Is lower cognitive function in one spouse associated with depressive symptoms in the other spouse?

This study examines whether lower cognitive function in one spouse is associated with depressive symptoms in the other spouse. The subjects were 528 community-dwelling spouse pairs aged 65+ who participated in the Chicago Health and Aging Project (CHAP), an ongoing longitudinal, bi-racial, population-based study of risk factors for incident Alzheimer's disease and other age-related chronic conditions. CHAP participants were assessed at 3-year intervals over a period of nearly ten years. The results show a cross-sectional association of wives' lower cognitive function at baseline with depressive symptoms in husbands; however, husbands' cognitive function was not associated with wives' depressive symptoms. There was no longitudinal association of cognitive function at baseline with increased depressive symptoms over time. Furthermore, change in cognitive function over time had no effect on depressive symptoms in either spouse. The relationship between cognitive function and depressive symptoms in spouse pairs is complex. Our findings suggest that husbands may be particularly psychologically vulnerable to the negative effects of their wives' cognitive impairment. This vulnerability may have a range of long-term health and caregiving implications.     

Does carotid endarterectomy lead to a decline in cognitive function or health related quality of life?

Carotid endarterectomy has been shown to reduce the long-term risk of stroke in selected patients. The present study was designed to examine cognitive function and health related quality of life in a series of carotid endarterectomy patients. One hundred and nine patients undergoing carotid endarterectomy were assessed before surgery and at 6 months post op (n = 100) on standard cognitive function tests and quality of life surveys. Microembolisation was detected using transcranial Doppler ultrasonography. Multivariate repeated measures analysis if variance identified evidences of significant impairments on some tests. Further analysis revealed that particulate Microembolisation detected during the procedure was a significant risk factor associated with declining cognitive function. Patients' self-reported health related quality of life had not deteriorated at 6 month following surgery.     

Is major depressive episode related to anxiety disorders in anorexics and bulimics?

OBJECTIVE: To determine whether the presence of anxiety disorders is related to depressive comorbidity in subjects with eating disorders (ED), while taking into account certain variables that may be related to depression (subjects' age, ED duration, prior incidents of anorexia nervosa in bulimic subjects, inpatient or outpatient status, nutritional state [as measured by body mass index]). METHOD: We evaluated the frequency of depressive disorders in 271 subjects presenting with a diagnosis of either anorexia nervosa or bulimia, using the Mini International Neuropsychiatric Interview, DSM-IV version. RESULTS: A multivariate analysis reveals that anxiety disorders do not all have the same influence in terms of risk of onset of major depressive episode in anorexics and bulimics when adjusted on variables related to depression. CONCLUSION: Depression in subjects with ED can be explained in part by comorbidity with obsessive-compulsive disorder, generalized anxiety, social phobia, and panic disorder.     

Is substance abuse in schizophrenia related to impulsivity, sensation seeking, or anhedonia?

OBJECTIVE: The authors compared impulsivity, sensation seeking, and anhedonia in a group of schizophrenic patients with and without lifetime substance abuse or dependence. METHOD: Patients (N=100) with schizophrenia or schizoaffective disorder (per DSM-III-R criteria) were assessed with the Composite International Diagnostic Interview's section on psychoactive substance use disorder, the Positive and Negative Syndrome Scale, the Barratt Impulsivity Scale, the Zuckerman Seeking Sensation Scale, and the Chapman Physical Anhedonia Scale. RESULTS: The mean scores for impulsivity and sensation seeking were higher in the group with substance abuse (N=41) than in the group without substance abuse (N=59). No significant difference between groups was found regarding physical anhedonia. CONCLUSIONS: As in the general population, high levels of impulsivity and sensation seeking are associated with substance abuse in patients with schizophrenia.     

Is freezing of gait in Parkinson's disease related to asymmetric motor function?

Freezing of gait (FOG) is a disabling phenomenon common in patients with advanced Parkinson's disease (PD). The cause of FOG is unclear. The objective of this study was to explore a novel hypothesis stating that FOG is related to asymmetric motor performance. We compared PD patients that experience FOG episodes (PD+FOG) with PD patients that do not (PD-FOG) and studied the relationship of FOG to asymmetry in gait and in rhythmic hand movement performance to determine whether potential FOG-related gait asymmetry is unique to walking or whether it is systemic. Subjects were tested in an "off" (unmedicated) and again in an "on" (medicated) state. Gait was more asymmetric in PD+FOG than in PD-FOG during "off" state (p = 0.005) and during "on" (p = 0.016). Rhythmicity of foot swing in one leg was correlated with the other leg in PD-FOG but not in PD+FOG. There was no difference in asymmetry in performance of rhythmic hand movements between the two groups. No correlation was found between asymmetry of clinical symptoms and gait asymmetry. Taken together, the results of this study suggest that bilateral uncoordinated gait and marked gait asymmetry, but not asymmetry in motor performance in general, are associated with FOG.     

Is neurogenic hypertension related to vascular inflammation of the brainstem?

Essential hypertension is idiopathic although it is accepted as a complex polygenic trait with underlying genetic components, which remain unknown. Our supposition is that hypertension involves activation of the sympathetic nervous system. One pivotal region controlling arterial pressure set point is nucleus tractus solitarii (NTS). We recently identified that pro-inflammatory molecules, such as junctional adhesion molecule-1 (JAM-1), were over expressed in endothelial cells of the microvasculature supplying the NTS in an animal model of human hypertension (the spontaneously hypertensive rat) compared to normotensive Wistar-Kyoto rats (WKY). Over expression of JAM-1 in NTS of WKY rats was pro-hypertensive and induced leukocyte adherence to the microvasculature. Since leukocyte adhesion causes cytokine release, we found expression of monocyte chemoattractant protein-1 (MCP-1) was higher in the NTS of SHR while inter-leukin-6 (IL-6) was lower compared to the WKY rat. Inflammation of the brainstem microvasculature may increase vascular resistance within the brainstem. High brainstem vascular resistance and its inflammation may release pathological paracrine signaling molecules affecting central neural cardiovascular activity conducive to neurogenic hypertension.     

Are self-efficacy beliefs and subjective task demand related to apathy in aging?

Objective: Apathy, defined as a reduction in voluntary goal-directed behaviors (GDBs), is common in aging, but the processes underlying apathy are still unclear. Self-efficacy beliefs are likely to play a key role in GDBs, by influencing goal setting, perceived difficulty, and the necessary amount of effort to achieve goals. The aim of this study was to examine the relationships between apathy and perceived self-efficacy.Method: Sixty-three healthy elderly participants worked on a memory task without fixed performance standard (‘do your best’) and indicated perceived difficulty and effort investment after performing the task. They also completed two short scales assessing general self-efficacy and negative mood. In addition, a close relative of each participant completed the Initiative Interest Scale, a new questionnaire assessing apathetic manifestations in aging.Results: The main results showed that subjective task demand (i.e., perceived difficulty and estimated effort) operated as a mediator between self-efficacy beliefs and apathy. These results suggest that elderly people with low self-efficacy beliefs who face a challenge judge the task to be highly difficult and effort demanding, which might result in GDB reduction.Conclusion: These results shed new light on the processes related to apathy in aging and open up an interesting prospect for psychological interventions.     

Do vascular lesions and related risk factors influence responsiveness to donepezil chloride in patients with Alzheimer's disease?

The purpose was to identify vascular influences on the responsiveness to donepezil chloride. The study included 50 untreated probable Alzheimer's disease patients with the Modified Hachinski Ischemic Score <4. We assessed baseline cognitive status using the Revised Hasegawa Dementia Scale (HDS-R), Clinical Dementia Rating (CDR) and the clock drawing test (CDT). The response to 5 mg of donepezil was monitored by the CDT for 12 months. Patients were classified as true responders (TR), unchanged (UC) and non-responders according to changes on the CDT in response to treatment. High HDS-R scores, low CDT scores, low CDR and presence of hypertension (HBP) and periventricular hyperintensities (PVH) predicted a TR- or UC-type outcome. Aggravation of executive function by HBP and/or PVH and its improvement by donepezil may have been detected by the CDT.     

Is the impairment in temporal allocation of visual attention in children with ADHD related to a developmental delay or a structural cognitive deficit?

