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An Investigation of the Cumulative Effects of Depressive Symptoms on the Cognitive Function in Community-Dwelling Older Adults: Analysis of the Korean Longitudinal Study of Aging

지역사회 거주 노인의 우울 증상이 인지기능에 미치는 누적적인 영향에 관한 연구: 고령화연구패널조사 Korean Longitudinal Study of Aging 자료를 중심으로

  • Kim, Eunmi (College of Nursing, Seoul National University) ;
  • Oh, Jinkyung (College of Nursing, Seoul National University) ;
  • Huh, Iksoo (College of Nursing, Seoul National University)
  • Received : 2023.02.08
  • Accepted : 2023.06.26
  • Published : 2023.08.31

Abstract

Purpose: This study investigated the cumulative effects of depressive symptoms on cognitive function over time in community-dwelling older adults. Methods: Data were investigated from 2,533 community-dwelling older adults who participated in the Korean Longitudinal Study of Aging (KLoSA) from the 5th (2014) to the 8th wave (2020). The association between cumulative depressive symptoms and cognitive function was identified through multiple regression analysis. Results: When the multiple regression analysis was conducted from each wave, the current depressive symptoms scores and cognitive function scores were negatively associated, regardless of the waves (B5th = - 0.26, B6th = - 0.26, B7th = - 0.26, and B8th = - 0.27; all p < .001). Further, when all the previous depressive symptoms scores were added as explanatory variables in the 8th wave, the current one (B8th = - 0.09, p < .001) and the previous ones (B5th = - 0.11, B6th = - 0.09, and B7th = - 0.13; all p < .001) were also negatively associated with the cognitive function score. The delta R2, which indicates the difference between the model's R2 with and without the depressive symptoms scores, was greater in the model with all the previous and current depressive symptoms scores (6.4%) than in the model with only the current depressive symptoms score (3.6%). Conclusion: Depressive symptoms in older adults have a long-term impact. This results in an accumulated adverse effect on the cognitive function. Therefore, to prevent cognitive decline in older adults, we suggest detecting their depressive symptoms early and providing continuous intervention to reduce exposure to long-term depressive symptoms.

