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Non-essential symptoms of depression and cognitive impairment no dementia (CIND) in community-dwelling elders without dysphoria or anhedonia

Published online by Cambridge University Press:  14 September 2010

Olivier Potvin ,
Carol Hudon ,
Sébastien Grenier  and
Michel Préville
Olivier Potvin*
Affiliation:
Centre de recherche Hôpital Charles LeMoyne, Longueuil, Québec, Canada Centre de recherche Université Laval Robert-Giffard, Québec, Canada Université de Sherbrooke, Sherbrooke, Québec, Canada
Carol Hudon
Affiliation:
Centre de recherche Université Laval Robert-Giffard, Québec, Canada Université Laval, Québec, Québec, Canada
Sébastien Grenier
Affiliation:
Centre de recherche Hôpital Charles LeMoyne, Longueuil, Québec, Canada Université de Sherbrooke, Sherbrooke, Québec, Canada
Michel Préville
Affiliation:
Centre de recherche Hôpital Charles LeMoyne, Longueuil, Québec, Canada Université de Sherbrooke, Sherbrooke, Québec, Canada
*
Correspondence should be addressed to: Olivier Potvin, Centre de recherche Université Laval Robert-Giffard (F4500), 2601 de la Canardière, Québec, Canada, G1J 2G3. Phone: +1 418 663–5000 ext. 6857; Fax: +1 418–663-5971. Email: [email protected].
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Abstract

Background: Several neuropsychiatric symptoms observed in elders with cognitive impairment no dementia (CIND) can be part of a major depressive episode (MDE) or a “subthreshold” depressive episode. Certain neuropsychiatric symptoms of CIND are essential symptoms of MDE (e.g. dysphoria, anhedonia), while other are non-essential symptoms (NESD; e.g. fatigue, insomnia, cognitive complaint). Contrary to essential symptoms, NESD are not specific to MDE and are present in other disorders. It is unknown whether NESD are linked to CIND in absence of MDE or subthreshold MDE. The present study examined the association between NESD and probable CIND in elders without essential MDE symptoms.

Methods: Participants were 2028 community-dwelling individuals aged 65–96 years who had not experienced dysphoria/anhedonia during the year preceding the interview. Semi-structured in-home interviews evaluated the following NESD: alteration of appetite, sleep disturbance, psychomotor alteration, fatigue/loss of energy, worthlessness/guilt, and cognitive complaints. Probable CIND cases were defined based on the Mini-mental State Examination cut-offs (15th percentile) stratified for age, education and sex.

Results: Symptoms of fatigue/loss of energy (OR: 2.41, 95% CI: 1.42–4.09), sleep disturbance (OR: 3.04 CI: 1.69–5.46) and cognitive complaints (OR: 2.86 CI: 1.71–4.77) were significantly associated with CIND. These associations were not modified after adjustments for potential confounders (age, education level, sex, benzodiazepine use, chronic diseases, and brain disorders).

Conclusion: A psychiatric symptomatology occurs in older adults with CIND in the absence of MDE or subthreshold MDE. NESD encountered in the absence of dysphoria/anhedonia should receive particular attention by clinicians since they can be linked to cognitive difficulties.

Keywords

cognitive impairmenteldersfatiguesleep disturbancecognitive complaintsdepression
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Special Issue 8: Focus on prevention in psychogeriatrics , December 2010 , pp. 1344 - 1352
Copyright
Copyright © International Psychogeriatric Association 2010

