Geriatric Depression Scale Score Research Articles

Depression and Its Effect on Geriatric Rehabilitation Outcomes in Switzerland’s Aging Population

Background and Objectives: Depression is a common mental problem in the older population and has a significant impact on recovery and general well-being. A comprehensive understanding of the prevalence of depressive symptoms and their effects on functional outcomes is essential for improving care strategies. The primary aim of this study was to determine the prevalence of depressive symptoms in older patients undergoing geriatric rehabilitation and to assess their specific impact on their functional abilities. Materials and Methods: A retrospective study was conducted at the Lucerne Cantonal Hospital in Wolhusen, Switzerland, spanning from 2015 to 2020 and including 1159 individuals aged 65 years and older. The presence of depressive symptoms was assessed using the Geriatric Depression Scale (GDS) Short Form, while functional abilities were evaluated using the Functional Independence Measure (FIM) and the Tinetti test. Data analysis was performed using TIBCO Statistica 13.3, with statistical significance set at p < 0.05. Results: Of the participants, 22.9% (N = 266) exhibited depressive symptoms, with no notable differences between genders. Although all patients showed functional improvements, the duration of rehabilitation was prolonged by two days (p = 0.012, d = 0.34) in those with depressive symptoms. Alarmingly, 76% of participants were classified as at risk of falling based on the Tinetti score. However, no significant correlation was found between the GDS and Tinetti scores at admission (p = 0.835, r = 0.211) or discharge (p = 0.336, r = 0.184). The results from the non-parametric Wilcoxon matched-pairs test provide compelling evidence of significant changes in FIM scores when comparing admission scores to those at discharge across all FIM categories. Conclusions: Depressive symptoms are particularly common in geriatric rehabilitation patients, leading to prolonged recovery time and increased healthcare costs. While depressive symptoms showed no correlation with mobility impairments, improvements in functional status were directly associated with reduced GDS scores. Considering mental health during admission and planning is critical in optimizing rehabilitation outcomes.

Association between oral health-related quality of life and physical frailty among community-dwelling older adults: A 2-year longitudinal study.

Frailty is a major health concern among older adults, and its association with oral health-related quality of life (OHRQoL) remains underexplored in longitudinal studies. To investigate the association between baseline OHRQoL and physical frailty incidence at a 2-year follow-up in community-dwelling older adults. Prospective longitudinal study. The study was conducted within the Tosa Longitudinal Aging Study framework in Japan. This study included 144 community-dwelling older adults (50 men and 94 women; median age, 81.0 years) with complete data who participated in the Tosa Longitudinal Aging Study in 2016 and 2018 and were not categorized as physical frailty in 2016. Baseline assessment included OHRQoL, which was evaluated using the General Oral Health Assessment Index (GOHAI; range 12-60), with higher scores indicating better OHRQoL, oral function, and general health status. The incidence of physical frailty was defined using the revised Japanese version of the Cardiovascular Health Study criteria. The association between the GOHAI score and physical frailty was assessed using logistic regression analysis. The median baseline GOHAI score was 58. The incidence of frailty after a 2-year follow-up was 13.9 % among the participants (18.0 and 11.7 % for men and women, respectively). Each point of the GOHAI score was associated with an 11 % reduction in frailty risk over 2 years after adjusting by age, sex, number of teeth, Food Diversity Score, Geriatric Depression Scale score, eating alone, smoking, and more than five medications (adjusted odds ratio: 0.893; 95 % confidence interval: 0.810-0.984). This longitudinal study showed that a higher baseline OHRQoL, based on the GOHAI score, was linked to a lower incidence of physical frailty among community-dwelling older adults after 2 years.

Decreased neutrophil-to-lymphocyte ratio predicted cognitive improvement in late-life depression treated with vortioxetine: Findings from an eight-week randomized controlled trial.

