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Objectives: To explore the strength of the association between cognitive functioning and depression and anxiety in older people without dementia. Methods: An exploratory, cross‐sectional analysis of Wave 1 (2004–2007) data from the Lothian Birth Cohort 1936 dataset. Three subgroups were based on Hospital Anxiety and Depression Scale (HADS) subscales: no probable anxiety or depression (N = 592), probable anxiety no depression (N = 122), probable depression with/without anxiety (depression) (N = 30). Regression analyses determined relationships between subgroups and identified cognitive test variables. Results: Participants were 744 individuals (male = 385 [51.5%]; mean [M] age = 69.5 years [Standard deviation = 0.83]); characteristics for subgroups were similar. Participants with probable depression had slower simple reaction time scores than those with no anxiety or depression (regression slope [β] on the log10 scale = 0.05, 95% Confidence Interval [0.03, 0.08], p ≤ 0.001). Those with probable anxiety had significantly worse scores on other tests: Spatial span (β = −0.80 [−1.36, −0.25], p ≤ 0.005), Symbol Search (β = −1.67 [−2.90, −0.45], p ≤ 0.01), Matrix Reasoning (β = −1.58 [−2.55, −0.60], p ≤ 0.005) and Block Design (β = −3.33 [−5.29, −1.37], p ≤ 0.001), than those without probable anxiety or depression. Conclusion: Probable depression and anxiety were found to be associated with lower cognitive function in those without evidence of dementia. People with probable anxiety showed poorer performance in tests that concerned making decisions. People with probable depression showed slower processing speed. [ABSTRACT FROM AUTHOR]

Objectives: Problem adaptation therapy (PATH) is a relatively new psychotherapy that recognises the importance of simultaneously targeting cognitive impairment and functional disability in the treatment of late‐life depression. This is the first systematic review to examine the effectiveness of PATH. Methods: Ageline, Embase, Medline, PsycINFO, Scopus and ProQuest databases were searched from 2010 until 5 April 2024, for studies that evaluated PATH for older people. Where possible, effect sizes (Hedges' g) with 95% confidence intervals and p values were calculated and pooled using a random effects model. The reporting quality of included studies was assessed using Joanna Briggs Institute Critical Appraisal tools and certainty of the evidence behind each result assessed with The Grading of Recommendations Assessment, Development and Evaluation method. Results: Twelve papers, from seven independent studies and a pooled sample of 579 older adults with multiple comorbidities, were included in this review. PATH participants experienced immediate reductions in depression symptom ratings (gw = 0.72, p < 0.01, Nstudies = 5), alongside small improvements in disability (gw = 0.61, p = 0.04, Nstudies = 4) compared to peers that received supportive therapy, brief psychoeducation, or usual care. The overall evidence quality was, however, characterised by bias, inconsistency, and imprecision in effect estimates. Positive participant feedback and low dropout rates (15%–31%) suggested treatment satisfaction, although these data were not routinely provided. Conclusions: PATH may be a viable treatment for older people living with mental and cognitive disorders, however there is a need for more rigorous research incorporating follow‐up assessments to consolidate the effectiveness of PATH relative to other treatments. Incorporating measures of treatment fidelity are also critical to interpreting and generalising these data. The protocol for this study was prospectively published on the Open Science Framework (https://osf.io/gx57a). [ABSTRACT FROM AUTHOR]

Objectives: To examine the association between pet ownership and psychosocial outcomes among the oldest old in Germany during the Covid‐19 pandemic. Methods/Design: Data from the "Old Age in Germany (D80+)" study were used, a large, nationwide representative study covering both individuals living at home and individuals in nursing homes aged 80 years and above (n = 2867 individuals). The telephone interviews were conducted from May to October 2021. Established tools (e.g., "Short Form of the Depression in Old Age Scale", DIA‐S4) were used to quantify the outcomes. Five groups were generated: (1) no pet ownership, (2) having at least one dog (but no other pets), (3) having at least one cat (but no other pets), (4) having at least one other pet (but neither dogs nor cats), (5) having at least two different types of pets (in any combination). Results: Multiple linear regressions showed that compared to individuals without a pet, individuals having at least one dog had significantly lower loneliness levels (β = −0.21, p < 0.01). In the fully‐adjusted models, other forms of pet ownership were not significantly associated with the outcomes examined. Conclusion: Particularly living with a dog was associated with lower loneliness among the oldest old people in Germany. If living with a dog is in line with the preferences and attitudes of the very old, this could be a strategy for reducing loneliness in this age group. Key points: There is a dearth of studies examining the association between pet ownership and psychosocial outcomes based on nationally representative data.Using nationally representative data of the D80+, our aim was to explore the association between pet ownership and psychosocial outcomes during the Covid‐19 pandemic ‐ an area in which literature is extremely limited.Living with a dog was associated with lower loneliness.Multiple pet ownership may help to maintain life satisfaction.This could indicate a strategy for reducing loneliness in this age group. [ABSTRACT FROM AUTHOR]

Background: The association between depression and dementia is still unclear, particularly regarding depression as a potential risk factor preceding dementia. Therefore, we aimed to verify if the presence of depression at baseline may increase the risk of dementia and cognitive impairment during 15 years of follow‐up in the SHARE (Survey of Health, Aging and Retirement in Europe) study. Methods: Depressive symptoms were defined using the EURO‐D, with a score ≥4 indicative of depression. Incident dementia was ascertained using self‐reported data and caregivers' information, cognitive impairment using objective cognitive tests. Cox regression analysis, adjusted for 10 baseline confounders, was run and hazard ratios (HRs), with their 95% confidence intervals, were estimated. Results: In total 22,789 participants were included in the present analysis (mean age 64.2 years) and were predominantly female. The prevalence of depression at baseline was 24.9%. Over 15 years of follow‐up, the onset of dementia occurred a median 2 years earlier in people with depression compared to those without. Depression at the baseline significantly increased the risk of dementia in the overall sample (HR = 1.74; 95% CI: 1.54–1.95) and the risk of cognitive impairment (HR = 1.15; 95% CI: 1.06–1.25). For dementia, the association was stronger in people less than 60 years (HR = 2.07; 95% CI: 1.42–3.02) than in participants aged ≥80 years (HR = 1.47; 95% CI: 1.14–1.91). A similar trend was observed for cognitive impairment. Among the single items of the EURO‐D, loss of concentration was the strongest individual variable predicting the onset of dementia. Conclusions: Depression increased the risk of dementia and cognitive impairment, particularly in younger adults, whereas loss of concentration was the strongest individual predicting variable of dementia. These findings demonstrate the need for early detection of depression for preventing future cognitive worsening. Key points: Depression is a common condition. Its role as a potential risk factor for dementia has been explored in several studies, but these have limitations, for example, differences in study population, insufficient numbers of younger patients, limited follow‐up duration, and differences in the assessment of depression and dementia.Our study, carried out using data from the SHARE project, showed that the presence of depression at baseline increased the risk of dementia by 74% and of cognitive impairment of 15%. The effect was stronger when considering young‐age depression. Among the single items of the questionnaire proposed for assessing depression, loss of concentration showed the strongest association.Our study indicates that depression may be associated with dementia and cognitive impairment in later life. Therefore, in the early recognition of depression we should remember that cognitive aspects are of critical importance for better individualizing pharmacological and non‐pharmacological approaches. [ABSTRACT FROM AUTHOR]

Objectives: Sensory impairment is a hypothesized risk factor for cognitive decline; however, the psychosocial pathways are not well understood. We evaluated whether the association between visual impairment (VI) and cognitive decline was partially mediated via depressive symptoms, loneliness, or social activity. Methods: We used data from 2601 older adults enrolled in the Memory and Aging Project in 1997 and the Minority Aging Research Study in 2004 with neuropsychological tests across five domains measured annually for up to 16 years. VI was assessed with the Rosenbaum Pocket Vision Screener. Depressive symptoms, loneliness, and social activity were self‐reported using validated scales. We used structural equation models to estimate the associations of VI with baseline and change in cognitive function, directly and indirectly through each mediator (depressive symptoms, loneliness, and social activity). We evaluated mediation via "psychological distress" using a latent variable combining depressive symptoms and loneliness. Results: The association between VI and global cognitive decline was mediated via lower social activity (indirect effect) [95% confidence interval (CI)] of linear slope: −0.025 (−0.048, −0.011), via loneliness (−0.011 [95% CI: −0.028, −0.002]), and via psychological distress (−0.017 [95% CI: −0.042, −0.003]). We did not find sufficient evidence for mediation via depressive symptoms alone. Conclusions: The harmful effect of VI on cognitive decline may be partially mediated through loneliness and lower social activity. Key points: We evaluated whether psychosocial factors mediate the association between visual impairment and cognitive decline.With data from the Memory and Aging Project and the Minority Aging Research Study, we used structural equation models to estimate the total, direct, and indirect associations through each mediator (depressive symptoms, loneliness, lower social activity, and a latent variable, psychological distress, combining depressive symptoms and loneliness).We found evidence for partial mediation via social activity and loneliness. [ABSTRACT FROM AUTHOR]

Objective: This study examined the relationship between precarious employment (PE) and mental well‐being, focusing on age‐specific interactions. Methods: Nationally representative Korean workers (N = 29,961) were surveyed between 2020 and 2021 to collect data on multidimensional PE (categorized as low, moderate, or high) and the WHO‐5 well‐being index. Workers' ages were classified as young (<35 years), middle‐aged (35–54 years), and older (≥55 years). Logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). The interaction between PE and age on well‐being was examined by including interaction terms in the regression models. Results: The prevalence of poor well‐being was 25%, 29%, and 39% for low, moderate, and high precariousness, respectively, whereas it was 26%, 30%, and 39% for young, middle‐aged, and older workers, respectively. In the overall sample, the OR (95% CI) of the association between PE and poor well‐being was 1.24 (1.17–1.32) for moderate and 1.54 (1.43–1.65) for high precariousness, compared with low precariousness. There was a significant interaction between old age and PE on the odds of poor well‐being. Compared with young workers with low PE, middle‐aged workers with high PE (OR: 1.85, 95% CI: 1.62–2.10) and older workers with high PE (OR: 2.10, 95% CI: 1.83–2.40) exhibited increased odds of having poor mental well‐being. Conclusion: PE serves as a social determinant of older workers' psychological well‐being. Policy interventions are required to protect older workers' psychological well‐being. Key points: We explored how precarious employment (PE) interacts with workers' age to affect the mental well‐being of employees.The odds of experiencing poor mental well‐being was greater for older workers with higher PE compared with those with lower PE.We observed a supra‐multiplicative interaction between workers' age and PE on the odds of experiencing poor mental well‐being.Policy interventions are required to protect the mental health of precarious older workers. [ABSTRACT FROM AUTHOR]

