Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Next article
Short Research Report

Networks of Depression and Cognition in Elderly Psychiatric Patients

Published Online:August 08, 2017https://doi.org/10.1024/1662-9647/a000170

Abstract

Abstract.Objective: Applying the network approach to explore connections between depression and cognition in dependency on cognitive status. Methods: 264 patients from a ward for geriatric psychiatry with depressive symptoms and/or cognitive impairment were included in the study. Assessments of neuropsychological functioning (CERAD, TMT, Clock) and depression (Geriatric Depression Scale) were used. Results: “Hopelessness” and “loss of energy” are the most pivotal nodes in the depression network. Various connections were found when cognitive status differed. “Social withdrawal” connects depression and cognition in the noncognitively impaired group and “subjective memory complaints” and “anxiety” in the cognitively impaired group. Conclusions: Network analyses provide new insights into the complexity of associations. Practical implications for targeted clinical interventions on the connection points are discussed.

References

  • Almeida, O. P., & Almeida, S. A. (1999). Short versions of the Geriatric Depression Scale: A study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV. International Journal of Geriatric Psychiatry, 14, 858–865. First citation in articleCrossref, Google Scholar

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). Washington, DC: Author. First citation in articleCrossref, Google Scholar

  • Andreas, S., Schulz, H., Volkert, J., Dehoust, M., Sehner, S., Suling, A., ... Da Ronch, C. (2016). Prevalence of mental disorders in elderly people: The European MentDis_ICF65+ study. The British Journal of Psychiatry, bjp.bp.115.180463. First citation in articleGoogle Scholar

  • Beaudreau, S. A., & O’Hara, R. (2008). Late-life anxiety and cognitive impairment: A review. The American Journal of Geriatric Psychiatry, 16, 790–803. First citation in articleCrossref, Google Scholar

  • Beekman, A. T., Deeg, D. J., van Tilburg, T., Smit, J. H., Hooijer, C., & van Tilburg, W. (1995). Major and minor depression in later life: A study of prevalence and risk factors. Journal of Affective Disorders, 36, 65–75. First citation in articleCrossref, Google Scholar

  • Bleecker, M. L., Bolla-Wilson, K., Kawas, C., & Agnew, J. (1988). Age-specific norms for the Mini-Mental State Exam. Neurology, 38, 1565–1565. First citation in articleCrossref, Google Scholar

  • Borsboom, D., & Cramer, A. O. (2013). Network analysis: An integrative approach to the structure of psychopathology. Annual Review of Clinical Psychology, 9, 91–121. First citation in articleCrossref, Google Scholar

  • Brigola, A. G., Manzini, C. S. S., Oliveira, G. B. S., Ottaviani, A. C., Sako, M. P., & Vale, F. A. C. (2015). Subjective memory complaints associated with depression and cognitive impairment in the elderly: A systematic review. Dementia and Neuropsychologia, 9, 51–57. First citation in articleCrossref, Google Scholar

  • Cacioppo, J. T., & Hawkley, L. C. (2009). Perceived social isolation and cognition. Trends in cognitive sciences, 13, 447–454. First citation in articleCrossref, Google Scholar

  • Costantini, G., Epskamp, S., Borsboom, D., Perugini, M., Mettus, R., Waldorp, L. J., & Cramer, A. O. (2015). State of the aRt personality research: A tutorial on network analysis of personality data in R. Journal of Research in Personality, 54, 13–29. First citation in articleCrossref, Google Scholar

  • Cramer, A. O., & Borsboom, D. (2015). Problems attract problems: A network perspective on mental disorders. In R. ScottS. KosslynEds., Emerging trends in the social and behavioral sciences: An interdisciplinary, searchable, and §linkable resource. New York: Wiley. First citation in articleGoogle Scholar

  • Cramer, A. O., Waldorp, L. J., van der Maas, H. L., & Borsboom, D. (2010). Comorbidity: A network perspective. Behavioral and Brain Sciences, 33, 137–150. First citation in articleCrossref, Google Scholar

  • Dong, H., Han, C., Jeon, S., Yoon, S., Jeong, H., Huh, Y., ... Steffens, D. (2016). Characteristics of neurocognitive functions in mild cognitive impairment with depression. International psychogeriatrics/IPA, 28, 1181–1190. First citation in articleCrossref, Google Scholar

  • Dufouil, C., Fuhrer, R., Dartigues, J.-F., & Alpérovitch, A. (1996). Longitudinal analysis of the association between depressive symptomatology and cognitive deterioration. American Journal of Epidemiology, 144, 634–641. First citation in articleCrossref, Google Scholar

  • Engmann, B. (2011). Mild cognitive impairment in the elderly: A review of the influence of depression, possible other core symptoms, and diagnostic findings. GeroPsych, 24, 71–76. First citation in articleLink, Google Scholar

  • Epskamp, S. (2015). bootnet: Bootstrap methods for various network estimation routines. Retrieved from https://cran.r-project.org/web/packages/bootnet/bootnet.pdf First citation in articleGoogle Scholar

  • Epskamp, S., Borsboom, D., & Fried, E. I. (2016). Estimating psychological networks and their stability: A tutorial paper. arXiv preprint arXiv:1604.08462. First citation in articleGoogle Scholar

  • Epskamp, S., Cramer, A. O., Waldorp, L. J., Schmittmann, V. D., & Borsboom, D. (2012). Qgraph: Network visualizations of relationships in psychometric data. Journal of Statistical Software, 48(4), 1–18. First citation in articleCrossref, Google Scholar

  • Espinosa, A., Alegret, M., Valero, S., Vinyes-Junqué, G., Hernández, I., Mauleón, A., ... Tárraga, L. (2015). A Longitudinal follow-up of 550 mild cognitive impairment patients: Evidence for large conversion to dementia rates and detection of major risk factors involved. Journal of Alzheimer’s Disease, 43, 769–780. First citation in articleGoogle Scholar

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198. First citation in articleCrossref, Google Scholar

  • Fruchterman, T. M., & Reingold, E. M. (1991). Graph drawing by force-directed placement. Softw., Pract. Exper., 21(11), 1129–1164. First citation in articleCrossref, Google Scholar

  • Gauggel, S., & Birkner, B. (1999). Validity and reliability of a German version of the Geriatric Depression Scale (GDS). Zeitschrift für Klinische Psychologie, Forschung und Praxis, 28, 18–27. First citation in articleLink, Google Scholar

  • Hill, R. D., Gallagher, D., Thompson, L. W., & Ishida, T. (1988). Hopelessness as a measure of suicidal intent in the depressed elderly. Psychology and Aging, 3, 230–232. First citation in articleCrossref, Google Scholar

  • Kendell, R. (1969). The continuum model of depressive illness. Proceedings of the Royal Society of Medicine, 62, 335–339. First citation in articleCrossref, Google Scholar

  • Leyhe, T., Reynolds, C. F., Melcher, T., Linnemann, C., Klöppel, S., Blennow, K., ... Hampel, H. (2017). A common challenge in older adults: Classification, overlap, and therapy of depression and dementia. Alzheimer’s and Dementia, 13, 59–71. First citation in articleCrossref, Google Scholar

  • Lyketsos, C. G., Steele, C., Baker, L., Galik, E., Kopunek, S., Steinberg, M., & Warren, A. (1997). Major and minor depression in Alzheimer’s disease: Prevalence and impact. Journal of Neuropsychiatry and Clinical Neurosciences, 9, 556–561. First citation in articleCrossref, Google Scholar

  • Lyness, J. M., Noel, T. K., Cox, C., King, D. A., Conwell, Y., & Caine, E. D. (1997). Screening for depression in elderly primary care patients: A comparison of the Center for Epidemiologic Studies – Depression Scale and the Geriatric Depression Scale. Archives of Internal Medicine, 157, 449–454. First citation in articleCrossref, Google Scholar

  • Memory Clinic. (2009). CERAD-Plus German Version. Retrieved from http://www.memoryclinic.ch First citation in articleGoogle Scholar

  • Modrego, P. J., & Ferrández, J. (2004). Depression in patients with mild cognitive impairment increases the risk of developing dementia of Alzheimer type: A prospective cohort study. Archives of Neurology, 61, 1290–1293. First citation in articleCrossref, Google Scholar

  • Morris, J., Heyman, A., Mohs, R., Hughes, J. P., Van Belle, G., Fillenbaum, G., ... Clark, C. (1989). The consortium to establish a registry for Alzheimer’s disease (CERAD): I. Clinical and neuropsychological assessment of Alzheimer’s disease. Neurology, 39, 1159. First citation in articleCrossref, Google Scholar

  • Newman, M. (2010). Networks: An introduction. New York: Oxford University Press. First citation in articleCrossref, Google Scholar

  • Panza, F., Frisardi, V., Capurso, C., D’Introno, A., Colacicco, A. M., Imbimbo, B. P., ... Pilotto, A. (2010). Late-life depression, mild cognitive impairment, and dementia: possible continuum? The American Journal of Geriatric Psychiatry, 18, 98–116. First citation in articleCrossref, Google Scholar

  • Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183–194. First citation in articleCrossref, Google Scholar

  • R Development Core Team. (2016). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2015. Retrieved from http://www.R-project.org First citation in articleGoogle Scholar

  • Sachs-Ericsson, N., & Blazer, D. G. (2015). The new DSM-5 diagnosis of mild neurocognitive disorder and its relation to research in mild cognitive impairment. Aging & mental health, 19(1), 2–12. First citation in articleCrossref, Google Scholar

  • Sarin, K., Punyaapriya, P., Sethi, S., & Nagar, I. (2016). Depression and hopelessness in institutionalized elderly: A societal concern. Open Journal of Depression, 5(3), 21–27. First citation in articleCrossref, Google Scholar

  • Schmand, B., Jonker, C., Hooijer, C., & Lindeboom, J. (1996). Subjective memory complaints may announce dementia. Neurology, 46, 121–125. First citation in articleCrossref, Google Scholar

  • Shulman, K. I. (2000). Clock-drawing: Is it the ideal cognitive screening test? International Journal of Geriatric Psychiatry, 15, 548–561. First citation in articleCrossref, Google Scholar

  • Thalmann, B., Monsch, A., Bernasconi, F., Berres, M., Schneitter, M., Ermini-Fuenfschilling, D., ... Staehelin, H. (1998). Die CERAD Neuropsychologische Testbatterie-Ein gemeinsames minimales Instrumentarium zur Demenzabklärung [The CERAD Neuropsychological Assessment Battery – A common minimal assessment for clarification of dementia]. Basel: Memory Clinic, Geriatrische Universitätsklinik Basel. First citation in articleGoogle Scholar

  • Thalmann, B., Monsch, A., Bernasconi, F., Berres, M., Schneitter, M., Ermini-Fünfschilling, D., ... Stähelin, H. (2001). CERAD-Consortium to Establish a Registry for Alzheimer’s Disease Assessment Battery – deutsche Fassung.Basel: Geriatrische Universitätsklinik. First citation in articleGoogle Scholar

  • Tombaugh, T. N., & McIntyre, N. J. (1992). The mini-mental state examination: A comprehensive review. Journal of the American Geriatrics Society, 40, 922–935. First citation in articleCrossref, Google Scholar

  • Van Borkulo, C. (Producer). (2015). Network comparison test: Permutation-based test of differences in strength of networks. Retrieved from https://github.com/cvborkulo/NetworkComparisonTest First citation in articleGoogle Scholar

  • Van Borkulo, C., Boschloo, L., Kossakowski, J., Tio, P., Schoevers, R., Borsboom, D., & Waldorp, L. (2016). Comparing network structures on three aspects: A permutation test. Manuscript submitted for publication. First citation in articleGoogle Scholar

  • Van Borkulo, C., & Epskamp, S. (2014). IsingFit: Fitting Ising models using the eLasso method. R package version 0.2.0. First citation in articleGoogle Scholar

  • Van Borkulo, C. D., Borsboom, D., Epskamp, S., Blanken, T. F., Boschloo, L., Schoevers, R. A., & Waldorp, L. J. (2014). A new method for constructing networks from binary data. Scientific Reports, 4, 5918. First citation in articleCrossref, Google Scholar

  • Wetherell, J. L., Reynolds, C. A., Gatz, M., & Pedersen, N. L. (2002). Anxiety, cognitive performance, and cognitive decline in normal aging. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 57, P246–P255. First citation in articleCrossref, Google Scholar

  • World Health Organization. (2004). International statistical classification of diseases and health-related problems (ICD-10). Geneva: Author. First citation in articleGoogle Scholar

  • Yesavage, J. A., Brink, T., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49. First citation in articleCrossref, Google Scholar

  • Zengarini, E., Hoogendijk, E. O., Pérez-Zepeda, M. U., Ruggiero, C., Mecocci, P., Vellas, B., & Cesari, M. (2016). Lack of energy and negative health-related outcomes in nursing home residents: Results from the INCUR Study. Journal of the American Medical Directors Association, 17, 525–529. First citation in articleCrossref, Google Scholar