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References

Alapin, I., Fichten, C. S., Libman, E., Creti, L., Bailes, S. and Wright, J. (2000). How is good and poor sleep in older adults and college students related to daytime sleepiness, fatigue, and ability to concentrate? Journal of Psychosomatic Research, 49, 381–390.CrossRefGoogle Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IVTR). Washington, DC: American Psychiatric Association.Google Scholar
Apostolova, L. G. and Cummings, J. L. (2008). Neuropsychiatric manifestations in mild cognitive impairment: a systematic review of the literature. Dementia and Geriatric Cognitive Disorders, 25, 115–126.CrossRefGoogle ScholarPubMed
Artero, S. et al. (2008). Risk profiles for mild cognitive impairment and progression to dementia are gender specific. Journal of Neurology, Neurosurgery and Psychiatry, 79, 979–984.CrossRefGoogle ScholarPubMed
Beaulieu-Bonneau, S. and Hudon, C. (2009). Sleep disturbances in older adults with mild cognitive impairment. International Psychogeriatrics, 21, 654–666.CrossRefGoogle ScholarPubMed
Bushnik, T., Englander, J. and Wright, J. (2008). Patterns of fatigue and its correlates over the first two years after traumatic brain injury. Journal of Head Trauma Rehabilitation, 23, 25–32.CrossRefGoogle Scholar
Busse, A., Bischkopf, J., Riedel-Heller, S. G. and Angermeyer, M. C. (2003). Mild cognitive impairment: prevalence and incidence according to different diagnostic criteria. Results of the Leipzig Longitudinal Study of the Aged (LEILA75+). British Journal of Psychiatry, 182, 449–454.CrossRefGoogle ScholarPubMed
Cricco, M., Simonsick, E. M. and Foley, D. J. (2001). The impact of insomnia on cognitive functioning in older adults. Journal of the American Geriatrics Society, 49, 1185–1189.CrossRefGoogle ScholarPubMed
DeLuca, J. (2005). Fatigue as a Window to the Brain. Cambridge: The MIT Press.CrossRefGoogle Scholar
Fisk, J. D., Merry, H. R. and Rockwood, K. (2003). Variations in case definition affect prevalence but not outcomes of mild cognitive impairment. Neurology, 61, 1179–1184.CrossRefGoogle Scholar
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
Fukuda, K., Straus, S. E., Hickie, I., Sharpe, M. C., Dobbins, J. G. and Komaroff, A. (1994). The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Annals of Internal Medicine, 121, 953–959.CrossRefGoogle ScholarPubMed
Graham, J. E. et al. (1997). Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet, 349, 1793–1796.CrossRefGoogle Scholar
Herrmann, L. L., Goodwin, G. M. and Ebmeier, K. P. (2007). The cognitive neuropsychology of depression in the elderly. Psychological Medicine, 37, 1693–1702.CrossRefGoogle ScholarPubMed
Kumar, R., Jorm, A. F., Parslow, R. A. and Sachdev, P. S. (2006). Depression in mild cognitive impairment in a community sample of individuals 60–64 years old. International Psychogeriatrics, 18, 471–480.CrossRefGoogle Scholar
Lichstein, K. L., Means, M. K., Noe, S. L. and Aguillard, R. N. (1997). Fatigue and sleep disorders. Behaviour Research and Therapy, 35, 733–740.CrossRefGoogle ScholarPubMed
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. and DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. Journal of the American Medical Association, 288, 1475–1483.CrossRefGoogle ScholarPubMed
Mitchell, A. J. (2008). Is it time to separate subjective cognitive complaints from the diagnosis of mild cognitive impairment? Age and Ageing, 37, 497–499.CrossRefGoogle ScholarPubMed
Mosko, S. et al. (1989). Self-reported depressive symptomatology, mood ratings, and treatment outcome in sleep disorders patients. Journal of Clinical Psychology, 45, 51–60.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
Nebes, R. D. et al. (2001). Relationship of deep white matter hyperintensities and apolipoprotein E genotype to depressive symptoms in older adults without clinical depression. American Journal of Psychiatry, 158, 878–884.CrossRefGoogle ScholarPubMed
Palmer, K., Wang, H. X., Backman, L., Winblad, B. and Fratiglioni, L. (2002). Differential evolution of cognitive impairment in nondemented older persons: results from the Kungsholmen Project. American Journal of Psychiatry, 159, 436–442.CrossRefGoogle ScholarPubMed
Palmer, K., Backman, L., Winblad, B. and Fratiglioni, L. (2008). Mild cognitive impairment in the general population: occurrence and progression to Alzheimer disease. American Journal of Geriatric Psychiatry, 16, 603–611.CrossRefGoogle ScholarPubMed
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183–194.CrossRefGoogle ScholarPubMed
Préville, M. et al. (2008). The epidemiology of psychiatric disorders in Quebec's older adult population. Canadian Journal of Psychiatry, 53, 822–832.CrossRefGoogle ScholarPubMed
Reid, L. M. and Maclullich, A. M. (2006). Subjective memory complaints and cognitive impairment in older people. Dementia and Geriatric Cognitive Disorders, 22, 471–485.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
Statistics Canada (2006). 2006 Census of Population. Ottawa: Statistics Canada.Google Scholar
Stulemeijer, M., Vos, P. E., Bleijenberg, G. and van der Werf, S. P. (2007). Cognitive complaints after mild traumatic brain injury: things are not always what they seem. Journal of Psychosomatic Research, 63, 637–645.CrossRefGoogle ScholarPubMed
Wittchen, H. U., Robins, L. N., Cottler, L. B., Sartorius, N., Burke, J. D. and Regier, D. (1991). Cross-cultural feasibility, reliability and sources of variance of the Composite International Diagnostic Interview (CIDI): the Multicentre WHO/ADAMHA Field Trials. British Journal of Psychiatry, 159, 645–653, 658.CrossRefGoogle ScholarPubMed
Ziino, C. and Ponsford, J. (2006). Selective attention deficits and subjective fatigue following traumatic brain injury. Neuropsychology, 20, 383–390.CrossRefGoogle ScholarPubMed