Objectives: Cognitive impairment, pain and depressive symptoms are common and interrelated factors in older adults. However, the directionality and specificity of their association remains unclarified. This study explored whether these factors prospectively increase reciprocal risk and examined the longitudinal association between these factors and quality of life (QoL). Methods: This study used longitudinal data from The Older Persons and Informal Caregivers Survey Minimal Data Set (TOPICS‐MDS; the Netherlands). Older adults self‐reported cognitive impairment, pain, depressive symptoms and QoL at baseline and after 6 and 12 months of follow‐up. The Random Intercept Cross‐Lagged Panel Model was used to assess the prospective association between the three factors, while a multilevel linear regression analysis in a two‐level random intercept model was used to examine the longitudinal associations between the three factors and QoL at the within‐person level. Results: The data of 11,582 home‐dwelling older adults with or without subjective cognitive impairment were analysed. At the within‐person level, pain at 6 months was associated with subsequent depressive symptoms (β = 0.04, p = 0.024). The reverse association from depression to pain, and longitudinal associations between pain and subjective cognitive impairment and between depressive symptoms and subjective cognitive impairment were non‐significant. Pain, depressive symptoms and subjective cognitive impairment showed a significant association with poor QoL 6 months later. Conclusions: A directional relationship was observed from pain to depressive symptoms. Pain reduction holds a potential benefit in the prevention of depressive symptoms, ultimately optimising the QoL of older adults. Key points: Older adults have multiple chronic conditions, and subjective cognitive impairment, pain and depressive symptoms are common and interrelated factors which affect the quality of life.Home‐dwelling older adults experiencing pain were more likely to report later depressive symptoms.Pain, depressive symptoms and subjective cognitive impairment were associated with subsequent poor quality of life.Pain reduction may help prevent depressive symptoms and poor quality of life. [ABSTRACT FROM AUTHOR]

BACKGROUND: Depressive symptoms are associated with age-related cognitive impairment, but the relative risk of specific subtypes of mild cognitive impairment (MCI) conferred by depressive symptoms is unclear. The purpose of this exploratory study was to determine the longitudinal association between baseline depressive symptoms and incident cases of MCI subtypes (amnestic vs. non-amnestic) and probable dementia (PD) (Alzheimers disease, vascular, mixed) among postmenopausal women. METHODS: Depressive symptoms were assessed at study baseline using an 8-item Burnam algorithm in 7043 postmenopausal women who participated in the Womens Health Initiative Memory Study (WHIMS) and the WHIMS-Epidemiology of Cognitive Health Outcomes (WHIMS-ECHO) extension study. During the median 9.4-year follow-up interval, the presence of MCI and PD was classified by a central adjudication committee. Classification of participants by MCI subtype (amnestic single and multi-domain, non-amnestic single and multi-domain) was done algorithmically based on established criteria using data from annual cognitive testing. RESULTS: At baseline, 557 women (7.9%) had clinically significant depressive symptoms based on Burnam algorithm cut-point of 0.06. Depressive symptoms at baseline were associated with an increased risk of incident amnestic MCI (hazard ratio [HR] = 1.91, 95% confidence interval [CI] 1.32-2.78, p

Objectives: There is a paucity of population‐level data on marijuana use and mental health and functioning in older adults. Methods: We analyzed cross‐sectional data (n = 910) from a well‐characterized cohort, the Monongahela‐Youghiogheny Healthy Aging Team (MYHAT) study. MYHAT is an age‐stratified random sample of the population age 65 years and older from a small‐town in the USA. Half the sample was female and half were over 75 (Mean age = 77). Most participants were non‐Hispanic White. Marijuana use was assessed by self‐report and symptoms of mood disorders were screened using the modified Centers for Epidemiological Studies‐Depression Scale and the Generalized Anxiety Disorder screener. Cognition was assessed by the Mini‐Mental State Examination and a neuropsychological test battery; functioning using the OARS Activities of Daily Living and Instrumental Activities of Daily Living; and overall assessment using the Clinical Dementia Rating (CDR®). Results: One in five MYHAT participants had a history of marijuana use and 5% reported recent use, primarily for pain (41%) and recreation/relaxation (37%). Recent use was associated with cigarette and alcohol use, symptoms of depression or anxiety, and impairments in attention. Conclusions: Twenty‐percent of community‐dwelling older adults living in a US state where recreational marijuana use is illegal had a history of marijuana use. Recent marijuana use was less common but, consistent with prior research, associated with other substance use and poorer mental health. Key points: One in five adults over 65 who live in a state without legal recreational marijuana laws have a history of marijuana use.Adults over 65 with recent marijuana use are more likely to smoke cigarettes and drink alcohol.Adults over 65 use marijuana for pain relief and recreation/relaxation.As with younger adults, recent marijuana use in people over 65 is associated with symptoms of depression and anxiety. [ABSTRACT FROM AUTHOR]

Background: Apathy and depression are common neuropsychiatric symptoms across neurodegenerative disorders and are associated with impairment in several cognitive domains, yet little is known about the influence of sex on these relationships. Objectives: We examined the relationship between these symptoms with neuropsychological performance across a combined cohort with mild or major neurodegenerative disorders, then evaluated the impact of sex. Design, Setting and Participants: We conducted a cohort analysis of participants in the COMPASS‐ND study with mild cognitive impairment (MCI), vascular MCI, Alzheimer's disease, mixed dementia, Parkinson's disease, frontotemporal dementia, and cognitively unimpaired (CU) controls. Measurements: Participants with neurodegenerative disease and CU controls were stratified by the presence (severity ≥1 on Neuropsychiatric Inventory Questionnaire) of either depressive symptoms alone, apathy symptoms alone, both symptoms, or neither. A neuropsychological battery evaluated executive function, verbal fluency, verbal learning, working memory, and visuospatial reasoning. Analysis of covariance was used to assess group differences with age, sex, and education as covariates. Results: Groups included depressive symptoms only (n = 70), apathy symptoms only (n = 52), both (n = 68), or neither (n = 262). The apathy and depression + apathy groups performed worse than the neither group on tests of working memory (t(312) = −2.4, p = 0.02 and t(328) = −3.8, p = 0.001, respectively) and visuospatial reasoning (t(301) = −2.3, p = 0.02 and t(321) = −2.6, p = 0.01, respectively). The depression, apathy, and depression + apathy groups demonstrated a similar degree of impairment on tests of executive function, processing speed, verbal fluency, and verbal learning when compared to participants without apathy or depression. Sex‐stratified analyses revealed that compared to the male neither group, the male apathy and depression + apathy groups were impaired broadly across all cognitive domains except for working memory. Females with depression alone showed deficits on tests of executive function (t(166) = 2.4, p = 0.01) and verbal learning (t(167) = −4.3, p = 0.001) compared to the female neither group. Conclusions: This study demonstrated that in neurodegenerative diseases, apathy with or without depression in males was associated with broad cognitive impairments. In females, depression was associated with deficits in executive function and verbal learning. These findings highlight the importance of effectively treating apathy and depression across the spectrum of neurodegenerative disorders with the goal of optimizing neuropsychological outcomes. Key points: Apathy and depression are common symptoms that patients with dementia face during the course of illness, and these symptoms are associated with impairments in several cognitive domains.We examined differences in cognitive performance between patients with either apathy alone, depression alone, both, or neither across a combined cohort with mild or major neurodegenerative disorders. Further, we evaluated this relationship within each sex.Among males, apathy with or without depression was associated with broad cognitive deficits. In females, depression was associated with deficits in executive function and verbal learning.These findings highlight the importance of effectively treating apathy and depression across the spectrum of neurodegenerative disorders with the goal of optimizing neuropsychological outcomes. [ABSTRACT FROM AUTHOR]

Objectives: The Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE‐BD) project pools archival datasets on older age bipolar disorder (OABD). An initial Wave 1 (W1; n = 1369) analysis found both manic and depressive symptoms reduced among older patients. To replicate this finding, we gathered an independent Wave 2 (W2; n = 1232, mean ± standard deviation age 47.2 ± 13.5, 65% women, 49% aged over 50) dataset. Design/Methods: Using mixed models with random effects for cohort, we examined associations between BD symptoms, somatic burden and age and the contribution of these to functioning in W2 and the combined W1 + W2 sample (n = 2601). Results: Compared to W1, the W2 sample was younger (p < 0.001), less educated (p < 0.001), more symptomatic (p < 0.001), lower functioning (p < 0.001) and had fewer somatic conditions (p < 0.001). In the full W2, older individuals had reduced manic symptom severity, but age was not associated with depression severity. Age was not associated with functioning in W2. More severe BD symptoms (mania p ≤ 0.001, depression p ≤ 0.001) were associated with worse functioning. Older age was significantly associated with higher somatic burden in the W2 and the W1 + W2 samples, but this burden was not associated with poorer functioning. Conclusions: In a large, independent sample, older age was associated with less severe mania and more somatic burden (consistent with previous findings), but there was no association of depression with age (different from previous findings). Similar to previous findings, worse BD symptom severity was associated with worse functioning, emphasizing the need for symptom relief in OABD to promote better functioning. Key points: With the global population of older adults increasing rapidly, it is important to understand how older adults with bipolar disorder (BD) differ from younger adults.This replication analysis using a large global dataset focused on older‐age bipolar disorder (OABD) and examined associations of older age, BD symptoms, somatic burden and functioning.Older age was associated with less severe mania and more somatic burden but there was no association of depression with age.Worse BD symptom severity was associated with worse functioning, emphasizing the need for symptom relief in OABD to promote better functioning. [ABSTRACT FROM AUTHOR]

