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Depression Symptoms and Cognitive Test Performance in Older American Indians: The Strong Heart Study.

MedStar author(s):

0002-8614

Name of journal: Journal of the American Geriatrics SocietyAbstract: BACKGROUND: American Indians have excess risk of depression, which can contribute to cerebrovascular and cognitive disability, with effects on memory, processing speed, executive function, and visuospatial ability. However, studies examining depression and cognition in American Indians are limited; this study aims to report associations of depression with general cognition, verbal fluency and memory, and processing speed.CONCLUSION: These findings maybe informative for health disparities populations, especially those with depressive risk. Clinicians may require particular training in cultural humility. Future studies should validate use of the CES-D scale in this population; longitudinal studies may focus on causal mechanisms and potential secondary prevention, such as social support. Copyright (c) 2020 The American Geriatrics Society.DESIGN: Cohort study.MEASUREMENTS: Participants completed evaluations for depressive symptomology, cognition, and physical function-including Center for Epidemiologic Studies Depression (CESD), Modified Mini-Mental State Examination (3MSE), Wechsler Adult Intelligence Scale-Fourth Edition coding (WAIS), Controlled Oral Word Association (COWA), California Verbal and Learning Test, Halstead finger tapping, grip strength, and Short Physical Performance Battery (SPPB) tests. Linear mixed models were adjusted for site, age, sex, education, income, marital status, alcohol, smoking, diabetes, hypertension, obesity, cholesterol, stroke, infarct, and hemorrhage.PARTICIPANTS: All eligible were included in this analysis (N=818).RESULTS: Symptoms of depression were common, with 20% (N=138) endorsing CES-D scores of 16+. More depressive symptoms were associated with older age, female sex, lower education, lower income, non-married status, not using alcohol, not smoking, hypertension, diabetes, and stroke. In adjusted analyses, processing speed (WAIS: beta -0.13, 95%CI -0.25, -0.03), general cognition (3MSE: beta -0.10, 95%CI -0.17, -0.03), verbal fluency (COWA: beta -0.10, 95%CI -0.19, -0.01), and motor function (SPPB: beta -0.05, 95%CI -0.07, -0.03) were significantly associated with more symptoms of depression.SETTING: The Cerebrovascular Disease and its Consequences in American Indians study was an ancillary examination of Strong Heart Study participants from 3 U.S. regions.All authors: Barbosa-Leiker C, Buchwald DS, Crane PK, Howard BA, Nelson LA, Suchy-Dicey A, Verney SPOriginally published: Journal of the American Geriatrics Society. 2020 Apr 06Fiscal year: FY2021Digital Object Identifier:

https://dx.doi.org/10.1111/jgs.16434

Date added to catalog: 2020-07-09

Holdings ( 1 )
Title notes ( 9 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	32250446	Available		32250446

Available online from MWHC library: 1995 - 2000, then 2006-present, Available in print through MWHC library: 1999 - 2006

BACKGROUND: American Indians have excess risk of depression, which can contribute to cerebrovascular and cognitive disability, with effects on memory, processing speed, executive function, and visuospatial ability. However, studies examining depression and cognition in American Indians are limited; this study aims to report associations of depression with general cognition, verbal fluency and memory, and processing speed.

CONCLUSION: These findings maybe informative for health disparities populations, especially those with depressive risk. Clinicians may require particular training in cultural humility. Future studies should validate use of the CES-D scale in this population; longitudinal studies may focus on causal mechanisms and potential secondary prevention, such as social support. Copyright (c) 2020 The American Geriatrics Society.

DESIGN: Cohort study.

MEASUREMENTS: Participants completed evaluations for depressive symptomology, cognition, and physical function-including Center for Epidemiologic Studies Depression (CESD), Modified Mini-Mental State Examination (3MSE), Wechsler Adult Intelligence Scale-Fourth Edition coding (WAIS), Controlled Oral Word Association (COWA), California Verbal and Learning Test, Halstead finger tapping, grip strength, and Short Physical Performance Battery (SPPB) tests. Linear mixed models were adjusted for site, age, sex, education, income, marital status, alcohol, smoking, diabetes, hypertension, obesity, cholesterol, stroke, infarct, and hemorrhage.

PARTICIPANTS: All eligible were included in this analysis (N=818).

RESULTS: Symptoms of depression were common, with 20% (N=138) endorsing CES-D scores of 16+. More depressive symptoms were associated with older age, female sex, lower education, lower income, non-married status, not using alcohol, not smoking, hypertension, diabetes, and stroke. In adjusted analyses, processing speed (WAIS: beta -0.13, 95%CI -0.25, -0.03), general cognition (3MSE: beta -0.10, 95%CI -0.17, -0.03), verbal fluency (COWA: beta -0.10, 95%CI -0.19, -0.01), and motor function (SPPB: beta -0.05, 95%CI -0.07, -0.03) were significantly associated with more symptoms of depression.

SETTING: The Cerebrovascular Disease and its Consequences in American Indians study was an ancillary examination of Strong Heart Study participants from 3 U.S. regions.

English