We investigated the temporal allocation of visual attention in 11-year-old children with attention-deficit/hyperactivity disorder (ADHD) by comparing their attentional blink (AB) parameters (duration, amplitude and minimum performance) with those observed in three groups of healthy control participants (8-year-olds, 11-year-olds and adults). The AB is a marker of impaired ability to detect a second target following the identification of a first target when both appear randomly within a rapid sequence of distractor items. Our results showed developmental effects; with age, the AB duration decreased and the AB minimum moved to shorter lag times. Importantly, 11-year old children with ADHD presented much the same similar AB patterns (in terms of duration and minimum position) as the healthy 8-year-old controls. Our results support the hypothesis whereby impaired allocation of temporal selective attention in children with ADHD is due to a developmental delay and not a specific cognitive deficit.     

Is cognitive function linked to serum free copper levels? A cohort study in a normal population

ObjectiveMuch research on copper-dependent neurodegeneration has focused on the study of total copper levels in the organism. However, recent evidence suggests that the portion of copper that does not bind to ceruloplasmin and is loosely transported by micronutrients (free copper) may play a more significant role than copper as a whole. In this paper, we measured markers of copper metabolism in the sera of a group of cognitively normal women to test whether abnormal amounts of free copper have detectable effects on the mental state of clinically normal people.MethodsWe measured serum levels of free and ceruloplasmin-bound copper in 64 women whose normal mental state had been assessed via a battery of neuropsychological tests representing the major cognitive domains.ResultsResults show a significant inverse correlation of the serum levels of free copper with both Mini-Mental State Examination (MMSE) and attention-related neuropsychological tests scores. Bound copper, instead, did not correlate with either MMSE scores or any cognitive domain.ConclusionsFree copper appears to be a player in cognitive decline.SignificanceThis evidence suggests the need for a shift of focus from total to free copper levels in the study of mental decline and sustains the notion that free copper may be a risk factor in the development of impaired cognition.     

Platelet GSK3B activity in patients with late-life depression: Marker of depressive episode severity and cognitive impairment?

Abstract

Objective. Increased GSK3B activity has been reported as a state marker of major affective episodes in patients with depression and bipolar disorder. No study so far has addressed GSK3B activity in late-life depression. The aims of the present study were to determine GSK3B activity in platelets of elderly patients with major depression, and the association between GSK3B activity and the severity of depressive symptoms and cognitive impairment. Methods. Forty drug-free elderly patients with major depressive episode were compared to healthy older adults (n = 13). Severity of the depressive episode and current cognitive state were determined by the Hamilton Depression Scale (HAM-D) and the Cambridge Cognitive Test (CAMCOG), respectively. Total- and ser-9-phosphorylated GSK3B (tGSK3B and pGSK3B) were determined in platelets by enzyme immunometric assays (EIA). GSK3B activity was indirectly inferred by the GSK3B ratio (i.e. pGSK3B/tGSK3B). Results. Elderly depressed patients had significantly lower pGSK3B levels (P = 0.03) and GSK3B ratio (P = 0.03), indicating higher GSK3B activity. Higher GSK3B activity were observed in patients with severe depressive episode (HAM-D scores >22, P = 0.03) and with cognitive impairment (CAMCOG scores <86, P = 0.01). Conclusion. The present findings provide additional evidence of the involvement of GSK3B in the pathophysiology of late-life major depression. Higher GSK3B activity may be more relevant in those patients with more severe depressive symptoms and cognitive impairment.     

Is the attentional dysfunction in schizotypy related to anxiety?

Two factors, 'anxiety-loaded' (AL) and 'perceptual-disorganization' (PD), emerged in a factor analysis of the Schizotypal Personality Questionnaire (SPQ). Sixty of the 219 participants performed a latent inhibition (LI) task. During the pre-exposure phase, one group was exposed to repeated non-reinforced presentations of an irrelevant stimulus and the other was not pre-exposed. In the subsequent test phase, learning was slower in the pre-exposed group than in the non-pre-exposed group. The LI effect was assessed, separately, as a function of SPQ, trait-anxiety sub-scale (TASS) of the State and Trait Anxiety Inventory (STAI), and AL and PD factors scores. LI was disrupted in participants with either high scores on SPQ, STAI, or the AL factor. A regression analysis indicated that both TASS and SPQ independently accounted for LI disruption in high schizotypals, but that the contribution of TASS was stronger. It was suggested that the anxiety component of schizotypy, more than the perceptual-disorganization (schizophrenia-like) component, accounts for the attentional dysfunction in high schizotypals, and for their greater than normal distraction by irrelevant stimuli.