Background: Geriatric depression and anxiety have been identified as mood disorders commonly associated with the onset of dementia. Currently, the diagnosis of geriatric depression and anxiety relies on self‐reported assessments for primary screening purposes, which is uncomfortable for older adults and can be prone to misreporting. When a more precise diagnosis is needed, additional methods such as in‐depth interviews or functional magnetic resonance imaging are used. However, these methods can not only be time‐consuming and costly but also require systematic and cost‐effective approaches. Objective: The main objective of this study was to investigate the feasibility of training an end‐to‐end deep learning (DL) model by directly inputting time‐series activity tracking and sleep data obtained from consumer‐grade wrist‐worn activity trackers to identify comorbid depression and anxiety. Methods: To enhance accuracy, the input of the DL model consisted of step counts and sleep stages as time series data, along with minimal depression and anxiety assessment scores as non‐time‐series data. The basic structure of the DL model was designed to process mixed‐input data and perform multi‐label‐based classification for depression and anxiety. Various DL models, including the convolutional neural network (CNN) and long short‐term memory (LSTM), were applied to process the time‐series data, and model selection was conducted by comparing the performances of the hyperparameters. Results: This study achieved significant results in the multi‐label classification of depression and anxiety, with a Hamming loss score of 0.0946 in the Residual Network (ResNet), by applying a mixed‐input DL model based on activity tracking data. The comparison of hyper‐parameter performance and the development of various DL models, such as CNN, LSTM, and ResNet contributed to the optimization of time series data processing and achievement of meaningful results. Conclusions: This study can be considered as the first to develop a mixed‐input DL model based on activity tracking data for the multi‐label identification of late‐life depression and anxiety. The findings of the study demonstrate the feasibility and potential of using consumer‐grade wrist‐worn activity trackers in conjunction with DL models to improve the identification of comorbid mental health conditions in older adults. The study also established a multi‐label classification framework for identifying the complex symptoms of depression and anxiety. Key points: Deep learning (DL) models, notably ResNet, significantly enhance depression and anxiety classification using activity tracking data, outperforming traditional models in accuracy.Mixed‐input models that combine activity tracking with minimal assessment data demonstrate superior performance, underscoring the advantages of integrating diverse data types for mental health diagnosis.This study confirms the practicality of employing consumer‐grade wearable devices for the multi‐label classification of geriatric mood disorders, presenting an affordable and effective tool for healthcare [ABSTRACT FROM AUTHOR]

Objectives: The COVID‐19 pandemic and accompanying public health measures exacerbated many known risk factors for depression, while also increasing numerous health‐related stressors for people with stroke history. Using a large longitudinal sample of older adults, the current study examined the prevalence of incident and recurrent depression among participants with stroke history, and also identified factors that were associated with depression during the pandemic among this population. Methods: Data came from four waves of the Canadian Longitudinal Study on Aging's (CLSA) comprehensive cohort (n = 577 with stroke history; 46.1% female; 20.8% immigrants; mean age = 74.56 SD = 9.19). The outcome of interest was a positive screen for depression, based on the CES‐D‐10, collected during the 2020 CLSA COVID autumn questionnaire. Bivariate and multivariate logistic regression analyses were conducted to identify factors that were associated with depression. Results: Approximately 1 in 2 (49.5%) participants with stroke history and a history of depression experienced a recurrence of depression early in the pandemic. Among those without a history of depression, approximately 1 in 7 (15.0%) developed depression for the first time during this period. The risk of depression was higher among immigrants, those who were lonely, those with functional limitations, and those who experienced COVID‐19 related stressors, such as increased family issues, difficulty accessing healthcare, and becoming ill or having a loved one become ill or die during the pandemic. Conclusions: Interventions that target those with stroke history, both with and without a history of depression, are needed to buffer against the stressors of the COVID‐19 pandemic and support the mental health of this population. Key points: One in seven older adults with a history of stroke experienced depression for the first time in their life during the COVID‐19 pandemic.One in two older adults with a history of stroke and depression experienced a recurrence or persistence of depression during the pandemic.Key factors that were associated with depression during the pandemic included feeling lonely at the beginning of the pandemic, being an immigrant, and experiencing functional limitations.COVID‐19 related stressors that were associated with depression included difficulty accessing healthcare, becoming ill or having a loved one become ill or die, and increased family stress, such as separation from family or increased time spent caregiving. [ABSTRACT FROM AUTHOR]

Objectives: Cognitive impairment and change are a focus of research into late‐life depression. The aims of this 5‐year prospective study were (1) to observe cognitive status change; (2) to investigate the rate and risk ratio of dementia or cognitive decline; and (3) to examine the cognitive domain predictors for conversion to dementia within 5 years among a clinical cohort with remitted major depressive disorder (MDD). Methods: The study cohort included 130 elderly persons with late‐life remitted MDD and 100 normal controls. Comprehensive neuropsychological tests were conducted to determine cognitive domain status. Diagnoses of mild cognitive impairment (MCI) and dementia were made at baseline and at a follow‐up visit at the 5‐year point. In total, 98 cases and 55 normal controls completed the 5‐year follow‐up assessment. Results: Of the study cohort with late‐life remitted MDD, 28.6% had MCI and 25.5% developed dementia within 5 years. Patients with late‐life remitted MDD had an approximate 3 times higher risk of subsequent cognitive decline as compared with the normal controls. Information‐processing speed (p = 0.009) and memory (p = 0.041) could predict subsequent progression to dementia within 5 years among patients with MDD. Conclusions: This study demonstrated that compared with the general elderly population, elderly patients with depression have more significant impairment in cognitive function after 5 years. Further, we found that in depressed patients, deficits in information‐processing speed and memory domains were highly suggestive of progression to dementia within 5 years. Key points: Elderly patients with depression had higher risk of subsequent cognitive decline.In elder patients with remitted major depressive disorder (MDD), deficits in information‐processing speed and memory domains were highly suggestive of progression to dementia within 5 years. [ABSTRACT FROM AUTHOR]

Objectives: Physical activity (PA) can reduce depressive symptoms but has not been tested amongst depressed older caregivers and their care‐recipients. The aim of this single‐blind randomized controlled trial was to investigate the effect of a 6‐month tailored PA program on depressive symptoms in older caregivers. Method: Caregivers were included if they had scores of ≥5 on the 15‐item geriatric depression scale (GDS‐15). Care‐recipients could have any type of physical, mental or cognitive condition requiring support. The PA intervention group completed an individualized program based on the Otago‐Plus Exercise Program. The primary outcome was improvement in depressive symptoms in caregivers measured at six and 12 months. Results: Two hundred and twelve participants (91 dyads and 30 caregivers only) were randomized using a 3:3:1 ratio to PA intervention, social‐control, and usual‐care control groups. There were no significant differences in depressive symptoms of the caregivers between the three groups at 6 months or 12 months. However, more than 50% of caregivers in all three groups no longer had a GDS‐15 score ≥5 at 6 months. Further analysis revealed that caregivers in the PA group caring for someone with a standardised mini‐mental state examination (SMMSE) score ≥24 had significantly less depressive symptoms than those caring for someone with a SMMSE score <24 compared with social‐control (p < 0.02) and usual‐care groups (p < 0.02). Conclusions: A PA intervention may be beneficial for some caregivers in reducing symptoms of depression but may not be as beneficial to caregivers of people living with cognitive impairment. Key points: Physical activity (PA) may help to reduce depression, stress and burden in caregivers.This study investigated the effects of an individually tailored, home‐based PA intervention for both caregivers and care‐recipients, of 6 months' duration, on improving depressive symptoms in older caregivers.A PA intervention may be beneficial for caregivers in reducing symptoms of depression but may not be as beneficial to caregivers of people living with cognitive impairment. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The association of pain and depression has not been evaluated in low- and middle-income countries, which have a disproportionate burden of pain compared to high-income countries. METHODS: Using data from the Mexican Health and Aging Study (baseline, 2012; follow-up, 2015), we examined the bidirectional relationship between pain and depressive symptoms and identified shared predictors among community-dwelling participants ≥60 years (n = 7237). Multivariable logistic regressions models evaluated the association between (1) baseline pain and incident elevated depressive symptoms and (2) baseline depressive symptoms and incident pain, adjusting for demographic, socioeconomic, and health-related factors. Models included inverse probability weights and evaluated interactions by gender. RESULTS: Participants (55.0% women) were on average 69.1 years old. Over half reported no pain (60.7%) and low/no depressive symptoms (67.9%) in 2012, of which, 20.2% reported elevated depressive symptoms and 25.3% self-reported pain in 2015. Baseline pain was associated with higher odds of incident elevated depressive symptoms (aOR 1.65; 95% CI, 1.41-1.93). Baseline elevated depressive symptoms were associated with higher odds of developing pain (aOR 1.57; 95% CI, 1.32-1.87). Age, gender, self-rated health, and activity of daily living limitations were shared risk factors for pain and elevated depressive symptomatology onset. Although the incidence of elevated depressive symptoms and pain was higher in women, there were no statistically significant interactions. CONCLUSIONS: Older adults with pain or depression may be at risk for developing the other. These shared predictors could help identify patients in clinical settings, where pain and depression are often overlooked, reducing the cascading risk of this comorbidity.

ObjectivesCare partners who provide informal care to individuals with Parkinson's disease (PD) report higher levels of burden and depression; however, longitudinal research on these symptoms is scarce. The current study assessed changes in care partner burden and depression, and patient and care partner predictors of these symptoms over time. Such knowledge may provide important information for assessment and treatment of depression and burden in care partners of individuals with PD.Research design and methodsParticipants were 88 PD patients without dementia and their self-identified care partner (n = 88). Care partners completed the Geriatric Depression Scale and Zarit Burden Interview. PD participants completed mood questionnaires and a motor exam at baseline and 2 year follow-up. Relationships among care partner burden and depression over time with patient and care partner predictors (i.e., demographic, mood, and disease characteristics) were assessed using correlations and regression analyses.ResultsCare partner burden and depression significantly increased over an approximate 2 year period. Greater baseline disease severity predicted worsening of care partner burden (p = 0.028), while baseline patient depression predicted worsening of care partner depression (p = 0.002).ConclusionsResults highlight differential impacts of specific PD symptoms on worsening care partner burden compared to depression; increased PD disease severity predicts increased burden, while patient mood predicts worsening of depression over time. Targeting PD disease severity and mood symptoms may prevent the progression of care partner burden and depression.

