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Disability but not social support predicts cognitive deterioration in late-life depression

Published online by Cambridge University Press:  05 December 2014

Meghan Riddle ,
Douglas R. McQuoid ,
Guy G. Potter ,
David C. Steffens  and
Warren D. Taylor
Meghan Riddle
Affiliation:
The Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, 37212, USA
Douglas R. McQuoid
Affiliation:
Department of Psychiatry, Duke University Medical Center, Durham, NC, 27710, USA
Guy G. Potter
Affiliation:
Department of Psychiatry, Duke University Medical Center, Durham, NC, 27710, USA
David C. Steffens
Affiliation:
Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, 06030, USA
Warren D. Taylor*
Affiliation:
The Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, 37212, USA Department of Veterans Affairs Medical Center, The Geriatric Research, Education, and Clinical Center (GRECC), Tennessee Valley Healthcare System, Nashville, TN, 37212, USA
*
Correspondence should be addressed to: Warren D. Taylor, Vanderbilt University, 1601 23rd Avenue South, Nashville, TN 37212, USA. Phone: (615) 322-1073; Fax: (615) 875-0686. Email: [email protected].
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Abstract

Background:

Depression in late life is a risk factor for cognitive decline. Depression is also associated with increased disability and social support deficits; these may precede conversion to dementia and inform risk. In this study, we examined if baseline or one-year change in disability and social support predicted later cognitive deterioration.

Methods:

299 cognitively intact depressed older adults were followed for an average of approximately seven years. Participants received antidepressant treatment according to a standardized algorithm. Neuropsychological testing and assessment of disability and social support were assessed annually. Cognitive diagnosis was reviewed annually at a consensus conference to determine if participants remained cognitively normal, or if they progressed to either dementia or cognitively impaired, no dementia (CIND).

Results:

During study participation, 167 individuals remained cognitively normal (56%), 83 progressed to CIND (28%), and 49 progressed to dementia (16%). Greater baseline instrumental activities of daily living (IADL) deficits predicted subsequent conversion to a cognitive diagnosis (CIND or dementia). However, neither baseline measures nor one-year change in basic ADLs (BADLs) and social support predicted cognitive conversion. In post hoc analyses, two IADL measures (managing finances, preparing meals) significantly increased the odds of cognitive conversion.

Conclusions:

Greater IADL deficits predicted increased risk of cognitive conversion. Assessment of IADL deficits may provide clues about risk of later cognitive decline.

Keywords

depressiondisabilitysocial supportdementiacognitionmemory
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 5 , May 2015 , pp. 707 - 714
Copyright
Copyright © International Psychogeriatric Association 2014 