Elevated neutrophil-to-lymphocyte ratio, a marker of inflammation, has been reported in adult and late-life depression. Vortioxetine has shown efficacy in treatment of late-life depression, yet little is known regarding its immunomodulatory role in clinical trials. This is a post-hoc analysis of an eight-week randomized controlled trial. Depressed patients aged 65 or above were treated by vortioxetine, duloxetine or placebo. 321 patients that have taken blood tests at baseline and endpoint were included in the analysis. Neutrophil-to-lymphocyte ratio (NLR) was calculated using the absolute counts of each cell type. Cognitive performance was assessed by composite score of Digit Symbol Substitution Test (DSST) and the Rey Auditory Verbal Learning Test (RAVLT) tasks, while depressive symptoms were assessed by Montgomery-Åsberg Depression Rating Scale (MADRS) and Geriatric Depression Scale (GDS). NLR levels decreased significantly in the entire analysis set (t(320) = 2.64, p = 0.008) and in the vortioxetine group (M = -0.186, t(105) = 2.070, p = 0.041, Cohen's d = 0.20), but not in the two other groups. This decrease was not significantly different compared to placebo (F(1, 213) = 0.420, p = 0.517). Furthermore, larger NLR changes in vortioxetine arm predicted significant cognitive improvement (β = -4.03, p = 0.03), specifically regarding the DSST correct symbols (β = -1.97, p = 0.04) and RAVLT delayed recall (β = -1.87, p = 0.02) tasks. Additionally, decreased NLR significantly predicted reduced GDS score (β = 1.82, p = 0.02), yet not MADRS score. Vortioxetine treatment was associated with decreased NLR levels in late-life depression, and reductions in NLR predicted improvements in cognitive function and depressive symptoms, suggesting a potential link between inflammation and clinical outcomes.

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.

Bone morphogenetic protein levels relate to osteoarthritis and neurobehavioral outcomes in cognitively unimpaired older adults

AbstractBackgroundOsteoarthritis (OA) is a degenerative disorder of bone aging and risk factor for cognitive decline. Bone morphogenetic proteins (BMPs) are growth factor proteins that regulate skeletal and neural development, and circulating BMPs may mediate molecular cross‐talk between bone and brain. The present study examined plasma BMP levels in relation to OA and neurobehavioral outcomes in cognitively unimpaired (CU) older adults.MethodsParticipants included 65 CU adults (mean age= 76.45, 60% female) enrolled in the UCSF Brain Aging Network for Cognitive Health (BrANCH) study who underwent cross‐sectional neurological examination, neuropsychological testing, and blood draw. Participants were classified as OA (n=31) or control (CTL; n=34) based on clinician exam (UDS Medical Conditions). Plasma was assayed for 11 different BMPs via SomaScan v4.1. Composite z‐scores were calculated for cognitive domains of memory and executive functioning. Mood symptoms were quantified with the 30‐item Geriatric Depression Scale (GDS). ANCOVA compared BMP concentrations between OA and CTL, adjusting for age and sex. Separate multiple linear regressions examined the relationship between OA‐associated BMPs and neurobehavioral outcomes across the entire sample (cognitive z‐scores, GDS total score), adjusting for age, sex, and education.ResultsOA and CTL groups did not significantly differ on demographics or neurobehavioral outcomes (ps&gt;0.10). Five BMPs were differentially abundant (ps&lt;.05) between OA and CTL (lower in OA: BMP5, BMP7, BMP10, BMP6; higher in OA: BMP4). In neurobehavioral models, lower BMP6 and higher BMP4 levels related to worse executive functioning (BMP6: β=0.27, p=.03; BMP4: β=‐0.28, p=.02) and higher GDS scores (BMP6: β=‐0.33, p=.02; BMP4: β=0.34, p=.01). Higher BMP10 also related to lower GDS scores (β=‐0.31, p=.02). No associations were observed between BMPs and memory z‐scores (ps&gt;0.05).ConclusionIn a cohort of CU older adults, OA related to differential plasma abundance of BMPs. In turn, circulating BMP levels, specifically BMP4, BMP6, and BMP10, were associated with executive function and depressive symptoms. These data help provide a molecular link connecting skeletal disorders of aging (e.g., OA) to adverse neurobehavioral outcomes. Given the diverse immunovascular, metabolic, and growth regulatory functions of BMPs, additional mechanistic work is needed to identify the precise pathways by which systemic BMPs interact with the central nervous system.