OBJECTIVES: Late Life Depression (LLD) is associated with persistent cognitive dysfunction even after depression symptoms improve. The present study was designed to examine cognitive outcomes associated with the pattern of depression severity change during psychotherapy intervention for LLD. METHODS: 96 community-dwelling adults ages 65-91 with major depressive disorder completed 12 sessions of Problem-Solving Therapy at the University of California, San Francisco. Nonlinear trajectories of depression severity ratings using the Hamilton Depression Rating Scale were computed from multiple time points collected throughout the weekly psychotherapy intervention. Performance on measures of cognition (information processing speed, executive functioning, verbal learning, memory) was assessed at baseline and post-treatment. Linear mixed-effects models examined associations between nonlinear depression severity trajectories and post-treatment change in cognitive performance. RESULTS: Broadly, different patterns of depression change during treatment were associated with improved cognition post-treatment. Greater and more consistent interval improvements in depression ratings were differentially associated with improvements in aspects of verbal learning, memory, and executive function post-treatment, while no associations were found with information processing speed. CONCLUSIONS: The heterogeneity of depression trajectories associated with improved cognitive outcomes suggests that the temporal pattern of depression response may impact specific cognitive processes distinctly. Results suggest that use of nonlinear depression severity trajectories may help to elucidate complex associations between the time course of depression response and cognitive outcomes of psychotherapy in LLD. These findings have important implications for identifying treatment targets to enhance clinical and cognitive outcomes of psychotherapy in LLD.

Objectives: We examined the impact of the social network before the coronavirus pandemic on loneliness and depressed mood during the pandemic in older European individuals, and how these relationships differ between different European countries. Methods: Data of N = 19,999 persons (age: M = 69.18 years; 51% female) from the pan‐European longitudinal survey of health, ageing and retirement in Europe, interviewed between October 2019 and March 2020 (Wave 8) and between June and August 2020 (Corona Questionnaire 1), were used. To test the models we employed path analyses, controlling for age, gender, education, and occupational status. Models were also run separately in collectivistic (Romania, Slovenia, Croatia, and Greece) and individualistic (Netherlands, Belgium, Denmark, and France) country groups. Results: A larger social network before the pandemic reduced the probability of an increase in loneliness and depression. The negative association between social network size and increase in loneliness was stronger in collectivist countries than in individualist ones. Moreover, an increase in loneliness increased the probability of feeling depressed. Conclusions: It appears that pre‐pandemic social networks served as a buffer to negative mental health consequences of the pandemic in older Europeans. In fact, this association was stronger in collectivist than for individualist countries. While this underscores the importance of social connectedness, it also stresses the vulnerability of socially isolated individuals regarding loneliness and depression. Future work should thus focus on supporting social networks in older adults. Key points: A larger social network before the pandemic reduced the probability of an increase in loneliness and depression.An increase in loneliness during the pandemic increased the probability of feeling depressed.The negative association between social network size and increase in loneliness was stronger in collectivist countries than in individualist ones. [ABSTRACT FROM AUTHOR]

Objectives: Apathy is a frequent neuropsychiatric syndrome after stroke. We determined whether pre‐morbid and early post‐stroke apathy predicts dementia 3 months after stroke. Methods: We included ischemic stroke patients without dementia who participated in the Prospective Observational Polish Study on post‐stroke delirium. We used the Neuropsychiatric Inventory and clinician‐reported version of Apathy Evaluation Scale to score apathy symptoms before stroke and on day 8 after stroke. Patients underwent neuropsychological examination 3 months after stroke. Results: Of 422 patients with ischemic stroke and without pre‐stroke dementia, 194 patients (mean age: 67.5 ± 12.3; 45.9% female) underwent neuropsychological examination. Dementia was diagnosed in 21.6% of them. Patients with dementia had higher apathy scores before stroke (mean: 0.9 ± 1.7 vs. 0.2 ± 0.9, p < 0.01) and on day 8 (mean: 37.2 ± 9.3 vs. 29.0 ± 9.6, p < 0.01). Depressive symptoms did not differ between groups. In multivariate analysis adjusted for age, diabetes mellitus, stroke severity and in‐hospital delirium, apathy symptoms before stroke and on day 8 after stroke predicted post‐stroke dementia (adjusted OR: 1.59, 95%CI: 1.13–2.26, p = 0.01 and OR: 1.06, 95%CI: 1.01–1.11, p = 0.03, respectively). Conclusions: Pre‐stroke and early post‐stroke apathy independently from age, stroke severity and delirium predicted dementia 3 months after stroke. Apathy might be useful in identifying at‐risk patients. Key points: Pre‐stroke and early post‐stroke apathy was associated with an increased risk of dementia 3 months after ischemic stroke. This association was independent from age, stroke severity and in‐hospital delirium.Pre‐stroke apathy displayed high specificity whereas early post‐stroke apathy had high sensitivity for predicting post‐stroke dementia.Apathy might be useful in identifying stroke patients at risk of dementia. [ABSTRACT FROM AUTHOR]

Objectives: There are few studies investigating the determinants of psychosocial outcomes using data exclusively from the oldest old; and even fewer that use longitudinal data. Thus, our aim was to explore the determinants of psychosocial factors (in terms of life satisfaction, loneliness, and depressive symptoms) amongst the oldest old (also stratified by sex) based on representative, longitudinal data from Germany. Methods/Design: Data from "Survey on quality of life and subjective well‐being of the very old in North Rhine‐Westphalia (NRW80+)" were used. This study includes community‐dwelling and institutionalized individuals aged 80 years and above (n = 1760 observations in the analytical sample) located in North Rhine‐Westphalia (the most populous state in Germany). The mean age was 86.6 years (SD: 4.3 years). Established instruments were used to quantify life satisfaction, loneliness, and depressive symptoms. Linear FE regressions were used in this study to mitigate the challenge of unobserved heterogeneity. Sex‐stratified regressions were also conducted. Results: Regressions showed that the loss of a spouse was significantly associated with worsening psychosocial factors (in terms of increases in depressive symptoms and loneliness). Furthermore, regressions revealed that increases in functional impairment were significantly associated with poorer psychosocial outcomes. Conclusions: This longitudinal study enhanced our understanding of the factors contributing to poorer psychosocial outcomes among the oldest old. Efforts to avoid or postpone functional impairment may contribute to more favorable psychosocial outcomes. Moreover, our current study underlines the importance of spousal relationships for psychosocial outcomes in the oldest age group. Key points: Using longitudinal, representative data of the North Rhine‐Westphalia (NRW80+), the objective of this study was to investigate the determinants of psychosocial outcomes among the oldest oldEstablished tools were used to quantify the key variables. Gender‐stratified regressions were also conductedPoorer psychosocial outcomes: linked to spousal loss and functional impairment in particularEfforts to avoid or postpone functional impairment may contribute to more favorable psychosocial outcomes [ABSTRACT FROM AUTHOR]

Objectives: The likelihood of depression symptoms in those with type 2 diabetes (T2D) is high. Psychological risk factors enhancing comorbidity of depression symptoms in T2D are yet to be determined. The present study examines the cross‐sectional and longitudinal relationship between personality traits and distinct depression dimensions in older adults with T2D. Methods: Participants were older adults (age ≥65yeas) with T2D from the Israel Diabetes and Cognitive Decline (IDCD) study (N = 356), with complete data on depression [Geriatric Depression Scale (GDS) ‐ 15 item version] and its dimensions‐ namely, dysphoric mood, apathy, hopelessness, memory complains and anxiety, and on personality [Big Five Inventory (BFI)]. Logistic and mixed linear regression models examined cross‐sectional and longitudinal associations while adjusting for socio‐demographics, cognition, cardiovascular and diabetes‐related factors. Results: Cross‐sectionally, high neuroticism was associated with high scores in total GDS and in all depression‐dimensions, except memory complaints. Higher extroversion was associated with lower total GDS and with lower scores on all depression dimensions, except anxiety. High levels of neuroticism were associated with increase in total number of depression symptoms over time. Conclusions: In older adults with T2D, neuroticism and extroversion are associated with most depression dimensions suggesting that these traits relate to a global depression symptomatology rather than to any specific dimension or phenomenology. High neuroticism was associated with increase in depression symptoms over time, highlighting its role in the development of depression symptoms in older adults with T2D. Highlights: What is the primary question addressed by this study? Do specific personality traits predict depression dimensions and contribute to the development of depression symptoms in older adults with T2D? What is the main finding of this study? Cross‐sectionally, high neuroticism and low extroversion are associated with most depression dimensions, and only high levels of neuroticism with an increase in overall depression symptoms over time. What is the meaning of the finding? In the context of T2D, personality traits are associated with global depression state rather than to any specific depression dimensions, with neuroticism specifically implicated in the development of depression symptoms. [ABSTRACT FROM AUTHOR]

Objectives: Depression may be a risk factor or a prodromal symptom of dementia, and decreased serum levels of brain‐derived neurotrophic factor (BDNF) have been observed in both depression and dementia. The aim of the present study was to determine whether serum levels of BDNF in the remitted or acute phase of depression predicted the transition from depression to dementia. Methods: Serum levels of BDNF were measured in the acute phase of depression (n = 204) and after remission (n = 117), and we followed (mean: 24.3 months) the participants to assess the subsequent onset of dementia or mild cognitive impairment (MCI). Results: Serum levels of BDNF after remission, but not those in the acute depressive phase, predicted the future development of dementia or MCI. Conclusions: Patients with low serum BDNF levels, even after depression remission, might have an increased risk of developing dementia. These findings suggest a potential association between residual low serum BDNF levels after remission and the prodromal state of dementia, or the involvement of BDNF in the transition from depression to dementia. However, given that this study is low‐powered and preliminary, interpretation of the results should be approached with caution. Key points: Serum brain‐derived neurotrophic factor (BDNF) levels in acute depressive phase did not predict the future development of dementia or mild cognitive impairment (MCI).Serum BDNF levels after remission predicted the future development of dementia or MCI.Residual low serum BDNF levels after remission may reflect the prodromal state of dementia.BDNF may be involved in the transition from depression to dementia. [ABSTRACT FROM AUTHOR]