Keywords

References

  1. Health Insurance Review and Assessment Service (HIRA). Analysis of the treatment status of depression and anxiety disorders in the last 5 years (2017-2021) [Internet]. Wonju: HIRA; c2022 [cited 2022 Sep 5]. Available from: https://www.hira.or.kr/bbsDummy.do?pgmid=HIRAA020041000100&brdScnBltNo=4&brdBltNo=10627&pageIndex=1.
  2. Guo X. Reciprocal effects of depressive symptoms and life satisfaction among Chinese older married couples from 2010 to 2014: Evidence from the China family panel studies. Aging & Mental Health. 2020;24(8):1216-1224. https://doi.org/10.1080/13607863.2019.1584876
  3. Graham E, Deschenes SS, Rosella LC, Schmitz N. Measures of depression and incident type 2 diabetes in a community sample. Annals of Epidemiology. 2021;55:4-9. https://doi.org/10.1016/j.annepidem.2020.11.010
  4. Carney RM, Freedland KE. Depression and coronary heart disease. Nature Reviews Cardiology. 2017;14(3):145-155. https://doi.org/10.1038/nrcardio.2016.181
  5. Wang YH, Li JQ, Shi JF, Que JY, Liu JJ, Lappin JM, et al. Depression and anxiety in relation to cancer incidence and mortality: A systematic review and meta-analysis of cohort studies. Molecular Psychiatry. 2020;25(7):1487-1499. https://doi.org/10.1038/s41380-019-0595-x
  6. Soleimani L, Schnaider Beeri M, Grossman H, Sano M, Zhu CW. Specific depression dimensions are associated with a faster rate of cognitive decline in older adults. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring. 2022;14(1):e12268. https://doi.org/10.1002/dad2.12268
  7. Linnemann C, Lang UE. Pathways connecting latelife depression and dementia. Frontiers in Pharmacology. 2020;11:279. https://doi.org/10.3389/fphar.2020.00279
  8. Butters MA, Young JB, Lopez O, Aizenstein HJ, Mulsant BH, Reynolds CF 3rd, et al. Pathways linking late-life depression to persistent cognitive impairment and dementia. Dialogues in Clinical Neuroscience. 2008;10(3):345-357. https://doi.org/10.31887/DCNS.2008.10.3/mabutters
  9. Verhoeven JE, Revesz D, Epel ES, Lin J, Wolkowitz OM, Penninx BW. Major depressive disorder and accelerated cellular aging: Results from a large psychiatric cohort study. Molecular Psychiatry. 2014;19(8):895-901. https://doi.org/10.1038/mp.2013.151
  10. Allison DJ, Ditor DS. The common inflammatory etiology of depression and cognitive impairment: A therapeutic target. Journal of Neuroinflammation. 2014;11:151. https://doi.org/10.1186/s12974-014-0151-1
  11. Rapp MA, Schnaider-Beeri M, Grossman HT, Sano M, Perl DP, Purohit DP, et al. Increased hippocampal plaques and tangles in patients with Alzheimer disease with a lifetime history of major depression. Archives of General Psychiatry. 2006;63(2):161-167. https://doi.org/10.1001/archpsyc.63.2.161
  12. Wilson RS, Mendes De Leon CF, Bennett DA, Bienias JL, Evans DA. Depressive symptoms and cognitive decline in a community population of older persons. Journal of Neurology, Neurosurgery & Psychiatry. 2004;75(1):126-129.
  13. Steenland K, Karnes C, Seals R, Carnevale C, Hermida A, Levey A. Late-life depression as a risk factor for mild cognitive impairment or Alzheimer's disease in 30 US Alzheimer's disease centers. Journal of Alzheimer's Disease. 2012;31(2):265-275. https://doi.org/10.3233/JAD-2012-111922
  14. Holmquist S, Nordstrom A, Nordstrom P. The association of depression with subsequent dementia diagnosis: A Swedish nationwide cohort study from 1964 to 2016. PLoS Medicine. 2020;17(1):e1003016. https://doi.org/10.1371/journal.pmed.1003016
  15. Li G, Wang LY, Shofer JB, Thompson ML, Peskind ER, McCormick W, et al. Temporal relationship between depression and dementia: Findings from a large community-based 15-year follow-up study. Archives of General Psychiatry. 2011;68(9):970-977. https://doi.org/10.1001/archgenpsychiatry.2011.86
  16. Verdelho A, Madureira S, Moleiro C, Ferro JM, O'Brien JT, Poggesi A, et al. Depressive symptoms predict cognitive decline and dementia in older people independently of cerebral white matter changes: The LADIS study. Journal of Neurology, Neurosurgery, & Psychiatry. 2013;84(11):1250-1254. https://doi.org/10.1136/jnnp-2012-304191
  17. Rensma SP, van Sloten TT, Ding J, Sigurdsson S, Stehouwer CDA, Gudnason V, et al. Type 2 diabetes, change in depressive symptoms over time, and cerebral small vessel disease: Longitudinal data of the AGES-Reykjavik Study. Diabetes Care. 2020;43(8):1781-1787. https://doi.org/10.2337/dc19-2437
  18. Wicke FS, Dinh TS, Riedel-Heller S, Weyerer S, Konig HH, Gensichen J, et al. Predictors of change in depressive symptoms in older and multimorbid patients: A longitudinal analysis of the multicare cohort. Aging & Mental Health. 2022;26(4):818-827. https://doi.org/10.1080/13607863.2021.1902470
  19. Barker ET, Howard AL, Villemaire-Krajden R, Galambos NL. The rise and fall of depressive symptoms and academic stress in two samples of university students. Journal of Youth and Adolescence. 2018;47(6):1252-1266. https://doi.org/10.1007/s10964-018-0822-9
  20. Gatchel JR, Rabin JS, Buckley RF, Locascio JJ, Quiroz YT, Yang HS, et al. Longitudinal association of depression symptoms with cognition and cortical amyloid among community-dwelling older adults. JAMA Network Open. 2019;2(8):e198964. https://doi.org/10.1001/jamanetworkopen.2019.8964
