people, depression and mental disability are more frequently present than in younger subjects. It is found that depressionis a risk factor for dementia, just as dementia is a risk factor for depression. In turn, both disturbances are known to be influenced by hormones. The present study aimed to see whether the hormonal changes in subjects over 75 years old correlate with the symptoms of depression measured using the Geriatric Depression Scale (GDS). In a group of patients aged over 75 years, concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), oestradiol, testosterone, dehydroepiandrosterone sulphate (DHEAs), and cortisol were measured in serum with the use of chemiluminescence. The symptoms of depression were estimated by GDS, and the mental functions were assessed by the Mini-Mental State Examination (MMSE). The correlations between the obtained results were estimated by Spearman's test. A significant correlation between GDS and MMSE scores was observed in the investigated patients. Some statistically significant correlations concerning cortisol and testosterone with GDS were observed in women, but not in men. On the other hand, no significant correlations between concentrations of FSH, LH, DHEAs, and oestradiol with GDS were noticed. Our data support the role of cortisol (possibly secreted during chronic stress) in the risk of depression. The gender difference in the mechanism of depression and stress in older age could be also hypothesized.

DEPRESSION IS ASSOCIATED WITH POORER CLINICAL FUNCTIONING AMONG HISPANIC OLDER ADULTS

Abstract Objective The aim of the current study was to examine associations between depression and clinical functioning among a multi-ethnic sample. Methods 35 cognitively normal and Mild Cognitive Impairment (MCI) participants were included and self-identified as Hispanic or white non-Hispanic (WNH). The Hispanic group (n=18), had a mean age of 70.83 (SD=7.66) and 15.59 mean years of education (SD= 3.43). The WNH group (n=17) had a mean age of 71.76 (SD=6.9) and 16.81 mean years of education (SD=2.59). Subjects were given the Alzheimer’s disease Cooperative Study (ADCS) ADL inventory, the modified Clinical Dementia Rating scale (mCDR), and the Geriatric Depression Scale (GDS). Linear regressions were conducted to analyze the predictive associations between GDS scores and ADL functioning while controlling for the effect of diagnosis and age. Results Among Hispanics, the overall regression was significant (R2 = .622, F(2,17)= 12.32, p&amp;lt;.001). Higher GDS scores was found to significantly predict worse mCDR scores (β = .676, p&amp;lt;.001) when controlling for the effects other factors. When examining ADCS-ADL scores, the overall model was also found to be significant (R2= .413, F(2,17)=5.28, p&amp;lt;.05). Higher GDS scores significantly predicted worse ADCS-ADL scores (β = =.652, p&amp;lt;.01) when controlling for the effects of other factors. Diagnosis and age did not significant predict ADL scores. Among the WNH group, the regression model was not significant and depression was not a significant predictor of ADL functioning. Conclusions The results suggest Hispanics are more vulnerable to the effects of depression on ADL function which has important implications for AD diagnosis.

DOES NEGATIVE AFFECT MODERATE THE RELATIONSHIP BETWEEN SUBJECTIVE COGNITIVE CONCERNS AND OBJECTIVE FUNCTIONING?

Abstract The onset of Alzheimer’s disease can be insidious, slowly affecting an individual’s cognitive abilities. Previous research demonstrated that informant-reported cognitive decline was associated with significantly worse baseline and longitudinal cognitive performance than was a participant’s subjective perceptions of decline. What remains unclear is how negative affect (i.e., depressive symptoms) could moderate the relation between objective cognitive performance and subjectively perceived cognitive concerns (participant vs. informant). Using the National Alzheimer’s Coordinating Center (NACC) database, we performed moderated multiple regressions to test whether Geriatric Depression Scale (GDS) score showed different relationships with cognitive measures (animal/vegetable fluency, digit span, Boston Naming Test, digit-symbol coding (DSC), Wechsler Memory Scale Logical Memory, Trail-Making Test, and Mini-Mental State Examination) for participant- and informant-reported cognitive decline (yes/no). Participants were aged ≥65 years and were cognitively healthy at baseline. Informants lived with the participant or visited the participant weekly (N = 9,354). Participant-reported cognitive concern interacted significantly (p&amp;lt;.05) with negative affect only for animal fluency while informant-reported cognitive concern interacted significantly with DSC. Depressive symptoms were associated more strongly with cognitive performance for participants who did not report a subjective cognitive decline compared to those who did report a subjective cognitive decline. Participant age showed significant negative relationships with all measures while GDS score showed significant negative relationships with all measures except immediate Logical Memory recall, regardless of decline status. In conclusion, negative affect generally did not moderate the relationship between participant- or informant-reported cognitive concerns and objective cognitive functioning except for animal category fluency and DSC.

