Late-life depression and risk of vascular dementia and Alzheimer's disease: systematic review and meta-analysis of community-based cohort studies

Diniz, Breno S.; Butters, Meryl A.; Albert, Steven M.; Dew, Mary Amanda; Reynolds, Charles F.

doi:10.1192/bjp.bp.112.118307

Cited by 1,046 publications

(797 citation statements)

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“…Studies on NCDs have shown that many factors are associated with this disorder. These factors include a history of cardiovascular disease or hypertension, depression, and osteoporosis (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

The Association Between Zinc and Cognitive Impairment in Elderly People of Iran

et al. 2017

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Section: Introductionmentioning

confidence: 99%

The Association Between Zinc and Cognitive Impairment in Elderly People of Iran

et al. 2017

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“…4,5 Prospective studies indicate that depression may also increase the risk of future dementia. 6,7 Still, the neurobiologic substrate of the relation between depression and AD remains poorly understood. Several studies have found structural brain abnormalities to be associated with late-life depression, including hippocampal volume reduction.…”

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confidence: 99%

Salivary cortisol, brain volumes, and cognition in community-dwelling elderly without dementia

et al. 2015

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Objective: We investigated the associations of morning and evening salivary cortisol levels with regional brain volumes and cognitive functioning in community-dwelling older persons without dementia.Method: From the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, we included 4,244 persons without dementia (age 76 6 5 years, 58% women) who had 1.5T brain MRI, assessment of cognitive functioning, and saliva collected at home 45 minutes after awakening and at night. Linear regression analysis was used to estimate the cross-sectional relationship among cortisol levels, brain volumes, and cognitive functioning, adjusting for covariates.Results: Higher evening cortisol was associated with smaller total brain volume (highest vs lowest tertile 216.0 mL; 95% confidence interval 219.7 to 212.2 mL, adjusted for age, sex, education, intracranial volume, smoking, steroid use, white matter lesions, and brain infarcts on MRI). The smaller volumes were observed in all brain regions, but were significantly smaller in gray matter than in white matter regions. Poorer cognitive functioning across all domains was also associated with higher evening cortisol. Higher levels of morning cortisol were associated with slightly greater normal white matter volume and better processing speed and executive functioning, but not with gray matter volume or with memory performance. Conclusions:In older persons, evening and morning cortisol levels may be differentially associated with tissue volume in gray and white matter structures and cognitive function. Understanding these differential associations may aid in developing strategies to reduce the effects of hypothalamic-pituitary-adrenal axis dysfunction on late-life cognitive impairment. With increasing age, the prevalence of dementia, including Alzheimer disease (AD), increases exponentially.1 At older age, depressive symptoms are also common, 2 often persist over years, 3 and are frequently comorbid with cognitive impairment and dementia. 4,5 Prospective studies indicate that depression may also increase the risk of future dementia. 6,7 Still, the neurobiologic substrate of the relation between depression and AD remains poorly understood. Several studies have found structural brain abnormalities to be associated with late-life depression, including hippocampal volume reduction. 8,9 Also, it has often been hypothesized that persistently high cortisol levels, often observed in depression, 10 have neurotoxic effects on the hippocampus. 6Because the hypothalamic-pituitary-adrenal (HPA) axis is inhibited by the hippocampus, 11 a cascade would occur in which age-associated hippocampal atrophy would lead to diminished ability to inhibit cortisol and, in turn, further atrophy of the hippocampus, 12 eventually leading to development of clinical dementia. Functional changes of the HPA axis have been observed in late-life depression. 13 However, relatively few studies have examined the association between

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“…There are also several sociodemographic and clinical factors such as age of onset and education levels which can limit the findings reported by the included trials. For instance, the presence of late-life depression symptoms 37 and low levels of education are significant predictors for development of dementia. 38,39 Several of the included studies lack information regarding MMSE and just one of the studies prospectively assures that the included patients did not develop any kind of dementia.…”

Section: ■ Discussionmentioning

confidence: 99%

Association between depression severity and executive functioning in late-life depression: a systematic review

Monteiro¹,

Monteiro²,

Candida³

et al. 2016

Medical Express

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OBJECTIVE: Late-life depression is an under-diagnosed and under-treated disease that reduces the well-being of older adults. Executive dysfunction is another critical impairment in elderly depressed individuals which further disrupts their everyday functioning. This systematic review aims to analyze the association between executive function and depression severity in elderly individuals diagnosed with major depressive disorder. METHOD:The studies were retrieved from MEDLINE/PubMed, ISI Web of Knowledge and PsychInfo, after a search strategy combining the terms "depression", "executive function", "neuropsychological assessment", "elderly" and "late life". Study selection, data collection and quality ratings was performed by two independent raters. RESULTS: A total of 1,130 articles were found but only 8 studies met the defined eligibility criteria and evaluated the association between depression severity and executive functioning. Six out of 8 studies found an association between depression severity and executive function, with correlations ranging from small to large (r= -0.15 to -0.53). The included reports had several methodological limitations such as selective data reporting, non-comprehensive executive function assessment and not controlling potential biases. CONCLUSION: Depression severity may be more strongly correlated with a specific set of executive abilities although it also seems to be a broad-based association with executive functioning as a whole. Future high-quality prospective studies are recommended in order to understand the causal relationship between depression severity and executive functioning taking into account possible mediators such as age-related or neurodegenerative cognitive impairment, educational level and other clinic characteristics (e.g. age of onset, medication).

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Late-life depression and risk of vascular dementia and Alzheimer's disease: systematic review and meta-analysis of community-based cohort studies

Cited by 1,046 publications

References 36 publications

The Association Between Zinc and Cognitive Impairment in Elderly People of Iran

The Association Between Zinc and Cognitive Impairment in Elderly People of Iran

Salivary cortisol, brain volumes, and cognition in community-dwelling elderly without dementia

Association between depression severity and executive functioning in late-life depression: a systematic review

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