Geriatric Depression Scale Score Research Articles

Ethnicity predicts long-term depressive symptom patterns in older adults with type 2 diabetes.

Depression is a chronic disorder that significantly affects functional decline in older adults, especially those with type 2 diabetes (T2D). Ethnic groups may experience different depression risks and severities, yet the effect of ethnicity on depression trajectories and specific dimensions in older adults with T2D remains largely unexamined. We examined the longitudinal associations of ethnicity with depression and its specific dimensions over time in older Ashkenazi and non-Ashkenazi Jews with T2D. Generalized estimating equations (GEE) models were employed to analyze the longitudinal associations of ethnicity with numbers of depressive symptoms and specific depression dimension, adjusting for sociodemographics, cognition, T2D characteristics, and cardiovascular risk factors. Community-dwelling older adults from the longitudinal Israel Diabetes and Cognitive Decline (IDCD) study. 902 Ashkenazi and non-Ashkenazi Jews, mean age=72.3 years. The Geriatric Depression Scale-15 (GDS-15) and its five dimensions: Dysphoric Mood, Withdrawal Apathy-Lack of Vigor, Anxiety, Hopelessness, and Memory Complaint. At baseline, Ashkenazi Jews reported significantly lower GDS-15 scores compared to non-Ashkenazi Jews. They exhibited lower scores in Dysphoric Mood and Hopelessness dimensions. GEE models confirmed these findings, showing Ashkenazi Jews had significantly lower total GDS-15 scores (β=0.86, 95% CI 0.75-0.99; p=0.03), Dysphoric Mood (β=0.76 (0.52-0.90], p=0.006), Hopelessness (β=0.74 [0.58-0.95], p=0.017) and lower rates of clinical depression (OR= 0.68 [0.52-0.90], p=0.006). These data offered no evidence of a difference in trends between the Ashkenazi and non-Ashkenazi groups on depression trajectories. Ethnicity is associated with the longitudinal trajectories of depression and its specific dimensions in older adults with T2D. Further investigation of contributing factors, including social determinants of health, is essential.

Determinants of Social Activity Among Geriatric Patients in Northern Romania: A Cross-Sectional Study.

Background/Objectives: The aging population poses a significant challenge to global public health, impacting the physical, mental, and social health of older adults. Social activity has been widely acknowledged as a protective factor for both mental and physical well-being. Research indicates that consistent engagement in social activities can mitigate the risk of depression, prevent cognitive decline, and support physical functionality. This study aims to explore the correlations and associations between two variables related to social activity (self-reported activity level and time spent with friends) and various other variables among geriatric patients in Northern Romania. Methods: This cross-sectional, single-center observational study utilized data from 588 geriatric patients (402 females and 186 males) admitted to the Geriatrics ward of the Municipal Clinical Hospital. The dataset included variables such as sociodemographic information, Geriatric Depression Scale (GDS), Montreal Cognitive Assessment (MoCA), and SARC-F questionnaire scores, time spent with friends, and activity levels. Descriptive statistics were computed alongside statistical tests to examine group differences, associations, and predictive relationships. Results: The sample was characterized by variability in age, educational attainment, and pension levels. The statistical analyses revealed significant differences based on education, pension, and civil status. Patients with higher GDS and SARC-F scores had lower odds of spending time with friends or belonging to the active or extremely active groups. Notably, women reported higher GDS scores and lower activity levels compared to men. Conclusions: Understanding the factors that influence social activity among older adults is essential for designing targeted interventions aimed at preventing social isolation and fostering healthy aging across diverse demographic and environmental contexts.

