The Effect of Subsyndromal Symptoms of Depression and White Matter Lesions on Disability for Individuals With Mild Cognitive Impairment

Abstract

OBJECTIVE-To assess the effect of subsyndromal symptoms of depression (SSD) on ratings of disability for individuals with mild cognitive impairment (MCI). MATERIAL AND METHODS-Data from 405 MCI participants from the Alzheimer's DiseaseNeuroimaging Initiative (ADNI) study were analyzed. Participants were evaluated at baseline and at six month intervals over two years. Severity of depressive symptoms was rated utilizing the Geriatric Depression Scale. Disability was assessed utilizing the Functional Assessment Questionnaire (FAQ). Other clinical variables included white matter lesion (WML) and intracranial brain (ICV) volumes derived from MRI, ratings of overall cognitive function (Alzheimer's Disease Assessment Scale; ADAS), and ApoE status. Demographic variables included age, education, and gender. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. * Data used in preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database (www.loni.ucla.edu/ADNI). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. ADNI investigators include (complete listing available at http://www.loni.ucla.edu/ADNI/Collaboration/ADNI_Manuscript_Citations.pdf HHS Public AccessAuthor manuscript Am J Geriatr Psychiatry. Author manuscript; available in PMC 2017 August 08. Author Manuscript Author ManuscriptAuthor Manuscript Author Manuscript RESULTS-SSD individuals had a lower volume of WML and higher frequency of ApoE ε4 alleles than depression free participants but the two groups did not differ with respect to other clinical or demographic variables. At baseline SSD individuals were 1.77 times more likely to have poorer FAQ scores than individuals with no symptoms of depression after controlling for the effect of cognitive functioning, ICV, WML, and ApoE status. The presence of SSD at baseline was not associated with poorer course of disability outcomes, cognitive functioning, or conversion to dementia over 24 months.CONCLUSIONS-SSD demonstrated a significant impact on disability for MCI individuals who are also at high risk for functional limitations related to neurodegenerative disease. Therefore, the treatment of SSD may represent a significant avenue to reduce the burden of disability in this vulnerable patient population.

Structural brain changes associated with depressive symptoms in the elderly with Alzheimer's disease

“…The GDS consists of 15 questions and total scores range from 0 to 15, with higher scores denoting more depressive symptoms. Subjects with subsyndromal depression were defined with a score of 1–5 on the GDS and non-depressed subjects with a score of 0 as previously reported 19. The ‘memory’ item, asking “if the subject feels he/she has more memory problems than most”, was excluded due to its association with cognitive performance.…”