Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-19T02:01:57.809Z Has data issue: false hasContentIssue false
  • English
  • Français

Influence of education and depressive symptoms on cognitive function in the elderly

Published online by Cambridge University Press:  30 March 2009

Renata Avila ,
Marco Antonio Aparício Moscoso ,
Salma Ribeiz ,
Jony Arrais ,
Omar Jaluul  and
Cassio M. C. Bottino
Renata Avila*
Affiliation:
Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Marco Antonio Aparício Moscoso
Affiliation:
Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Salma Ribeiz
Affiliation:
Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Jony Arrais
Affiliation:
Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Omar Jaluul
Affiliation:
Department of Internal Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Cassio M. C. Bottino
Affiliation:
Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
*
Correspondence should be addressed to: Renata Avila, Guarara, 529-cj. 135, Jardim Paulista, São Paulo, Brazil Cep: 01425-001. Phone: +55 11 3885 8101; Fax: +55 11 3885 8101. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: The purpose of the present study was to investigate the influence that education and depression have on the performance of elderly people in neuropsychological tests.

Methods: The study was conducted at the Institute of Psychiatry, University of São Paulo School of Medicine, Hospital das Clínicas. All of the individuals evaluated were aged 60 or older. The study sample consisted of 59 outpatients with depressive disorders and 51 healthy controls. We stratified the sample by level of education: low = 1–4 years of schooling; high = 5 or more years of schooling. Evaluations consisted of psychiatric assessment, cognitive assessment, laboratory tests and cerebral magnetic resonance imaging.

Results: We found that level of education influenced all the measures of cognitive domains investigated (intellectual efficiency, processing speed, attention, executive function and memory) except the Digit Span Forward and Fuld Object Memory Evaluation (immediate and delayed recall), whereas depressive symptoms influenced some measures of memory, attention, executive function and processing speed. Although the combination of a low level of education and depression had a significant negative influence on Stroop Test part B, Trail Making Test part B and Logical Memory (immediate recall), we found no other significant effects of the interaction between level of education and depression.

Conclusion: The results of this study underscore the importance of considering the level of education in the analysis of cognitive performance in depressed elderly patients, as well as the relevance of developing new cognitive function tests in which level of education has a reduced impact on the results.

