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Evaluating the Associations of Cardio-Metabolic Conditions and Depression with Cognitive Decline: Longitudinal Analysis of the Health and Retirement Study.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Evaluating the Associations of Cardio-Metabolic Conditions and Depression with Cognitive Decline: Longitudinal Analysis of the Health and Retirement Study./
作者:	Yang, Dominik.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2020,
面頁冊數:	79 p.
附註:	Source: Masters Abstracts International, Volume: 82-10.
Contained By:	Masters Abstracts International82-10.
標題:	Comorbidity. -
電子資源:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28383844
ISBN:	9798708712967

Evaluating the Associations of Cardio-Metabolic Conditions and Depression with Cognitive Decline: Longitudinal Analysis of the Health and Retirement Study.
Yang, Dominik.

Evaluating the Associations of Cardio-Metabolic Conditions and Depression with Cognitive Decline: Longitudinal Analysis of the Health and Retirement Study. - Ann Arbor : ProQuest Dissertations & Theses, 2020 - 79 p.

Source: Masters Abstracts International, Volume: 82-10.

Thesis (M.Sc.)--McGill University (Canada), 2020.

This item must not be sold to any third party vendors.

Objective: Recent studies have shown strong associations between cardiovascular conditions and dementia. However, little is known on when changes in cognitive function begin. There is some evidence that cognitive decline for people with chronic somatic conditions might start in mid-life, but evidence from large longitudinal community-based studies with long follow-up data is still lacking. The role of mental conditions like depression is also not clear. For example, individuals with depression and diabetes have a higher risk for dementia than individuals with either depression or diabetes alone, but it is not clear if the comorbidity of depression with diabetes is associated with accelerated cognitive decline in the middle age. The aims of this thesis were:a)to examine longitudinal cognitive function trajectories associated with the presence of cardio-metabolic conditions in middle-aged adults using data from the longitudinal US Health and Retirement Study (HRS).b)to evaluate if elevated depressive symptoms and diabetes were associated with accelerate worse cognitive function trajectories in middle-aged adults in the HRS.Methods: HRS is a prospective cohort study with a nationally representative sample of US adults 50 years and older. We included individuals who participated in HRS in 2002 with follow-up until 2016. For the first study, participants between ages 50-65 in 2002 with a minimum of two follow-up assessments and information about baseline cardio-metabolic conditions were included (n=5011). Cognitive function was assessed using a modified Telephone Interview for Cognitive Status (TICS-M) scored out of 27 points. Cognitive function trajectories were modeled for different numbers of cardio-metabolic conditions (heart disease, hypertension, diabetes and stroke). Linear mixed effects modelling was used to estimate the mean longitudinal trajectory of total cognitive score amongst the different groups. The analyses controlled for baseline age, sex, depression, education, marital status, physical activity, BMI, smoking and alcohol. For the second study, we included individuals aged 50 to 70 in 2002 with at least three follow-ups between 2004 and 2016, as well as information about diabetes diagnosis and a depression assessment in 2002 (n=7538). Latent growth curve modeling was performed to identify different classes of cognitive trajectories. Multinomial logistic regression was used to analyze the association between diabetes and elevated depressive symptoms at baseline with the cognitive function trajectory groups, adjusting for baseline age, sex, education, marital status, physical activity, and smoking.Results:Study 1: Compared to the group without cardio-metabolic conditions at baseline (trajectory intercept 18.87 [95% confidence interval (CI) 18.29 to 19.45]), trajectory slope -0.17 [95% CI -0.22 to -0.13]), participants with one cardio-metabolic condition had a similar decrease in cognitive function over time (intercept 18.65 [95% CI 18.45 to 18.85], slope -0.17 [-0.20 to -0.15]). Participants with two cardio-metabolic conditions had a steeper cognitive decline (intercept 18.53 [95% CI 18.28 to 18.79], slope -0.21 [95% CI -0.23 to -0.18]); participants with three or more conditions had the greatest decline in cognitive function (intercept 18.62 [95% CI 18.21 to 19.03], slope -0.25 [95% CI -0.29 to -0.22]).Study 2: We identified three trajectory classes using latent growth modelling adjusting for baseline age: high (40.5%), intermediate (44.2%) and low (15.2%). The high trajectory class had a high baseline cognitive score with a small decline over time; the intermediate class had a lower baseline score with a steeper decline while the low class had the lowest baseline score and the steepest decline. In reference to the high trajectory class, comorbidity was associated with an OR of 6.74 [95% CI 3.96 to 11.48] for being in the low trajectory group and an OR of 2.81 [95% CI 1.73 to 4.57] for the intermediate trajectory group.Conclusions: Cognitive trajectories for those with two or more cardio-metabolic conditions were significantly worse compared to those with one or less, suggesting that cognitive decline may occur in middle-aged adults with multiple chronic conditions long before the onset of dementia. Elevated depressive symptoms and diabetes were individually associated with a low or intermediate class cognitive trajectory; comorbidity increased the risk of belonging to the low trajectory group.

