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Cognitive performance of community-dwelling oldest-old individuals with major depression: the Pietà study

Published online by Cambridge University Press:  01 June 2017

Filipi Leles da Costa Dias ,
Antônio Lúcio Teixeira ,
Henrique Cerqueira Guimarães ,
Maira Tonidandel Barbosa ,
Elisa de Paula França Resende ,
Rogério Gomes Beato ,
Karoline Carvalho Carmona  and
Paulo Caramelli
Filipi Leles da Costa Dias
Affiliation:
Post-graduate Program in Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Antônio Lúcio Teixeira
Affiliation:
Post-graduate Program in Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Henrique Cerqueira Guimarães
Affiliation:
Post-graduate Program in Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Maira Tonidandel Barbosa
Affiliation:
Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Elisa de Paula França Resende
Affiliation:
Post-graduate Program in Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Rogério Gomes Beato
Affiliation:
Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Karoline Carvalho Carmona
Affiliation:
Post-graduate Program in Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Paulo Caramelli*
Affiliation:
Post-graduate Program in Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
*
Correspondence should be addressed to: Prof. Paulo Caramelli, Av. Prof. Alfredo Balena, 190 - Sala 246 30130-100, Belo Horizonte (MG), Brasil Phone/Fax: +55-31-3409.9746. Email: caramelli@ufmg.br.
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Abstract

Background:

Individuals with late-life depression (LLD) may present cognitive symptoms. We sought to determine whether a brief cognitive battery (BCB) could identify cognitive and functional deficits in oldest-old individuals with LLD and a low level of education.

Methods:

We evaluated 639 community-dwelling individuals aged 75+ years in Caeté (MG), Brazil. We used the MINI and GDS-15 to diagnose major depression and evaluate its severity, respectively. The cognitive evaluation comprised the Mini-Mental State Examination (MMSE), BCB, clock-drawing test, category fluency test (animals) and Pfeffer's Functional Activities Questionnaire (FAQ).

Results:

Fifty-four (11.6%) of the included individuals were diagnosed with LLD; on average, these participants were aged 81.0 ± 4.8 years and had 3.9 ± 3.4 years of schooling, and 77.8% of the subjects with LLD were female. Depressed individuals scored lower than subjects without dementia/depression on the MMSE overall (p < 0.001) and on several of the MMSE subscales, namely, time (p < 0.001) and spatial orientation (p = 0.021), attention/calculation (p = 0.019), and language (p = 0.004). Individuals with LLD performed worse on the incidental and (p = 0.011) immediate memory (p = 0.046) and learning tasks (p = 0.039) of the BCB. Individuals with LLD also performed worse on the category fluency test (p = 0.006), clock-drawing test (p = 0.011) and FAQ (p < 0.001). Depression severity was negatively correlated with incidental memory (ρ = −0.412; p = 0.003) and positively correlated with FAQ score (ρ = 0.308; p = 0.035). In the multiple regression analysis, only temporal orientation and FAQ score remained independently associated with LLD.

Conclusion:

Individuals with depression and a low level of education presented several cognitive and functional deficits. Depression severity was negatively correlated with incidental memory and functionality. Our findings serve as a description of the presence of cognitive dysfunction in individuals with LLD and suggest that these deficits may be identified based on the results of a BCB.

