The relationship between hippocampal volume, chronic pain, and depressive symptoms in older adults.
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ABSTRACT:
SUBMITTER: Ezzati A
PROVIDER: S-EPMC6645699 | biostudies-literature | 2019 Jul
REPOSITORIES: biostudies-literature
Publications
The relationship between hippocampal volume, chronic pain, and depressive symptoms in older adults.
Ezzati Ali A Zammit Andrea R AR Lipton Michael L ML Lipton Richard B RB
Psychiatry research. Neuroimaging 20190515
We aimed to test the hypothesis that the effect of chronic pain on depressive symptoms is mediated through hippocampal volume (HV). Participants were 131 non-demented adults over the age of 70 years from the Einstein Aging Study. Smaller right and left HV were both associated with higher depressive symptoms, but only smaller right HV was associated with chronic pain. In mediation models, right HV was a significant mediator for the effect of chronic pain on depression. Our findings suggest presen ...[more]
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Project description:ObjectivesTo investigate the association between depressive symptoms and several medical morbidities, and their combination, in a large older population.DesignCross-sectional study of baseline data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial.SettingMulticentric study conducted in Australia and the United States.ParticipantsA total of 19,110 older adults (mean age = 75 years [standard deviation = ±4.5]).MeasurementsDepressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D 10) scale. Medical morbidities were defined according to condition-specific methods. Logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) to test associations before and after accounting for possible confounders.ResultsDepressive symptoms were significantly associated with obesity (OR = 1.19; 95% CI = 1.07-1.32), diabetes (OR = 1.22; 95% CI = 1.05-1.42), gastroesophageal reflux disease (GERD) (OR = 1.41; 95% CI = 1.28-1.57), metabolic syndrome (OR = 1.16; 95% CI = 1.03-1.29), osteoarthritis (OR = 1.41; 95% CI = 1.27-1.57), respiratory conditions (OR = 1.25; 95% CI = 1.10-1.42), history of cancer (OR = 1.19; 95% CI = 1.05-1.34), Parkinson's disease (OR = 2.56; 95% CI = 1.83-3.56), polypharmacy (OR = 1.60; 95% CI = 1.44-1.79), and multimorbidity (OR = 1.29; 95% CI = 1.12-1.49). No significant association was observed between depressive symptoms and hypertension, chronic kidney disease, dyslipidemia, and gout (P > .05). A significant dose-response relationship was evident between the number of medical comorbidities and the prevalence of depression (OR = 1.18; 95% CI = 1.13-1.22).ConclusionLate-life depressive symptoms are significantly associated with several medical morbidities, and there appears to be a cumulative effect of the number of somatic diseases on the prevalence of depression. These findings augment the evidence for a complex relationship between mental and physical health in an otherwise healthy older population and might guide clinicians toward early recognition of high-risk individuals. J Am Geriatr Soc 68:1834-1841, 2020.
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Project description:Telomere length (TL) has been reported to be associated with depression and cognitive impairment in elderly. Early detection of depression and cognitive impairment is important to delay disease progression. Therefore, we aimed to identify whether TL is associated with early subjective depressive symptoms and cognitive complaints among healthy elderly subjects. This study was a multicenter, outcome assessor-blinded, 24-week, randomized controlled trial (RCT). Measurement of questionnaire and physical activity scores and blood sample analyses were performed at baseline and after six months of follow-up in all study participants. Linear regression analyses were performed to identify whether early subjective depressive symptoms, cognitive complaints, and several blood biomarkers are associated with TL. Altogether, 137 relatively healthy elderly individuals (60-79 years old) were enrolled in this prospective RCT. We observed an approximate decrease of 0.06 and 0.11-0.14 kbps of TL per one point increase in the geriatric depression scale and cognitive complaint interview scores, respectively, at baseline and after six months of follow-up. We also found an approximate decrease of 0.08-0.09 kbps of TL per one point increase in interleukin (IL)-6 levels at baseline and after six months of follow-up. Our study showed that both early subjective depressive symptoms and cognitive complaints were associated with a relatively shorter TL in relatively healthy elderly individuals. In addition, based on our findings, we believe that IL-6 plays an important role in the relationship between shortening TL and early subjective depressive symptoms and cognitive complaints.