ISBN: 9798708712967Subjects--Topical Terms:

838466
Comorbidity.
Subjects--Index Terms:

Cardio-metabolic

Evaluating the Associations of Cardio-Metabolic Conditions and Depression with Cognitive Decline: Longitudinal Analysis of the Health and Retirement Study.
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520 $a Objective: Recent studies have shown strong associations between cardiovascular conditions and dementia. However, little is known on when changes in cognitive function begin. There is some evidence that cognitive decline for people with chronic somatic conditions might start in mid-life, but evidence from large longitudinal community-based studies with long follow-up data is still lacking. The role of mental conditions like depression is also not clear. For example, individuals with depression and diabetes have a higher risk for dementia than individuals with either depression or diabetes alone, but it is not clear if the comorbidity of depression with diabetes is associated with accelerated cognitive decline in the middle age. The aims of this thesis were:a)to examine longitudinal cognitive function trajectories associated with the presence of cardio-metabolic conditions in middle-aged adults using data from the longitudinal US Health and Retirement Study (HRS).b)to evaluate if elevated depressive symptoms and diabetes were associated with accelerate worse cognitive function trajectories in middle-aged adults in the HRS.Methods: HRS is a prospective cohort study with a nationally representative sample of US adults 50 years and older. We included individuals who participated in HRS in 2002 with follow-up until 2016. For the first study, participants between ages 50-65 in 2002 with a minimum of two follow-up assessments and information about baseline cardio-metabolic conditions were included (n=5011). Cognitive function was assessed using a modified Telephone Interview for Cognitive Status (TICS-M) scored out of 27 points. Cognitive function trajectories were modeled for different numbers of cardio-metabolic conditions (heart disease, hypertension, diabetes and stroke). Linear mixed effects modelling was used to estimate the mean longitudinal trajectory of total cognitive score amongst the different groups. The analyses controlled for baseline age, sex, depression, education, marital status, physical activity, BMI, smoking and alcohol. For the second study, we included individuals aged 50 to 70 in 2002 with at least three follow-ups between 2004 and 2016, as well as information about diabetes diagnosis and a depression assessment in 2002 (n=7538). Latent growth curve modeling was performed to identify different classes of cognitive trajectories. Multinomial logistic regression was used to analyze the association between diabetes and elevated depressive symptoms at baseline with the cognitive function trajectory groups, adjusting for baseline age, sex, education, marital status, physical activity, and smoking.Results:Study 1: Compared to the group without cardio-metabolic conditions at baseline (trajectory intercept 18.87 [95% confidence interval (CI) 18.29 to 19.45]), trajectory slope -0.17 [95% CI -0.22 to -0.13]), participants with one cardio-metabolic condition had a similar decrease in cognitive function over time (intercept 18.65 [95% CI 18.45 to 18.85], slope -0.17 [-0.20 to -0.15]). Participants with two cardio-metabolic conditions had a steeper cognitive decline (intercept 18.53 [95% CI 18.28 to 18.79], slope -0.21 [95% CI -0.23 to -0.18]); participants with three or more conditions had the greatest decline in cognitive function (intercept 18.62 [95% CI 18.21 to 19.03], slope -0.25 [95% CI -0.29 to -0.22]).Study 2: We identified three trajectory classes using latent growth modelling adjusting for baseline age: high (40.5%), intermediate (44.2%) and low (15.2%). The high trajectory class had a high baseline cognitive score with a small decline over time; the intermediate class had a lower baseline score with a steeper decline while the low class had the lowest baseline score and the steepest decline. In reference to the high trajectory class, comorbidity was associated with an OR of 6.74 [95% CI 3.96 to 11.48] for being in the low trajectory group and an OR of 2.81 [95% CI 1.73 to 4.57] for the intermediate trajectory group.Conclusions: Cognitive trajectories for those with two or more cardio-metabolic conditions were significantly worse compared to those with one or less, suggesting that cognitive decline may occur in middle-aged adults with multiple chronic conditions long before the onset of dementia. Elevated depressive symptoms and diabetes were individually associated with a low or intermediate class cognitive trajectory; comorbidity increased the risk of belonging to the low trajectory group.