Geriatric depression scale in patients with chronic kidney disease

Introduction: Older individuals, particularly those with chronic kidney disease (CKD), are highly susceptible to depression, although this population is often excluded from clinical studies. The use of the Geriatric Depression Scale (GDS) can be useful in identifying symptoms of depression in this population. Objective: Our objective was to test the GDS as a tool for identifying factors associated with depression in older patients with CKD. Additionally, we aimed to identify which question had the best sensitivity/specificity in detecting moderate/severe symptoms. Methods: This cross-sectional study included 124 patients (≥ 70 years, stage 4 or 5 CKD) who were been followed in the Nephrology Service. GDS-15 classified patients in: no depression (scores 0-4), mild depression (scores 5-8), and moderate/severe depression (scores ≥ 9). Clinical and demographic data were collected from medical records. Results: The mean age was 84 years, 52.4% were male, and 55.6% had diabetes. The median global GDS score was 7 (6, 8), identifying the following patient groups: no depression (8.9%), mild depression (66.9%), and moderate/severe depression (24.2%). Moderate/severe depression was more prevalent in women (66.7% vs. 37.3%, p=0.005). The question that performed best in detecting moderate/severe depression was question number 12: “Do you feel worthless the way you are now?” Conclusion: The prevalence of moderate/advanced depression in older patients with CKD is extremely high. Question number 12 of the GDS showed the best sensitivity/specificity in identify these patients. Integrating the GDS into routine clinical practice may be important and clinically beneficial for this population.

Functional mobility and depression negatively impact quality of life in older adults with stroke

Background The quality of life (QoL) in elderly post-stroke patients may deteriorate due to an interplay of physical and psychological impairments, compounded by social challenges stemming from these issues. Objective This study aimed to identify predictors of QoL in elderly post-stroke patients by evaluating their functional capabilities, depressive symptoms, and levels of social support. Methods A cohort of 122 individuals aged 65 and older, who had experienced a stroke, was assessed. Functional independence was gauged using the Functional Independence Measure (FIM), depressive states were evaluated with the Geriatric Depression Scale (GDS), and social support was quantified through the Social Support Scale (SSS). The WHOQOL-BREF questionnaire was employed to measure QoL. Results The FIM and GDS scores were significant predictors for WHOQOL-BREF domains 1 and 2 (adjusted R² = 0.522, p < 0.01; and adjusted R² = 0.586, p < 0.01, respectively). GDS alone was a significant predictor for domain 3 (adjusted R² = 0.236, p < 0.01), while all variables were significant predictors for domain 4 (adjusted R² = 0.315, p < 0.01). Conclusions Depression, motor function, and social support were identified as the primary predictors of QoL in elderly individuals after suffering a stroke.

The Effect of Virtual Intelligence Games Applied to Older Adults on Cognitive Skills

Objective: This study aimed to evaluate cognitive status, quality of life, and mood in older adults through intelligence games loaded onto smartphones. Methods: In this study, 60 older adults aged 65 and over, who voluntarily participated and visited the outpatient clinic of the Department of Physical Therapy and Rehabilitation at Kırıkkale University Faculty of Medicine, were evaluated. The sociodemographic information of the older adults such as age, height, weight, etc., was recorded. The cognitive statuses were assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), the quality of life was evaluated using the Nottingham Health Profile, and the depression statuses were assessed with the Geriatric Depression Scale (GDS). Those older adults meeting the inclusion criteria, with a MMSE score below 24, were included in the study, totaling 50 participants. Subsequently, the individuals were randomly divided into 2 groups: training and control, with each group consisting of 25 older adults. The training group was requested to play intelligence games developed by researchers and installed on their smartphones at least once a day for 8 weeks. Both the training and control groups were assessed using a questionnaire created before and after the training period. Results: According to the statistical analysis conducted, a significant difference was found between the training and control groups in the MMSE, MoCA, and GDS scores after the training. There was a significant difference found in the total score of sleep, emotional state, and overall quality of life (P < .05), while no significant differences were detected among the other parameters (P > .05). Conclusion: In conclusion, it was determined that technological advancements and the intelligence games loaded onto their smartphones, which they can access anytime and anywhere, improved the cognitive status of older adults in areas such as memory, attention, calculation, and shape matching and, it was observed that these activities enhanced their mood, sleep, and overall quality of life.

A novel framework for entertainment robots in personalized elderly care using adaptive emotional resonance technologies

The aging population suffers from some difficult aspects, such as loneliness, dementia, and lack of meaning, which diminish their enjoyment of life. This work presents a novel model using robotics and artificial intelligence to create entertainment robots that can adapt their interaction based on the elderly’s emotion. The model is implemented through the use of the multimodal emotion recognition technology that holds the facial expression, voice tone, physiological expressions, and body postures. Supported by the emotional resonance algorithm and personalization features, these robots can deliver emotional resonance that corresponds to the user’s mood. With time, this model may learn and provide better feedback. Ethical factors are also taken into account. The robot handles multimedia content, natural language processing, and gentle movements that enhance interaction. The trial involved 20 elderly users, which showed effective outcomes of mood and engagement. Standardized psychological assessments, such as the Geriatric Depression Scale (GDS) and the Quality of Life in Alzheimer’s Disease (QOL-AD) scale, revealed that participants exhibited a 2.1-point decrease in GDS scores, indicating a reduction in depressive symptoms, and a 3.8-point increase in QOL-AD scores. This framework, is thus, a promising tool in transforming elderly care

Subjective health complaints and life satisfaction in older adults: the predictive role of geriatric depression.