Association between Stress and White Matter Hyperintensity Volume in Diverse Populations: A HABS‐HD Study

AbstractBackgroundOlder African American (AA) and Hispanic American (HA) adults have a higher risk for Alzheimer’s disease and related dementias (ADRD) than older non‐Hispanic white (NHW) adults. Adverse experiences like stress and discrimination may contribute to the higher vascular disease burden observed in AA and HA persons. Cerebrovascular disease reflected by white matter hyperintensity (WMH) lesions on magnetic resonance imaging (MRI) may affect ADRD risk in older AA and HA adults. As stress may influence vascular disease and thus ADRD risk, this study explores associations between stress and WMH burden in a diverse cohort.MethodWe analyzed stress scores and WMH volume data from self‐reported NHW, AA, and HA participants in the Health and Aging Brain Study: Health Disparities. Data obtained at the baseline study visit includes the Clinical Dementia Rating (CDR), Chronic Stress Scale (CSS), Everyday Discrimination Scale (EDS), Penn State Worry Questionnaire (PSWQ), Geriatric Depression Scale (GDS), and MRI brain scans. With this data, we used global CDR scores (normal=0, impaired≥0.5) and race to create race/cognitive groups (white/normal, white/impaired, AA/normal, AA/impaired, HA/normal, HA/impaired). We compared baseline characteristics, stress and GDS scores, and WMH burden in the groups with ANOVA and chi‐square. Next, we performed linear regression adjusted for age, education, and sex to test associations between stress scores and WMH burden.ResultData from 3,035 participants was analyzed (mean age: 65.2; female: 62.3%; impaired: 20.1%). Compared to the NHW and HA groups, AA participants had higher CSS scores (NHW: 7.44, HA: 7.1, AA: 8.42, p=.0003), EDS scores (NHW: 5.59, HA: 6.2, AA: 9.47, p&lt;.0001), and WMH volume (NHW: 4.16, HA: 3.18, AA: 18.4, p&lt;.0001). The HA group had higher GDS scores (NHW: 4.86, HA: 6.71, AA: 5.61, p&lt;.0001). Regression showed that higher EDS scores were associated with higher WMH volume in the AA/impaired (β=3.48, p=.02) and HA/impaired (β=.27, p=.002) groups.ConclusionOur results suggest that higher discrimination scores may be linked to higher WMH volume in older AA and HA adults with cognitive impairment. As vascular disease may contribute to their higher ADRD risk, further study of stress, microvascular brain disease, and ADRD risk is needed.

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.

The effect of comorbidities on Alzheimer’s disease/cognition by race/ethnicity and the mediating role of AD pathologies measured by blood biomarkers

