Are subtypes of affective symptoms differentially associated with change in cognition over time: A latent class analysis.

Affective Symptoms Anxiety / diagnosis Cognition Depression / epidemiology Humans Latent Class Analysis Sleep
Affective symptoms Anxiety Depression Heterogeneity Latent class analysis Sleep

Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
15 07 2022
Historique:
received: 21 01 2022
revised: 14 04 2022
accepted: 24 04 2022
pubmed: 2 5 2022
medline: 25 5 2022
entrez: 1 5 2022
Statut: ppublish

Résumé

In the absence of disease-modifying treatments, identifying potential psychosocial risk factors for dementia is paramount. Depression and anxiety have been identified as potential risk factors. Studies however have yielded mixed findings, lending possibility to the fact that potential constellations of co-occurring depression and anxiety symptoms may better explain the link between affective symptoms and cognitive decline. Data from participants (aged 50 and above) of the PROTECT study was used. Latent Class Analysis (LCA) was conducted on 21,684 participants with baseline anxiety and depression measures. Multiple linear regressions models, using a subset of these participants (N = 6136) who had complete cognition data at baseline and at 2-year follow-up, were conducted to assess for associations between class membership and longitudinal changes in cognition. The LCA identified a 5-class solution: "No Symptoms", "Sleep", "Sleep and Worry", "Sleep and Anhedonia", and "Co-morbid Depression and Anxiety". Class membership was significantly associated with longitudinal change in cognition. Furthermore, this association differed across different cognitive measures. Limitations included significant attrition and a generally healthy sample which may impact generalisability. Substantial heterogeneity in affective symptoms could explain previous inconsistent findings concerning the association between affective symptoms and cognition. Clinicians should not focus solely on total symptom scores on a single affective domain, but instead on the presence and patterns of symptoms (even if sub-clinical) on measures across multiple affective domains. Identifying particular subgroups that are at greater risk of poor cognitive outcomes may support targeted prevention work.

Sections du résumé

BACKGROUND
In the absence of disease-modifying treatments, identifying potential psychosocial risk factors for dementia is paramount. Depression and anxiety have been identified as potential risk factors. Studies however have yielded mixed findings, lending possibility to the fact that potential constellations of co-occurring depression and anxiety symptoms may better explain the link between affective symptoms and cognitive decline.
METHODS
Data from participants (aged 50 and above) of the PROTECT study was used. Latent Class Analysis (LCA) was conducted on 21,684 participants with baseline anxiety and depression measures. Multiple linear regressions models, using a subset of these participants (N = 6136) who had complete cognition data at baseline and at 2-year follow-up, were conducted to assess for associations between class membership and longitudinal changes in cognition.
RESULTS
The LCA identified a 5-class solution: "No Symptoms", "Sleep", "Sleep and Worry", "Sleep and Anhedonia", and "Co-morbid Depression and Anxiety". Class membership was significantly associated with longitudinal change in cognition. Furthermore, this association differed across different cognitive measures.
LIMITATIONS
Limitations included significant attrition and a generally healthy sample which may impact generalisability.
CONCLUSIONS
Substantial heterogeneity in affective symptoms could explain previous inconsistent findings concerning the association between affective symptoms and cognition. Clinicians should not focus solely on total symptom scores on a single affective domain, but instead on the presence and patterns of symptoms (even if sub-clinical) on measures across multiple affective domains. Identifying particular subgroups that are at greater risk of poor cognitive outcomes may support targeted prevention work.

Identifiants

DOI: 10.1016/j.jad.2022.04.139 PMID: 35490883
pubmed: 35490883
pii: S0165-0327(22)00483-9
doi: 10.1016/j.jad.2022.04.139
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

437-445

Informations de copyright

Copyright © 2022. Published by Elsevier B.V.

Auteurs

Timothy Singham (T)

Adapt Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.

Rob Saunders (R)

Adapt Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK; Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.

Helen Brooker (H)

College of Medicine and Health, University of Exeter, UK.

Byron Creese (B)

College of Medicine and Health, University of Exeter, UK.

Dag Aarsland (D)

Department of Old age Psychiatry, IoPPN, Kings College London, UK; Centre for Age-related research, Stavanger University Hospital, Stavanger, Norway.

Adam Hampshire (A)

Department of Brain Sciences, Faculty of Medicine, Imperial College London, UK.

Clive Ballard (C)

College of Medicine and Health, University of Exeter, UK.

Anne Corbett (A)

College of Medicine and Health, University of Exeter, UK.

Roopal Desai (R)

Adapt Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.

Joshua Stott (J)

Adapt Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK. Electronic address: j.stott@ucl.ac.uk.

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Classifications MeSH

questionsmedicales.fr › Comportement et mécanismes comportementaux › Comportement › Symptômes comportementaux › Symptômes affectifs › Are subtypes of affective symptoms...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Émotions › Anxiété › Are subtypes of affective symptoms...
questionsmedicales.fr › Phénomènes psychologiques › Processus mentaux › Cognition › Are subtypes of affective symptoms...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Émotions › Dépression › Are subtypes of affective symptoms...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Are subtypes of affective symptoms...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de regroupements › Analyse de structure latente › Are subtypes of affective symptoms...
questionsmedicales.fr › Phénomènes physiologiques de l'appareil locomoteur et du système nerveux › Phénomènes physiologiques du système nerveux › Sommeil › Are subtypes of affective symptoms...