Keywords

geriatric depressionlate-life depressioncognitionoldest-old
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 9 , September 2017 , pp. 1507 - 1513
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Almeida, O. P. and Almeida, S. A. (1999). Reliability of the Brazilian version of the abbreviated form of geriatric depression scale (GDS) short form. Arquivos de Neuropsiquiatria, 57, 421–426.Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. Washington, DC: American Psychiatric Association.Google Scholar
Amorim, P. (2000). Mini International Neuropsychiatric Interview (MINI): validation of a short structured diagnostic psychiatric interview. Revista Brasileira de Psiquiatria, 22, 106–115.CrossRefGoogle Scholar
Assis, L. O., de Paula, J. J., Assis, M. G., de Moraes, E. N. and Malloy-Diniz, L. F. (2014). Psychometric properties of the Brazilian version of Pfeffer's functional activities questionnaire. Frontiers in Aging Neuroscience, 6, 255.Google Scholar
Bschor, T. et al. (2004). Time experience and time judgment in major depression, mania and healthy subjects. A controlled study of 93 subjects. Acta Psychiatrica Scandinavica, 109, 222–229.Google Scholar
Butters, M. A. et al. (2004). The nature and determinants of neuropsychological functioning in late-life depression. Archives of General Psychiatry, 61, 587–595.Google Scholar
Caramelli, P. et al. (2011). The Pieta study: epidemiological investigation on successful brain aging in Caete (MG), Brazil. Methods and baseline cohort characteristics. Arquivos de Neuropsiquiatria, 69, 579–584.CrossRefGoogle ScholarPubMed
Caramelli, P., Carthery-Goulart, M. T., Porto, C. S., Charchat-Fichman, H. and Nitrini, R. (2007). Category fluency as a screening test for Alzheimer disease in illiterate and literate patients. Alzheimer Disease & Associated Disorders, 21, 65–67.Google Scholar
Chang, Y. H. et al. (2013). Cognitive performance in older elderly men with late-life depression and cardiovascular comorbidities: symptomatological correlation. Annals of General Psychiatry, 12, 36.Google Scholar
Costa, E., Barreto, S. M., Uchoa, E., Firmo, J. O., Lima-Costa, M. F. and Prince, M. (2007). Prevalence of international classification of diseases, 10th Revision common mental disorders in the elderly in a Brazilian community: the bambui health ageing study. American Journal of Geriatric Psychiatry, 15, 17–27.CrossRefGoogle Scholar
Dybedal, G. S., Tanum, L., Sundet, K., Gaarden, T. L. and Bjolseth, T. M. (2013). Neuropsychological functioning in late-life depression. Frontiers in Psychology, 4, 381.Google Scholar
Elderkin-Thompson, V., Moody, T., Knowlton, B., Hellemann, G. and Kumar, A. (2011). Explicit and implicit memory in late-life depression. American Journal of Geriatric Psychiatry, 19, 249–255.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Harvey, P. D. (2012). Clinical applications of neuropsychological assessment. Dialogues in Clinical Neuroscience, 14, 91–99.CrossRefGoogle ScholarPubMed
Instituto Brasileiro de Geografia e Estatística (2012). Uma análise das Condições de Vida da População Brasileira Rio de Janeiro. Brazil: Ministério do Planejamento Orçamento e Gestão.Google Scholar
Koenig, A. M., Bhalla, R. K. and Butters, M. A. (2014). Cognitive functioning and late-life depression. Journal of the International Neuropsychological Society, 20, 461–467.CrossRefGoogle ScholarPubMed
Luppa, M. et al. (2012). Age- and gender-specific prevalence of depression in latest-life–systematic review and meta-analysis. Journal of Affective Disorders, 136, 212–221.CrossRefGoogle ScholarPubMed
Nitrini, R. et al. (1994). Neuropsychological tests of simple application for diagnosing dementia. Arquivos de Neuropsiquiatria, 52, 457–465.CrossRefGoogle ScholarPubMed
Nitrini, R. et al. (2004). Performance of illiterate and literate nondemented elderly subjects in two tests of long-term memory. Journal of the International Neuropsychological Society, 10, 634–638.Google Scholar
Pfeffer, R. I., Kurosaki, T. T., Harrah, C. H. Jr., Chance, J. M. and Filos, S. (1982). Measurement of functional activities in older adults in the community. Journal of Gerontology, 37, 323–329.CrossRefGoogle ScholarPubMed
Sheehan, D. V. et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59 (Suppl. 20), 22–33; quiz 34–57.Google ScholarPubMed
Silva, L. S. V. et al. (2014). Relations between memory complaints, depressive symptoms and cognitive performance among community dwelling elderly. Revista de Psiquiatria Clínica, 41, 67–71.CrossRefGoogle Scholar
Sunderland, T. et al. (1989). Clock drawing in Alzheimer's disease. A novel measure of dementia severity. Journal of the American Geriatrics Society, 37, 725–729.CrossRefGoogle ScholarPubMed
United Nations (2015). World Population Ageing 2015 - Highlights (p. 27). New York, NY: United Nations, Department of Economic and Social Affairs, Population Division.Google Scholar
Wilkins, C. H., Mathews, J. and Sheline, Y. I. (2009). Late life depression with cognitive impairment: evaluation and treatment. Clinical Interventions in Aging, 4, 51–57.Google Scholar
Woo, B. K., Rice, V. A., Legendre, S. A., Salmon, D. P., Jeste, D. V. and Sewell, D. D. (2004). The clock drawing test as a measure of executive dysfunction in elderly depressed patients. Journal of Geriatric Psychiatry and Neurology, 17, 190–194.CrossRefGoogle ScholarPubMed
Xavier, F. M. F., Ferraz, M. P. T., Bertolucci, P., Poyares, D. and Moriguchi, E. H. (2001). The prevalence of major depression and its impact in the quality of life, sleep patterns and cognitive function in a octogenarian population. Revista Brasileira de Psiquiatria, 23, 62–70.Google Scholar
Yen, Y. C., Rebok, G. W., Gallo, J. J., Jones, R. N. and Tennstedt, S. L. (2011). Depressive symptoms impair everyday problem-solving ability through cognitive abilities in late life. The American Journal of Geriatric Psychiatry, 19, 142–150.CrossRefGoogle ScholarPubMed
Yesavage, J. A. et al. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar