Synergistic Effect of Cardiometabolic Multimorbidity and Depression on Longitudinal Cognitive Decline: Results from two Longitudinal Asian Elderly Cohorts

IF 1.9 Q3 CLINICAL NEUROLOGY
Xuhao Zhao , Yifan Yan , Eddie Chong , Narayan aswamy Venket asubra manian , Changzheng Yuan , Christopher Chen , Xiaolin Xu , Xin Xu
{"title":"Synergistic Effect of Cardiometabolic Multimorbidity and Depression on Longitudinal Cognitive Decline: Results from two Longitudinal Asian Elderly Cohorts","authors":"Xuhao Zhao ,&nbsp;Yifan Yan ,&nbsp;Eddie Chong ,&nbsp;Narayan aswamy Venket asubra manian ,&nbsp;Changzheng Yuan ,&nbsp;Christopher Chen ,&nbsp;Xiaolin Xu ,&nbsp;Xin Xu","doi":"10.1016/j.cccb.2024.100233","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Cardiometabolic multimorbidity (CMM) and depression are risk factors for cognitive decline and dementia. We investigated the independent and synergistic associations of CMM and depression on longitudinal cognitive deterioration in two Asian cohorts of elderly at varying cognitive status with differed underlying neuropathology.</p></div><div><h3>Methods</h3><p>Eligible memory clinic (Harmonization) and stroke patients (Coast) aged ≥50 completed cognitive and clinical assessments at baseline and up to 5 follow-up visits in 6 years. Cardiometabolic diseases (CMDs), including hypertension, hyperlipidemia, diabetes mellitus, stroke and other cardiovascular diseases were assessed. Presence of CMM was defined as having two or more CMDs. Depression was defined by Geriatric Depression Scale (GDS) of ≥5. Biomarkers including cerebral beta-amyloid, cerebrovascular disease and ApoE genotype, were assessed by MRI and laboratory tests. Cognitive outcomes included cognitive trajectory patterns identified by the group-based trajectory model (GBTM) and the rate of change of global cognitive z-score. Multivariable logistic models and mixed models were conducted to assess the associations of CMM(+) and depression(+) with longitudinal cognitive decline. Stratification analysis by demographics and biomarkers was conducted.</p></div><div><h3>Results</h3><p>Among a total of 809 (Harmonization: 586, Coast: 223) participants, three cognitive trajectories were identified by the GBTM in each cohort. CMM(+) was independently associated with longitudinal cognitive decline. There was a significant interaction among CMM, depression and time with longitudinal cognition in both cohorts (ps of β(CMM*depression*time) &lt; 0.05). Compared with reference group, CMM(+) and depression(+) were associated with patterns of rapid decline (OR=3.58, =95%CI=(1.64,7.81)) and slow decline (OR=3.32, 95%CI=(1.20,9.19)) in Harmonization, and decline/low stable (OR=4.01, 95%CI=(1.03,15.50)) in Coast. Participants with CMM(+) and depression(+) had a 0.24 (95%CI= -0.49, -0.01) and 0.13 (95%CI=-0.24,-0.01) units decline per year on global cognitive z-scores in Harmonization and Coast, respectively, compared with those with CMM(-) and depression(-). The combined effect between CMM and depression was more pronounced among older and male participants, as well as APOEε4 carriers.</p></div><div><h3>Discussion</h3><p>Our study demonstrated a synergistic effect between CMM and depression on longitudinal cognitive decline among elderly with differed underlying neuropathology. Targeting both CMM and depression in preventing cognitive decline may lead to greater effectiveness.</p></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"6 ","pages":"Article 100233"},"PeriodicalIF":1.9000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666245024000345/pdfft?md5=02f2ff57c4ad5bf443a30801cdc151a3&pid=1-s2.0-S2666245024000345-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cerebral circulation - cognition and behavior","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666245024000345","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction

Cardiometabolic multimorbidity (CMM) and depression are risk factors for cognitive decline and dementia. We investigated the independent and synergistic associations of CMM and depression on longitudinal cognitive deterioration in two Asian cohorts of elderly at varying cognitive status with differed underlying neuropathology.

