Cognitive performance in old-age depression

Study I assessed the influence of depression severity on cognitive performance, while controlling for a range of clinical and demographic factors. Individuals with moderate/severe depression exhibited deficits in multiple cognitive domains, whereas only processing speed was affected in mild depression. Study II examined the influence of combined KIBRA (CC) and CLSTN2 (TT) risk alleles on episodic memory performance. Episodic memory deficits were only observed in individuals with both depression and the disadvantageous CC/TT allelic combination. Study III investigated the role of psychiatric history on cognitive performance in acute and remitted states of depression. Currently depressed individuals with a psychiatric inpatient history and individuals with late-onset depression performed at the lowest levels, whereas cognitive performance in individuals with self-reported recurrent unipolar depression was intermediate. Individuals with remitted unipo lar depression exhibited no cognitive deficits. Physical inactivity, cumulative inpatient days, heart disease burden , and prodromal dementia modulated cognitive p erformance . Study IV assessed cognitive performance in different depression courses (depressed - remitted, remitted-depressed, and nondepressed-late-onset depression ) longitudinally over a maximum period of 6 years. Cognitive decline was observed in all groups for multiple domains, although individuals who changed their status from nondepressed to depressed showed exacerbated cognitive decline. In remitted states, only processing speed and attention were affected. However, these deficits were modulated by benzodiazepine intake. In sum, depression-related cognitive deficits were observed in processing speed, attention, executive function, verbal fluency (Studies I, III, I V), episodic memory (Studies I, II), and semantic memory ( Study I). No depression-related deficits were observed in general knowledge, short-term memory, or spatial ability. As multiple factors were found to modulate cognitive performance in dementia-free unipolar old-age depression, and consistent with the notion that depression is a heterogeneous disorder, this may explain why patterns of cognitive deficits in depression vary between studies. Recurrence rates of depression remain high, and cognitive deficits in depression are associated with a poor prognosis and take a longer time to recover than depressive symptoms. This underscores the importance of early detection of cognitive deterioration in depression. Importantly, cognitive deficits in depression seem largely reversible. Thus, they should be regarded as treatment targets rather than as stable vulnerabilities. Combined profiles of psychiatric history, cognitive performance , and health behaviors may provide important information to individualized treatment

Neuroticism i relation till sångteknik och hälsa under 3.5 år hos operastudenter

Yrkesgruppen artister har tidigare rapporterat höga testpoäng vid mätning av neuroticism, vilket yttrar sig i upplevd sämre fysisk hälsa och låg självutvärdering av prestation. Den longitudinella populationsstudiens generella syfte var att undersöka neuroticism i relation till sångteknik och hälsa under 3.5 år hos operastudenter. Högre registret, lägre registret, sjunga piano, egalisering och uthållighet respektive röstlig-, fysisk- och mental hälsa undersöktes. Enkäter utformade för självrapportering användes (EPQ, KSP, STAI och 2 specialkonstruerade enkäter). Resultaten visade att rapportering av sångteknik och rösthälsa förbättrades signifikant, men att kroppshälsa och mental hälsa inte förbättrades signifikant över tid. Neuroticism och självutvärdering av sångteknik och hälsa gav inte signifikant interaktionseffekt. Rapporterad hög testpoäng av neuroticism gav inte signifikant lägre självutvärdering i jämförelse med rapporterad låg testpoäng av neuroticism. Potentiella felkällor är få antal undersökningspersoner och bortfall. Vidare intressant forskning är huruvida manliga artister rapporterar högre testpoäng vid mätning av neuroticism i jämförelse med kvinnor och varför detta i så fall kommer sig

A bi-factor model of the Montgomery Åsberg depression rating scale and future cognitive impairments in older adults:A 6-year follow-up study

Depression has been found to be associated with cognitive decline. This study evaluated the association of general depressive symptoms and motivational-related symptoms with cognitive impairment 6 years later and to explore the role of potential underlying mechanisms. In 2690 cognitively healthy persons aged ≥60 from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) depressive symptoms were derived from the Montgomery Åsberg Depression Rating Scale (MADRS). Cognitive performance was assessed at baseline and 6 years later in 1810 persons with the Mini Mental State Examination (global cognition), Digit Span Forward (short-term memory), Digit Span Backward (working memory), Clock-test (visuospatial construction), and the 5-item test (immediate and delayed recall). Bi-factor analysis on the MADRS yielded a General Depression factor and an unrelated Motivational factor. After adjusting for demographics, the General Depression factor was only associated with 6-year impairment in delayed recall (OR (95% CI): 1.18 (1.04–1.34)). This association was no longer significant after adjusting for demographics, cardiovascular risk, lifestyle factors and medication use. The Motivational factor was not significantly associated with future cognitive impairments after adjusting for demographics. Concluding, almost all associations of general depressive symptoms and motivational-related symptoms with future cognitive impairments appeared to be confounded by demographics. Only the association of general depressive symptoms with future memory impairments appeared to be explained by a combination of demographics, cardiovascular risk, lifestyle and medication use

