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Depressive symptoms with cognitive dysfunction increase the risk of cognitive impairment: analysis of the Korean Longitudinal Study of Aging (KLoSA), 2006–2018

Published online by Cambridge University Press:  16 November 2020

Minyoung Shin Open the ORCID record for Minyoung Shin [Opens in a new window]
Minyoung Shin*
Affiliation:
Department of Counseling Psychology, Yongmoon Graduate School of Counseling Psychology, Seoul, Republic of Korea
*
Correspondence should be addressed to: Minyoung Shin, Department of Counseling Psychology, Yongmoon Graduate School of Counseling Psychology, 154 Yulgok-ro, Jongro-gu, Seoul 03136, Republic of Korea. Phone +82 2 6964 7039; Fax: +82 2 3672 1012. Emails: mywindy@empal.com; shinminyoung@yongmoon.ac.kr.
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Abstract

Objectives:

Geriatric depression complicates cognitive health in older adults. This study aims to investigate the impact of depressive symptoms on cognitive impairment in community-dwelling older adults, depending on whether cognitive dysfunction accompanied.

Design:

A community-based longitudinal cohort study.

Setting:

This study analyzed data from the Korean Longitudinal Study of Aging (KLoSA) from 2006 to 2018.

Participants:

Among 10,254 individuals who were registered in the KLoSA study, a total of 9119 subjects met the criteria, and 4547 subjects were included in the final analysis. The subjects were grouped into 4 categories based on depressive symptoms and cognitive dysfunction at baseline assessment: “normal control” (NC, n = 3341), “depression only” (Dep-only, n = 652), “cognitive dysfunction only” (CD-only, n = 393), and “depression with cognitive dysfunction” (Dep-CD, n = 161).

Measurements:

Cognitive impairment 10 years later was defined as K-MMSE scores below two percentile on demographically adjusted norms.

Results:

Ten-year survival, that is, not experiencing cognitive impairment, was 80 $$ \pm \,$$1% in NC group, 72 $$ \pm $$ 2% in Dep-only group, 52 $$ \pm $$ 3% in CD-only group, and 44 $$ \pm $$ 5% in Dep-CD group. The hazard ratio (HR) of the Dep-only group (HR = 1.18, 95% CI, 0.97–1.43, n.s.) did not differ from that of the NC group, but the HR of the Dep-CD group was significantly higher (HR = 2.85, 95% CI, 2.23–3.66, p < 0.001) than the NC group. When the Dep-CD group was compared to the CD-only group, the HR was 1.13 (95% CI, 0.85–1.49, n.s.), which indicates that it did not significantly differ from the CD-only group.

Conclusions:

Our findings suggest that depressive symptoms with cognitive dysfunction are associated with a higher risk of cognitive impairment. Furthermore, cognitive dysfunction occurring with depressive symptoms is as much a risk for cognitive impairment as is pure cognitive dysfunction. Thus, healthcare providers should pay close attention to the community-dwelling elderly when depressive symptoms occur with cognitive dysfunction.

Keywords

depressive symptomspseudodementiacognitive impairmentKLoSA
Type
Original Research Article
Information
International Psychogeriatrics , Volume 33 , Special Issue 8: Issue Theme: Longitudinal Studies of Aging , August 2021 , pp. 791 - 801
Copyright
© International Psychogeriatric Association 2020

