Aging/Alzheimer's Disease
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Browsing Aging/Alzheimer's Disease by Author "Hall, James"
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Item COMORBID DIABETES AND DEPRESSION AND INCREASED RISK FOR COGNITIVE IMPAIRMENT IN MEXICAN AMERICANS(2014-03) Dickensheets, Tony; Johnson, Leigh; Hall, James; Obryant, SidBackground: By 2050, the percent of Hispanics in America age 65 and above will nearly triple compared to other ethnic groups. During this timeframe, the numbers of Alzheimer’s disease (AD) and Mild Cognitive Impairment (MCI, a prodromal stage to AD) cases among Hispanic elders is expected to grow exponentially. Given that 65% of the U.S. Hispanic population is Mexican American (MA), this ethnic group represent the fastest growing segment of the aging population, which will be disproportionately impacted by MCI and /AD in the near future. Recent work from our group suggest that depression is a significant risk factor for MCI and AD among Mexican Americans while many other “established” risk factors among non-Hispanic whites (i.e. education, gender, hypertension, diabetes, ApoEε4 genotype) are not. Another important risk factor among this population is diabetes (DM). Depression and DM have been shown to be pathologically linked several times in the past, however little research has examined the affect that comorbidity of depression and DM has on cognitive impairment in an ethnically diverse sample Purpose (a): To determine whether there is a connection between depression, diabetes and Alzheimer's disease in the Mexican American population. Methods (b): Methods: This study used data from three separate cohorts: HABLE, TARCC, and Project FRONTIER. In HABLE data was collected from 208 MA (AGE= 62years; EDU=7years); TARCC had 2080 Non- Hispanic white (AGE=75; EDU=15years) and 543 MA (AGE=70; EDU=11); Project FRONTIER had 330 non-Hispanic white (AGE=65; EDU=13) and 233 MA (AGE=55; EDU=7years). Logistic regression analyses were conducted to examine comorbid diagnosis of depression and diabetes on Alzheimer’s disease diagnosis or a diagnosis of Mild Cognitive Impairment. Covariates entered into the model were age, education, and gender. Results (c): Results: Comorbid diagnosis of diabetes and depression was significantly related to diagnosis of Mild Cognitive Impairment in Mexican Americans across all three cohorts: TARCC (odds ratio [OR]= 8.6, 95% CI=1.5 to 2.7); HABLE (odds ratio [OR]= 2.4, 95% CI= 1.3-3.2), and FRONTIER (odds ratio [OR]= 2.6, 95% CI=1.2 to 6.4). TARCC was the only cohort with a large enough sample of AD patients to run the analyses split by ethnicity. In TARCC, comorbidity was related to AD diagnosis in MA (odds ratio [OR]= 10.4, 95%=1.2-2.7), and narrowly related in Non-Hispanic Whites (odds ratio [OR]= 8.3, 95%=.14 to 1.4). Conclusions (d): Discussion: Comorbid diagnosis of depression and diabetes increases risk for diagnosis of cognitive impairment, and Mexican Americans were found to be at greater risk than non- Hispanic whites for Mild Cognitive Impairment. These findings were validated across multiple cohorts, and could have significant clinical implications.Item RELATIONSHIP BETWEEN WORRY AND DEPRESSION IN ELDERLY MEXICAN-AMERICANS(2014-03) Sosa, Horacio; Johnson, Leigh; Hall, James; Edwards, Melissa; O'Bryant, Sid E.Purpose (a): Research has found a strong correlation between worry and mental and physical health. Later stages of life particularly entail increased stress related to multiple health problems, financial matters, etc., which often are associated with increased worry, anxiety and/or depression. In addition, worry has been linked to cognitive decline in the elderly. Our research has demonstrated that specific symptoms of depression (called the DepE) are related to cognitive impairment and can be used to identify a subgroup of individuals at greater risk for developing Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD). The goal of this study was to examine the relationship between DepE and worry in an elderly Mexican-American population. Methods (b): Data was collected from 253 Mexican-Americans (198 women, 60 men) enrolled in the Health and Aging Brain Study among Latino Elders (HABLE), a recently developed community-based study of factors related to aging. The mean age of the sample was 60 years, and the average years of education were 8. Worry was assessed using the Penn State Worry Questionnaire, and DepE was calculated using items from GDS30. The sample was divided into two groups based on DepE scores (high- and low-risk). Independent sample t-test was used to analyze the data. Results (c): The independent sample t-test showed a significant difference between the two groups (t = -10.4, p <0.05). Individuals with higher DepE scores have significantly higher scores in the PSWQ (Mean [SD] = 54 [16]), than those with low DepE scores (32 [13]). PSWQ items endorsed by the high-risk group include high worry under pressure (57%), an inability to dismiss worry (53%), consciousness about generalized worry (52%), a general tendency to worry (48%), and an inability to control worry (47%). Conclusions (d): DepE has been validated in multiple independent cohorts. Higher scores on the DepE are related to poor cognition and diagnosis of Mild Cognitive Impairment and Alzheimer’s disease (4). The results of this study suggest individuals with higher DepE scores have significantly higher worry, almost indicative of Generalized Anxiety Disorder according the PSWQ interpretation. This is consistent with literature linking worry to cognitive decline.