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Heterogeneity of Cognition in Older Adults with Remitted Major Depressive Disorder: A Latent Profile Analysis.

Authors :
Marawi T
Zhukovsky P
Brooks H
Bowie CR
Butters MA
Fischer CE
Flint AJ
Herrmann N
Lanctôt KL
Mah L
Pollock BG
Rajji TK
Voineskos AN
Mulsant BH
Source :
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry [Am J Geriatr Psychiatry] 2024 Jul; Vol. 32 (7), pp. 867-878. Date of Electronic Publication: 2024 Feb 02.
Publication Year :
2024

Abstract

Objectives: To identify data-driven cognitive profiles in older adults with remitted major depressive disorder (rMDD) with or without mild cognitive impairment (MCI) and examine how the profiles differ regarding demographic, clinical, and neuroimaging measures.<br />Design: Secondary cross-sectional analysis using latent profile analysis.<br />Setting: Multisite clinical trial in Toronto, Canada.<br />Participants: One hundred seventy-eight participants who met DSM-5 criteria for rMDD without MCI (rMDD-MCI; n = 60) or with MCI (rMDD + MCI; n = 118).<br />Measurements: Demographic, clinical, neuroimaging measures, and domain scores from a neuropsychological battery assessing verbal memory, visuospatial memory, processing speed, working memory, language, and executive function.<br />Results: We identified three latent profiles: Profile 1 (poor cognition; n = 75, 42.1%), Profile 2 (intermediate cognition; n = 75, 42.1%), and Profile 3 (normal cognition; n = 28, 15.7%). Compared to participants with Profile 3, those with Profile 1 or 2 were older, had lower education, experienced a greater burden of medical comorbidities, and were more likely to have MCI. The profiles did not differ on the severity of residual symptoms, age of onset of rMDD, number of depressive episodes, psychotropic medication, cerebrovascular risk, ApoE4 carrier status, or family history of depression, dementia, or Alzheimer's disease. The profiles differed in cortical thickness of 15 regions, with the most prominent effects for left precentral and pars opercularis, and right inferior parietal and supramarginal.<br />Conclusion: Older patients with rMDD can be grouped cross-sectionally based on data-driven cognitive profiles that differ from the absence or presence of a diagnosis of MCI. Future research should determine the differential risk for dementia of these data-driven subgroups.<br /> (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1545-7214
Volume :
32
Issue :
7
Database :
MEDLINE
Journal :
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
Publication Type :
Academic Journal
Accession number :
38403532
Full Text :
https://doi.org/10.1016/j.jagp.2024.01.225