Associations of Depressive Symptoms with Subjective Cognitive Decline in Elderly People—A Cross-Sectional Analysis from the AgeWell.de-Study

Author:

Zöllinger Isabel1,Bauer Alexander2ORCID,Blotenberg Iris3,Brettschneider Christian4ORCID,Buchholz Maresa3,Czock David5ORCID,Döhring Juliane6,Escales Catharina6,Fankhaenel Thomas2,Frese Thomas2ORCID,Hoffmann Wolfgang37,Kaduszkiewicz Hanna6,König Hans-Helmut4ORCID,Luppa Melanie8ORCID,Oey Anke9,Pabst Alexander8ORCID,Sanftenberg Linda1,Thyrian Jochen René37ORCID,Weiss Julian1,Wendel Flora1ORCID,Wiese Birgitt10,Riedel-Heller Steffi G.8,Gensichen Jochen1

Affiliation:

1. Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany

2. Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany

3. German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany

4. Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany

5. Department of Clinical Pharmacology and Pharmacoepidemiology, University Hospital Heidelberg, 69120 Heidelberg, Germany

6. Institute of General Practice, University of Kiel, 24105 Kiel, Germany

7. Institute for Community Medicine, University Medicine Greifswald, 17487 Greifswald, Germany

8. Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany

9. State Health Department of Lower Saxony, 30449 Hannover, Germany

10. Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, 30625 Hannover, Germany

Abstract

To develop effective dementia prevention strategies, it is necessary to understand risk factors, associated factors and early signs of dementia. Subjective cognitive decline (SCD) is the earliest form of dementia. The aim of this study is to assess depression as a factor that is significantly associated with SCD. The data of 1030 general practitioner patients from the AgeWell.de-study (60–77 years; CAIDE dementia risk score ≥ 9) were analysed. A descriptive analysis was conducted using validated instruments like the Geriatric depression scale (GDS), Lubben social network scale (LSNS-6) and education classes according to CASMIN (Comparative Analysis of Social Mobility in Industrial Nations). A multivariate regression model with the dependent variable SCD was calculated. Of the 1030 participants, 5.9% had depressive symptoms and 31.3% SCD. The group with depressive symptoms showed significantly higher body-mass-index (p = 0.005), lower education class (p = 0.022), lower LSNS-6 score (p < 0.001), higher sports activity (p < 0.001), and more sleeping problems (p = 0.026). In the regression model a higher GDS-score [Odds ratio (OR): 1.219 (p < 0.001)], more sleeping problems [OR: 1.550 (p = 0.017)] and higher education class [middle/high: OR: 1.474/1.875 (p = 0.037/0.004)] were significantly associated with SCD. This study identified depressive symptoms, sleeping problems, and higher education classes as factors associated with SCD, which can represent an early form of dementia.

Funder

German Federal Ministry for Education and Research

Publisher

MDPI AG

Subject

General Medicine

Reference57 articles.

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2. Anders, W., and Prince, M. (2010). World Alzheimer Report 2010. The Global Economic Impact of Dementia, Alzheimer’s Disease International.

3. The global prevalence of dementia: A systematic review and metaanalysis;Prince;Alzheimer’s Dement. J. Alzheimer’s Assoc.,2013

4. WHO (2012). Dementia: A Public Health Priority, World Health Organization.

5. Zülke, A., Luck, T., Pabst, A., Hoffmann, W., Thyrian, J.R., Gensichen, J., Kaduszkiewicz, H., König, H.H., Haefeli, W.E., and Czock, D. (2019). AgeWell.de—Study protocol of a pragmatic multi-center cluster-randomized controlled prevention trial against cognitive decline in older primary care patients. BMC Geriatr., 19.

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