520 $a Objectif: Des etudes recentes ont montre de fortes associations entre les conditions cardiovasculaires et la demence. Cependant, on sait peu de choses sur le debut des changements dans la fonction cognitive. Il existe des preuves que le declin cognitif des personnes atteintes de maladies somatiques chroniques pourrait commencer au milieu de la vie, mais les preuves provenant de grandes etudes communautaires longitudinales avec de longues donnees de suivi font toujours defaut. Le role des conditions mentales comme la depression n'est pas clair non plus. Par exemple, les personnes atteintes de depression et de diabete ont un risque plus eleve de demence que les personnes atteintes de depression ou de diabete seul, mais il n'est pas clair si la comorbidite de la depression avec le diabete est associee a un declin cognitif accelere au moyen age. Les objectifs de cette these etaient:a) pour examiner les trajectoires longitudinales des fonctions cognitives associees a la presence de conditions cardio-metaboliques chez les adultes d'age moyen en utilisant les donnees de la longitudinale US Health and Retirement Study (HRS).b) pour evaluer si des symptomes depressifs eleves et le diabete etaient associes a une acceleration des trajectoires des fonctions cognitives chez les adultes d'age moyen dans le HRS.Conception: HRS est une etude de cohorte prospective avec un echantillon nationalement representatif d'adultes americains de 50 ans et plus. Nous avons inclus des personnes qui ont participe a HRS en 2002 avec un suivi jusqu'en 2016. Pour la premiere etude, des participants ages de 50 a 65 ans en 2002 avec au moins deux evaluations de suivi et des informations sur les conditions cardio-metaboliques de base ont ete inclus (n = 5011). La fonction cognitive a ete evaluee a l'aide d'une interview telephonique modifiee pour l'etat cognitif (TICS-M) avec 27 points. Les trajectoires des fonctions cognitives ont ete modelisees pour differents nombres de conditions cardio-metaboliques (maladie cardiaque, hypertension, diabete et accident vasculaire cerebral). Une modelisation a effets mixtes lineaires a ete utilisee pour estimer la trajectoire longitudinale moyenne du score cognitif total parmi les differents groupes. Les analyses controlaient l'age de base, le sexe, la depression, l'education, l'etat matrimonial, l'activite physique, l'IMC, le tabagisme et l'alcool.Resultats:Etude 1: Compare au groupe sans conditions cardio-metaboliques au depart (interception de trajectoire 18,87 [intervalle de confiance a 95% (IC) 18,29 a 19,45]), pente de la trajectoire - 0,17 [IC a 95% -0,22 a -0,13]), participants avec une condition cardio-metabolique avait une diminution similaire de la fonction cognitive au fil du temps (interception de trajectoire 18,65 [IC a 95% 18,45 a 18,85], pente de la trajectoire -0,17 [-0,20 a -0,15]). Les participants avec deux conditions cardio-metaboliques ont eu un declin cognitif plus prononce (interception de trajectoire 18,53 [IC 95% 18,28 a 18,79], pente de la trajectoire -0,21 [IC 95% -0,23 a -0,18]); les participants avec trois conditions ou plus avaient le plus grand declin de la fonction cognitive (interception de trajectoire 18,62 [IC 95% 18,21 a 19,03], pente de la trajectoire - 0,25 [IC 95% -0,29 a -0,22]).Etude 2: Nous avons identifie trois classes de trajectoires a l'aide de la modelisation de la croissance latente ajustee a l'age de reference: elevee (40,5%), intermediaire (44,2%) et faible (15,2%). La classe a trajectoire elevee avait un score cognitif de base eleve avec un leger declin au fil du temps; la classe intermediaire avait un score de base plus faible avec un declin plus prononce tandis que la classe basse avait le score de base le plus bas et le declin le plus prononce. En reference a la classe a trajectoire elevee, le diabete seul etait associe a un rapport de cotes (OR) de 2,09 [IC a 95% 1,63 a 2,66] pour etre dans la classe a trajectoire basse et a un OR de 1,56 [IC a 95% 1,30 a 1,86] pour etre dans la classe de trajectoire intermediaire. Le fait d'avoir des symptomes de depression eleves seuls etait associe a un OR de 1,97 [IC a 95% 1,51 a 2,56] pour les membres de la classe basse et 1,75 [IC a 95% 1,44 a 2,12] pour les membres de la classe intermediaire. La comorbidite etait associee a un OR de 6,74 [IC a 95% 3,96 a 11,48] pour etre dans le groupe a trajectoire basse et a un OR de 2,81 [IC a 95% 1,73 a 4,57] pour etre dans le groupe a trajectoire intermediaire.Conclusions: Les trajectoires cognitives des personnes atteintes de deux affections cardiometaboliques ou plus etaient significativement moins bonnes que celles qui en avaient une ou moins, ce qui suggere qu'un declin cognitif peut survenir chez les adultes d'age moyen souffrant de multiples maladies chroniques bien avant le debut de la demence. Des symptomes depressifs eleves et le diabete etaient individuellement associes a une trajectoire cognitive de classe basse ou intermediaire; la comorbidite augmentait le risque d'appartenance au groupe a faible trajectoire.
590 $a School code: 0781.
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650 4 $a Metabolism. $3 541349
650 4 $a Middle age. $3 683375
650 4 $a Cognitive ability. $3 3560491
650 4 $a Epidemiology. $3 568544
650 4 $a Dementia. $3 568139
650 4 $a Hypertension. $3 825110
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