Keywords

depressionmemoryattentionexecutive functionprocessing speed
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 3 , June 2009 , pp. 560 - 567
Copyright
Copyright © International Psychogeriatric Association 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexopoulos, G. S., Meyers, B. S., Young, R. C., Kakuma, T., Sibereweig, D. and Charlson, M. (1997). Clinically defined vascular depression. American Journal of Psychiatry, 154, 562–565.Google ScholarPubMed
Arbuckle, T. Y., Maag, U., Pushkar, D. and Chaikelson, J. S. (1998). Individual differences in trajectory of intellectual development over 45 years of adulthood. Psychology and Aging, 13, 663–675.CrossRefGoogle ScholarPubMed
Bäckman, L. et al. (2005). Cognitive impairment in preclinical Alzheimer's disease: a meta-analysis. Neuropsychology, 19, 520–531.CrossRefGoogle ScholarPubMed
Baudic, S., Tzortzis, C., Barba, G. D. and Traykov, L. (2004). Executive deficits in elderly patients with major unipolar depression. Journal of Geriatric and Psychiatry and Neurology, 17, 195–201.CrossRefGoogle ScholarPubMed
Bhalla, R. K. et al. (2005). Does education moderate neuropsychological impairment in late-life depression? International Journal of Geriatric Psychiatry, 20, 413–417.CrossRefGoogle ScholarPubMed
Bennett, D. A. et al. (2003). Education modifies the relation of AD pathology to level of cognitive function in older persons. Neurology, 60, 1909–1915.CrossRefGoogle ScholarPubMed
Blazer, D. (2003). Depression in late life: Review and commentary. Journal of Gerontology Medical Science, 3, 249–265.CrossRefGoogle Scholar
Bottino, C. M. C., Almeida, O. P., Tamai, S., Forlenza, O. V., Scalco, M. Z. and Carvalho, I. A. M. (1999). Entrevista estruturada para diagnóstico de transtornos mentais em idosos – CAMDEX: The Cambridge Examination for Mental Disorders of the Elderly. Brazilian version (translated and adapted by the editors). Cambridge: Cambridge University Press.Google Scholar
Butters, M. A. et al. (2004). The nature and determinants of neuropsychological functioning in late-life depression. Archives of General Psychiatry, 61, 5878–5895.CrossRefGoogle ScholarPubMed
Christensen, H., Griffiths, K., Mackinnon, A. and Jacomb, P. (1997). A quantitative review of cognitive deficits in depression and Alzheimer-type dementia. Journal of International Neuropsychological Society, 3, 631–651.CrossRefGoogle ScholarPubMed
Del Porto, J. A. (1989). Aspectos gerais das escalas para avaliação e depressão. In Escalas de avaliação para Monitorização de Tratamento com Psicofármacos (pp. 93–100). São Paulo: Centro de Pesquisa em Psicobiologia Clínica do Departamento de Psicobiologia da Escola Paulista de Medicina.Google Scholar
Dixon, R. A., Bäckman, L. and Nilsson, L. G. (2004). New Frontiers in Cognitive Aging. New York: Oxford University Press.CrossRefGoogle Scholar
Dufouil, C., Alpérovitch, A. and Tzourio, C. (2003). Influence of education on the relationship between white matter lesions and cognition. Neurology, 60, 813–836.CrossRefGoogle ScholarPubMed
Elderkin-Thompson, V., Mintz, J., Haroon, E., Lavretsky, H. and Kumar, A. (2006). Executive dysfunction and memory in older patients with major and minor depression. Archives of Clinical Neuropsychology, 21, 669–676.CrossRefGoogle ScholarPubMed
Evans, D. A. et al. (1993). Level of education and change in cognitive function in a community population of older persons. Annals of Epidemiology, 3, 71–77.CrossRefGoogle Scholar
Folquitto, J. C. et al. (2007). The Bayer Activities of Daily Living Scale (B-ADL) in the differentiation between mild to moderate dementia and normal aging. Revista Brasileira de Psiquiatria, 29, 350–353.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 Psychiatry Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Fuld, P. A. (1980). Guaranteed stimulus-processing in the evaluation of memory and learning. Cortex, 16, 255–272.CrossRefGoogle ScholarPubMed
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.CrossRefGoogle ScholarPubMed
Kramer-Ginsberg, E. et al. (1999). Neuropsychological functioning and MRI signal hyperintensities in geriatric depression. American Journal of Psychiatry, 156, 438–444.CrossRefGoogle ScholarPubMed
Lehfeld, H. et al. (1997). Informant-rated activities of daily living (ADL) assessments: results of a study of 141 items in the USA, Germany, Russia and Greece from the International ADL Scale Development Project. Alzheimer Disease Association Disorder, 11 (Suppl. 4), 39–44.Google ScholarPubMed
Lezak, M. D. Howieson, D. B. and Loring, D. W. (2004). Neuropsychological Assessment. 4th edn. New York: Oxford University Press.Google Scholar
Linn, B. S., Linn, M. W. and Gurell, L. (1968). Cumulative Illness Rating Scale. Journal of American Geriatric Society, 16, 622–625.CrossRefGoogle ScholarPubMed
Lyketsos, C. G., Chen, L. S. and Anthony, J. C. (1999). Cognitive decline in adulthood: an 11.5 years follow-up of the Baltimore Epidemiologic Catchment Area study. American Journal of Psychiatry, 156, 58–65.CrossRefGoogle ScholarPubMed
Mesulam, M. M. (1985). Principle of Behavior Neurology. Philadelphia: F.A. Davies.Google Scholar
Montgomery, S. A. and Åsberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.CrossRefGoogle ScholarPubMed
Nitrini, R. et al. (2004). Performance of illiterate and literate nondemented elderly subjects in two tests of long-term memory. Journal of International Neuropsychology Society, 10, 634–638.CrossRefGoogle ScholarPubMed
Rapp, M. A., Dahlman, K., Sano, M., Grossman, H. T., Haroutunian, V. and Gorman, J. M. (2005). Neuropsychological differences between late-onset and recurrent geriatric major depression. American Journal of Psychiatry, 162, 691–698.CrossRefGoogle ScholarPubMed
Roth, M. et al. (1986). CAMDEX: a standardized instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry, 149, 698–709.CrossRefGoogle Scholar
Sheline, Y. I. et al. (2006). Cognitive function in late life depression: relationship to depression severity, cerebrovascular risk factor and processing speed. Biological Psychiatry, 60, 58–65.CrossRefGoogle ScholarPubMed
Spreen, O. and Benton, A. L. (1996). Neurosensory Center Comprehensive Examination for Aphasia (NCCEA). Victoria, BC: University of Victoria Neuropsychology Laboratory.Google Scholar
Spreen, O. and Strauss, E. (1998). A Compendium of Neuropsychological Tests: Administration, Norms and Commentary. New York: Oxford University Press.Google Scholar
Springer, M. V., McIntosh, A. R., Winocur, G. and Grady, C. L. (2005). The relation between brain activity during memory tasks and years of education in young and older adults. Neuropsychology, 19, 181–192.CrossRefGoogle ScholarPubMed
Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of International Neuropsychological Society, 8, 448–460.CrossRefGoogle ScholarPubMed
Stern, Y. (2003). The concept of cognitive reserve: a catalyst for research. Journal of Clinical Experimental Neuropsychology, 25, 589–593.CrossRefGoogle ScholarPubMed
Thomas, A. J., Kalarina, R. N. and O'Brien, J. T. (2004). Depression and vascular disease: what is the relationship? Journal of Affective Disorders, 79, 81–95.CrossRefGoogle ScholarPubMed
Vinkers, D., Gussekloo, J., Stek, M. L., Westendorp, R. G. J. and van der Mast, R. (2004). Temporal relation between depression and cognitive impairment in old age: prospective population-based study. BMJ, 329, 881–883.CrossRefGoogle ScholarPubMed
Wechsler, D. (1987). Wechsler Memory Scale-revised (WMS-R). New York: The Psychological Corporation.Google Scholar
Wechsler, D. (1999). Wechsler Abbreviated Scale of Intelligence (WASI). New York: The Psychological Corporation.Google Scholar
Wight, R. G., Aneshensel, C. S. and Seeman, T. E. (2002). Educational attainment continued learning experience, and cognitive function among older men. Journal of Aging and Health, 14, 211–236.CrossRefGoogle ScholarPubMed