Kathrin Heser1, Janine Stein2, Melanie Luppa2, Birgitt Wiese3, Silke Mamone3, Siegfried Weyerer4, Jochen Werle4, Hans-Helmut König5, André Hajek5, Martin Scherer6, Anne Stark6, Hanna Kaduszkiewicz7, Wolfgang Maier1, Steffi G Riedel-Heller2, Michael Wagner1,8. 1. Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Germany. 2. Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Germany. 3. Institute of General Practice, Working Group Medical Statistics and IT Infrastructure, Hannover Medical School, Germany. 4. Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany. 5. Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany. 6. Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Germany. 7. Institute of General Practice, Medical Faculty, Kiel University, Germany. 8. DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany.
Abstract
OBJECTIVES: This study examines the relationship between late-life depressive symptoms, cognitive and functional impairment in a cohort of very old community-based participants. METHODS: A sample of 1,226 primary care patients was assessed at baseline (Mage = 80.6 years). Statistical analyses were conducted using baseline and 12-month follow-up data. RESULTS: At baseline, depressed participants showed minor cognitive deficits compared with nondepressed participants, whereas functional deficits were pronounced. Depressive symptoms and global cognition were not associated longitudinally. In contrast, follow-up functional impairment was predicted by baseline level and increase of depressive symptoms between baseline and follow-up. Reversely, follow-up depressive symptoms were predicted by functional decline between baseline and follow-up, whereas baseline functional status was not predictive. DISCUSSION: Depressive symptoms and global cognitive function were not associated longitudinally, but level and increase of depressive symptoms over time predicted functional impairment after 1 year. Interventions to reduce depressive symptoms, or to encourage coping strategies might be promising to reduce functional impairment. Elevated follow-up depressive symptoms were only predicted by functional decline, supposedly emphasizing that incident functional impairment might be associated with an acute increase of depressive symptoms. Psychological adjustment processes were not examined, but might be targeted in future.
OBJECTIVES: This study examines the relationship between late-life depressive symptoms, cognitive and functional impairment in a cohort of very old community-based participants. METHODS: A sample of 1,226 primary care patients was assessed at baseline (Mage = 80.6 years). Statistical analyses were conducted using baseline and 12-month follow-up data. RESULTS: At baseline, depressed participants showed minor cognitive deficits compared with nondepressed participants, whereas functional deficits were pronounced. Depressive symptoms and global cognition were not associated longitudinally. In contrast, follow-up functional impairment was predicted by baseline level and increase of depressive symptoms between baseline and follow-up. Reversely, follow-up depressive symptoms were predicted by functional decline between baseline and follow-up, whereas baseline functional status was not predictive. DISCUSSION: Depressive symptoms and global cognitive function were not associated longitudinally, but level and increase of depressive symptoms over time predicted functional impairment after 1 year. Interventions to reduce depressive symptoms, or to encourage coping strategies might be promising to reduce functional impairment. Elevated follow-up depressive symptoms were only predicted by functional decline, supposedly emphasizing that incident functional impairment might be associated with an acute increase of depressive symptoms. Psychological adjustment processes were not examined, but might be targeted in future.
Authors: Britta Müller; Peter Kropp; Maria Isabel Cardona; Bernhard Michalowsky; Nanja van den Berg; Stefan Teipel; Wolfgang Hoffmann; Jochen René Thyrian Journal: BMC Geriatr Date: 2021-04-23 Impact factor: 3.921