Relationship Between Cognitive Impairment and Depression Among Middle Aged and Older Adults in Primary Care.

IF 2.1 Q3 GERIATRICS & GERONTOLOGY Gerontology and Geriatric Medicine Pub Date : 2024-03-11 eCollection Date: 2024-01-01 DOI:10.1177/23337214231214217

Alex D Federman, Jacqueline Becker, Fernando Carnavali, Monica Rivera Mindt, Dayeon Cho, Gaurav Pandey, Lili Chan, Laura Curtis, Michael S Wolf, Juan P Wisnivesky

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Abstract

Objectives: To determine rates of previously undetected cognitive impairment among patients with depression in primary care. Methods: Patients ages 55 and older with no documented history of dementia or mild cognitive impairment were recruited from primary care practices in New York City, NY and Chicago, IL (n = 855). Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA) and depression with the Patient Health Questionnaire-8. Results: The mean age was 66.8 (8.0) years, 45.3% were male, 32.7% Black, and 29.2% Latinx. Cognitive impairment increased with severity of depression: 22.9% in persons with mild depression, 27.4% in moderate depression and 41.8% in severe depression (p = .0002). Severe depression was significantly associated with cognitive impairment in multivariable analysis (standardized β = -.11, SE = 0.33, p < .0001). Discussion: Depression was strongly associated with previously undetected cognitive impairment. Primary care clinicians should consider screening, or expand their screening, for both conditions.

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基层医疗机构中的中老年人认知障碍与抑郁之间的关系。

目的确定基层医疗机构抑郁症患者中以前未被发现的认知功能障碍的比例。方法从纽约州纽约市和伊利诺伊州芝加哥市的初级医疗机构招募 55 岁及以上、无痴呆或轻度认知障碍病史的患者（n = 855）。认知功能通过蒙特利尔认知评估（MoCA）进行评估，抑郁通过患者健康问卷-8进行评估。结果平均年龄为 66.8 (8.0) 岁，45.3% 为男性，32.7% 为黑人，29.2% 为拉丁裔。认知障碍随抑郁症的严重程度而增加：轻度抑郁症患者为 22.9%，中度抑郁症患者为 27.4%，重度抑郁症患者为 41.8%（p = 0.0002）。在多变量分析中，严重抑郁症与认知障碍有明显相关性（标准化 β = -.11, SE = 0.33, p 讨论）：抑郁症与之前未发现的认知功能障碍密切相关。初级保健临床医生应考虑对这两种情况进行筛查或扩大筛查范围。

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来源期刊

Gerontology and Geriatric Medicine Medicine-Geriatrics and Gerontology

CiteScore

2.90

自引率

3.70%

发文量

119

审稿时长

12 weeks

期刊介绍： Gerontology and Geriatric Medicine (GGM) is an interdisciplinary, peer-reviewed open access journal where scholars from a variety of disciplines present their work focusing on the psychological, behavioral, social, and biological aspects of aging, and public health services and research related to aging. The journal addresses a wide variety of topics related to health services research in gerontology and geriatrics. GGM seeks to be one of the world’s premier Open Access outlets for gerontological academic research. As such, GGM does not limit content due to page budgets or thematic significance. Papers will be subjected to rigorous peer review but will be selected solely on the basis of whether the research is sound and deserves publication. By virtue of not restricting papers to a narrow discipline, GGM facilitates the discovery of the connections between papers.