Given the growing number of older adults, it is crucial to understand geriatric depression and to determine the impact of depression on well-being and health. The aim of this study was to examine the predictive effect of geriatric depression on subjective health complaints and life satisfaction in older adults. This cross-sectional study was carried out in two family health centres in a city centre in the northwest of Türkiye. The sample consisted of 257 older adults. Structural equation modelling path analysis was utilised to examine the extent to which geriatric depression predicted subjective health complaints and life satisfaction among older adults. The study found that geriatric depression was a predictor of both subjective health complaints and life satisfaction. Results showed that as geriatric depression scale score increased, subjective health complaints also increased (Std. β = 0.470, P < 0.001), while life satisfaction decreased (Std. β = -0.573, P < 0.001). Geriatric depression is a complex health issue that biopsychosocially affects older adults. The findings of this study highlight the importance of identifying, diagnosing, and treating depression in older adults.

Impact of Weekly Community-Based Dance Training Over 8 Months on Depression and Blood Oxygen Level-Dependent Signals in the Subcallosal Cingulate Gyrus for People With Parkinson Disease: Observational Study.

Dance has emerged as a complementary treatment that may promote adaptive neural plasticity while improving symptoms of Parkinson disease (PD), such as balance, gait, posture, and walking. Understanding brain changes that arise from participation in dance interventions is important as these neural plastic changes play an important role in protecting and healing the brain. Although dance has been shown to improve PD motor and nonmotor symptoms, the neural mechanisms underlying these changes, specifically depression and mood, remain elusive. Further, many side effects of PD drug treatments can be exacerbated or even induced by dopaminergic drugs, particularly depression and anxiety, making these nonmotor symptoms more noticeable throughout the progression of the disease. In this study, we focused on the impact of dance interventions on PD nonmotor symptoms by conducting an 8-month observational study, tracking the relationship between depression scores and functional neuroimaging measures for people with PD. A total of 34 dancers-23 (68%) people with PD and 11 (32%) healthy controls-completed the Geriatric Depression Scale (GDS) before and after attending weekly community-based dance classes, referred to as Dance for PD classes. Specifically, we examined changes within the functional magnetic resonance imaging signal from the subcallosal cingulate gyrus (SCG), an important node within the depression network and a controversial target for deep brain stimulation in the treatment of major depressive disorder. Depression scores on the GDS decreased in each preintervention to postintervention comparison (all P<.025). In addition, GDS scores also improved over the 8-month dance period (all P<.01). Blood oxygen level-dependent signals from frontal cortex brain region implicated for emotional regulation within the SCG decreased at each testing time point (all P<.05). Also, a significant decrease in depression scores (GDS) was correlated with reduced blood oxygen level-dependent signals from the SCG (P=.02). This study contributes to an improved understanding of the neural mechanisms that are involved in depression, as well as the beneficial contribution that longitudinal dance interventions have in reducing nonmotor symptoms associated with PD, particularly in depression symptoms.

Association of Sleep Disturbances With Prevalent and Incident Motoric Cognitive Risk Syndrome in Community-Residing Older Adults.