Effects of Mindful Awareness Practice (MAP) on Subclinical Depressive and Anxiety Symptoms and General Cognitive Function in Older Adults with Mild Cognitive Impairment: A 5-Year Follow-Up of the MAP-Randomized Controlled Trial.

Few randomized controlled trials (RCTs) investigated the effects of mindfulness intervention on affective and cognitive symptoms in older adults with mild cognitive impairment (MCI). Furthermore, no RCTs on mindfulness followed participants beyond two years. To examine the longitudinal effects of a mindful awareness practice (MAP) intervention on depressive, anxiety, and cognitive symptoms in MCI. In this parallel-arm and assessor-blinded RCT, 55 community-dwelling older adults with MCI were randomized into the MAP or active control, i.e., health education program (HEP). Intervention sessions were conducted weekly for three months and monthly for the subsequent six months. Assessments and follow-up were conducted at baseline, 3-month, 9-month, and 5-year time points. Depressive, anxiety, and cognitive symptoms were measured using the Geriatric Depression Scale-15 (GDS-15), Geriatric Anxiety Inventory-20 (GAI-20), and Mini-Mental State Examination (MMSE), respectively. Linear-mixed models, following the intention-to-treat principle, were used for data analyses. A total of 55 participants aged 60 to 86 (Mean age: 71.3±6 years old) was recruited, with n = 28 allocated to the MAP arm and n = 27 allocated to the HEP arm. Compared to HEP, GDS-15, GAI-20, and MMSE scores did not differ significantly in MAP during follow-ups. Compared to HEP, MAP did not improve affective symptoms nor delay deteriorations in general cognition in community-dwelling older adults with MCI. Compared to our previous findings showing domain-specific improvements in MAP over HEP in attention and memory up to 9 months, this study highlights the importance of examining domain-specificity using detailed cognitive measures in non-pharmacological intervention with MCI.

A longitudinal analysis of depressive symptoms in relation to repeated measurements of regional tau

AbstractBackgroundDepressive symptoms are commonly observed early in Alzheimer’s disease (AD), but their temporal association with progression along the AD continuum is less clear. We sought to determine if initial measurements of regional tau were predictive of increasing depressive symptoms, and if changes in depressive symptoms predicted later tau levels. We examined these relationships in a region of early tau accumulation (i.e., entorhinal cortex (EC)), and in regions of later neocortical tau spread commonly involved in affective regulation (amygdala and medial and lateral orbitofrontal cortex (mOFC, lOFC)).MethodParticipants (n = 257; mean age = 70.7; 61% female) came from the Harvard Aging Brain Study, a longitudinal observational cohort of cognitively unimpaired adults with no/low depression at baseline (mean years of follow‐up = 7.2). All participants completed the self‐reported 30‐item Geriatric Depression Scale (GDS) annually and tau PET imaging (Flortaucipir‐FTP) every 3 years. On average, initial tau PET scans occurred 2.3 years after enrollment and the latest available scan occurred 5.1 years after enrollment. Separate linear mixed effects models investigated relationships between longitudinal GDS and cross‐sectional regional tau (FTP PET SUVr), at initial scan and at the latest scan available, in the following regions of interest: EC, amygdala, mOFC, and lOFC. Covariates included age, sex, and education.ResultHigher initial FTP levels were associated with significant increases in GDS score over time in temporal cortex (amygdala: b = 0.29,p = 0.0002; EC: b = 0.21,p = 0.0006) and mOFC (b = 0.30,p = 0.004), with marginal significance in lOFC (b = 0.21,p = 0.07). However, the reverse temporal sequence was only observed between GDS scores over all time points and later measurement of amygdala FTP, such that increasing depressive symptoms over time preceded higher final amygdala tau levels (b = 0.15,p = 0.02).ConclusionHigher tau in EC, amygdala and OFC regions predicted increasing depressive symptoms over time in older adults. Only for the amygdala did we also observe the converse relationship: increasing depressive symptoms predicting higher final tau. These results suggest early tau proliferation in affective regions is associated with increased depressive symptoms, though the question of causality is still unclear. Further work is needed to dissect possible temporal relationships across whole brain voxels to better understand depressive symptoms in AD progression.