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References

Alexopoulos, G. S., Meyers, B. S., Young, R. C., Mattis, S. and Kakuma, T. (1993). The course of geriatric depression with “reversible dementia”: A controlled study. American Journal of Psychiatry, 150, 1693–1693. https://doi.org/10.1176/ajp.150.11.1693 Google ScholarPubMed
Andersen, K., Lolk, A., Kragh-Sørensen, P., Petersen, N. E. and Green, A. (2005). Depression and the risk of Alzheimer disease. Epidemiology, 16, 233–238. https://doi.org/10.1097/01.ede.0000152116.32580.24 CrossRefGoogle ScholarPubMed
Andresen, E. M., Malmgren, J. A., Carter, W. B. and Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D. American Journal of Preventive Medicine, 10, 77–84. https://doi.org/10.1016/s0749-3797(18)30622-6 CrossRefGoogle Scholar
APA. (2013). Diagnostic and Statistical Manual of Mental Disorders. Arlington, VA: American Psychiatric Publishing.Google Scholar
Becker, J. T. et al. (2009). Depressed mood is not a risk factor for incident dementia in a community-based cohort. The American Journal of Geriatric Psychiatry, 17, 653–663. https://doi.org/10.1097/jgp.0b013e3181aad1fe CrossRefGoogle ScholarPubMed
Biegler, K. A., Alejandro Chaoul, M. and Cohen, L. (2009). Cancer, cognitive impairment, and meditation. Acta Oncologica, 48, 18–26. https://doi.org/10.1080/02841860802415535 CrossRefGoogle ScholarPubMed
Björgvinsson, T., Kertz, S. J., Bigda-Peyton, J. S., McCoy, K. L. and Aderka, I. M. (2013). Psychometric properties of the CES-D-10 in a psychiatric sample. Assessment, 20, 429–436. https://doi.org/10.1177/1073191113481998 CrossRefGoogle Scholar
Broe, G. et al. (1990). A case-control study of Alzheimer’s disease in Australia. Neurology, 40, 1698–1698. https://doi.org/10.1212/WNL.40.11.1698 CrossRefGoogle ScholarPubMed
Byers, A. L., Covinsky, K. E., Barnes, D. E. and Yaffe, K. (2012). Dysthymia and depression increase risk of dementia and mortality among older veterans. The American Journal of Geriatric Psychiatry, 20, 664–672. https://doi.org/10.1097/jgp.0b013e31822001c1 CrossRefGoogle ScholarPubMed
Byers, A. L. and Yaffe, K. (2011). Depression and risk of developing dementia. Nature Reviews Neurology, 7, 323–331. https://doi.org/10.1038/nrneurol.2011.60 CrossRefGoogle ScholarPubMed
Chae, K.-M. (2018). Advanced Statistics by Using SPSS and AMOS. Kyungkido: Yangseowon.Google Scholar
Chen, R., Hu, Z., Wei, L., Qin, X., McCracken, C. and Copeland, J. R. (2008). Severity of depression and risk for subsequent dementia: cohort studies in China and the UK. The British Journal of Psychiatry, 193, 373–377. https://doi.org/10.1192/bjp.bp.107.044974 CrossRefGoogle ScholarPubMed
Colla, M. et al. (2007). Hippocampal volume reduction and HPA-system activity in major depression. Journal of Psychiatric Research, 41, 553–560. https://doi.org/10.1055/s-2003-825290 CrossRefGoogle ScholarPubMed
Crook, T., Bartus, R. T., Ferris, S. H., Whitehouse, P., Cohen, G. D. and Gershon, S. (1986). Age-associated memory impairment: Proposed diagnostic criteria and measures of clinical change—report of a national institute of mental health work group. Developmental Neuropsychology, 2, 261–276. https://doi.org/10.1080/87565648609540348 CrossRefGoogle Scholar
Crum, R. M., Anthony, J. C., Bassett, S. S. and Folstein, M. F. (1993). Population-based norms for the Mini-Mental State Examination by age and educational level. JAMA, 269, 2386–2391. https://doi.org/10.1001/jama.1993.03500180078038 CrossRefGoogle ScholarPubMed
Demura, S. and Sato, S. (2003). Relationships between depression, lifestyle and quality of life in the community dwelling elderly: A comparison between gender and age groups. Journal of Physiological Anthropology and Applied Human Science, 22, 159–166. https://doi.org/10.2114/jpa.22.159 CrossRefGoogle ScholarPubMed