There is growing evidence that sleep disturbances are associated with cognitive impairment risk, but their association with the incidence of motoric cognitive risk syndrome (MCR)-a predementia syndrome characterized by slow gait speed and cognitive complaints-is unknown. We aimed to examine the association of sleep disturbances, overall and specific subtypes, with (1) incident and (2) prevalent MCR in older adults. Community-residing adults aged 65 years and older without dementia were recruited from population lists and included in Central Control of Mobility and Aging, a prospective cohort study, in Albert Einstein College of Medicine, Bronx, NY. We included participants with available data for MCR and Pittsburgh Sleep Quality Index (PSQI). MCR was defined as cognitive complaints reported on standardized questionnaires and slow gait speed as recorded on an electronic treadmill and was adjudicated at baseline and annual follow-up visits. Participants were divided into "good" sleepers (≤5) and "poor" sleepers (>5) based on an established PSQI cut score. Among participants without MCR at baseline, Cox proportional hazard models adjusted for (1) age, sex, and education and (2) further for comorbidity index, Geriatric Depression Scale score, and global cognitive score were used to examine the association of baseline sleep disturbances with MCR incidence. Association between poor sleep quality and prevalent MCR at baseline in the overall population was explored using multivariate logistic regression analysis. 445 participants were included (56.9% women, mean age: 75.9 years [75.3; 76.5]). In MCR-free participants at baseline (n = 403), 36 developed incident MCR over a mean follow-up of 2.9 years. Poor sleepers had a higher risk of incident MCR (HR = 2.7 [1.2; 5.2]) compared with good sleepers, but this association was not significant after adjustment for depressive symptoms (adjusted hazard ratio [aHR] = 1.6 [0.7-3.4]). Among the 7 PSQI components, only sleep-related daytime dysfunction (excessive sleepiness and lower enthusiasm) showed a significant risk of MCR in fully adjusted models (aHR = 3.3 [1.5-7.4]). Prevalent MCR was not associated with poor sleep quality (OR [95% CI] = 1.1 [0.5-2.3]). Overall poor sleep quality was associated with incident MCR, but not with prevalent MCR. Specifically, older adults with sleep-related daytime dysfunction are at increased risk of developing MCR. Further studies are needed to validate mechanisms of this relationship.

Mild parkinsonian signs and incidence of Motoric Cognitive Risk syndrome

AbstractBackgroundMild parkinsonian signs (MPS) are prevalent in older adults and linked to an increased risk of dementia. However, their association with Motoric Cognitive Risk syndrome (MCR), a pre‐dementia syndrome characterized by slow gait speed and cognitive complaints, is unclear. This study aims to examine the association of MPS with incident MCR.MethodNon‐demented older adults without Parkinson’s disease were monitored annually (average follow‐up 30 months). We excluded participants with MCR at baseline and dementia incidence without previous MCR, as non‐cases. MPS were defined at baseline by the presence of bradykinesia, rigidity, or rest tremor rated by a study clinician using the Unified Parkinson’s Disease Rating Scale (UPDRS). MCR was diagnosed using established criteria at baseline and follow‐up. The association of baseline MPS and incident MCR was examined using survival analysis and reported as hazard ratio and 95% confidence intervals (CI).ResultOf the 580 participants, 227 (39.1%) had MPS and 44 (7.5%) had MCR at baseline. Of the 513 initially MCR‐free participants, 46 (8.9%) developed incident MCR. Incident MCR cases had a higher prevalence of MPS at baseline compared to participants who did not develop MCR (OR adjusted for age, geriatric depression scale (GDS) score, and stroke history = 3.8, 95% CI 1.8‐8.2), particularly bradykinesia (52.3% vs. 19.0%; p&lt;0.001) and rigidity (54.5% vs. 28.1%; p&lt;0.001). They were older (p&lt;0.001), more disabled (p&lt;0.001), and had more strokes (p = 0.005), and depressive symptoms (p&lt;0.001) compared to individuals who did not develop MCR. Participants with MPS at baseline had a greater risk of developing incident MCR (HR adjusted for age, GDS score, and stroke history = 3.7, 95% CI 1.8‐7.7).ConclusionMPS predicted the onset of MCR, suggesting a significant role in the pathogenesis and in improving early assessment of risk for MCR.

Depression Significantly Predicts Clinical Functioning Among Hispanic older adults

