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68 Interactive Effects of Sleep Apnea and Depression Symptoms on Cognition in Older Adults
- Abigail Overstreet, Matthew Hollander, Ben Hougaard, Jamie Kiefer, Vennisia Mo, Rowena Gomez
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 577-578
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Objective:
Sleep deprivation and depressive symptoms have been shown to negatively impact cognitive function within older adult populations (Gilley, 2022; Donovan et al., 2016). However, there is minimal research on interactions between sleep disturbance and depressive symptoms in relation to their shared impact on cognitive impairment. The purpose of this study is to examine possible interactions between sleep disorders and depression and their relationship with cognition among relatively good functioning and healthy older adults.
Participants and Methods:The sample was obtained from the Memory and Aging Project (Rush Alzheimer's Disease Center, Rush University, 2019) and consisted of 3,345 community dwelling older adults. The study analyzed data from 2552 women (76.3%) and 1093 men (23.7%). The average age of participants was 80 years and ranged from 45 to 98 years old. Measures used included the Berlin Questionnaire (risk for sleep apnea), Center for Epidemiological Studies Depression Scale (CES-D; depression), and a neuropsychological battery (visuospatial ability/perceptual reasoning and processing speed).
Results:ANOVA analyses exhibited a significant main effect of depression on visuospatial ability/perceptual reasoning (p <.001), processing speed (p <.001), and semantic memory (p <.001). No significant main effect was found for sleep apnea on these cognitive domains. However, when sleep apnea was analyzed between those with any depressive symptoms versus those without, significant interactions were found for visuospatial ability/perceptual reasoning (p =.027), processing speed (p <.001), and semantic memory (p =.016). Sleep apnea symptoms had a greater detrimental effect on visuospatial skills and perceptual reasoning (F=4.90; p=.027) only when any depression symptom is present. In contrast, there was a steeper decline of processing speed when only depressive symptoms were present apart from sleep apnea symptoms (F=10.34; p =.001) Similarly, depressive symptoms had a greater negative effect on semantic memory for older adults who reported no sleep apnea symptoms compare to those who did (F=5.83, p=.016).
Conclusions:The current study indicated that while sleep apnea was negatively related to several cognitive domains, the impact became greater with the presence of depression on visuospatial skills and perceptual reasoning among older adults. However, the detrimental impact of sleep apnea was somewhat less with the presence of depression for processing speed and semantic memory. This may be due to likely higher endorsements of depressive symptoms compared to sleep apnea symptoms within the study sample. These findings suggest that there are differential interactive effects of sleep impairment and depressive symptoms on cognitive domains among older adults. Considering the relationship that exists between depression and increased disease burden among older adults, it is crucial for clinicians to also take sleep behaviors into account when examining and treating their patients. Clinicians should be mindful of their older patient's sleep health and depression measures when cognitive declines are suspected. They also suggest that cognitive performance may be improved with treating any symptoms of sleep apnea and depression in older adults.
44 Dietary Nitrate Intake in Older Adults Associated with Increased Cognition and Reduced Depression
- Matthew M Hollander, Abigail Overstreet, Ban Hougaard, Vennisia Mo, Christopher Calzada, Carl St Goar, Brandon Jennings, Ayushi Agrawal, Jas Chok, Rowena Gomez
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 352-353
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- Article
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- You have access Access
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Objective:
Individuals with major depressive disorder (MDD) are observed to have reduced plasma nitrate levels and plasma nitric oxide (NO) metabolites (Chrapko et al., 2004; Garcia et al., 2011). Endothelial cell dependent dilation of vascular smooth muscle function has been observed to be blunted in adults with Major Depressive Disorder (MDD) and mediated by NO-dependent dilation (Greaney et al., 2019). Certain vegetables and fruits are particularly high in dietary nitrates, which is reduced to nitric oxide in the stomach, entering intravascular circulation, and acting as a potent dilator, blood pressure reducing, and vasoprotective substance (Webb et al., 2008). In older adults, dietary nitrates which are found in certain vegetables and fruits (e.g., green leafy vegetables) is shown to increase cerebral blood perfusion in frontal lobe white matter between the dorsolateral prefrontal and anterior cingulate cortex, regions particularly implicated in cognitive functioning (Presley et al., 2011). Recently, Morris et al. (2018) observed that in older adults from the Memory and Aging Project (MAP), the highest quintile of dietary nitrate intake was associated with slower cognitive decline than that of the lowest quintile of nitrate intake. Although viewing the extremes of dietary nitrate intake reveals valuable information, the present study investigated the association of all levels of dietary nitrate intake with cognition and depression among older adults in the same MAP dataset.
Participants and Methods:The sample included 461 community dwelling older adults (Mage=80; Medu =14.9, 74% female) from the MAP study (Bennett et al., 2012). The measures used for the present study include: the Center for Epidemiological Studies Depression Scale (CESD, depression), a neuropsychological battery (global cognition, perceptual organization and semantic memory), and a dietary nutrient analysis of the food frequency questionnaire (FFQ, nitrate).
Results:Using Pearson correlations we observed that increased dietary nitrate intake was associated with increased global cognition (r(458) = .100, p = .031), perceptual organization (r(448) = .095, p = .04) and semantic memory (r(453) = .142, p = .002). Furthermore, we observed that dietary nitrate intake was associated with lower depression severity (r(459) = -.132, p = .004).
Conclusions:The present study’s results revealed that in a sample of community dwelling older adults, eating more nitrate rich foods is not only associated with improved cognition similar to findings of Morris et al. (2018), it is also associated with lower levels of depression. This further extends the Morris et al. (2018) study by suggesting that it is not only those older adults who eat the highest quantity of nitrate rich foods that can benefit from higher levels of nitrate intake. Overall, this study reveals that older adults who increase their dietary nitrate intake may improve their mood and thinking ability.