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Project description:Depressive symptoms occurring late in life are an important risk factor for Alzheimer's disease (AD). The latest research finds that onset of depressive symptoms in late life may herald the development of AD, not only for amnestic Mild Cognitive Impairment (aMCI) patients, but also for cognitively-normal older adults. Neuroimaging of brain structure, blood flow, and glucose metabolism indicates that depressive symptoms in late life are accompanied by structural and functional changes in limbic brain regions vulnerable to AD. The present cross-sectional study was guided by the hypothesis that compared to their non-depressed counterparts, older adults with mild to moderate depressive symptoms have less volume in limbic structures vulnerable to changes in AD-specifically, cortical midline structures such as anterior cingulate and posterior cingulate cortex as well as mesial temporal regions such as bilateral hippocampi and amygdalae. Consistent with our hypothesis, results of a voxel-based morphometry analysis revealed smaller retrosplenial, posterior cingulate, and precuneus gray matter volumes in depressed individuals relative to healthy controls. Right lateral parietal cortex-another region vulnerable to change in AD-was also smaller in the group with depressive symptoms. Contrary to our hypothesis, no volumetric differences were found in the anterior cingulate cortex or mesial temporal lobe. Results of this study show a relationship between geriatric depressive symptoms and brain volume in regions vulnerable to AD. Follow-up of participants over time will tell if brain changes detected here predict development of AD.
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Project description:Although previous studies have demonstrated that the hippocampus plays a role in pain processing, the role of hippocampal subfields is uncertain. The goal of this study was to examine the relationship between hippocampal subfield volumes and chronic pain in nondemented older adults. The study sample included 86 community-residing adults age 70 or older who were free of dementia and recruited from the Einstein Aging Study. Chronic pain was defined as pain over the last 3 months, that was moderate or severe (minimum rating of 4 out of 10) most, or all of the time. Hippocampal subfield volumes were estimated using FreeSurfer software. We modeled the association between chronic pain and hippocampal and subfield volume using linear regression. The sample had a mean age of 80 and was 58% female. Chronic pain, present in 55% of the sample, was associated with smaller right and total hippocampal volumes, particularly in women, after adjusting for age, education, and intracranial volume (eTICV). In addition, in women, volume was significantly reduced in participants with chronic pain in right CA2-3 (?=-0.35, p=0.010), right CA4-DG (?=-0.35, p=0.011), left presubiculum (?=-0.29, p=0.030), and left fimbria (?=-0.30, p=0.023). In men, chronic pain was not associated with the volume of any of the hippocampal subfield volumes. Chronic pain in women is associated with a reduction in the volume of right hippocampus and also selected hippocampal subfields. Future studies should clarify the mechanisms underlying the association between regional hippocampal volumes and chronic pain, particularly in women.
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Project description:Ageing and depression are associated with disability and have significant consequences for health systems in many other developing countries. Depression prevalence figures among the elderly are scarce in developing countries.To estimate the prevalence of depressive symptoms and their cross-sectional association with selected covariates in a community sample of Mexico City older adults affiliated to the main healthcare provider.Cross-sectional, multistage community survey.A total of 7,449 persons aged 60 years and older.Depression was assessed using the 30-item Geriatric Depression Scale (GDS); cognitive impairment, using the Mini-Mental State Examination; and health-related quality of life with the SF-36 questionnaire.The prevalence of significant depressive symptoms was estimated to be 21.7%, and 25.3% in those aged 80 and older. After correcting for GDS sensitivity and specificity, major depression prevalence was estimated at 13.2%. Comparisons that follow are adjusted for age, sex, education and stressful life events. The prevalence of cognitive impairment was estimated to be 18.9% in depressed elderly and 13.7% in non-depressed. SF-36 overall scores were 48.0 in depressed participants and 68.2 in non-depressed (adjusted mean difference = -20.2, 95% CI = -21.3, -19.1). Compared to non-depressed elderly, the odds of healthcare utilization were higher among those depressed, both for any health problem (aOR 1.4, 95% CI = 1.1, 1.7) and for emotional problems (aOR 2.7, 95% CI = 2.2, 3.2).According to GDS estimates, one of every eight Mexican older adults had major depressive symptoms. Detection and management of older patients with depression should be a high priority in developing countries.
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Project description:BackgroundRecent studies have found that higher levels of exercise are associated with fewer symptoms of depression among young people. In addition, research suggests that exercise may modify hippocampal volume, a brain region that has been found to show reduced volume in depression. However, it is not clear whether this relationship emerges as early as preadolescence.MethodsWe examined data from a nationwide sample of 4191 children 9 to 11 years of age from the Adolescent Brain and Cognitive Development Study. The parents of the children completed the Child Behavior Checklist, providing data about the child's depressive symptoms, and the Sports and Activities Questionnaire, which provided data about the child's participation in 23 sports. Children also took part in a structural magnetic resonance imaging scan, providing us with measures of bilateral hippocampal volume.ResultsSports involvement interacted with sex to predict depressive symptoms, with a negative relationship found in boys only (t = -5.257, β = -.115, p < .001). Sports involvement was positively correlated with hippocampal volume in both boys and girls (t = 2.810, β = .035, p = .007). Hippocampal volume also interacted with sex to predict depressive symptoms, with a negative relationship in boys (t = -2.562, β = -.070, p = .010), and served as a partial mediator for the relationship between involvement in sports and depressive symptoms in boys.ConclusionsThese findings help illuminate a potential neural mechanism for the impact of exercise on the developing brain, and the differential effects in boys versus girls mirror findings in the animal literature. More research is needed to understand the causal relationships between these constructs.