AbstractBackgroundHispanics are disproportionately affected by Alzheimer’s disease and related dementias (ADRD) when compared to non‐Hispanic Whites (NHW). Previous studies have shown that neuropsychiatric symptoms can further exacerbate clinical functioning among ADRD patients, leading to increase in caregiver burden and poorer quality of life. However, most studies in this area have focused on predominately Caucasian samples, and relationships between emotional and clinical functioning among Hispanic older adults at risk of ADRD are poorly understood. The aim of the current study was to examine predictive associations between emotional and clinical functioning among Hispanic ADRD older adults at risk of developing ADRD.MethodsThe Geriatric Depression Scale (GDS) and the modified Clinical Dementia Rating scale (mCDR) were administered to Hispanic (n = 159) and NHW (n = 101) participants from the 1Florida Alzheimer’s Disease Research Center (ADRC). Participants were aged 60‐90 years (Hispanics: M = 70.87, SD = 7.28; NHW: M = 73.24, SD = 7.72) and were either cognitive normal (n = 52) or diagnosed with Mild Cognitive Impairment (MCI, n = 208). Multiple linear regression analyses controlling for age and diagnosis were applied to examine predictive relationships between the emotional and functional measures for the two ethnic groups separately.ResultsResults showed significant positive relationship between the mCDR and the GDS (β = 0.01, SE = 0.00, t = 2.33, p &gt; .05) among the Hispanic sample and interaction effects between diagnosis and GDS scores were not significant (β = 0.00, SE = 0.01, t = ‐0.41, p = 0.68). No significant associations were noted among the NHW group (β = 0.01, SE = 0.00, t = 1.13, p = 0.26).ConclusionDepression significantly predicted poorer clinical functioning among the Hispanic group only even when controlling for the effects of diagnosis. These findings indicate that the effect of emotional symptoms has a clinical impact on functioning among Hispanic older adults and may be related to increased risk of further decline and ADRD diagnosis. These results have important implications for dementia care. Future studies should examine these associations as they relate to ADRD risk and longitudinal clinical functioning.

Exercise habits in adolescence and old age are positively associated with geriatric depressive symptoms: the Bunkyo Health Study.

Exercise is a crucial method for preventing geriatric depression. In this cross-sectional study, we investigated the associations between exercise habits in adolescence and old age and geriatric depressive symptoms. This study used baseline data from the Bunkyo Health Study, a prospective observational cohort study investigating the preventive effects of physical activity on causative diseases requiring long-term care. This analysis included 1,629 older adults (687 men and 942 women) aged 65-84 years who participated in the Bunkyo Health Study. Participants were divided into four groups according to their exercise habits in adolescence and old age: never exercised (none-none; NN), exercised only in old age (none-active; NA), exercised only in adolescence (active-none; AN), and exercised in adolescence and old age (active-active; AA). Geriatric depressive symptoms were defined as the short version of the Geriatric Depression Scale score ≥ 5, including depression tendency. Multivariate-adjusted logistic regression models were used to estimate the odds ratios (ORs) and associated 95% confidence intervals in each group for the prevalence of geriatric depressive symptoms compared with the NN group. The ORs for geriatric depressive symptoms were notably lower in the AN, NA, and AA groups than in the NN group in both older men and older women. These results indicate that older adults with exercise habits in adolescence and/or in old age exhibit a lower prevalence of geriatric depressive symptoms.

The Safety, Feasibility, and Efficacy of a Structured Individual Exercise Program for Community-Dwelling Stroke Patients.

Stroke is a leading cause of mortality and long-term disability worldwide, often resulting in low levels of physical activity post-discharge. A comprehensive exercise program could be a safe method to increase stroke patients' physical activity and exercise volume. This pilot study examines the effectiveness, safety, and feasibility of a comprehensive exercise regimen for stroke patients residing in the community after discharge. This single-group pilot study included patients who received inpatient rehabilitation for motor impairment following a stroke. Community-dwelling participants engaged in a comprehensive exercise program, which was structured and individualized, consisting of stretching, aerobic exercise, strength training, and balance exercises, conducted under the supervision of a health exercise specialist in a dedicated living lab within the hospital. The program involved 20 sessions, each lasting 50 min, conducted three to five times weekly. The pre- and post-intervention evaluations were comprehensive, including safety and validity assessments, along with physical function tests such as cardiopulmonary exercise testing and various fitness tests (6 min walk test, timed up and go test, chair stand test, figure-of-8 walk test, grip strength test, and sit-and-reach test). Depression levels were assessed using the Geriatric Depression Scale (GDS). A total of 22 subjects were recruited, with 21 completing the study after one dropout due to fatigue and visiting distance. Among the 21 completers, one subject experienced a mild adverse event (hypoglycemia), which was not serious, confirming the program's safety. The exercise participation rate was 95.5%, and the adherence rate averaged 95.2%, with all completers achieving over 80% adherence. Significant improvements were observed in VO2 peak (p = 0.000), 6 min walk test (p = 0.000), timed up and go test (p = 0.000), chair stand test (p = 0.000), figure-of-8 walk test (p = 0.000), and grip strength (p = 0.001). However, changes in the peak respiratory exchange ratio (p = 0.078), sit-and-reach test (p = 0.228) and GDS scores (p = 0.275) were not significant. This study demonstrates that the comprehensive exercise program is sufficiently safe and valid for stroke rehabilitation patients. The program significantly enhances cardiopulmonary endurance, walking ability, balance, muscle strength, muscle endurance, and coordination. Further research with larger sample sizes and control groups is needed to confirm these findings and explore additional benefits.

