Relationship Between Cognitive Impairment and Depression Among Middle Aged and Older Adults in Primary Care.
Ontology highlight
ABSTRACT:
SUBMITTER: Federman AD
PROVIDER: S-EPMC10929046 | biostudies-literature | 2024 Jan-Dec
REPOSITORIES: biostudies-literature
Publications
Relationship Between Cognitive Impairment and Depression Among Middle Aged and Older Adults in Primary Care.
Federman Alex D AD Becker Jacqueline J Carnavali Fernando F Rivera Mindt Monica M Cho Dayeon D Pandey Gaurav G Chan Lili L Curtis Laura L Wolf Michael S MS Wisnivesky Juan P JP
Gerontology & geriatric medicine 20240101
<b>Objectives:</b> To determine rates of previously undetected cognitive impairment among patients with depression in primary care. <b>Methods:</b> Patients ages 55 and older with no documented history of dementia or mild cognitive impairment were recruited from primary care practices in New York City, NY and Chicago, IL (<i>n</i> = 855). Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA) and depression with the Patient Health Questionnaire-8. <b>Results:</b> The mean ...[more]
Similar Datasets
Project description:BackgroundBiologic studies have suggested that tea may have neuroprotective activity. However, tea's protective effect on cognitive function is controversial in human epidemiological studies, and no data, including the middle-aged, are available. The objective of this study was to investigate the association of habit, frequency, and types of tea consumption with incident cognitive impairment in middle-aged and older adults.MethodsData from the Asymptomatic Polyvascular Abnormalities in Community study were used (aged over 40y). We gathered information on tea consumption, including habit, frequency, and types, via a standardized questionnaire and assessed cognitive function by Mini-Mental State Examination (MMSE) and/or Montreal Cognitive Assessment (MoCA). Three thousand eight hundred sixty-eight and 806 participants were selected in MMSE and MoCA subgroups. Multivariate logistic regression models were utilized to examine associations between tea consumption and cognitive impairment in middle-aged and older participants.ResultsIn MMSE analyses, after adjustment for potential confounding factors, habitual (odds ratio (OR) 0.47, [95% confidence interval (CI) 0.33-0.68], p < 0.001) and high frequency (p trend < 0.001) of tea intake were associated with a lower risk of cognitive impairment. The risk of cognitive impairment was lower in green tea consumption (OR 0.36, [95% CI 0.22-0.61], p < 0.001) than other types (OR 0.59, [95% CI 0.38-0.91], p = 0.017). In MoCA analyses, we got similar results.ConclusionsHabitual tea consumption, especially high-frequency and green tea consumption, was significantly associated with a lower prevalence of cognitive impairment in middle-aged and older individuals.
| S-EPMC7640442 | biostudies-literature
Project description:BackgroundHigh-density lipoprotein cholesterol (HDL-C) is widely recognized for its protective effects against cognitive decline. However, recent studies have presented conflicting results, with some suggesting no significant cognitive benefits or even an increased risk of dementia associated with high HDL-C levels. For those who suffer from depression, the cognitive benefits of HDL-C may be diminished or reversed. The purpose of this study is to investigate the associations between HDL-C, cognitive ability, and depressive symptoms in middle-aged and older Chinese adults.MethodsThe datasets utilized were sourced from the China Health and Retirement Longitudinal Study (CHARLS) for the years 2011 and 2015, comprising 4,302 participants. Cross-lagged models were employed to explore the temporal sequence between cognitive performance and HDL-C levels, and to examine the interplay among depression, cognition, and HDL-C. Confounding factors such as sociodemographic characteristics, sleep conditions, and history of chronic diseases were controlled for.ResultsThe analysis revealed unidirectional effects of baseline impaired cognition and greater severity of depression on increased HDL-C levels at follow-up (β = - 0.036 and β = 0.028, respectively, P < 0.05). However, higher baseline HDL-C levels did not significantly predict cognitive performance or depression 4 years later (β = - 0.008 and β = 0.023, respectively, P > 0.05). Depressive symptoms and cognition were found to have a significant bidirectional association (β = - 0.026 and β = - 0.053, respectively, P < 0.05).ConclusionsCognitive impairment and depression are associated with higher HDL-C levels, whereas higher HDL-C levels do not appear to protect against cognitive decline or depressive symptoms. These findings underscore the importance of preserving cognitive and mental health, which may lower the likelihood of cardiovascular disease and dementia. Future studies should validate these findings and develop targeted interventions tailored to specific populations.