  21. Shin J, Cho E. Trajectories of depressive symptoms among community-dwelling Korean older adults: Findings from the Korean longitudinal study of aging (2006-2016). BMC Psychiatry. 2022;22(1):246. https://doi.org/10.1186/s12888-022-03905-3
  22. Jin Y, Lee Y, Kim TH, Lim S, Chung W. Associations between chronic diseases and depression in the Korean elderly: A gender-specific analysis. Health Policy and Management. 2020;30(2):231-244. https://doi.org/10.4332/KJHPA.2020.30.1.231
  23. Cole MG, Dendukuri N. Risk factors for depression among elderly community subjects: A systematic review and meta-analysis. American Journal of Psychiatry. 2003;160(6):1147-1156. https://doi.org/10.1176/appi.ajp.160.6.1147
  24. Lyness JM, Kim J, Tang W, Tu X, Conwell Y, King DA, et al. The clinical significance of subsyndromal depression in older primary care patients. The American Journal of Geriatric Psychiatry. 2007;15(3):214-223. https://doi.org/10.1097/01.JGP.0000235763.50230.83
  25. Hybels CF, Pieper CF, Blazer DG. The complex relationship between depressive symptoms and functional limitations in community-dwelling older adults: The impact of subthreshold depression. Psychological Medicine. 2009;39(10):1677-1688. https://doi.org/10.1017/S0033291709005650
  26. Shin HG, Lee HJ. CAPI and higher data quality: The case of KLoSA and Blaise CAPI programme. Survey Research. 2006;7(2):71-95.
  27. Korean Society for the Study of Obesity, Committee of Clinical Practice Guidelines. 2022 Clinical practice guidelines for obesity - quick reference guideline [Internet]. Seoul: Korean Society for the Study of Obesity; c2022 [cited 2023 Apr 29]. Available from: http://general.kosso.or.kr/html/?pmode=BBBS0001300003&smode=view&seq=1383.
  28. Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement. 1977;1(3):385-401. https://doi.org/10.1177/014662167700100306
  29. Kohout FJ, Berkman LF, Evans DA, Cornoni-Huntley J. Two shorter forms of the CES-D depression symptoms index. Journal of Aging and Health. 1993;5(2):179-193. https://doi.org/10.1177/089826439300500202
  30. Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: Evaluation of a short form of the CES-D. American Journal of Preventive Medicine. 1994;10(2):77-84. https://doi.org/10.1016/S0749-3797(18)30622-6
  31. Bae SS, Kim YY, Doh M, Kim H, Park BS. Testing factor structure and measurement invariance of 10-item versions of the CES-D scale: Focusing on Andersen form and Boston form of the CES-D-10. Mental Health & Social Work. 2020;48(1):33-55. https://doi.org/10.24301/MHSW.2020.03.48.1.33
  32. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research. 1975;12(3):189-198. https://doi.org/10.1016/0022-3956(75)90026-6
  33. Kang Y, Na DL, Hahn S. A validity study on the Korean Mini-Mental State Examination (K-MMSE) in dementia patients. Journal of the Korean Neurological Association. 1997;15(2):300-308.
  34. Kim JM, Shin IS, Yoon JS, Lee HY. Comparison of diagnostic validities between MMSE-K and K-MMSE for screening of dementia. Journal of Korean Neuropsychiatric Association. 2003;42(1):124-130.
  35. Lee HJ, Kahng SK. Age and gender differences in cognitive functioning among elderly. Mental Health & Social Work. 2011;37:255-278.
  36. Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, et al. Dementia prevention, intervention, and care. The Lancet. 2017;390(10113):2673-2734. https://doi.org/10.1016/S0140-6736(17)31363-6
  37. Lee YK, Kim SJ, Hwang NH, Lim JM, Joo BH, Namgoong EH, et al. The survey on the welfare and living conditions of the elderly 2020 [Internet]. Sejong: Korea Institute for Health and Social Affairs; c2021 [cited 2022 Nov 3]. Available from: http://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=032901&CONT_SEQ=366496&page=1.
  38. Blazer DG 2nd, Hybels CF. Origins of depression in later life. Psychological Medicine. 2005;35(9):1241-1252. https://doi.org/10.1017/S0033291705004411
  39. Hong SS, Kim HC, Cho SH. The effects of forests healing for cognitive function. Journal of Oriental Neuropsychiatry. 2013;24(1):63-74. https://doi.org/10.7231/jon.2013.24.1.063
  40. Woo JM, Park SM, Lim SK, Kim W. Synergistic effect of forest environment and therapeutic program for the treatment of depression. Journal of Korean Forest Society. 2012;101(4):677-685.
  41. Jun AY, Lee KS, Lee SM. Effects of the forest experience intervention program on depression, cognitive function, and quality of life in the elderly people with mild cognitive impairment. Korean Journal of Health Education and Promotion. 2019;36(3):73-82. https://doi.org/10.14367/kjhep.2019.36.3.73
  42. Zhu Y, Li C, Wu T, Wang Y, Hua R, Ma Y, et al. Associations of cumulative depressive symptoms with subsequent cognitive decline and adverse health events: Two prospective cohort studies. Journal of Affective Disorders. 2023;320:91-97. https://doi.org/10.1016/j.jad.2022.09.128
  43. Zeki Al Hazzouri A, Vittinghoff E, Byers A, Covinsky K, Blazer D, Diem S, et al. Long-term cumulative depressive symptom burden and risk of cognitive decline and dementia among very old women. Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2014;69(5):595-601. https://doi.org/10.1093/gerona/glt139