Eggermont, L. H., De Boer, K., Muller, M., Jaschke, A. C., Kamp, O. and Scherder, E. J. (2012). Cardiac disease and cognitive impairment: A systematic review. Heart, 98, 1334–1340. https://doi.org/10.1136/heartjnl-2012-301682 CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E., McHugh, P. R. and Fanjiang, G. (2001). Mini-Mental State Examination: MMSE User’s Guide. FL: Psychology Assessment Resources.Google Scholar
Forton, D. M. et al. (2002). Hepatitis C and cognitive impairment in a cohort of patients with mild liver disease. Hepatology, 35, 433–439. https://doi.org/10.1053/jhep.2002.30688 CrossRefGoogle Scholar
Ganguli, M., Du, Y., Dodge, H. H., Ratcliff, G. G. and Chang, C.-C. H. (2006). Depressive symptoms and cognitive decline in late life: A prospective epidemiological study. Archives of General Psychiatry, 63, 153–160. https://doi.org/10.1001/archpsyc.63.2.153 CrossRefGoogle ScholarPubMed
Gatz, J. L., Tyas, S. L., St. John, P. and Montgomery, P. (2005). Do depressive symptoms predict Alzheimer’s disease and dementia? The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 60, 744–747. https://doi.org/10.1093/gerona/60.6.744 CrossRefGoogle ScholarPubMed
He, S.-B., Tang, W.-G., Tang, W.-J., Kao, X.-L., Zhang, C.-G. and Wong, X.-T. (2012). Exercise intervention may prevent depression. International Journal of Sports Medicine, 33, 525–530. https://doi.org/10.1055/s-0032-1306325 Google ScholarPubMed
IBM. (2019). IBM SPSS Statistics for Windows. NY: IBM Corp.Google Scholar
Jorm, A. F. (2001). History of depression as a risk factor for dementia: An updated review. Australian & New Zealand Journal of Psychiatry, 35, 776–781. https://doi.org/10.1046/j.1440-1614.2001.00967.x CrossRefGoogle ScholarPubMed
Kang, H., Zhao, F., You, L. and Giorgetta, C. (2014). Pseudo-dementia: A neuropsychological review. Annals of Indian Academy of Neurology, 17, 147–154. https://doi.org/10.4103/0972-2327.132613 Google ScholarPubMed
Kang, Y. (2006). A normative study of the Korean Mini-Mental State Examination (K-MMSE) in the elderly. Korean J Psychology, 25, 1–12.Google Scholar
Kang, Y., Na, D. L. and Hahn, S. (1997). A validity study on the Korean Mini-Mental State Examination (K-MMSE) in dementia patients. Journal of the Korean Neurological Association, 15, 300–308.Google Scholar
Kiloh, L. (1961). Pseudo-dementia. Acta Psychiatrica Scandinavica, 37, 336–351. https://doi.org/10.1111/j.1600-0447.1961.tb07367.x CrossRefGoogle ScholarPubMed
Korea Labor Institute. (2007). User Guide for 2006 Korean Longitudinal Study of Ageing. Seoul: Korea Labor Institute.Google Scholar
Kral, V. A. and Emery, O. B. (1989). Long-term follow-up of depressive pseudodementia of the aged. The Canadian Journal of Psychiatry, 34, 445–446. https://doi.org/10.1177/070674378903400515 CrossRefGoogle ScholarPubMed
Levy, R. (1994). Aging-associated cognitive decline. International Psychogeriatrics, 6, 63–68. https://doi.org/10.1017/S1041610294001626 Google ScholarPubMed
Lindsay, J. et al. (2002). Risk factors for Alzheimer’s disease: A prospective analysis from the Canadian Study of Health and Aging. American Journal of epidemiology, 156, 445–453. https://doi.org/10.1093/aje/kwf074 CrossRefGoogle ScholarPubMed
Marcopulos, B. A., McLain, C. A. and Giuliano, A. J. (1997). Cognitive impairment or inadequate norms? A study of healthy, rural, older adults with limited education. The Clinical Neuropsychologist, 11, 111–131. https://doi.org/10.1080/13854049708407040 CrossRefGoogle Scholar
Mcdowell, I. et al. (1994). The Canadian Study of Health and Aging: Risk factors for Alzheimer’s disease in Canada. Neurology, 44, 2073–2080. https://doi.org/10.1212/wnl.44.11.2073 Google Scholar
