Rachel Pascal de Raykeer1, Nicolas Hoertel2, Carlos Blanco3, Pierre Lavaud4, Arthur Kaladjian5, Yvonne Blumenstock4, Christine-Vanessa Cuervo-Lombard6, Hugo Peyre7, Cédric Lemogne2, Frédéric Limosin2. 1. Department of Psychiatry, AP-HP, Western Paris University Hospitals, 92130 Issy-les-Moulineaux, France; INSERM UMR 894, Psychiatry and Neurosciences Center, Paris, France. Electronic address: rachel.pascalderaykeer@aphp.fr. 2. Department of Psychiatry, AP-HP, Western Paris University Hospitals, 92130 Issy-les-Moulineaux, France; INSERM UMR 894, Psychiatry and Neurosciences Center, Paris, France; Sorbonne Paris Cité, Paris Descartes University, Paris, France. 3. Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, United States. 4. Department of Psychiatry, AP-HP, Western Paris University Hospitals, 92130 Issy-les-Moulineaux, France. 5. Department of Psychiatry, Robert Debré Hospital, Reims University Hospital, Reims, France; Cognition, Health and Socialization Laboratory (EA 6291), University of Reims Champagne-Ardenne, Reims, France. 6. Department of Psychiatry, Robert Debré Hospital, Reims University Hospital, Reims, France; Department of Psychology, CERPPS laboratory, Toulouse 2 Jean Jaurès University, EA 7411, Toulouse, France. 7. Child and Adolescent Psychiatry Department, Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Paris, France; Laboratoire de Sciences Cognitives et Psycholinguistique (ENS, EHESS, CNRS), Ecole Normale Supérieure, PSL Research University, Paris, France; INSERM UMR 1141, Paris Diderot University, Paris, France.
Abstract
BACKGROUND: Little is known about the respective effects of depression and cognitive impairment on quality of life among older adults with schizophrenia spectrum disorder. METHODS: We used data from the Cohort of individuals with Schizophrenia Aged 55-years or more (CSA) study, a large multicenter sample of older adults with schizophrenia or schizoaffective disorder (N = 353). Quality of life (QoL), depression and cognitive impairment were assessed using the Quality of Life Scale (QLS), the Center of Epidemiologic Studies Depression scale and the Mini-Mental State Examination, respectively. We used structural equation modeling to examine the shared and specific effects of depression and cognitive impairment on QoL, while adjusting for sociodemographic characteristics, general medical conditions, psychotropic medications and the duration of the disorder. RESULTS: Depression and cognitive impairment were positively associated (r = 0.24, p < 0.01) and both independently and negatively impacted on QoL (standardized β = -0.41 and β = -0.32, both p < 0.01) and on each QLS quality-of-life domains, except for depression on instrumental role and cognitive impairment on interpersonal relations in the sensitivity analyses excluding respondents with any missing data. Effects of depression and cognitive impairment on QoL were not due to specific depressive symptoms or specific cognitive domains, but rather mediated through two broad dimensions representing the shared effects across all depressive symptoms and all cognitive deficits, respectively. LIMITATIONS: Because of the cross-sectional design of this study, measures of association do not imply causal associations. CONCLUSIONS: Mechanisms underlying these two broad dimensions should be considered as important potential targets to improve quality of life of this vulnerable population.
BACKGROUND: Little is known about the respective effects of depression and cognitive impairment on quality of life among older adults with schizophrenia spectrum disorder. METHODS: We used data from the Cohort of individuals with Schizophrenia Aged 55-years or more (CSA) study, a large multicenter sample of older adults with schizophrenia or schizoaffective disorder (N = 353). Quality of life (QoL), depression and cognitive impairment were assessed using the Quality of Life Scale (QLS), the Center of Epidemiologic Studies Depression scale and the Mini-Mental State Examination, respectively. We used structural equation modeling to examine the shared and specific effects of depression and cognitive impairment on QoL, while adjusting for sociodemographic characteristics, general medical conditions, psychotropic medications and the duration of the disorder. RESULTS:Depression and cognitive impairment were positively associated (r = 0.24, p < 0.01) and both independently and negatively impacted on QoL (standardized β = -0.41 and β = -0.32, both p < 0.01) and on each QLS quality-of-life domains, except for depression on instrumental role and cognitive impairment on interpersonal relations in the sensitivity analyses excluding respondents with any missing data. Effects of depression and cognitive impairment on QoL were not due to specific depressive symptoms or specific cognitive domains, but rather mediated through two broad dimensions representing the shared effects across all depressive symptoms and all cognitive deficits, respectively. LIMITATIONS: Because of the cross-sectional design of this study, measures of association do not imply causal associations. CONCLUSIONS: Mechanisms underlying these two broad dimensions should be considered as important potential targets to improve quality of life of this vulnerable population.
Authors: Aditi Kadakia; Qi Fan; Jason Shepherd; Carole Dembek; Hollie Bailey; Chloe Walker; G Rhys Williams Journal: Schizophr Res Cogn Date: 2021-12-21
Authors: Mario Luciano; Gaia Sampogna; Mario Amore; Ileana Andriola; Pietro Calcagno; Claudia Carmassi; Valeria Del Vecchio; Liliana Dell'Osso; Giorgio Di Lorenzo; Barbara Gelao; Vincenzo Giallonardo; Alessandro Rossi; Rodolfo Rossi; Alberto Siracusano; Andrea Fiorillo Journal: Eur Psychiatry Date: 2021-11-23 Impact factor: 5.361