A longitudinal analysis of depressive symptoms in relation to repeated measurements of regional tau

AbstractBackgroundDepressive symptoms are commonly observed early in Alzheimer’s disease (AD), but their temporal association with progression along the AD continuum is less clear. We sought to determine if initial measurements of regional tau were predictive of increasing depressive symptoms, and if changes in depressive symptoms predicted later tau levels. We examined these relationships in a region of early tau accumulation (i.e., entorhinal cortex (EC)), and in regions of later neocortical tau spread commonly involved in affective regulation (amygdala and medial and lateral orbitofrontal cortex (mOFC, lOFC)).MethodParticipants (n=257; mean age=70.7; 61% female) came from the Harvard Aging Brain Study, a longitudinal observational cohort of cognitively unimpaired adults with no/low depression at baseline (mean years of follow‐up=7.2). All participants completed the self‐reported 30‐item Geriatric Depression Scale (GDS) annually and tau PET imaging (Flortaucipir‐FTP) every 3 years. On average, initial tau PET scans occurred 2.3 years after enrollment and the latest available scan occurred 5.1 years after enrollment. Separate linear mixed effects models investigated relationships between longitudinal GDS and cross‐sectional regional tau (FTP PET SUVr), at initial scan and at the latest scan available, in the following regions of interest: EC, amygdala, mOFC, and lOFC. Covariates included age, sex, and education.ResultHigher initial FTP levels were associated with significant increases in GDS score over time in temporal cortex (amygdala: b=0.29,p=0.0002; EC: b=0.21,p=0.0006) and mOFC (b=0.30,p=0.004), with marginal significance in lOFC (b=0.21,p=0.07). However, the reverse temporal sequence was only observed between GDS scores over all time points and later measurement of amygdala FTP, such that increasing depressive symptoms over time preceded higher final amygdala tau levels (b=0.15,p=0.02).ConclusionHigher tau in EC, amygdala and OFC regions predicted increasing depressive symptoms over time in older adults. Only for the amygdala did we also observe the converse relationship: increasing depressive symptoms predicting higher final tau. These results suggest early tau proliferation in affective regions is associated with increased depressive symptoms, though the question of causality is still unclear. Further work is needed to dissect possible temporal relationships across whole brain voxels to better understand depressive symptoms in AD progression.

Subjective Cognitive Decline Interacts with Sex and Education on CSF β‐Amyloid.

AbstractBackgroundSubjective cognitive decline (SCD) may be an early risk factor for dementia, particularly in highly educated individuals and women. This study examined the effect of education and sex on the association between SCD and Alzheimer’s disease (AD) biomarkers in non‐demented older adults.MethodVanderbilt Memory and Aging Project participants free of clinical dementia or stroke (n = 129, 73±7 years, 33% mild cognitive impairment, 28% female) completed fasting lumbar puncture, SCD assessment, and Wide Range Achievement Test 3rd edition Reading subtest to assess reading level at baseline. Cerebrospinal fluid (CSF) biomarkers for AD (β‐amyloid42 (Aβ42), Aβ42/40 ratio, phosphorylated tau, tau, neurofilament light) were analyzed in batch. Linear mixed effects models related SCD to CSF AD biomarkers adjusting for baseline age, sex, education, race/ethnicity, apolipoprotein E (APOE)‐e4 status, cognitive diagnosis, and Geriatric Depression Scale scores (minus points for cognition). Follow‐up models assessed SCD x reading level, SCD x education, and SCD x sex interactions on AD biomarkers.ResultIn main effect models, higher SCD was associated with lower Aβ42 and Aβ42/40 ratio (p‐values&lt;0.005) but not associated with tau, p‐tau, or NfL levels (p‐values&gt;0.38). SCD score interacted with education on Aβ42 and Aβ42/40 ratio (p‐values&lt;0.005), such that associations were stronger in individuals with higher education. In stratified models, no significant associations were observed in any individual educational tertile (p‐values&gt;0.07). SCD score interacted with sex on Aβ42/40 ratio (p = 0.03). In stratified models, higher SCD was associated with lower Aβ42/40 ratio in men (p = 0.002) but not in women (p = 0.89). Reading level did not interact with SCD score on any biomarker (p‐values&gt;0.19), though significant associations between SCD score and Aβ42 and Aβ42/40 ratio were observed in the higher reading level (p‐values&lt;0.005), but not the lower reading level group (p‐values&gt;0.11).ConclusionAmong community‐dwelling older adults free of clinical dementia, higher SCD was associated with greater cerebral amyloid accumulation, one of the earliest pathological AD changes. SCD may be most useful in detecting early AD pathology in individuals of higher education and men. SCD was not associated with CSF markers of tau or neurodegeneration. These findings suggest that considering sex and education is important when assessing SCD in older adults.