| S-EPMC11382475 | biostudies-literature
Project description:BackgroundPhysical activity (PA) is crucial for the prevention and management of chronic diseases and may be associated with cognitive impairment. This study investigated the longitudinal relationship between PA from different parameters (e.g., frequency, duration, intensity, and volume) and the incidence of cognitive impairment in middle-aged and older adults.MethodsData were derived from the China Health and Retirement Longitudinal Study (2011-2015). A total of 891 adults aged 45 and older were included in this study. Cognitive function was assessed using the Telephone Interview for Cognitive Status criteria, focused on episodic memory and executive function. We categorized participants into normal cognition and cognitive impairment groups. Self-reported PA information including frequency, duration, intensity, and volume was collected through a representative survey. Poisson regression analysis was employed to explore the relationship between PA parameters and the incidence of cognitive impairment over four years.ResultsEngaging in moderate or light PA (MPA or LPA) at least three days per week, and vigorous PA (VPA) one to two days per week, was associated with a reduced incidence of cognitive impairment. Additionally, spending 30-119 min per day or 150 min per week or more on any PA intensity was linked to lower cognitive impairment prevalence. Sensitivity analysis, excluding individuals with neurological, mental, or memory impairments, confirmed these findings.ConclusionsThe findings highlight that the frequency, duration, and volume of VPA, MPA, or LPA are linked to the incidence of cognitive impairment. Regular PA may reduce the risk of cognitive impairment in middle-aged and older adults.
| S-EPMC11921536 | biostudies-literature
Project description:BackgroundBarriers to depression care differ across countries, highlighting the importance of identifying gaps in health-service coverage for regional health systems. This study aims to identify the bottlenecks of depression care and associated factors.MethodsWe used data from the Taiwan Longitudinal Study on Aging of 2015, included 7675 participants aged 50 years and older. We identified participants with clinically relevant depression using the Center for Epidemiological Studies Depression Scale or Taiwan's National Health Insurance program claims records of depressive disorders. Bottleneck analysis was based on a modified Tanahashi framework with four stages: healthcare accessibility, initial contact, adequate treatment, and effective coverage. Individual factors associated with achieving these stages were estimated using multivariable logistic regression models with multiple imputation.FindingsWe identified 1253 patients with clinically relevant depression; 83% perceived it as convenient to access healthcare, but only 27% had initial contact with health services, 16% received adequate coverage, and 11% achieved effective treatment. In terms of factors associated with initial contact, being female, married, or retired/unemployed; having a high education level, social group engagement, or self-reported diabetes mellitus; exercising regularly; and participating in social leisure activities were associated with increasing contact. Those with alcohol use had a low likelihood of treatment.InterpretationInitial contact constitutes the primary bottleneck of depression care in Taiwan. Improving mental health literacy and enhancing depression screening would be helpful to elevate treatment rates and improve depression care.FundingThis study was supported by a grant from the Ministry of Health and Welfare, Taiwan.
| S-EPMC9535419 | biostudies-literature
Project description:BACKGROUND: Depression is common among older cancer patients, but little is known about the optimal approach to caring for this population. This analysis evaluates the effectiveness of the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) program, a stepped care management program for depression in primary care patients who had an ICD-9 cancer diagnosis. METHODS: Two hundred fifteen cancer patients were identified from the 1,801 participants in the parent study. Subjects were 60 years or older with major depression (18%), dysthymic disorder (33%), or both (49%), recruited from 18 primary care clinics belonging to 8 health-care organizations in 5 states. Patients were randomly assigned to the IMPACT intervention (n = 112) or usual care (n = 103). Intervention patients had access for up to 12 months to a depression care manager who was supervised by a psychiatrist and a primary care provider and who offered education, care management, support of antidepressant management, and brief, structured psychosocial interventions including behavioral activation and problem-solving treatment. RESULTS: At 6 and 12 months, 55% and 39% of intervention patients had a 50% or greater reduction in depressive symptoms (SCL-20) from baseline compared to 34% and 20% of usual care participants (P = 0.003 and P = 0.029). Intervention patients also experienced greater remission rates (P = 0.031), more depression-free days (P < 0.001), less functional impairment (P = 0.011), and greater quality of life (P = 0.039) at 12 months than usual care participants. CONCLUSIONS: The IMPACT collaborative care program appears to be feasible and effective for depression among older cancer patients in diverse primary care settings.