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Project description:Due to different nature of social engagements of older adults in South Asian countries specially attributed to the traditional family-based care and support, beneficial effects of religiosity and religious involvement on mental health and cognitive function in older age might be different than those in the Western world. Yet, there is a paucity of research in these countries on the role of religion in moderating the relationship between late life depression and cognition. This study explored the association of depressive symptoms with cognitive impairment and the moderating effects of religiosity and religious participation in those associations among older Indian adults. A cross-sectional study was conducted on data that were drawn from the Longitudinal Ageing Study in India wave-1, collected during 2017-2018. The sample size comprised of 31,464 older adults aged 60 years and above. Shortened 10-item Centre for Epidemiologic Studies Depression Scale was used to measure depressive symptoms. Items from the Mini-Mental State Examination and the cognitive module of the China Health and Retirement Longitudinal Study and the Mexican Health and Aging Study were adapted for measuring cognitive impairment. Moderated multiple linear regression models were used to test the research hypotheses of the study. The proportion of older adults who reported religion as less important to them was 21.24%, whereas, only 19.31% of the respondents participated in religious activities. The mean score of cognitive impairment (on a scale of 0-43) in the current sample was 19.43 [confidence interval (CI): 19.32-19.53] among men and 23.55 [CI: 23.44-23.66] among women. Older adults with depressive symptoms had significantly higher likelihood of cognitive impairment [aCoef: 0.18, CI: 0.16-0.20] in comparison to older adults with no depressive symptoms. Older individuals who were religious were significantly less likely to have cognitive impairment [aCoef: - 0.43, CI: - 0.61 to - 0.25] than their non-religious counterparts. Compared to older adults who did not participate in religious activities, those who participated in religious activities were less likely [aCoef: - 0.52, CI: - 0.69 to - 0.34] to have cognitive impairment. Further, significant moderating effects of religiosity and religious participation in the relationship between depressive symptoms and cognitive impairment were observed. The current study contributes to advancing knowledge about the mental health benefits of religiosity and religious participation by focusing on older adults in India who culturally have limited chances to participate in social activities. The findings suggest that older adults with depressive symptoms may participate in religious activities which may reduce their chances of cognitive impairment. This protective effect of religiosity and religious participation on late life cognitive health has important implications for promoting alternative social support mechanisms for older adults in terms of enhancing their mental wellbeing and contributing to active aging.
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Project description:Older adults are more susceptible to higher inflammatory levels and depression. Moreover, diet may influence inflammation as well as depression but no previous study examined whether inflammatory dietary patterns are related to depression in an older population. To investigate the longitudinal association between inflammatory dietary patterns (using reduced rank regression (RRR)) and depressive symptoms in a population sample of Italian older adults.We included 827 participants (aged?65years) at baseline in 1998. Follow-up measurements were collected after 3, 6 and 9years. We used RRR to identify inflammatory dietary patterns at baseline. The Centre for Epidemiologic Studies Depression (CES-D) scale was used to assess depressive symptoms by using continuous scores and depression by using a cut-off point (CES-D?20).We identified two inflammatory dietary patterns using different sets of response variables. Dietary pattern I was related to inflammatory markers C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor ? and was characterized by high intakes of refined grains, sweet snacks, pasta and rice. After full adjustment for confounders, no longitudinal association was found when comparing extreme quartiles of this dietary pattern and depressive symptoms (Q1vs Q4, model 4: B=0.04, 95% CI: -0.06, 0.13) or depression (Q1vs Q4, model 4: OR=0.90, 95% CI: 0.55, 1.45). Dietary pattern II was related to inflammatory markers CRP, IL-18, IL-1?, IL-1 receptor antagonist and was characterized by high intakes of pasta, sugar-sweetened beverages, processed meat and chocolate and sweets. When comparing extreme quartiles, this dietary pattern was not longitudinally associated with depressive symptoms (Q1vs Q4, model 4: B=-0.04, 95% CI: -0.13, 0.05) but an inverse association was found for depression (Q1vs Q4, model 4: OR=0.56, 95% CI: 0.40, 0.94).Our study does not support the hypothesis that dietary patterns linked to inflammatory markers are associated with higher depressive symptoms and higher depression incidence. However, dietary intake in our population of older adults was quite homogeneous which makes it difficult to show clear associations.
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