Effects of psychiatric history on cognitive performance in old-age depression

Cognitive deficits in old-age depression vary as a function of multiple factors; one rarely examined factor is long-term psychiatric history. We investigated effects of psychiatric history on cognitive performance in old-age depression and in remitted persons. In the population-based Swedish National Study on Aging and Care in Kungsholmen study, older persons (≥60 years) without dementia were tested with a cognitive battery and matched to the Swedish National Inpatient Register (starting 1969). Participants were grouped according to current depression status and psychiatric history and compared to healthy controls (n = 96). Group differences were observed for processing speed, attention, executive functions, and verbal fluency. Persons with depression and psychiatric inpatient history (n = 20) and late-onset depression (n = 49) performed at the lowest levels, whereas cognitive performance in persons with self-reported recurrent unipolar depression (n = 52) was intermediate. Remitted persons with inpatient history of unipolar depression (n = 38) exhibited no cognitive deficits. Heart disease burden, physical inactivity, and cumulative inpatient days modulated the observed group differences in cognitive performance. Among currently depressed persons, those with inpatient history, and late onset performed at the lowest levels. Importantly, remitted persons showed no cognitive deficits, possibly reflecting the extended time since the last admission (m = 15.6 years). Thus, the present data suggest that cognitive deficits in unipolar depression may be more state- than trait-related. Information on profiles of cognitive performance, psychiatric history, and health behaviors may be useful in tailoring individualized treatment

Relationships Between Aerobic Fitness Levels and Cognitive Performance in Swedish Office Workers

Objectives: Aerobic exercise influence cognition in elderly, children, and neuropsychiatric populations. Less is known about the influence of aerobic exercise in healthy samples (particularly working age), and of different fitness levels on cognition. Two hypotheses were posed: 1) low fitness levels, compared to moderate and high, will be related to poorer cognitive performance, and 2) breakpoints for the beneficial relationship between VO2 and cognition will be observed within the moderate-to-high fitness span. Design and Methods: The sample consisted of n=362 office workers. A submaximal cycle ergometer test estimated maximal oxygen consumption (VO2max, mL•kg-1•min-1). Based on estimated VO2max participants were split into tertiles; low (n=121), moderate (n=119), and high (n=122). A cognitive test battery (9 tests), assessed processing speed, working memory, executive functions and episodic memory. Results: Both hypotheses were confirmed. Groups of moderate (≈40) and high (≈49) fitness outperformed the group of low (≈31) fitness for inhibition and episodic recognition, whereas no significant differences between moderate and high fitness were observed (ANCOVAs). Breakpoints between benefits fromVO2max for inhibition and recognition were estimated to ≈44/43 mL•kg-1•min-1 (multivariate broken line regressions). Conclusions: Results suggest that it is conceivable to expect a beneficial relationship between VO2max and some cognitive domains up to a certain fitness level. In a sample of healthy office workers, this level was estimated to 44 mL•kg-1•min-1. This has implications on organizational and societal levels; where incentives to improve fitness levels from low to moderate could yield desirable cognitive and health benefits in adults.Fysisk aktivitet och hälsosamma hjärnfunktioner bland kontorsarbetare: Delprojekt 1, Tvärsnittsstudi

Cognitive performance in unipolar old-age depression: A longitudinal study

Objective: Previous studies on cognitive deficits in acute and remitted states of old-age depression have shown mixed findings. The episodic nature of depression makes repeated assessment of cognitive performance important in order to address reversibility and stability of cognitive deficits. Methods: Dementia-free older participants ( 6560years) from the population-based Swedish National Study on Aging and Care in Kungsholmen who completed neuropsychological testing at baseline (T1) and follow-up (T2) formed the basis of the study sample. Participants were grouped according to depression status at T1 and T2: depressed-remitted (n=32), remitted-depressed (n=45), and nondepressed-depressed (n=29). These groups were compared with a group of randomly selected and matched (age, gender, education, and follow-up time) healthy controls (n=106) over a period of maximum 6years. Results: Mixed ANCOVAs, controlling for age and gender, revealed depression-related deficits for processing speed, attention, executive function, and category fluency. In remitted states, only processing speed and attention were affected. However, these deficits were attenuated after exclusion of persons using benzodiazepine medications. A general pattern of cognitive decline was observed across all groups for processing speed, executive function, category fluency, and episodic and semantic memory; persons transitioning from a nondepressed to depressed state tended to show exacerbated cognitive decline. Conclusions: The results support the notion that cognitive deficits in depression may be more transient than stable. Consequently, cognitive deficits in depression might be regarded as potential treatment targets rather than stable vulnerabilities. As such, repeated assessment of cognitive functioning may provide an additional marker of treatment response

Genetic Effects on Old-Age Cognitive Functioning: A Population-Based Study

Associations between genotypes and cognitive outcomes may provide clues as to which mechanisms cause individual differences in old-age cognitive performance. We investigated the effects of five polymorphisms on cognitive functioning in a population-based sample of 2,694 persons without dementia (60-102 years). A structural equation model (SEM) was fit to the cognitive data, yielding five specific latent factors (perceptual speed, episodic memory, semantic memory, category fluency, and letter fluency), as well as a global cognitive factor. These factors showed the expected associations with chronological age. Genotyping was performed for five single-nucleotide polymorphisms that have been associated with cognitive performance: APOE (rs429358), COMT (rs4680), BDNF (rs6265), KIBRA (rs17070145), and CLSTN2 (rs6439886). After controlling for age, gender, and education, as well as correcting for multiple comparisons, we observed negative effects of being an APOE epsilon 4 carrier on episodic memory and perceptual speed. Furthermore, being a CLSTN2 TT carrier was associated with poorer semantic memory. For the global factor, the same pattern of results was observed. In addition, being a BDNF any A carrier was associated with better cognitive performance. Also, older age was associated with stronger genetic effects of APOE on global cognition. However, this interaction effect was partly driven by the presence of preclinical dementia cases in our sample. Similarly, excluding future dementia cases attenuated the effects of APOE on episodic memory and global cognition, suggesting that part of the effects of APOE on old-age cognitive performance may be driven by dementia-related processes