| S-EPMC2763171 | biostudies-other
Project description:BackgroundCognitive decline poses one of the greatest global challenges for health and social care, particularly in China, where the burden on the older adult population is most pronounced. Despite the rapid expansion of internet access, there is still limited understanding of the long-term cognitive impacts of internet use among middle-aged and older adults.ObjectiveThis study aims to explore the association between internet use and age-related cognitive decline among middle-aged and older Chinese adults. To gain a more comprehensive understanding of the effects of internet use, we also focused on assessing the impact of both the frequency of internet use and the types of internet devices on cognition. Moreover, we assessed the mediating role of internet use on cognitive function for characteristics significantly linked to cognition in stratified analysis.MethodsWe analyzed data based on 12,770 dementia-free participants aged ≥45 years from the China Health and Retirement Longitudinal Study. We used a fixed effects model to assess the relationship between internet use and cognitive decline and further validated it using multiple linear regression analysis, generalized estimating equations, propensity score matching, inverse probability of treatment weighting, and overlap weighting. We further examined the varying effects of internet device type and frequency on cognitive function using fixed effects models and Spearman rank correlations. The Karlson-Holm-Breen method was used to estimate the mediating role of internet use in the urban-rural cognitive gap.ResultsParticipants using the internet (n=1005) were younger, more likely to be male, more educated, married, retired and living in an urban area and had higher cognitive assessment scores than nonusers (n=11,765). After adjusting for demographic and health-related risk factors, there was a positive correlation between internet use and cognitive function (β=0.551, 95% CI 0.391-0.710). Over the follow-up period, persistent internet users had a markedly lower 5-year incidence of neurodegenerative diseases, at 2.2% (15/671), compared with nonusers, at 5.3% (379/7099; P<.001). The negative impact of aging (>50 years) on cognitive function was consistently less pronounced among internet users than among nonusers. Furthermore, increased frequency of internet use was associated with greater cognitive benefits for middle-aged and older adults (rs=0.378, P<.001). Among digital devices used for internet access, cell phones (β=0.398, 95% CI 0.283-0.495) seemed to have a higher level of cognitive protection than computers (β=0.147, 95% CI 0.091-0.204). The urban-rural disparity in cognitive function was partially attributed to the disparity in internet use (34.2% of the total effect, P<.001).ConclusionsThis study revealed that the use of internet by individuals aged 45 years and older is associated with a reduced risk of cognitive decline. Internet use has the potential to be a viable, cost-effective, nonpharmacological intervention for cognitive decline among middle-aged and older adults.
| S-EPMC11660964 | biostudies-literature
Project description:This study aimed to synthesize the current literature examining the association between migration and cognitive function among middle-aged and older adults.We used the PRISMA as a guideline for this systematic review and searched the following databases: PubMed, CINAHL, EMBASE, and Global Health.Twenty-five published studies were included. Twenty-two studies were focused on international migrants, while only 3 studied internal migrants. Fourteen studies were conducted in the United States, followed by UK (n = 2), Israel (n = 2), India (n = 2) and other countries like Canada and Australia. Some studies showed that middle-aged and older migrants demonstrated poorer cognitive function comparing to non-migrants in hosting places; while other studies indicated no association between migration and cognitive function. A higher level of acculturation was associated with better performance on cognitive function tests among migrants.It is unclear how or whether migration and cognitive function are related. The quality of current literature suffered from methodological deficiencies. Additional research is needed to examine the linkages using more comprehensive measures of migration and cognitive function.
