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Cognitive performance of community-dwelling oldest-old individuals with major depression: the Pietà study

Published online by Cambridge University Press:  01 June 2017

Filipi Leles da Costa Dias
Affiliation:
Post-graduate Program in Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Antônio Lúcio Teixeira
Affiliation:
Post-graduate Program in Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Henrique Cerqueira Guimarães
Affiliation:
Post-graduate Program in Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Maira Tonidandel Barbosa
Affiliation:
Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Elisa de Paula França Resende
Affiliation:
Post-graduate Program in Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Rogério Gomes Beato
Affiliation:
Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Karoline Carvalho Carmona
Affiliation:
Post-graduate Program in Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Paulo Caramelli*
Affiliation:
Post-graduate Program in Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
*
Correspondence should be addressed to: Prof. Paulo Caramelli, Av. Prof. Alfredo Balena, 190 - Sala 246 30130-100, Belo Horizonte (MG), Brasil Phone/Fax: +55-31-3409.9746. Email: [email protected].

Abstract

Background:

Individuals with late-life depression (LLD) may present cognitive symptoms. We sought to determine whether a brief cognitive battery (BCB) could identify cognitive and functional deficits in oldest-old individuals with LLD and a low level of education.

Methods:

We evaluated 639 community-dwelling individuals aged 75+ years in Caeté (MG), Brazil. We used the MINI and GDS-15 to diagnose major depression and evaluate its severity, respectively. The cognitive evaluation comprised the Mini-Mental State Examination (MMSE), BCB, clock-drawing test, category fluency test (animals) and Pfeffer's Functional Activities Questionnaire (FAQ).

Results:

Fifty-four (11.6%) of the included individuals were diagnosed with LLD; on average, these participants were aged 81.0 ± 4.8 years and had 3.9 ± 3.4 years of schooling, and 77.8% of the subjects with LLD were female. Depressed individuals scored lower than subjects without dementia/depression on the MMSE overall (p < 0.001) and on several of the MMSE subscales, namely, time (p < 0.001) and spatial orientation (p = 0.021), attention/calculation (p = 0.019), and language (p = 0.004). Individuals with LLD performed worse on the incidental and (p = 0.011) immediate memory (p = 0.046) and learning tasks (p = 0.039) of the BCB. Individuals with LLD also performed worse on the category fluency test (p = 0.006), clock-drawing test (p = 0.011) and FAQ (p < 0.001). Depression severity was negatively correlated with incidental memory (ρ = −0.412; p = 0.003) and positively correlated with FAQ score (ρ = 0.308; p = 0.035). In the multiple regression analysis, only temporal orientation and FAQ score remained independently associated with LLD.

Conclusion:

Individuals with depression and a low level of education presented several cognitive and functional deficits. Depression severity was negatively correlated with incidental memory and functionality. Our findings serve as a description of the presence of cognitive dysfunction in individuals with LLD and suggest that these deficits may be identified based on the results of a BCB.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2017 

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