Preoperative Neurofilament Light Associated With Postoperative Delirium in Hip Fracture Repair Patients Without Dementia

Delirium commonly occurs in older adults following surgery; although its pathophysiology is not fully understood, underlying neurodegeneration is a risk factor. Examine the association of preoperative levels of markers of neuronal damage, neurofilament light (NfL) and phosphorylated tau (p-tau)181, with postoperative delirium. Preoperative cerebrospinal fluid (CSF) and plasma were obtained from 158 patients undergoing hip fracture repair and enrolled in the clinical trial "A STrategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients." Delirium diagnosis was adjudicated by a consensus panel. The association of plasma and CSF NfL and p-tau181 levels with delirium incidence and severity were examined for the overall cohort and for a subgroup (n= 134) of patients without dementia. Patients who developed delirium were older, had lower Mini-Mental State Exam score, higher Clinical Dementia Rating and Geriatric Depression Scale scores at baseline; the overall incidence of delirium was 37.6% and 31.1% for the subgroup without dementia. Plasma and CSF p-tau181 levels were not associated with delirium incidence or severity. CSF NfL levels were significantly associated with delirium severity, but not with incidence in the overall cohort. In the subgroup of patients without dementia, CSF NfL levels were significantly associated with increased odds of delirium incidence (odds ratio 4.74, 95% confidence level 1.21-18.59, P= 0.03) adjusted for age, sex, and Clinical Dementia Rating. CSF NfL was significantly associated with delirium incidence and severity in patients without dementia undergoing hip fracture repair. Results confirm prior studies suggesting NfL as an important marker of delirium risk and supports an association between pre-existing axonal injury and delirium. These results highlight delirium vulnerability in older hip fracture patients, even when clinical dementia is not identified.

The Relation between Parameters of Physical Performance and Depression in Consecutive Hospitalized Geriatric Patients with Heart Failure.

In the geriatric population, the risk of cardiometabolic diseases is strongly influenced by comorbidities. The aim of the study was to estimate the prevalence of depression among hospitalized patients with heart failure (HF) and to assess the relation between physical performance and depression in this population. We included consecutive hospitalized patients with HF aged >65 years. The depression symptoms were evaluated using the Geriatric Depression Scale (GDS), the physical performance was assessed using the grip strength measurements, the Back Scratch Test, the Timed Up and Go Test (TUGT), the Five Times Sit to Stand Test (5 × SST), and the 6 min walk test. We included 206 patients (134 females and 72 males, median age 82 years (77-86) years). Altogether, 33% of participants had signs of depression. The association was found between depression severity and economic status (p = 0.001), stressful events (p = 0.005), self-reported general health status (p = 0.001), and heart failure severity assessed by the New York Heart Association class (NYHA), p = 0.003. The Back Scratch Test, the TUGT, and the 5xSST were associated with depression severity in a univariable regression analysis (β coefficient 0.04 [95% CI 0.00-0.08], 0.20 [95% CI 0.12-0.27], 0.18 [95% CI 0.07-0.27], respectively); however, when adjusted for co-factors, the TUGT and the 5xSST (0.17 [95% CI 0.08-0.26] and 0.14 [95% CI 0.02-0.26], respectively) were significantly related to the GDS score. Grip strength and the 6 min walk test were not related to the GDS score in the univariable nor multivariable analysis. These findings were confirmed in the logistic analyses. Our study indicated a high incidence of depression among elderly hospitalized patients with heart failure. Depression severity in older patients with HF is related to physical performance decline as assessed by the Timed Up and Go Test and the Five Times Sit to Stand Test. Grip strength and the 6 min walk test are not related to the GDS score in this population.