Background: Observational studies have shown the relationship between sarcopenia and psychiatric disorders. However, due to the limitations of traditional research methods, the causal relationship between them has not been accurately concluded. At the same time, considering that sarcopenia is mainly manifested by low muscle strength and low muscle mass, we used Mendelian randomization (MR) analysis in this study to explore the causal relationship of anxiety, depression, and neuroticism with muscle strength and muscle mass, respectively. Methods: Genetic variants associated with depression were obtained from FinnGen Biobank (Ncase = 33,812, Ncontrol = 271,380), those associated with anxiety were from FinnGen Biobank (Ncase = 21,519, Ncontrol = 307,558), and those associated with neuroticism, including 12 items, were from a large‐scale genome‐wide association study (N range: 366,301–375,913). Muscle strength was represented by the hand grip strength (HGS), and muscle mass was represented by the appendicular lean mass (ALM) and the body fat percentage. The inverse‐variance weighted (IVW) method was used as the primary analysis method, and the Mendelian Randomization Egger (MR‐Egger) and the weighted median were used as supplementary methods to test whether the three psychological factors were causally related to these two main indicators of sarcopenia severity. Results: Depression and neuroticism had different degrees of causal influence on muscle mass and strength, which was statistically significant. Specifically, the depression predicted by genes was significantly associated with ALM (beta = −0.043, p = 0.027), low hand grip strength (LHGS, measured for people of 60 years and older) (odds ratio (OR) = 1.129 (1.019–1.251), p = 0.019), right HGS (beta = −0.050, p = 0.001), left HGS (beta = −0.06, p = 0.001), and body fat percentage (beta = 0.035, p = 0.0138). The neuroticism predicted by genes was significantly associated with ALM (beta = −0.073, p = 0.034), LHGS (OR = 1.222 (1.085–1.377), p = 0.001), right HGS (beta = −0.058, p = 0.000), left HGS (beta = −0.080, p < 0.000), and body fat percentage (beta = 0.063, p = 0.008). However, anxiety was only significantly associated with LHGS (OR = 1.215 (1.008–1.465), p = 0.041) but not significantly associated with ALM (beta = 0.033, p = 0.313), right HGS (beta = −0.008, p = 0.678), left HGS (beta = 0.007, p = 0.712), or body fat percentage (beta = 0.022, p = 0.559). Conclusion: This study supported the causal association of depression and neuroticism with muscle strength and mass, which are the two main indicators of sarcopenia. At the same time, there was no sufficient evidence for the causal relationship between anxiety and muscle strength or mass. The results of this study pointed to the need to intervene in the mental health of the elderly to prevent sarcopenia or reduce its severity. Key points: Muscle strength and mass are two main indicators of sarcopenia.Genetically predicted depression and neuroticism were causally associated with muscle strength and mass; and anxiety was not, which may be related to population selection.Focusing on the mental health of elderly patients can prevent the occurrence of sarcopenia or alleviate its severity. [ABSTRACT FROM AUTHOR]

Background: Older adults with mild cognitive impairment (MCI) and depression have a higher dementia conversion rate, which requires timely intervention. Objectives: A non‐randomized controlled trial was conducted to explore the effect of a nurse‐led positive psychological intervention (PPI) in relieving depression and promoting cognition in this population. Methods: A total of 70 older adults were enrolled, with 35 each in the intervention and control groups. The control group received one‐to‐one health education, and the intervention group received a 40‐ to 60‐minute PPI for eight successive weeks. Results: During the intervention, most participants reached the standard of active participation, and 2.86% continued to complete homework every day during follow‐up. The Patient Health Questionnaire‐9 (PHQ‐9) score in the intervention group was significantly lower than that in the control group at the end of intervention (t = −3.64, p < 0.05) and at 3‐month follow‐up (t = −4.48, p < 0.05). Interaction effects of time and group on PHQ‐9 scores (F = 8.11, p < 0.001), with significant differences between the groups in scores (F = 9.11, p < 0.05) and times (F = 23.58, p < 0.05) was observed. In the Montreal Cognitive Assessment (MoCA) scale, the intervention group had significantly higher scores than controls at the end of intervention (t = 7.28, p < 0.05) and 3‐month follow‐up (t = 8.01, p < 0.05). Cognition in the two groups was significantly affected by intergroup effects (F = 42.80, p < 0.001), interaction effects (F = 30.38, p < 0.001), and time effects (F = 33.67, p < 0.05). Conclusions: Although the effects tended to decrease in follow‐up, the nurse‐led PPI was feasible and valid in relieving depression and promoting cognition among older participants with MCI and depression. The present findings warrant further exploration. A nurse‐led positive psychological intervention was applicable among elderly MCI adults with depression and effective in relieving depression and promoting cognition. Key points: Older adults with mild cognitive impairment (MCI) and depression exhibited higher conversion rate to dementia.Positive psychology emphasized transforming negative emotions and strengthening positive emotions to reduce mental illness and increase well‐being.A positive psychology intervention could be conducted by nursing staff and acceptable by elder MCI with depression resident in community.The nurse‐led eight‐week positive psychology intervention with a frequency of once a week and 40‐ to 60‐minute sessions was effective in relieving depression and promoting cognition among participants. [ABSTRACT FROM AUTHOR]

Background: Psychiatric comorbidity is high in adults with posttraumatic stress disorder (PTSD), with up to 90% having at least one additional condition, and two‐thirds having two or more other diagnoses. With an increasing aging population in industrialized counties, knowing which psychiatric disorders frequently co‐occur in older adults with PTSD can have implications to improve diagnosis and treatment. This systematic literature review explores the current empirical literature on psychiatric comorbidity in older adults with PTSD. Method: Literature databases PubMed, Embase, PsycINFO, and CINAHL were searched. The following inclusion criteria were applied: research done since 2013, PTSD diagnosis based on diagnostic criteria according to Diagnostic and Statistics Manual‐Fifth Edition, International Classification of Diseases—10th Revision (ICD‐10), or ICD‐11, and studies include individuals aged 60 years or older. Results: Of 2068 potentially relevant papers identified, 246 articles were examined based on titles and abstracts. Five papers met the inclusion criteria and were included. Major depressive disorder and alcohol use disorder were the most frequently studied and diagnosed psychiatric comorbidities in older adults with PTSD. Conclusions and implications: Screening for depression and substance use in older adults should include an assessment of trauma and PTSD. Additional studies in the general older adult population with PTSD and a broader range of comorbid psychiatric disorders are needed. Key points: Major depressive disorder and alcohol use disorders are the most frequently studied and diagnosed psychiatric comorbidities in older adults with PTSD.Based on this, screening for trauma and PTSD should be included in older adults with depression and substance useQualitative epidemiological studies on psychiatric comorbidities, such as personality disorders, in older adults with PTSD are limited and needed. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated the association between depression and non‐compliance with COVID‐19 preventive behaviors among community‐dwelling South Korean older adults. Methods: We utilized the 2020 Korean Community Health Survey—a community‐based nationwide survey. A score of 10 points or higher on the Patient Health Questionnaire‐9 was defined as depression. Non‐compliance with COVID‐19 preventive behaviors was assessed on the following three behaviors: washing hands, wearing masks, and watching distance. We also included socio‐demographic characteristics, health behaviors, and COVID‐19‐related characteristics as covariates. Multiple logistic regression analyses were performed, and all statistical analyses were stratified by sex. Results: The 70,693 participants included 29,736 men and 40,957 women. Notably, 2.3% of men and 4.2% of women had depression. Non‐compliance with washing hands was significantly higher in men than women (1.3% vs. 0.9%), whereas no significant differences were observed in wearing masks and watching distance. The adjusted logistic regression analysis showed that depression was positively associated with non‐compliance with washing hands and watching distance in both sexes. The association between depression and non‐compliance with wearing masks was significant only in women. Conclusions: There was an association between depression and non‐compliance with COVID‐19 preventive behaviors in South Korean older adults. This signifies that health providers need to reduce depression to improve compliance with preventive behaviors in older adults. Key points: Men are less likely to comply with washing hands than are women.Depression is associated with non‐compliance with COVID‐19 preventive behaviors in both sexes. [ABSTRACT FROM AUTHOR]

Introduction: Recent studies highlight the negative impact of social isolation and involvement in leisure activities on enhanced well‐being of individuals. However, there is dearth of evidence on relationship between social isolation and leisure activities on cognitive abilities and depression of older adults in the Indian context. The paper reports the impact of social isolation and leisure activities on cognitive functioning and depression of older adults. Methods: Data were collected from the Longitudinal Ageing Study of India (LASI), and 63,806 participants aged 45 years or above were considered for the study with adherence to the exclusion criteria. Multivariate analysis was carried out to analyse the group‐based differences. Results: Social isolation (F = 102.09, p < 0.01; η2 = 0.09) and leisure (F = 224.54, p < 0.01; η2 = 0.07) had a statistically significant impact on the cognition and depressive symptoms of participants. Socially isolated older adults with little involvement in leisure activities had the worst cognitive functioning (M = 32.76, SD = 4.41), whereas middle‐aged adults who were actively involved in leisure activities and experienced the least social isolation exhibited the best cognitive functioning (M = 32.76, SD = 4.41). However, leisure and age as independent factors did not have a significant impact on depression. Conclusion: Socially isolated participants, irrespective of age, and involvement in leisure activities exhibit poor cognitive functioning and are more likely to suffer from depression as compared to their counterparts. The findings of the study can be used to design intervention strategies aimed at reducing social isolation by incorporating leisure activities to ensure the optimal functioning of middle‐aged and older adults. Key points: Socially isolated older adults with least involvement in leisure activities reported the worst cognitive functioning.Socially isolated participants reported a positive association with depressive symptomatology.Both middle‐aged and older adults who engaged in leisure activities reported better cognitive functioning as compared to their counterparts who did not engage in any form of leisure activities.Leisure as an independent factor is not significantly associated with depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: As we age, cognitive abilities decline which can lead to a decrease in quality of life (QoL) and an increase in depressive symptoms even in healthy (i.e., non‐clinical) older adults. Cognitive trainings (CT) are a promising approach to not only improve cognition, but also QoL and mood. However, it is unclear which prognostic factors are associated with changes in QoL and depression after CT. Objective: To identify prognostic factors and models of changes in QoL and depressive symptoms after a multi‐domain CT in healthy older adults. Methods: MEDLINE, Web of Science Core Collection, CENTRAL and PsycInfo were systematically searched for multi‐domain CT studies in healthy older adults until August 2022. Studies investigating prognostic factors and/or models on QoL and depressive symptoms were included. Risk of bias was assessed using the QUIPS and the PROBAST tool. Results: Our search revealed N = 12,916 studies, of which only 6 could be included in the review. Prognostic factors included were sociodemographics, cognitive reserve, cognitive baseline level, and cognitive change. However, data were too rare and heterogenous regarding the assessment measures of QoL and depressive scores, the used multi‐domain CT and the investigated prognostic factors to draw clear conclusions or conduct meta‐analyses. Conclusion: There is an urgent need for research on prognostic factors and models of changes in QoL and depressive symptoms after CT in healthy older participants as they could help to tailor interventions to individuals in terms of future precision medicine approaches. Key points: Although cognitive training (CT) is known to have positive effects on quality of life (QoL) and depression, a systematic review examining prognostic factors and models for these effects was lacking.Prognostic factors included were sociodemographics, cognitive reserve, cognitive baseline level, and cognitive change.Data were too heterogenous to draw clear conclusions or conduct meta‐analyses.Future research should enlighten which factors and models predict CT changes on QoL and depression to foster individualized cognitive interventions. [ABSTRACT FROM AUTHOR]