| S-EPMC5561610 | biostudies-other
Project description:It is necessary to determine which variables help prevent the presence of decline or deterioration during the aging process as a function of advancing age. This research analyses the relations between cognitive reserve (CR) and cognitive impairment in 300 individuals. It also aims to confirm the influence of different variables (gender, age, level of studies and institutionalization) in CR and in deterioration in a population of older adults. The results indicate that people with higher CR present less deterioration. Regarding the role of the sociodemographic variables in the level of deterioration and CR, there are no differences between men and women, but there are differences in the variables age, level of studies and institutionalization, in such a way that the older age the greater the cognitive deterioration, the higher the level of studies, the more RC and less deterioration and it was found that the non-institutionalized people present less deterioration and greater CR. It is affirmed that two people with similar clinical characteristics may present different levels of pathology, being the CR the explanation of this fact. The results obtained allow us to affirm that the measurement of CR is considered an essential variable for the diagnosis of neurodegenerative diseases.
| S-EPMC7459499 | biostudies-literature
Project description:BackgroundVision loss is associated with increased risk of falls and restricted physical activity, yet the relationship between multiple vision measures and objectively measured physical activity, especially activity patterns, in mid-to-late life is not well understood.MethodThis study included 603 participants aged 50 years and older (mean age = 73.5) in the Baltimore Longitudinal Study of Aging who had the following assessments: presenting and best-corrected visual acuity, contrast sensitivity, visual fields, stereo acuity, and free-living physical activity using a wrist-worn ActiGraph accelerometer for 7 days. Linear regression models were used to examine the association between vision measures and daily activity counts, active minutes, and activity fragmentation (defined as an active-to-sedentary transition probability), adjusting for potential confounders. Mixed-effects models estimated differences in activity by time of day comparing those with and without each visual impairment.ResultsIn the fully adjusted model, worse presenting visual acuity, contrast sensitivity, and visual fields were associated with fewer activity counts, less active time, and more fragmented activity patterns (p < .05 for all). Participants with presenting or best-corrected visual acuity impairment had 19.2 and 29.3 fewer active minutes (p = .05 and p = .03, respectively) per day. Visual field impairment was associated with 268 636 fewer activity counts (p = .02), 46.2 fewer active minutes (p = .02) per day, and 3% greater activity fragmentation (p = .009). Differences in activity levels tended to be greatest from 6 am to 6 pm (p < .05).ConclusionsOlder adults with visual impairment have restricted and more fragmented patterns of daily activity. Longitudinal studies to quantify the long-term impacts of visual impairments on activity decline are warranted.
| S-EPMC8599058 | biostudies-literature
Project description:ObjectivesCognitive impairment is underdiagnosed in primary care. Understanding factors that precipitate memory-related discussion could inform strategies to improve diagnosis and counseling. We assessed whether: 1) having a cognitive impairment or dementia diagnosis, 2) ratings of cognition by clinicians, or 3) ratings of cognition by family companions were associated with memory-related discussion during primary care visits.MethodsWe examined audio-recorded primary care visits of cognitively impaired patients aged 65 years and older, family companions (n = 93 dyads), and clinicians (n = 14). Cognitive impairment and dementia diagnoses were extracted from the electronic health record. Clinicians and family rated patient cognition on a 10-point scale in postvisit surveys. We measured memory-related discussion using a ratio of memory-related discussion episodes to total visit statements.ResultsWe observed more memory-related discussion during primary care visits of patients with a diagnosis of mild cognitive impairment (+7.8% episodes; P < .001) or dementia (+26.3% episodes; P < .001) than no diagnosis. Clinician and family ratings of cognition varied by diagnosis: among patients with no diagnosis, family rated worse impairment than clinicians (average: 2.4 versus 1.3; P = .004) while for patients with a dementia diagnosis, clinicians rated worse impairment than family (average: 7.1 versus 5.5; P = .006). Each unit increase in clinician-rated severity of cognitive impairment was associated with more memory-related discussion (+2.6% episodes; P < .001); this association was attenuated for family (+0.7% episodes; P = .095).ConclusionsDiscussion of cognitive impairment appears largely driven by clinician ratings of cognition and presence of an established diagnosis. Findings suggest potential benefit of engaging family to improve cognitive impairment detection in primary care.
| S-EPMC6954826 | biostudies-literature