Modrego, P. J. and Ferrández, J. (2004). Depression in patients with mild cognitive impairment increases the risk of developing dementia of Alzheimer type: A prospective cohort study. Archives of Neurology, 61, 1290–1293. https://doi.org/10.1001/archneur.61.8.1290 CrossRefGoogle ScholarPubMed
Pan, Z. et al. (2019). Cognitive impairment in major depressive disorder. CNS Spectrums, 24, 22–29. https://doi.org/10.1017/S1092852918001207 CrossRefGoogle ScholarPubMed
Papademetriou, V. (2005). Hypertension and cognitive function. Geriatrics, 60, 20–24.Google ScholarPubMed
Pearlson, G. D. et al. (1989). Structural brain CT changes and cognitive deficits in elderly depressives with and without reversible dementia (‘pseudodementia’). Psychological Medicine, 19, 573–584. https://doi.org/10.1017/s003329170002417x CrossRefGoogle Scholar
Perini, G., Ramusino, M. C., Sinforiani, E., Bernini, S., Petrachi, R. and Costa, A. (2019). Cognitive impairment in depression: Recent advances and novel treatments. Neuropsychiatric Disease and Treatment, 15, 1249–1258. https://doi.org/10.2147/NDT.S199746 CrossRefGoogle ScholarPubMed
Rabins, P. V., Merchant, A. and Nestadt, G. (1984). Criteria for diagnosing reversible dementia caused by depression: Validation by 2-year follow-up. The British Journal of Psychiatry, 144, 488–492. https://doi.org/10.1192/bjp.144.5.488 CrossRefGoogle ScholarPubMed
Roberts, R. O. et al. (2008). Association of duration and severity of diabetes mellitus with mild cognitive impairment. Archives of Neurology, 65, 1066–1073. https://doi.org/10.1001/archneur.65.8.1066 CrossRefGoogle ScholarPubMed
Sáez-Fonseca, J. A., Lee, L. and Walker, Z. (2007). Long-term outcome of depressive pseudodementia in the elderly. Journal of Affective Disorders, 101, 123–129. https://doi.org/10.1016/j.eurpsy.2007.01.099 CrossRefGoogle ScholarPubMed
Sachdev, P. S., Smith, J. S., Angus-Lepan, H. and Rodriguez, P. (1990). Pseudodementia twelve years on. Journal of Neurology, Neurosurgery & Psychiatry, 53, 254–259. https://doi.org/10.1136/jnnp.53.3.254 CrossRefGoogle Scholar
Sheline, Y. I., Wang, P. W., Gado, M. H., Csernansky, J. G. and Vannier, M. W. (1996). Hippocampal atrophy in recurrent major depression. Proceedings of the National Academy of Sciences, 93, 3908–3913. https://doi.org/10.1073/pnas.93.9.3908 CrossRefGoogle ScholarPubMed
Singh, B. et al. (2014). A prospective study of chronic obstructive pulmonary disease and the risk for mild cognitive impairment. JAMA Neurology, 71, 581–588. https://doi.org/10.1001/jamaneurol.2014.94 CrossRefGoogle ScholarPubMed
Steger, M. F. and Kashdan, T. B. (2009). Depression and everyday social activity, belonging, and well-being. Journal of Counseling Psychology, 56, 289–300. https://doi.org/10.1037/a0015416 CrossRefGoogle ScholarPubMed
Vinkers, D. J., Gussekloo, J., Stek, M. L., Westendorp, R. G. and van der Mast, R. C. (2004). Temporal relation between depression and cognitive impairment in old age: Prospective population based study. BMJ, 329, 881–884. https://doi.org/10.1136/bmj.38216.604664.de CrossRefGoogle ScholarPubMed
Wells, C. E. (1979). Pseudodementia. The American Journal of Psychiatry, 136, 895–900. https://doi.org/10.1176/ajp.136.7.895 Google ScholarPubMed
Yaffe, K., Blackwell, T., Gore, R., Sands, L., Reus, V. and Browner, W. S. (1999). Depressive symptoms and cognitive decline in nondemented elderly women: A prospective study. Archives of General Psychiatry, 56, 425–430. https://doi.org/10.1001/archpsyc.56.5.425 CrossRefGoogle ScholarPubMed
Zaudig, M. (1992). A new systematic method of measurement and diagnosis of “mild cognitive impairment” and dementia according to ICD-10 and DSM-III-R criteria. International Psychogeriatrics, 4, 203–219. https://doi.org/10.1017/s1041610292001273 CrossRefGoogle ScholarPubMed