Background Detection of suicidal ideation (SI) is key for trying to prevent suicide. The aim of this study was to analyze the frequency of SI and related factors in Spanish people with Parkinson's Disease (PwPD) and to compare them with a control group. Methods PD patients and controls recruited from the Spanish cohort COPPADIS from January 2016 to November 2017 were included. Two visits were conducted: V0 (baseline); V2 (2-year ± 1 month follow-up). SI was defined as a score ≥1 on item nine of the Beck Depression Inventory-II (BDI-II). Regression analyses were conducted to identify factors related to SI. Results At baseline, 693 PwPD (60.2% males; 62.59 ± 8.91 years old) and 207 controls (49.8% males; 60.99 ± 8.32 years old) were included. No differences between PwPD and controls were detected in SI frequency at either V0 (5.1% [35/693] vs. 4.3% [9/207]; p = 0.421) or at V2 (5.1% [26/508] vs. 4.8% [6/125]; p = 0.549). Major depression (MD) and a worse quality of life were associated with SI at both visits in PwPD: V0 (MD, OR = 5.63; p = 0.003; PDQ-39, OR = 1.06; p = 0.021); V2 (MD, OR = 4.75; p = 0.027; EUROHIS-QOL8, OR = 0.22; p = 0.006). A greater increase in the BDI-II total score from V0 to V2 was the only factor predicting SI at V2 (OR = 1.21; p = 0.002) along with an increase in the total number of non-antiparkinsonian drugs (OR = 1.39; p = 0.041). Conclusion The frequency of SI (5%) in PwPD was similar to in controls. Depression, a worse quality of life, and a greater comorbidity were related to SI. [ABSTRACT FROM AUTHOR]

Objectives: Anxiety and depression are prevalent in the elderly and lead to loss of functionality and increased mortality. Although the use of antidepressants and face-to‐face psychotherapies are indicated, the current context of telemedicine provides an alternative, with the advantage of facilitating access to care. The study aimed to evaluate the efficacy of telemedicine interventions to reduce anxiety and depression in the elderly through a systematic review with meta‐analysis. Methods: The systematic review, through a search in 7 databases, included studies that evaluated the use of telemedicine interventions for depressive or anxious symptoms in the elderly, compared with usual care or waiting list or with another telemedicine intervention. Quantitative assessment was performed through meta-analysis. Results: A total of 31 articles identified in the search met the eligibility criteria and four were included for meta‐analysis. Studies showed that telemedicine interventions are feasible and several studies demonstrated significant improvement in depressive or anxiety symptoms. Four studies evaluated the efficacy of internet-delivered cognitive behavioral therapy for depression and anxiety in older adults, compared with a waitlist, and found pooled effect sizes of −1.20 (95% CI −1.60 to −0.81) and −1.14 (95% CI −1.56 to −0.72), respectively, with low heterogeneity. Conclusions: Telemedicine interventions can be an alternative for the treatment of mood and anxiety symptoms in the elderly. However, more studies are needed to prove their clinical effectiveness, especially in countries with lower incomes and diverse culture and education. [ABSTRACT FROM AUTHOR]

Background: Recent research suggests that abnormalities in the habenula (HB), a core area of the brain that transmits reward information, may be a determinant of depression. However, it is not clear whether the functional connectivity (FC) pattern of the mild cognitive impairment (MCI) with and without depression symptoms is abnormal. Methods: In this study, we used resting‐state functional magnetic resonance imaging (fMRI) to examine the FC pattern of the HB in MCI patients with depression symptoms (D‐MCI). We acquired fMRI data from 54 subjects on a 3T MRI. Subjects collected included 16 patients with D‐MCI, 18 patients with MCI with no depression, and 20 healthy controls. One way ANCOVA and post hoc t‐test were used to compare the difference in FC strength between the three groups. Results: The D‐MCI group had altered FC between the left HB and the right superior temporal gyrus, right inferior frontal gyrus/opercular part, and right middle frontal gyrus. The D‐MCI group had increased FC between the right HB and precuneus. Conclusions: These results suggest that the dysfunction of the HB–Default model network might be involved in the neural mechanism underlying depression in MCI. Key points: Recent research suggests that abnormalities in the habenula may be a determinant of depression.We used resting‐state functional magnetic resonance imaging to examine the functional connectivity (FC) pattern of the habenula in mild cognitive impairment (MCI) patients with depression symptoms.The MCI patients with depression symptoms had altered FC between the left habenula and the right superior temporal gyrus, right inferior frontal gyrus/opercular part, and right middle frontal gyrus. The MCI patients with depression symptoms group had increased FC between the right habenula and precuneus.The dysfunction of the habenula–Default model network might be involved in the neural mechanism underlying depression in MCI. [ABSTRACT FROM AUTHOR]

Objectives: Hearing loss, depression, and cognitive decline are common among older people. We investigated the association of hearing loss with depressive symptoms and cognitive function in a nationally representative sample of people aged 50+ in Brazil. Methods: Data from the Brazilian Longitudinal Study of Aging (ELSI‐Brazil) included information on self‐reported hearing loss, hearing aid use (effective or not effective), depressive symptoms (CES‐D‐8), and a global cognitive score (composed of immediate and late recall, verbal fluency, orientation and prospective memory) in a sample of 9412 individuals. Multiple linear regression was used to estimate the association of hearing loss and hearing aid use with both depressive symptoms and cognitive performance. The analyses were conducted with 7837 participants with complete data, and then repeated with data from the whole sample after multiple imputation. Results: Compared to those without hearing loss, those with hearing loss were more likely to have a higher number of depressive symptoms (β: 0.53 (0.40–0.67) p < 0.001) but not worse cognitive performance (β: −0.01 (−0.03 to 0.19) p = 0.631). Among those with hearing loss, the use of hearing aid was neither associated with cognitive performance (β: −0.08 (−0.19 to 0.03) p = 0.169) or depressive symptoms (β: −0.42 (−0.98 to 0.14) p = 0.143); its effective use was associated with less depressive symptoms (β: −0.62 (−1.23 to −0.01) p = 0.045) but not worse cognitive performance (β: −0.15 (−0.030 to 0.03) p = 0.057). Sensitivity analyses revealed that hearing loss is associated with a worse performance in two non‐amnestic cognitive domains. Conclusions: Hearing loss may negatively affect specific cognitive domains and depressive symptoms among older people, and the use of a hearing aid may mitigate the association with depressive symptoms. Key points: Hearing loss is highly prevalent among older people and may contribute to an increased risk of depression, cognitive impairment, and dementia.In our nationally representative sample of Brazilians aged 50 and older, those with hearing loss had more depressive symptoms compared to those without hearing loss, and individuals with hearing loss with an effective use of a hearing aid had fewer depressive symptoms than those without hearing aid.Individuals with hearing loss had more depressive symptoms compared to those without hearing loss, but did not have a poorer cognitive performance. An effective use of hearing aids was associated with fewer depressive symptoms but was not associated with cognitive performance.Hearing rehabilitation in the older people might be a feasible public health intervention to reduce the burden of depression among older adults. [ABSTRACT FROM AUTHOR]

Background: Depression affects 10%–20% of older adults worldwide. The course of late‐life depression (LLD) is often chronic, with a poor long‐term prognosis. Lower treatment adherence, stigma, and suicide risk lead to significant challenges in the continuity of care (COC) for patients with LLD. Elderly patients with chronic diseases can benefit from COC. As a common chronic disease of the elderly, whether depression can also benefit from COC has not been systematically reviewed. Methods: Systematic literature search in Embase, Cochrane Library, Web of Science, Ovid, PubMed and Medline. Randomized Controlled Trials (RCTs) on the intervention effects of COC and LLD, published on 12 April 2022, were selected. Two independent researchers made research choices based on consensus. An RCT with COC as an intervention measure for the elderly with depression 60 years old was the inclusion criteria. Results: A total of 10 RCTs involving 1557 participants were identified in this study. The findings showed that: (1) COC significantly reduced depressive symptoms compared to usual care (standardized mean difference [SMD] = −0.47, 95% confidence interval: −0.63 to −0.31), with the best improvement at 3‐ to 6‐month follow up; (2) The reduction in depressive symptoms was more pronounced for patients with comorbid chronic conditions with LLD (SMD = −0.93, 95% CI: −1.18 to −0.68); (3) COC was more effective than other regions for LLD in Europe and the Americas (SMD = −0.84, 95% CI: −1.07 to −0.61); and (4) COC had a positive impact on the quality of life of patients with LLD (SMD = 0.21, 95% CI: 0.02–0.40). Limitations: The included studies included several multi‐component interventions with widely varying methods. Therefore, it was almost impossible to analyze which of these interventions had an impact on the assessed outcomes. Conclusions: This meta‐analysis shows that COC can significantly reduce depressive symptoms and improve quality of life in patients with LLD. However, when treating and caring for patients with LLD, health care providers should also pay attention to timely adjustments of intervention plans according to follow‐up, synergistic interventions for multiple co‐morbidities, and actively learning from advanced COC programs at home and abroad to improve the quality and effectiveness of services. [ABSTRACT FROM AUTHOR]

Background: Few studies have examined the association of comorbid depression with health‐care utilization among dementia patients. This study compared health‐care utilization between dementia patients with and without comorbid depression. Methods: Using Taiwan's National Health Insurance Research Database, we identified 10,710 patients with newly diagnosed dementia between 2005 and 2014: 1785 had comorbid depression (group 1) and 8925 did not (group 2). Patients were tracked for 1 year to evaluate outpatient, emergency, and inpatient service utilization and length of hospital stay (LOS). Multivariable regression was applied to examine the association between comorbid depression and health‐care utilization and analyze factors associated with inpatient visits and LOS. Results: Group 1 had significantly fewer outpatient visits (β = −0.115; p < 0.001), more inpatient visits (β = 0.157; p = 0.005), and a longer LOS (β = 0.191; p < 0.001) than did group 2. The groups did not differ significantly in emergency visits (β = 0.030; p = 0.537). In group 1, age, gender, and specific comorbidities were predictors of inpatient visits; those factors and salary‐based insurance premiums were predictors of LOS. Conclusion: Group 1 utilized less outpatient care but more inpatient care, suggesting health‐care service for these patients may be needed to improvement. Key points: We investigated whether dementia with comorbid depression was associated with higher health‐care utilization.Compared with dementia patients only, patients coexisting dementia and depression had no significant emergency visits and even significantly less outpatient visits. However, patients coexisting dementia and depression had higher inpatient visits and longer length of stay (LOS) than those with dementia only. The significant predictors associated with hospitalization utilizations among dementia patients with comorbid depression are age, gender, salary‐based insurance premiums, and specific comorbidities.Our findings suggest that outpatient and emergency health‐care services for dementia patients with comorbid depression may be insufficient and are not integrated with inpatient care services. [ABSTRACT FROM AUTHOR]