Longitudinal association of depressive symptoms with cognition and neuroimaging biomarkers in cognitively unimpaired older adults, mild cognitive impairment, and Alzheimer's disease.

We aimed to longitudinally examine the relationship between depression and cognitive function and investigate the mediating effects of imaging indicators in this relationship. 2,251 subjects with longitudinal assessment of geriatric depression scale, Mini-Mental State Examination, Montreal Cognitive Assessment, Clinical Dementia Rating-Sum of Boxes (CDRSB), Alzheimer's Disease Assessment Scale11, Alzheimer's Disease Assessment Scale13 and imaging of 3DT1, diffusion tensor imaging, fluid-attenuated inversion recovery, arterial spin labeling, fluorodeoxyglucose positron emission tomography, 18F-AV45-PET, and 18F-AV1451-PET were included from the Alzheimer's Disease Neuroimaging Initiative database. The multivariate mixed-effects models were employed to analyze the correlation between geriatric depression scale scores, cognitive function, and imaging indicators. The sgmediation software package was utilized to analyze the mediating effects of imaging indicators. The geriatric depression scale was negatively correlated with Mini-Mental State Examination and Montreal Cognitive Assessment, and positively correlated with CDRSB, Alzheimer's Disease Assessment Scale11, and Alzheimer's Disease Assessment Scale13 when the subjects were not grouped. The geriatric depression scale was negatively correlated with Montreal Cognitive Assessment and positively correlated with Alzheimer's Disease Assessment Scal13 in groups with baseline diagnosis of early mild cognitive impairment and late mild cognitive impairment. Furthermore, depression was associated with regional imaging indicators, while cognitive function was linked to broad imaging indicators. Some of these indicators were related to both depression and cognitive function, playing a mediating role in their relationship. Depression was related to cognitive function, especially in subjects with mild cognitive impairment. Some imaging indicators may represent the underlying basis for the association between depression and cognitive function.

Association Between Depressive Symptoms, Cognitive Status, and the Dual-Task Performance Index in Older Adults: A Cross-Sectional Study.

The Performance Index (P-Index) is a measure for evaluating mobility-related dual-task performance in older adults. The identification of specific clinicodemographic factors predictive of P-Index scores, however, remains unclear. This cross-sectional study analyzed data from 120 community-dwelling older adults (average age 71.3 ± 11.23years) to explore clinicodemographic variables that influence P-Index scores during the instrumented timed up and go test. Unadjusted analyses suggested several factors, including age, gender, body mass index, Mini-Mental Status Examination scores, functional reach test performance, history of falls, ethnicity, Geriatric Depression Scale scores, alcohol consumption, and educational levels, as potential predictors of P-Index. However, adjusted multinomial multiple regression analysis revealed Geriatric Depression Scale and Mini-Mental Status Examination scores as the exclusive independent predictors of P-Index classifications, segmented into high, intermediate, or low (percentiles ≤ 25, 26-74, or ≥ 75, respectively). A significant association was observed between the manifestation of depressive symptoms, lower Mini-Mental Status Examination scores, and reduced cognitive-motor performance. The findings implicate depressive symptoms and low cognitive performance as substantial impediments to optimal dual-task mobility within this cohort. Further studies are warranted to examine the efficacy of cognitive stimulation and antidepressant therapy, in augmenting mobility-related dual-task performance among older adults.

Effects of adjunctive esketamine on depression in elderly patients undergoing hip fracture surgery: a randomized controlled trial