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References

Alexopoulos, G. S. et al. (1996). Disability in geriatric depression. American Journal of Psychiatry, 153, 877–885.Google Scholar
Alexopoulos, G. S. et al. (2011). Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction: effect on disability. Archives of General Psychiatry, 68, 33–41.Google Scholar
Amieva, H. et al. (2008). Prodromal Alzheimer's disease: successive emergence of the clinical symptoms. Annals of Neurology, 64, 492–498.CrossRefGoogle ScholarPubMed
Barberger-Gateau, P., Fabrigoule, C., Rouch, I., Letenneur, L. and Dartiques, J. F. (1999). Neuropsychological correlates of self-reported performance in instrumental activities of daily living and prediction of dementia. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 54, 293–303.Google Scholar
Branch, L. G., Katz, S., Kniepmann, K. and Papsidero, J. A. (1984). A prospective study of functional status among community elders. American Journal of Public Health, 74, 266–268.CrossRefGoogle ScholarPubMed
Bruce, M. L., Seeman, T. E., Merrill, S. S. and Blazer, D. G. (1994). The impact of depressive symptomatology on physical disability: MacArthur studies of successful aging. American Journal of Public Health, 84, 1796–1799.CrossRefGoogle ScholarPubMed
Clark, C. M. and Ewbank, D. C. (1996). Performance of the dementia severity rating scale: a caregiver questionnaire for rating severity in Alzheimer disease. Alzheimer Disease and Associated Disorders, 10, 31–39.Google Scholar
Desai, A. K., Grossberg, G. T. and Sheth, D. N. (2004). Activities of daily living in patients with dementia: clinical relevance, methods of assessment and effects of treatment. CNS Drugs, 18, 853–875.Google Scholar
Dickinson, W. J., Potter, G. G., Hybels, C. F., McQuoid, D. R. and Steffens, D. C. (2011). Change in stress and social support as predictors of cognitive decline in older adults with and without depression. International Journal of Geriatric Psychiatry, 26, 1267–1274.Google Scholar
Farias, S. T., Mungas, D., Reed, B. R., Harvey, D. and DeCarli, C. (2009). Progression of mild cognitive impairment to dementia in clinic- vs community-based cohorts. Archives of Neurology, 66, 1151–1157.CrossRefGoogle ScholarPubMed
Fields, J. A. et al. (2010). Utility of the DRS for predicting problems in day-to-day functioning. The Clinical Neuropsychologist, 24, 1167–1180.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state” a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
George, L. K., Blazer, D. G., Hughes, D. C. and Fowler, N. (1989). Social support and the outcome of major depression. British Journal of Psychiatry, 154, 478–485.Google Scholar
Hsiung, G. Y. et al. (2006). Outcomes of cognitively impaired not demented at 2 years in the Canadian cohort study of cognitive impairment and related dementias. Dementia and Geriatric Cognitive Disorders, 22, 413–420.Google Scholar
Hybels, C. F., Pieper, C. F. and Blazer, D. G. (2009). The complex relationship between depressive symptoms and functional limitations in community-dwelling older adults: the impact of subthreshold depression. Psychological Medicine, 39, 1677–1688.Google Scholar
Isaac, V., Stewart, R., Artero, S., Ancelin, M. L. and Ritchie, K. (2009). Social activity and improvement in depressive symptoms in older people: a prospective community cohort study. Amercian Journal of Geriatric Psychiatry, 17, 688–696.CrossRefGoogle ScholarPubMed
James, B. D., Wilson, R. S., Barnes, L. L. and Bennett, D. A. (2011). Late-life social activity and cognitive decline in old age. Journal of the International Neuropsychological Society, 17, 998–1005.Google Scholar
Kiosses, D. N. and Alexopoulos, G. S. (2005). IADL functions, cognitive deficits, and severity of depression: a preliminary study. American Journal of Geriatric Psychiatry, 13, 244–249.CrossRefGoogle ScholarPubMed
Montgomery, S. A. and Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.Google Scholar
Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Tangalos, E. G. and Kokmen, E. (1999). Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology, 56, 303–308.Google Scholar
Potter, G. G., McQuoid, D. R., Payne, M. E., Taylor, W. D. and Steffens, D. C. (2012). Association of attentional shift and reversal learning to functional deficits in geriatric depression. International Journal of Geriatric Psychiatry, 27, 1172–1179.Google Scholar
Robins, L. N., Helzer, J. E., Croughan, J. and Ratcliff, K. S. (1981). National institute of mental health diagnostic interview schedule. Its history, characteristics, and validity. Archives of General Psychiatry, 38, 381–389.Google Scholar
Rosow, I. and Breslau, N. (1966). A Guttman health scale for the aged. Journal of Gerontology, 21, 556–559.Google Scholar
Steffens, D. C., Hays, J. C. and Krishnan, K. R. R. (1999). Disability in geriatric depression. American Journal of Geriatric Psychiatry, 7, 34–40.CrossRefGoogle ScholarPubMed
Steffens, D. C., McQuoid, D. R. and Potter, G. G. (2009). Outcomes of older cognitively impaired individuals with current and past depression in the NCODE study. Journal of Geriatric Psychiatry and Neurology, 22, 52–61.Google Scholar
Steffens, D. C. et al. (2004). Methodology and preliminary results from the neurocognitive outcomes of depression in the elderly study. Journal of Geriatric Psychiatry and Neurology, 17, 202–211.Google Scholar
Taylor, W. D. (2014). Depression in the elderly. The New England Journal of Medicine, 371, 1228–1236.Google Scholar
Taylor, W. D. et al. (2003). Smaller orbital frontal cortex volumes associated with functional disability in depressed elders. Biological Psychiatry, 53, 144–149.Google Scholar
Tilvis, R. S., Kahonen-Vare, M. H., Jolkkonen, J., Valvanne, J., Pitkala, K. H. and Strandberg, T. E. (2004). Predictors of cognitive decline and mortality of aged people over a 10-year period. Journal of Gerontology: Medical Sciences, 59, 268–274.Google Scholar
Tschanz, J. T. et al. (2000). Dementia diagnoses from clinical and neuropsychological data compared: the Cache County study. Neurology, 54, 1290–1296.Google Scholar