Objectives: This narrative review describes the clinical features of apathy and depression in individuals with neurocognitive disorders (NCDs), with the goal of differentiating the two syndromes on the basis of clinical presentation, diagnostic criteria, neuropathological features, and contrasting responses to treatments. Methods: Literature was identified using PubMed, with search terms to capture medical conditions of interest; additional references were also included based on our collective experience and knowledge of the literature. Results: Evidence from current literature supports the distinction between the two disorders; apathy and depression occur with varying prevalence in individuals with NCDs, pose different risks of progression to dementia, and have distinct, if overlapping, neurobiological underpinnings. Although apathy is a distinct neuropsychiatric syndrome, distinguishing apathy from depression can be challenging, as both conditions may occur concurrently and share several overlapping features. Apathy is associated with unfavorable outcomes, especially those with neurodegenerative etiologies (e.g., Alzheimer's disease) and is associated with an increased burden for both patients and caregivers. Diagnosing apathy is important not only to serve as the basis for appropriate treatment, but also for the development of novel targeted interventions for this condition. Although there are currently no approved pharmacologic treatments for apathy, the research described in this review supports apathy as a distinct neuropsychiatric condition that warrants specific treatments aimed at alleviating patient disability. Conclusions: Despite differences between these disorders, both apathy and depression pose significant challenges to patients, their families, and caregivers; better diagnostics are needed to develop more tailored treatment and support. Key points: Apathy and depression are distinct neuropsychiatric syndromes that share overlapping features and may occur concurrently in individuals with neurocognitive disorders (NCDs)Distinguishing apathy from depression can be challenging, but proper identification of each syndrome is important for appropriate interventionThis narrative review describes clinical features associated with apathy and depression and differentiates each syndrome based on clinical presentation and diagnostic criteria, neuropathological features, and differences in response to treatment [ABSTRACT FROM AUTHOR]

BACKGROUND:Despite a large literature on the stress process, little attention has focused on how caregivers for persons living with dementia (PLWDs) provide care and how this may impact care outcomes. Criticism is a management strategy caregivers may use to respond to behavioral symptoms. We consider whether criticism is associated with caregivers' mental health and service utilization. METHODS:Data are drawn from the Advancing Caregiver Training intervention study including 256 informal caregivers living with a PLWD. In multiple linear regressions controlling for caregivers' demographics and PLWDs' clinical factors, we consider criticism (criticism subscale of the Dementia Management Strategies Scale) as a predictor of caregiver burden, depressive symptoms, desire to institutionalize the PLWD, level of frustration with care, and the number of home-based, social, and health services utilized. RESULTS:On average, 15% of the sample sometimes reported using criticism as a management strategy to manage the challenges of care. Greater use of criticism was associated with significantly more caregiver burden (β = 0.26, P

ObjectivesWith the world population rapidly aging, it is increasingly important to identify sociodemographic, cognitive, and clinical features that predict poor outcome in geriatric depression. Self-report measures of resilience-ie, the ability to adapt and thrive in the face of adversity-may identify those depressed older adults with more favorable prognoses.MethodsWe investigated the utility of baseline variables including 4 factors of resilience (grit, active coping self-efficacy, accommodative coping self-efficacy, and spirituality) for predicting treatment response and remission in a 16-week randomized controlled trial of methylphenidate, citalopram, or their combination in 143 adults over the age of 60 with MDD.ResultsFinal logistic regression models revealed that greater total baseline resilience (Wald χ2  = 3.8, P = 0.05) significantly predicted both treatment response and remission. Specifically, a 20% increase in total resilience predicted nearly 2 times greater likelihood of remission (OR = 1.98, 95% CI = [1.01, 3.91]). Examining the individual factors of resilience, only accommodative coping self-efficacy (Wald χ2  = 3.7, P = 0.05; OR = 1.41 [1.00-2.01]) was significantly associated with remission. We found no relation between baseline sociodemographic factors (age, sex, race, education level) or measures of cognitive performance and posttreatment depressive symptoms.ConclusionsSelf-reported resilience may predict greater responsivity to antidepressant medication in older adults with MDD. Future research should investigate the potential for resilience training-and in particular, interventions designed to increase accommodative coping-to promote sustained remission of geriatric depression.

The Geriatric Depression Scale (GDS) is recommended for screening depression in individuals with Parkinson's disease (PD). Empirical evidence, however, is limited regarding its validity and factor structure in PD. Thus, the current study sought to evaluate the convergent and divergent validity of the GDS, as well as the structure and validity of the derived factors.MethodNondemented individuals with PD (n = 158) completed the GDS-30, and items were subjected to a principle component analysis. Geriatric Depression Scale total and factor scores were correlated with depression items from the Movement Disorder Society Unified Parkinson's disease Rating Scale (MDS-UPDRSd) and Hamilton Rating Scale for Depression (HAMDd), as well as with the Apathy Scale (AS), State-Trait Anxiety Inventory (STAI), Modified Fatigue Impact Scale (MFIS), Parkinson's disease Sleep Scale, and a Subjective Cognitive Function composite score.ResultsThe GDS total score was strongly correlated with divergent neuropsychiatric measures (AS, r = 0.57; STAI, r = 0.66; MFIS, r = 0.60), while only moderately correlated with convergent measures (MDS-UPDRSd, r = 0.36; HAMDd, r = 0.32; Ps

Background: Older adults have both the highest risk of contracting SARS-CoV-2 and in many jurisdictions have had additional restrictions placed on the social interactions. As a result, the COVID-19 pandemic has led to increased depression and loneliness among older adults. Using data from an established cohort of older adults, the aims of this study was to describe changes in loneliness and depression and to examine the directionality of the association between depression and loneliness over a 5-year period that included the early months of the pandemic. Methods: Data were from The Irish Longitudinal Study on Ageing (TILDA), a large cohort of community-dwelling adults aged 54+. We applied an auto-regressive cross-lagged panel modelling approach to estimate the effect of depression on loneliness and vice versa over three time points. Results: Both depression and loneliness increased significantly in the early months of the pandemic. While the association between loneliness and depression was bidirectional, loneliness was a stronger predictor of depression. Conclusion: The strength and bi-directionality of the association between loneliness and depression suggests that interventions to alleviate loneliness may also help reduce depressive symptoms and vice versa. [ABSTRACT FROM AUTHOR]

Background: Depression in individuals with Alzheimer's disease (AD) is common, difficult to treat and inadequately understood. Previous studies have identified possible differences in regional brain atrophy in individuals with AD and depression, but the results have been inconsistent and some studies had less robust definitions of depression. We aimed to examine regional brain atrophy in two large dementia focused cohorts. Methods: We used data from Alzheimer's disease neuroimaging initiative (ADNI) and the National Alzheimer's Co-ordinating Center (NACC), for those with data from at least one MRI scan. Depression ratings were available using the Geriatric Depression Scale (GDS) and Neuropsychiatric Inventory (NPI). Intermittent depressive symptoms were defined as one episode above threshold (≥8 on GDS, ≥6 on NPI depression subscale and ≥2 on the Neuropsychiatric Inventory version Q depression sub-scale) and persistent as ≥2 episodes. Derived regional volumetric data was available from ADNI and the NACC. Results: Data was available from 698 individuals with AD in NACC and from 666 individuals in ADNI. We found no evidence of between group differences in regional brain volume at baseline, or of differential atrophy in NACC. In ADNI we found evidence of increased brain atrophy in several frontal brain areas. Limitations: Because this study was limited to those with MRI data, the numbers in some analyses were low. MRI parcellation differed between studies making direct comparison difficult. For some individuals only the NPI was used to rate depression. Conclusions: We have found mixed evidence of increased regional atrophy in depression in AD, mainly in frontal brain regions. We found no evidence to support a vascular basis for depression in AD. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether vitamin D supplementation reduces depressive symptoms and incidence of antidepressant use.Methods: We used data from the D-Health Trial (N = 21,315), a randomized double-blind placebo-controlled trial of monthly vitamin D3 for the prevention of all-cause mortality. Participants were Australians aged 60-84 years. Participants completed the Patient Health Questionnaire (PHQ-9) at 1, 2 and 5 years after randomization to measure depressive symptoms; national prescribing records were used to capture antidepressant use. We used mixed models and survival models.Results: Analyses of PHQ-9 scores included 20,487 participants (mean age 69·3 years, 46% women); the mean difference (MD) in PHQ-9 score (vitamin D vs. placebo) was 0·02 (95% CI -0·06, 0·11). There was negligible difference in the prevalence of clinically relevant depression (PHQ-9 score ≥10) (odds ratio 0·99; 95% CI 0·90, 1·08). We included 16,670 participants in the analyses of incident antidepressant use (mean age 69·4 years, 43% women). Incidence of antidepressant use was similar between the groups (hazard ratio [HR] 1·04; 95% CI 0·96, 1·12). In subgroup analyses, vitamin D improved PHQ-9 scores in those taking antidepressants at baseline (MD -0·25; 95% CI -0·49, -0·01; p-interaction = 0·02). It decreased risk of antidepressant use in participants with predicted 25(OH)D concentration <50 nmol/L (HR 0·88; 95% CI 0·75, 1·02; p-interaction = 0·01) and increased risk in those with predicted 25(OH)D ≥ 50 nmol/L (HR 1·10; 95% CI 1·01, 1·20).Conclusion: Monthly supplementation with high-dose vitamin D3 was not of benefit for measures of depression overall, but there was some evidence of benefit in subgroup analyses.Clinical Trial Registration: The trial is registered on the Australian New Zealand Clinical Trials Registry: ACTRN12613000743763. https://www.anzctr.org.au/. [ABSTRACT FROM AUTHOR]

