| 1. |
- Morin, Ruth T., et al.
(author)
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Depression Severity, but Not Cognitive Impairment or Frailty, is Associated with Disability in Late-Life Depression
- 2020
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In: Clinical Gerontologist. - : Informa UK Limited. - 0731-7115 .- 1545-2301. ; 43:4, s. 411-419
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Journal article (peer-reviewed)abstract
- Objectives: Assess the relationship of cognitive impairment to disability, accounting for depression severity and frailty, among older adults with late-life depression (LLD). Methods: Data were analyzed from 78 community-dwelling older adults with LLD and without dementia (age M = 71.9; SD = 6.1). Cognitive functioning was assessed using a comprehensive neuropsychological battery. Depression severity was measured using the 17-item Hamilton Depression Rating Scale (HDRS; cutoff ≥15). Frailty was assessed using several motor tests. The World Health Organization Disability Assessment Schedule (WHO-DAS) measured disability status. A linear regression analysis was performed to identify relationships of cognition, frailty and depression severity with disability. Results: The average number of impaired cognitive tests was 2.0 (SD = 1.9), with 28.2% of participants showing no impaired scores. On average participants reported depression severity of 17.3 (SD = 3.6), and disability total score of 15.1 (SD = 6.9). The regression model accounted for 25.1% of the variance in disability, with only depression severity significantly predicting disability status. Burden of cognitive impairment and frailty were not predictive of disability in this sample. Conclusions: In this sample, only depression severity was associated with increased disability. Clinical Implications: These findings have implications for intervention in LLD, as depression severity may represent a more modifiable risk factor for disability.
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| 2. |
- Morin, Ruth T., et al.
(author)
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Latent Classes of Cognitive Functioning among Depressed Older Adults Without Dementia
- 2019
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In: Journal of the International Neuropsychological Society. - 1355-6177. ; 25:8, s. 811-820
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Journal article (peer-reviewed)abstract
- Objective:Use latent class analysis (LCA) to identify patterns of cognitive functioning in a sample of older adults with clinical depression and without dementia and assess demographic, psychiatric, and neurobiological predictors of class membership.Method:Neuropsychological assessment data from 121 participants in the Alzheimer's Disease Neuroimaging Initiative-Depression project (ADNI-D) were analyzed, including measures of executive functioning, verbal and visual memory, visuospatial and language functioning, and processing speed. These data were analyzed using LCA, with predictors of class membership such as depression severity, depression and treatment history, amyloid burden, and APOE e4 allele also assessed.Results:A two-class model of cognitive functioning best fit the data, with the Lower Cognitive Class (46.1% of the sample) performing approximately one standard deviation below the Higher Cognitive Class (53.9%) on most tests. When predictors of class membership were assessed, carrying an APOE e4 allele was significantly associated with membership in the Lower Cognitive Class. Demographic characteristics, age of depression onset, depression severity, history of psychopharmacological treatment for depression, and amyloid positivity did not predict class membership.Conclusion:LCA allows for identification of subgroups of cognitive functioning in a mostly cognitively intact late life depression (LLD) population. One subgroup, the Lower Cognitive Class, more likely to carry an APOE e4 allele, may be at a greater risk for subsequent cognitive decline, even though current performance on neuropsychological testing is within normal limits. These findings have implications for early identification of those at greatest risk, risk factors, and avenues for preventive intervention.
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| 3. |
- Morin, Ruth T., et al.
(author)
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Somatic and anxiety symptoms of depression are associated with disability in late life depression
- 2020
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In: Aging and Mental Health. - : Informa UK Limited. - 1360-7863 .- 1364-6915. ; 24:8, s. 1225-1228
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Journal article (peer-reviewed)abstract
- Objectives: To assess the relationships of somatic and anxiety symptoms of depression with functional disability in a sample of older adults with late life depression. Method: Data were analyzed from 78 older adults aged 65–88 with current major depression. Somatic and anxiety symptoms from the 24-item Hamilton Depression Rating Scale (HDRS) were summed to create variables measuring severity of these symptoms. Other symptoms of depression were also assessed using the remaining items of the HDRS. Current physical health burden was assessed using the Functional Comorbidity Index (FCI). Disability was measured with the Late Life Function and Disability Instrument (LLFDI) total limitation score. A linear regression analysis was performed to assess the association of somatic and anxiety symptoms with disability independent of other factors. Results: The model accounted for 26.6% of variance in disability, (F(6,51) = 3.1, p =.01). Somatic (B = −1.9, p =.004) and anxiety (B = −3.7, p =.04) symptoms of depression were significantly associated with disability. Other depressive symptoms and physical illness burden were not associated with disability. Discussion: In older adults with major depression, somatic and anxiety symptoms of depression are associated with disability. Identification and treatment to remission of these symptoms may improve functional outcomes among older depressed adults.
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