Plasma Biomarkers of Neurodegeneration and Tau in Relation to Longitudinal Depressive Symptoms in Older Adults: Findings from the Harvard Aging Brain Study

AbstractBackgroundDepressive symptoms are common in late life and Alzheimer’s Disease (AD) but the underlying neurobiology of these symptoms and their relationships to AD biomarkers is unclear. Probing these relationships using biomarkers of neurodegeneration and tau that can be measured via plasma can importantly guide AD prognosis and treatment. The current study determined the relationships between baseline measures of neurofilament light (NfL) (a marker of neurodegeneration) and an N‐terminal fragment of tau (NT1, an early and specific marker of AD) and longitudinal depressive symptoms in a cohort of older adults.MethodLongitudinal data were analyzed from 342 participants from the Harvard Aging Brain Study, an observational cohort study of individuals who were cognitively unimpaired and with no/minimal depressive symptoms at baseline (age: 71.7 +/‐ 8.1; % female: 61%; average follow up: 3.94 years, range: 0–7.88). Depressive symptoms were assessed annually with the 30‐item Geriatric Depression Scale (GDS). At study baseline, all participants had plasma samples assayed for NfL and NT1 and underwent amyloid (PiB) PET imaging to derive a cortical amyloid composite. Linear mixed effects models were used to examine relationships between dependent variable longitudinal GDS (log‐transformed) and predictors of interest: (plasma NfL or NT1) x time, and covariates: age, sex, education. Secondary models were adjusted for cortical amyloid and examined the interactive effects of amyloid and plasma biomarkers on longitudinal GDS.ResultHigher baseline NfL predicted increasing GDS scores over time (β = 0.04 +/‐0.01, t = 3.8, p = 0.0001), while a trend was observed for NT1 (β = 0.02 +/‐0.01, t = 1.9, p = 0.06). Similar results were obtained when adjusting models for amyloid x time (NfL x time: β = 0.04 +/‐0.01, t = 3.8, p = 0.0002; NT1 x time: β = 0.02 +/‐0.01, t = 1.7, p = 0.09). Neither NfL nor NT1 interacted with amyloid to predict increasing GDS over time.ConclusionFindings support an association between depressive symptoms and plasma measures of neurodegeneration–whether cause or consequence. Moreover, for NfL, this relationship is independent of amyloid, suggesting that multiple pathways may underlie the emergence of depressive symptoms in older adults. Further longitudinal investigation in relation to cognition and across depressive symptom severity is needed to better understand the pathophysiology of depression in late life and AD.

Status of cognitive frailty in elderly patients with chronic kidney disease and construction of a risk prediction model: a cross-sectional study

ObjectiveTo investigate the risk factors of cognitive frailty in elderly patients with chronic kidney disease (CKD), and to establish an artificial neural network (ANN) model.DesignA cross-sectional design.SettingTwo tertiary hospitals in...

Detection of Amyloid status in patients with uncertain diagnosis and associations with remotely‐collected cognitive composites

AbstractBackgroundIn an effort to build efficient and scalable screening tools for early detection of cognitive impairment, the Brain Health Registry (BHR) was created to collect demographic and cognitive information in a remote setting. A select cohort of participants enrolled in the BHR also underwent amyloid PET scans, allowing the utilization of remotely collected cognitive data for amyloid enrichment.MethodSelf‐reported measures were collected through the BHR from 656 older adults co‐enrolled in the Imaging Dementia ‐ Evidence For Amyloid Scanning (IDEAS) study with an in‐clinic diagnosis of unexplained mild cognitive impairment (MCI; n = 522) or dementia of uncertain cause (n = 134) (Table 1). Global Amyloid‐PET centiloid values were obtained via a published PET‐Only processing method. An independent pathology‐based cut‐off of 24.4 was applied to define amyloid status. A comprehensive set of BHR variables were regressed on the continuous centiloid values to quantify the association between online measures with global amyloid burden. Then, logistic regression was employed to determine the ability of BHR variables to detect amyloid positivity. Results from both regression models are provided in Table 2. Accuracy measures are reported in Table 3.ResultThe overall model fit of the BHR data with centiloid values was statistically significant (F = 4.69; p‐val&lt;0.001), while R^2 = 0.09, highlighting the strong association with global amyloid burden and the high variability for this cohort. For both dichotomous and continuous models, family history of AD and subjective memory concern are associated with higher amyloid accumulation; higher Geriatric Depression Scale scores are associated with lower amyloid, while low scores of Memtrax N‐back test are related to higher amounts of amyloid. When applying 5‐fold cross‐validation to the logistic model, the classification accuracy of the BHR variables is 64% (cvAUC = 64%; spec = 67%; sens = 60%).ConclusionDespite high variability in BHR data, remotely collected subjective and cognitive information are associated with amyloid in older adults with unexplained MCI or dementia of an uncertain cause. The ability to detect amyloid status with online data points to the large potential for building an online screener and motivates further online data collection.