Introduction: Executive function deficits (EFD) in late life depression (LLD) are associated with poor outcomes. Dysfunction of the cognitive control network (CCN) has been posited in the pathophysiology of LLD with EFD. Methods: Seventeen older adults with depression and EFD were randomized to iTBS or sham for 6 weeks. Intervention was delivered bilaterally using a recognized connectivity target. Results: A total of 89% (17/19) participants completed all study procedures. No serious adverse events occurred. Pre to post-intervention change in mean Montgomery-Asberg-depression scores was not different between iTBS or sham, p = 0.33. No significant group-by-time interaction for Montgomery-Asberg Depression rating scale scores (F3, 44 = 0.51; p = 0.67) was found. No significant differences were seen in the effects of time between the two groups on executive measures: Flanker scores (F1, 14 = 0.02, p = 0.88), Dimensional-change-card-sort scores F1, 14 = 0.25, p = 0.63, and working memory scores (F1, 14 = 0.98, p = 0.34). The Group-by-time interaction effect for functional connectivity (FC) within the Fronto-parietal-network was not significant (F1, 14 = 0.36, p = 0.56). No significant difference in the effect-of-time between the two groups was found on FC within the Cingulo-opercular-network (F1, 14 = 0, p = 0.98). Conclusion: Bilateral iTBS is feasible in LLD. Preliminary results are unsupportive of efficacy on depression, executive function or target engagement of the CCN. A future Randomized clinical trial requires a larger sample size with stratification of cognitive and executive variables and refinement in the target engagement. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to develop a classification model to detect and distinguish apathy and depression based on text, audio, and video features and to make use of the shapely additive explanations (SHAP) toolkit to increase the model interpretability.Methods: Subjective scales and objective experiments were conducted on 319 mild cognitive impairment (MCI) patients to measure apathy and depression. The MCI patients were classified into four groups, depression only, apathy only, depressed-apathetic, and the normal group. Speech, facial and text features were extracted using the open-source data analysis toolkits. Multiclass classification and SHAP toolkits were used to develop a classification model and explain the contribution of specific features.Results: The macro-averaged f1 score and accuracy for overall model were 0.91 and 0.90, respectively. The accuracy for the apathetic, depressed, depressed-apathetic, and normal groups were 0.98, 0.88, 0.93, and 0.82, respectively. The SHAP toolkit identified speech features (Mel-frequency cepstral coefficient (MFCC) 4, spectral slopes, F0, F1), facial features (action unit (AU) 14, 26, 28, 45), and text feature (text 6 semantic) associated with apathy. Meanwhile, speech features (spectral slopes, shimmer, F0) and facial expression (AU 2, 6, 7, 10, 14, 26, 45) were associated with depression. Apart from the shared features mentioned above, new speech (MFCC 2, loudness) and facial (AU 9) features were observed in the depressive-apathetic group.Conclusions: Apathy and depression shared some verbal and facial features while also exhibited distinct features. A combination of text, audio, and video could be used to improve the early detection and differential diagnosis of apathy and depression in MCI patients. [ABSTRACT FROM AUTHOR]

Objectives: Identify the health profiles of older nursing home residents with and without at-admission self-reported suicidal ideation (SI) and examine the association between the identified profiles and self-reported SI at 90 days.Methods: Using the Minimum Data Set 3.0 and the ninth Patient Health Questionnaire-9 (PHQ-9) item, we identified 15,277 older residents with and 562,184 without self-reported SI at nursing home admission. Latent class analysis, using frailty, cognitive impairment, palliative care index, pain, and remaining PHQ-9 items as indicators, identified health profiles by at-admission SI and the BCH method estimated their association with SI at 90 days.Results: Profiles identified for residents without at-admission SI were: (1) frail and depressedNoSI (prevalence: 33.9%); (2) frail and severe cognitive impairmentNoSI (38.1%); (3) pre-frailNoSI (28.0%). Residents in the frail and depressedNoSI group had greater odds [adjusted OR: 2.80; 95% Confidence Interval: 2.60-3.00] while those in the frail and severe cognitive impairmentNoSI group had lower odds [aOR: 0.79; 95% CI: 0.71-0.86] of 90-day SI than those in the pre-frailNoSI group. Profiles identified for residents with at-admission SI were: (1) frail and all depressive symptomsSI (22.8%); (2) frail and some depressive symptomsSI (32.2%); (3) frail and severe cognitive impairmentSI (22.9%); (4) pre-frailSI (22.0%). Compared to those in the pre-frailSI group, residents in the frail and all depressive symptomsSI group had greater odds of continuing reporting SI at 90 days [aOR: 1.22; 95% CI:1.09-1.35].Conclusions: Findings indicated unique health profiles of nursing home residents at higher risk of new onset of or continued SI. [ABSTRACT FROM AUTHOR]

ObjectiveOur aim is to evaluate if and how neuropsychiatric symptoms (NPS) of dementia influence the management and disposition of older adults who present to emergency care settings.MethodsThis is a retrospective cohort study that involved the medical and psychiatric emergency departments of a tertiary academic medical center. Participants included patients ≥65 years of age with dementia who presented between 1 February 2012 and 16 July 2014 (n = 347). Subjects with documented NPS (n = 78) were compared with a group of subjects without documented NPS (n = 78) randomly selected from the overall group with dementia. The groups with and without NPS were compared on demographic, clinical, management, and disposition characteristics.ResultsPatients with NPS were more likely to have additional diagnostic testing performed and receive psychotropic medications including benzodiazepines and antipsychotics. Significantly fewer patients with NPS (59.0%) returned to their original setting from the emergency department than patients without NPS (76.9%). Among patients with NPS, those who had a motor disturbance were more likely to receive psychotropic medications than patients who did not have a motor disturbance. Depression/dysphoria, anxiety, disinhibition, irritability/lability, and motor disturbance were all associated with transfer from medical to psychiatric emergency department. Patients with depression/dysphoria or anxiety were more likely to be psychiatrically hospitalized.ConclusionsThere are significant differences in the management of dementia with and without NPS in the emergency room setting. Developing and implementing successful methods to manage NPS in the emergency department and outpatient setting could potentially lead to less emergent psychotropic administration and reduce hospitalizations. Copyright © 2016 John Wiley & Sons, Ltd.

Objectives: The association of pain and depression has not been evaluated in low- and middle-income countries, which have a disproportionate burden of pain compared to high-income countries.Methods: Using data from the Mexican Health and Aging Study (baseline, 2012; follow-up, 2015), we examined the bidirectional relationship between pain and depressive symptoms and identified shared predictors among community-dwelling participants ≥60 years (n = 7237). Multivariable logistic regressions models evaluated the association between (1) baseline pain and incident elevated depressive symptoms and (2) baseline depressive symptoms and incident pain, adjusting for demographic, socioeconomic, and health-related factors. Models included inverse probability weights and evaluated interactions by gender.Results: Participants (55.0% women) were on average 69.1 years old. Over half reported no pain (60.7%) and low/no depressive symptoms (67.9%) in 2012, of which, 20.2% reported elevated depressive symptoms and 25.3% self-reported pain in 2015. Baseline pain was associated with higher odds of incident elevated depressive symptoms (aOR 1.65; 95% CI, 1.41-1.93). Baseline elevated depressive symptoms were associated with higher odds of developing pain (aOR 1.57; 95% CI, 1.32-1.87). Age, gender, self-rated health, and activity of daily living limitations were shared risk factors for pain and elevated depressive symptomatology onset. Although the incidence of elevated depressive symptoms and pain was higher in women, there were no statistically significant interactions.Conclusions: Older adults with pain or depression may be at risk for developing the other. These shared predictors could help identify patients in clinical settings, where pain and depression are often overlooked, reducing the cascading risk of this comorbidity. [ABSTRACT FROM AUTHOR]

Background: Handgrip strength (HGS) is a frequent and general indicator of muscle strength and it may affect several aspects of mental health among older people. This study explored the association of HGS with depression and cognitive impairment among community-dwelling older adults in resource-constrained setting of India.Method: Data were drawn from the Longitudinal Ageing Study in India (LASI), and the analysis was conducted on 27,707 older adults aged 60 years and above. Outcome measures included depression (assessed by the Short Form Composite International Diagnostic Interview (CIDI-SF) and the Center for Epidemiological Studies-Depression (CES-D) scales) and cognitive impairment. Descriptive statistics and mean scores of HGS were reported and multivariable linear regression analyses were conducted to test the research hypotheses of the study.Results: Mean score of HGS was 24.33 (SD: 7.22) for males and 15.94 (SD: 5.14) for females. Mean age was 68.86 (SD: 7.19) and 68.40 (SD: 7.31) years among males and females respectively. Older participants who had weak HGS were significantly more likely to be depressed in CIDI-SF scale (B: 0.06, CI: 0.01-0.13) and CES-D scale (B: 0.02, CI: 0.01-0.03) in comparison to those who had strong HGS after adjusting for a large number of confounders. Older participants who had weak HGS were significantly more likely (B: 0.92, CI: 0.76-1.07) to have cognitive impairment compared to those who had strong HGS.Conclusion: The findings highlight the independent association of HGS with major depression, depressive symptoms and cognitive impairment that have implications on promoting resistance-training programs among aged population. [ABSTRACT FROM AUTHOR]

Introduction: This study examined the effects of the coronavirus disease 2019 (COVID-19) pandemic on depression and suicidal ideation in community-dwelling elderly in Korea., Methods: Data were employed from a survey on elderly mental health in Jeollanam-do (southwest province in Korea), conducted by the Jeollanam-do Provincial Mental Health and Welfare Center. A total of 2423 people were recruited from all 22 cities in Jeollanam-do from April to October, 2021. We used self-reported questionnaires including sociodemographic factors, COVID-19-related stress, the Geriatric Depression Scale-Short Form Korean Version, the Multidimensional Scale of Perceived Social Support, the Satisfaction With Life Scale and the Brief Resilience Scale. Logistic regression was performed to examine the factors of depression and suicidal ideation., Results: Of the 2423 subjects, 622 (25.7%) reported depressive symptoms and 518 (21.4%) reported suicidal ideation. The multivariate logistic regression analysis revealed that living alone, poor perceived health status, worry of COVID-19 infection, and restriction of daily activities due to COVID-19 pandemic are significantly associated with depression. Female gender, poor perceived health status, inability to perform household chores, and depressive symptom are risk factors of suicidal ideation., Conclusion: These findings show that old age, negative perception of health, and restriction of daily activities due to COVID-19 are risk factors of depression in community-dwelling elderly in the context of the COVID-19 pandemic. Female gender, poor self-perceived health status, and depression increase the risk of suicidal ideation among the elderly. Social support and life satisfaction are protecting factors of both depression and suicidal ideation. Resilience decreased risk of depression but not in suicidal ideation., (© 2024 John Wiley & Sons Ltd.)