Is Depression in Mild Cognitive Impairment a Precursor to Dementia?

MedicalResearch.com Interview with:
Zahinoor Ismail MD FRCPC

Clinical Associate Professor,
Hotchkiss Brain Institute
University of Calgary

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Depression and depressive symptoms are common in mild cognitive impairment (MCI). Evidence suggests that depression in MCI increases the likelihood of progression from MCI to dementia, compared to non-depressed people with MCI. In the newer construct of mild behavioural impairment (MBI), which describes the relationship between later life onset of sustained and impactful neuropsychiatric symptoms and the risk of cognitive decline and dementia, depression is an important subdomain (in addition to apathy, impulse control, social cognition and psychotic symptoms). Thus, depression and depressive symptoms are a significant risk factor for cognitive, behavioural and functional outcomes in older adults who have at most mild cognitive impairment. As the importance of neuropsychiatric symptoms in older adults emerges, good prevalence estimates are required to inform clinicians and researchers as well as public health policy and decision makers.

We performed a systematic review and meta-analysis to determine the best estimate of prevalence of depression in  mild cognitive impairment. We included 57 studies, representing 20,892 participants in the analysis. While we determined that the omnibus prevalence estimate was 32%, there was significant heterogeneity in this sample based on setting. In community samples, the rate was 25%, but in clinical samples this was higher at 40%. Additionally, different case ascertainment methods for depression (self report, clinician administered or caregiver report) and different MCI criteria didn’t change the prevalence estimates.

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Omega-3 fatty Acid Supplementation May Benefit Mild Cognitive Impairment

Milan Fiala, M.D. Research Professor, UCLA Department of Surgery Los Angeles, CAMedicalResearch.com Interview with:
Milan Fiala, M.D.

Research Professor, UCLA Department of Surgery
Los Angeles, CA

Medical Research: What is the background for this study? What are the main findings?

Dr. Fiala: Omega-3 fatty acid supplementation is well-known to public for its health benefits in cardiovascular diseases and putative benefits against “Minor Cognitive Impairment” reported in other studies . This study shows that omega-3 protected against oxidation and resveratrol improves the immune system against amyloid-beta in the brain,  probably by increasing its clearance from the brain by the immune system. Overall the patients taking the drink seemed to preserve their memory better for up to 2 years than expected based on previous studies. However, our study was small and not controlled by a placebo, which may present a bias.   Continue reading

Diabetes Key Risk Factor for Cognitive Impairment in Late-Life

Rosebud O Roberts, M.B., Ch.B. Professor of Epidemiology Professor of Neurology Mayo ClinicMedicalResearch.com Interview with:
Rosebud O Roberts, M.B., Ch.B.
Professor of Epidemiology
Professor of Neurology
Mayo Clinic

 

MedicalResearch.com: What are the main findings of the study?

Dr. Roberts: The onset of type two diabetes in midlife (before age 65 years)  is associated with brain pathology (subcortical brain infarctions, reduced hippocampal volume, reduced whole brain volume) in late-life. Early onset of diabetes also increases the risk of developing mild cognitive impairment  which is an intermediate stage between normal cognitive aging and dementia. Our findings suggest that loss of brain volumes may be an intermediate stage or a link between diabetes and cognitive impairment.

We also found that diabetes onset in late-life (after age 65 years), is also associated with brain pathology (cortical infarctions, reduced whole brain volume).

Finally, onset of hypertension in midlife, but not late-life, is associated with brain pathology in late- life.

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COPD and Risk of Mild Cognitive Impairment

Michelle M. Mielke, Ph.D. Associate Professor Department of Health Sciences Research, Division of Epidemiology Department of Neurology Mayo Clinic Rochester, MN 55905MedicalResearch.com Interview with:
Michelle M. Mielke, Ph.D.
Associate Professor
Department of Health Sciences Research, Division of Epidemiology
Department of Neurology
Mayo Clinic Rochester, MN 55905

MedicalResearch.com: What are the main findings of the study?

Dr. Mielke: Using a population-based sample of cognitively normal individuals, aged 70-89 at baseline, we found that a medical-record confirmed diagnosis of COPD was associated with an increased risk of mild cognitive impairment, specifically non-amnestic mild cognitive impairment.  The risk of mild cognitive impairment increased with a longer duration of COPD such that individuals who had COPD for more than 5 years had a 2.5-fold increased risk of developing non-amnestic mild cognitive impairment.
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Hypothyroidism and Mild Cognitive Impairment Risk?

Ajay K Parsaik, MD, MS Department of Psychiatry and Behavior Sciences The University of Texas Medical School, Houston Department of Neurology and Mayo Alzheimer’s Disease Research Center, Mayo Clinic, Rochester, MinnesotaMedicalResearch.com Interview with:
Ajay K Parsaik, MD, MS
Department of Psychiatry and Behavior Sciences
The University of Texas Medical School, Houston
Department of Neurology and Mayo Alzheimer’s Disease Research Center, Mayo Clinic, Rochester, Minnesota

MedicalResearch.com: What are the main findings of the study?

Dr. Parsaik: Main findings of our study are that clinical and subclinical hypothyroidism is not associated with mild cognitive impairment in an elderly population after accounting for possible confounding factors and interactions.
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Parkinson’s Disease: Cognitive Impairment and Plasma Ceramides

Michelle M. Mielke, Ph.D. Associate Professor Department of Health Sciences Research Division of Epidemiology Mayo Clinic 200 First Street SW Rochester, MN 55905MedicalResearch.com: Interview with:

Michelle M. Mielke, Ph.D.
Associate Professor
Department of Health Sciences Research
Division of Epidemiology
Mayo Clinic 200 First Street SW
Rochester, MN 55905

MedicalResearch.com: What are the main findings of the study?

Dr. Mielke: Among Parkinson’s disease (PD) patients, plasma levels of ceramides and monohexylceramides were higher in patients with cognitive impairment or dementia compared to patients who were cognitively normal.  Levels of these lipids were also higher in the combined group of PD patients compared to non-PD controls but the number of controls were small.

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Cognitive Impairment and Hospital Readmissions

Mark W. Ketterer, PhD, ABPP Senior Bioscientific Staff Henry Ford Hospital/A2 Detroit, MI 48202 Clinical Professor of Psychiatry & Behavioral Neurosciences Department of Psychiatry Wayne State UniversityMedicalResearch.com Interview with:
Mark W. Ketterer, PhD, ABPP
Senior Bioscientific Staff
Henry Ford Hospital/A2
Detroit, MI 48202
Clinical Professor of Psychiatry & Behavioral Neurosciences
Department of Psychiatry Wayne State University

MedicalResearch.com: What are the main findings of the study:

Dr. Ketterer:  A survey of 84 patients admitted to Henry Ford Hospital found 54% to have Moderate-Severe Cognitive Impairment (CI).
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