Methods

Eligible memory clinic (Harmonization) and stroke patients (Coast) aged ≥50 completed cognitive and clinical assessments at baseline and up to 5 follow-up visits in 6 years. Cardiometabolic diseases (CMDs), including hypertension, hyperlipidemia, diabetes mellitus, stroke and other cardiovascular diseases were assessed. Presence of CMM was defined as having two or more CMDs. Depression was defined by Geriatric Depression Scale (GDS) of ≥5. Biomarkers including cerebral beta-amyloid, cerebrovascular disease and ApoE genotype, were assessed by MRI and laboratory tests. Cognitive outcomes included cognitive trajectory patterns identified by the group-based trajectory model (GBTM) and the rate of change of global cognitive z-score. Multivariable logistic models and mixed models were conducted to assess the associations of CMM(+) and depression(+) with longitudinal cognitive decline. Stratification analysis by demographics and biomarkers was conducted.

Results

Among a total of 809 (Harmonization: 586, Coast: 223) participants, three cognitive trajectories were identified by the GBTM in each cohort. CMM(+) was independently associated with longitudinal cognitive decline. There was a significant interaction among CMM, depression and time with longitudinal cognition in both cohorts (ps of β(CMM*depression*time) < 0.05). Compared with reference group, CMM(+) and depression(+) were associated with patterns of rapid decline (OR=3.58, =95%CI=(1.64,7.81)) and slow decline (OR=3.32, 95%CI=(1.20,9.19)) in Harmonization, and decline/low stable (OR=4.01, 95%CI=(1.03,15.50)) in Coast. Participants with CMM(+) and depression(+) had a 0.24 (95%CI= -0.49, -0.01) and 0.13 (95%CI=-0.24,-0.01) units decline per year on global cognitive z-scores in Harmonization and Coast, respectively, compared with those with CMM(-) and depression(-). The combined effect between CMM and depression was more pronounced among older and male participants, as well as APOEε4 carriers.

Discussion

Our study demonstrated a synergistic effect between CMM and depression on longitudinal cognitive decline among elderly with differed underlying neuropathology. Targeting both CMM and depression in preventing cognitive decline may lead to greater effectiveness.

心脏代谢性多病和抑郁症对认知能力纵向衰退的协同效应:两个亚洲老年人纵向队列的研究结果
导言:心脏代谢多病症(CMM)和抑郁症是认知能力下降和痴呆症的风险因素。方法年龄≥50岁的符合条件的记忆门诊患者(Harmonization)和中风患者(Coast)在基线和6年内的5次随访中完成认知和临床评估。对心血管代谢疾病(CMD),包括高血压、高脂血症、糖尿病、中风和其他心血管疾病进行了评估。患有两种或两种以上 CMD 即为患有 CMM。抑郁的定义是老年抑郁量表(GDS)≥5。生物标志物包括脑β-淀粉样蛋白、脑血管疾病和载脂蛋白E基因型,通过核磁共振成像和实验室测试进行评估。认知结果包括基于群体的认知轨迹模型(GBTM)所确定的认知轨迹模式和全球认知Z-score的变化率。采用多变量逻辑模型和混合模型评估CMM(+)和抑郁(+)与纵向认知能力下降的关系。结果在总共 809 名(协调:586 人,沿海:223 人)参与者中,每个队列中的 GBTM 都确定了三种认知轨迹。CMM(+)与认知能力的纵向衰退有独立的关联。在两个队列中,CMM、抑郁和时间与纵向认知能力之间存在明显的交互作用(β(CMM*抑郁*时间) <0.05的ps)。与参照组相比,CMM(+)和抑郁(+)与 "协调 "组的快速下降(OR=3.58,=95%CI=(1.64,7.81))和缓慢下降(OR=3.32,95%CI=(1.20,9.19))模式相关,与 "海岸 "组的下降/低稳定(OR=4.01,95%CI=(1.03,15.50))模式相关。与患有CMM(-)和抑郁症(-)的参与者相比,患有CMM(+)和抑郁症(+)的参与者在 "协调 "和 "海岸 "的全球认知Z值每年分别下降0.24(95%CI=-0.49,-0.01)和0.13(95%CI=-0.24,-0.01)个单位。讨论我们的研究表明,在基础神经病理学不同的老年人中,CMM和抑郁症对认知能力纵向下降的协同作用更为明显。同时针对 CMM 和抑郁症预防认知能力下降可能会取得更好的效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Cerebral circulation - cognition and behavior
Cerebral circulation - cognition and behavior Neurology, Clinical Neurology
CiteScore
2.00
自引率
0.00%
发文量
0
审稿时长
14 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信