Fatigue and depression in elderly patients with poorly controlled diabetes.

In this study, it was aimed to evaluate the severity of depression and fatigue in patients with type 2 diabetes mellitus (T2DM), aged ≥ 60 years, with poor diabetes control. Between December 2018 and June 2019, 310 patients aged ≥ 60 years, with hemoglobin A1C ≥ 10%, followed-up with the diagnosis of T2DM for at least 3 years in the internal medicine outpatient clinics of Bursa Yüksek İhtisas Training and research hospital were included in the study. The geriatric depression scale (GDS) and fatigue severity scale (FSS) questionnaires were administered. Patients were analyzed according to their sociodemographic and clinical characteristics, according to their GDS and FSS scores. The GDS and FSS scores were higher in the female patients than in the male patients, those with diabetes aged ≥ 21 years than those aged < 21 years, those using premixed insulin than those using basal bolus insulin and oral antidiabetic drug for + basal insulin, and those living alone than in those living with their families. The FSS score was higher in patients with vitamin D levels < 20 ng/mL. The factors affecting the GDS score were the FGS and FSS scores in the multivariate analysis. The factors affecting the FSS score were the GDS, diabetes age, hemoglobin level, and vitamin D level in the multivariate analysis. Poorly controlled diabetes affects elderly patients more in terms of their mental and physical health. Therefore, these patients should be considered in terms of psychosocial aspects to increase treatment compliance and effects.

Fatigue and primary sarcopenia in geriatric patients.

This study aimed to investigate the frequency of fatigue in geriatric patients with primary sarcopenia and to evaluate the relationship between fatigue and symptoms such as depression and sleepiness. This case-control study was conducted between December 2020 and August 2021 in the geriatrics outpatient clinic of Istanbul University-Cerrahpasa. The European Working Group on Sarcopenia in Older People 2 criteria were considered for the diagnosis of sarcopenia. Demographic data, accompanying chronic diseases, comprehensive geriatric assessments, and laboratory values of the patients were noted. Scales used to assess fatigue in all participants include Fatigue Assessment Scale, Fatigue Severity Scale, and Fatigue Impact Scale and associated symptoms include Geriatric Depression Scale and Epworth Sleepiness Scale. The mean (standard deviation) age was 75.3 (7.1) for 51 primary sarcopenia (38 female) patients and 73.5 (5.8) for 51 control (37 female) patients. There was no significant difference between the two groups in terms of gender and age (p=0.822, p=0.171). The prevalence of hypertension was higher, and the level of education was lower in the sarcopenic group than in the nonsarcopenic group (p=0.017, p=0.013). Fatigue Assessment Scale, Fatigue Severity Scale, Fatigue Impact Scale total, Fatigue Impact Scale cognitive, Fatigue Impact Scale physical, and Fatigue Impact Scale social questionnaire scores were significantly higher in the sarcopenic group (all p<0.001). The Geriatric Depression Scale score was statistically higher in the sarcopenic group; however, there was no significant difference in the Epworth Sleepiness Scale score between the two groups (p=0.014, p=0.072). Multivariate analysis was performed on education level, hypertension, fatigue questionnaires, and Geriatric Depression Scale, which were found to be significant in the univariate logistic regression analysis. In the multivariate logistic regression analysis, only the Fatigue Impact Scale total was determined to be associated with sarcopenia [odds ratio 1.161, 95% confidence interval (1.084-1.242)]. In primary sarcopenia, there is mental and social fatigue as well as physical fatigue. Therefore, the prevention and treatment of sarcopenia in geriatric patients is important.