AbstractBackgroundThe study aims to assess the associations of comorbidities (hypertension, dyslipidemia, diabetes, chronic kidney disease [CKD], and depression) with mild cognitive impairment (MCI), Alzheimer’s dementia (AD dementia), and cognition by race/ethnicity; and to examine whether blood AD biomarkers mediate the associations.MethodWe used data from the baseline and visit 2 of the Health &amp; Aging Brain Study‐Health Disparities (HABS‐HD) study. 2057 participants were included in the cross‐sectional analyses, and 792 participants, who were cognitively normal at baseline and had follow‐up data, were included in the longitudinal analyses. Race/ethnicity was categorized into Latinos, non‐Hispanic Black, and non‐Hispanic Whites. Blood AD biomarkers included amyloid β40 (Aβ40), amyloid β42 (Aβ42), total tau, phosphorylated tau 181(p‐tau 181), and neurofilament light chain (NfL). Blood AD biomarker changes between the two visits were calculated. Global cognition was assessed by the Mini Mental State Examination (MMSE). Causal mediation analyses were used.ResultIn the cross‐sectional analyses, the odds of AD dementia and MCI increased with higher levels of Geriatric Depression Scale (GDS) scores across all races/ethnicities. In the longitudinal analyses, those with CKD (β=‐0.431, 95% CI: ‐0.812, ‐0.049) and higher levels of GDS score (β=‐0.027, 95% CI: ‐0.050, ‐0.004) were negatively associated with global cognition at visit 2. While triglyceride (β=0.002, 95% CI: 0.0003, 0.003) and hemoglobin A1c (β=0.086, 95% CI: 0.002, 0.170) values were positively associated with global cognition at visit 2. Changes in Aβ40 and Aβ42 were found to be significantly associated with global cognition in both the overall sample and the Latino sample. The natural indirect effect of triglyceride on global cognition through changes in Aβ40 (β=0.0002, 95% CI: 0.00002, 0.0006) was found to be significant among the overall sample, with 15.80% of the association being mediated via changes in Aβ40.ConclusionOur study is the first to examine the mediating role of blood AD biomarkers in associations of various comorbidities with AD and cognition by race/ethnicity. We found that changes in Aβ40 mediated the associations between triglyceride and global cognition, providing evidence that amyloid pathology might be the underlying mechanism.

Associations among Neurofilament light chain (NfL), Depressive Symptoms and Cognition in autosomal dominant Alzheimer´s disease

AbstractBackgroundDepressive symptoms are associated with neurodegeneration in individuals at increased risk for late‐onset Alzheimer’s disease, but these relationships are less clear in younger individuals and those at risk for autosomal dominant Alzheimer’s Disease (ADAD). Neurofilament light chain (NfL) is a biomarker of axonal damage and neuronal degeneration that becomes abnormal several decades before clinical onset in ADAD. To address this gap, we investigated the associations among depressive symptoms, plasma NfL and cognition in a younger cohort affected by the PSEN1‐E280A genetic variant. Carriers of this variant usually develop dementia by their 50s.MethodA total of 677 carriers (574 cognitively unimpaired and 103 cognitively impaired) and 620 non‐carriers (median age 32 [Interquartile range IQR 24‐42], 55% women, 8 median education years [IQR 4‐11] from the Colombian kindred with ADAD due to the PSEN1‐E280A mutation were included. Participants underwent a neuropsychological evaluation, which included the Mini‐Mental State Examination (MMSE), a Spanish version of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) word list learning test (WLL), the 15‐item Geriatric Depression Scale (GDS), and the Functional Assessment Staging Test (FAST) to assess functional independence. Mann‐Whitney‐Wilcoxon test was used to examine group differences, and Spearman’s correlations were used to investigate associations among depressive symptoms, NfL and cognition.ResultCompared to non‐carriers, carriers had higher levels of NfL (carriers=10.98, IQR 5.34‐13.44; non‐carriers=7.41, IQR 4.68‐8.90, p&lt;0.001). There were no group differences in depressive symptoms (carriers =3.44, IQR 1‐5; non‐carriers=2.73, IQR 1‐4, p=0.19). In carriers, higher NfL levels were associated with higher GDS scores (r=0.093; p&lt;0.001). Higher GDS scores were associated with lower MMSE scores (r= ‐0.18; p&lt;0.001) and poorer CERAD WLL performance (r=‐0.17; p&lt;0.001).ConclusionOur study showed that higher NfL plasma levels are associated with higher levels of self‐reported depressive symptoms in individuals with ADAD. These findings support neurodegenerative pathology underlying neuropsychiatric symptoms in ADAD and that these relationships can be detected using plasma measures. Future longitudinal analyses, examining other pathological mechanisms, and GDS‐items are needed to understand these symptoms more clearly in individuals with ADAD and whether they may be useful targets for AD prevention efforts.

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.