BackgroundDepression is a prevalent perioperative psychiatric complication among elderly hip fracture patients. Esketamine has rapid and robust antidepressant effects. However, it is unknown whether it can alleviate depressive symptoms in elderly patients who undergo hip fracture surgery. This study aimed to explore whether the adjunctive esketamine in patient-controlled intravenous analgesia (PCIA) could improve depressive symptoms in elderly patients undergoing hip fracture surgery.MethodsA single-center, prospective, double-blind and randomized controlled clinical trial was carried out from July 2022 to August 2023 at the Wenzhou People’s Hospital among 90 patients, aged ≥ 65 years with hip fracture undergoing elective surgery. Participants were randomly allocated to either the esketamine group (group S) or the control group (group C). In Group S, patients were administered 0.5 mg/kg of esketamine as a PCIA adjuvant for 48 h, while the control group received saline. The primary outcome was the assessment of depressive symptoms using the Geriatric Depression Scale-15 (GDS-15) on postoperative day 2. The secondary outcomes were assessments of depressive symptoms on postoperative day 7 and postoperative day 30, serum levels of brain-derived neurotrophic factor (BDNF) and 5-hydroxytryptamine (5-HT), postoperative pain intensity, the number of effective PCIA presses, sufentanil consumption, and adverse events.ResultsThe prevalence and GDS-15 scores of depression were significantly lower in group S on postoperative day 2 (28.6% vs. 53.5%; 3.5 ± 1.8 vs. 4.3 ± 1.7, P < 0.05). In group S, the number of effective PCIA presses was significantly lower on postoperative day 2 than that in group C [2(1–4) vs. 1(0–2), P<0.05]. Higher levels of BDNF (23.8 ± 1.7 ng/mL vs. 25.3 ± 2.0 ng/mL, P < 0.05) and 5-HT (219.5 ± 19.5 ng/mL vs. 217.0 ± 22.2 ng/mL, P < 0.05) in the blood were observed on postoperative day 2 in group S.ConclusionIn elderly patients aged ≥ 65 years undergoing hip fracture surgery, the administration of adjunctive esketamine in PCIA could improve depressive symptoms and increase levels of BDNF and 5-HT in the blood.Trial registrationChinese Clinical Trial Registry, ChiCTR2200061956 (Date: 13/07/2022).

Транскраниальная стимуляция постоянным током в лечении депрессии у пожилых людей: пилотное рандомизированное контролируемое исследование

&lt;p&gt;Depression is one of the most common disorders in older adults. Depression management is one of the problems of geriatrics. This study evaluated the effect of Transcranial Direct Current Stimulation (TDCS) on depression in older adults. This study is an unblinded randomized controlled trial. We selected 60 patients with depression based on the Geriatric Depression Scale (GDS) and randomly divided them into two groups. The intervention group received Sertraline 25&amp;ndash;50 mg and TDCS for five days (each day: 20 min at two mA). The control group received Sertraline (25&amp;ndash;50 mg). Data were analyzed using SPSS v. 22 software. The mean age was 72 years. There was a significant decrease in GDS score before and after the study in the control group (8.6&amp;plusmn;1.55 to 6.40&amp;plusmn;1.45, p=0.001) and the intervention group (8.86&amp;plusmn;1.35 to 5.46&amp;plusmn;0.91, p=0.001). The comparison of the two groups shows a significant difference in the changes in the GDS score (p=0.01). The results of this study suggest that Transcranial Direct Current Stimulation (TDCS) with medication affects depression in old patients, but more studies are needed.&lt;/p&gt;

Hippocampal volume maximally modulates the relationship between subsyndromal symptomatic depression and cognitive impairment in non-demented older adults

BackgroundSubsyndromal symptomatic depression (SSD) is associated with an elevated risk of cognitive impairment in non-demented older adults. Given that hippocampal and middle temporal gyrus atrophy have been shown to cause SSD, our study aimed to investigate the effect of hippocampal volume on the association between SSD and cognitive impairment. Methods338 non-demented older adults from the ADNI (Alzheimer's Disease Neuroimaging Initiative) cohort who underwent cognitive assessments, questionnaires on depressive symptoms and MRI brain were studied. SSD group is defined as a score of 1–5 based on Geriatric Depression Scale scores. We conducted causal mediation analyses to investigate the effect of hippocampal volume on cognitive performance cross-sectionally. ResultsThe SSD group displayed lower left and right hippocampal volume (p<0.01) than the non-SSD group. SSD was linked to poorer cognition and smaller hippocampal volume. We found that hippocampal volume partially mediated the effect of SSD on cognitive performance including the global cognition and the cognitive section of Alzheimer's Disease Assessment Scale, with mediation percentages ranging from 6.45 % to 30.46 %. In addition, we found that the thickness of the left middle temporal, right entorhinal and right fusiform gyrus, brain regions linked to AD, mediate the relationship between SSD and cognition with mediation percentages ranging from 8.67 % to 21.44 %. LimitationsOur article didn't differentiate between mild cognitive impairment and normal population. ConclusionThe associations of SSD and cognitive impairment are linked to alterations in Alzheimer's Disease related brain regions.