Network Analysis Revealed the Role of Helplessness as a Central Feature Among Late-Life Depressive Symptoms in Patients With Mild Cognitive Impairment and Early Stage Dementia
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective It has been reported that depressive symptoms in older adults are different from those in younger adults, especially when accompanied by cognitive decline. However, few studies have investigated the network structure of depressive symptoms in this population.Methods The participants consisted of 627 older adults (>60 yr) who were diagnosed with mild cognitive impairment (MCI) or early stage dementia. Among them, 36.7% were male and the mean age was 76.20±7.71 years. The Korean form of Geriatric Depression Scale (KGDS) was used to evaluate their depressive symptoms and network analyses were performed using bootnet R-package to identify the central features among depressive symptoms.Results Of all the KGDS items, we found that KGDS 2 (often feel helpless) had the highest node strength followed by KGDS 21 (in good spirits), KGDS 14 (not confident at all), and KGDS 15 (cheerful and happy). In terms of node betweenness, KGDS 2 also showed the highest value. The edge weights of edges connected to node KGDS 2 were strongest in KGDS 3 (restless and fidgety) and KGDS 28 (easily get tired).Conclusion In this study, we presented which symptoms are central among the elderly with MCI and early stage dementia. This result not only increases the understanding of depressive symptoms in this group but would also help determine target symptoms in the treatment program.
Abstract
Objective It has been reported that depressive symptoms in older adults are different from those in younger adults, especially when accompanied by cognitive decline. However, few studies have investigated the network structure of depressive symptoms in this population.Methods The participants consisted of 627 older adults (>60 yr) who were diagnosed with mild cognitive impairment (MCI) or early stage dementia. Among them, 36.7% were male and the mean age was 76.20±7.71 years. The Korean form of Geriatric Depression Scale (KGDS) was used to evaluate their depressive symptoms and network analyses were performed using bootnet R-package to identify the central features among depressive symptoms.Results Of all the KGDS items, we found that KGDS 2 (often feel helpless) had the highest node strength followed by KGDS 21 (in good spirits), KGDS 14 (not confident at all), and KGDS 15 (cheerful and happy). In terms of node betweenness, KGDS 2 also showed the highest value. The edge weights of edges connected to node KGDS 2 were strongest in KGDS 3 (restless and fidgety) and KGDS 28 (easily get tired).Conclusion In this study, we presented which symptoms are central among the elderly with MCI and early stage dementia. This result not only increases the understanding of depressive symptoms in this group but would also help determine target symptoms in the treatment program.
참고문헌 (50)
- Blazer DG, "The association of depression and mortality in elderly persons : a case for multiple, independent path ways", J Gerontol A Biol Sci Med Sci, 56, pp.M505~M509 (2001)
- Steel Z, "The global prevalence of common mental disorders : a systematic review and meta-analysis 1980–2013", Int J Epidemiol, 43, pp.476~493 (2014)
- Park JH, "A na tionwide survey on the prevalence and risk factors of late life depres sion in South Korea", J Affect Disord, 138, pp.34~40 (2012)
- Koç Z, "The investigation of factors that influence self-care agency and daily life activities among the elderly in the northern region of Turkey", Collegian, 22, pp.251~258 (2015)
- Donovan NJ, "Social isolation and loneliness in older adults : review and commentary of a National Academies report", Am J Geriatr Psychiatry, 28, pp.1233~1244 (2020)
- Galán-Arroyo C, "Depression and exercise in older adults : exercise looks after you program, user profile", Healthcare, 10, pp.181~ (2022)
- Ahmad NA, "Association between functional limitations and depression among community-dwelling older adults in Malaysia", Geriatr Gerontol Int, 20, pp.21~25 (2020)
- Allan CE, "Depression in older people is un derdiagnosed", Practitioner, 258, pp.19~22 (2014)
- Gallo JJ, "Age differences in the symptoms of depression : a latent trait analysis", J Gerontol, 49, pp.251~264 (1994)
- Baldwin RC, "Poor prognosis of depression in elderly people : causes and actions", Ann Med, 32, pp.252~256 (2000)
- Simpson S, "Is subcortical disease as sociated with a poor response to antidepressants? Neurological, neu ropsychological and neuroradiological findings in late-life depression", Psychol Med, 28, pp.1015~1026 (1998)
- Prince MJ, "A prospective popu lation-based cohort study of the effects of disablement and social mi lieu on the onset and maintenance of late-life depression. The Gospel Oak Project VII", Psychol Med, 28, pp.337~350 (1998)
- Sarin K, "Depression and hopelessness in institutionalized elderly : a societal concern", Open J Depress, 5, pp.21~ (2016)
- Ismail Z, "Depression ver sus dementia : is this construct still relevant?", Neurodegener Dis Manag, 4, pp.119~126 (2014)
- Morimoto SS, "Cognitive impair ment in depressed older adults : implications for prognosis and treat ment", Psychiatr Ann, 44, pp.138~142 (2014)
- Ma L, "Depression, anxiety, and apathy in mild cognitive impairment : current perspectives", Front Aging Neurosci, 12, pp.9~ (2020)
- Santabarbara J, "Clinically relevant late-life depression as risk factor of dementia : a systematic review and meta-analysis of prospective cohort studies", Rev Neurol, 68, pp.493~502 (2019)
- Ismail Z, "Neu ropsychiatric symptoms as early manifestations of emergent dementia : provisional diagnostic criteria for mild behavioral impairment", Al zheimers Dement, 12, pp.195~202 (2016)
- Gellis ZD, "Treatments for depression in older persons with dementia. Treatments for depression in older per sons with dementia", Ann Longterm Care, 17, pp.29~36 (2009)
- Borsboom D, "Network analysis : an integrative approach to the structure of psychopathology", Annu Rev Clin Psychol, 9, pp.91~121 (2013)
- Borsboom D, "A network theory of mental disorders", World Psychiatr, 16, pp.5~13 (2017)
- Fried EI, "Mental disorders as networks of problems : a review of recent insights", Soc Psychiatry Psychiatr Epidemiol, 52, pp.1~10 (2017)
- Lee Pe M, "Emotion-network density in major depressive dis order", Clin Psychol Sci, 3, pp.292~300 (2015)
- Robinaugh DJ, "Network analy sis of persistent complex bereavement disorder in conjugally bereaved adults", J Abnorm Psychol, 123, pp.510~522 (2014)
- Hughes CP, "A new clini cal scale for the staging of dementia", Br J Psychiatry, 140, pp.566~572 (1982)
- Morris JC, "The Clinical Dementia Rating(CDR) : current version and scoring rules", Neurology, 43, pp.2412~2414 (1993)
- Choi SH, "Estimat ing the validity of the Korean version of expanded clinical dementia rating(CDR)scale", J Korean Neurol Assoc, 19, pp.585~591 (2001)
- Reisberg B, "The Global Deterioration Scale for assessment of primary degenerative dementia", Am J Psychia try, 139, pp.1136~1139 (1982)
- Choi SH, "The valid ity of the Korean version of Global Deterioration Scale", J Korean Neurol Assoc, pp.612~617 (2002)
- Brink TL, "Screening tests for geriatric depression", Clin Gerontol, 1, pp.37~43 (1982)
- Jung IK, "A preliminary study on standard ization of Korean form of geriatric depression scale (KGDS)", J Korean Neurol Assoc, pp.340~351 (1998)
- Epskamp S, "qgraph : network visualizations of relationships in psychometric data", J Stat Softw, 48, pp.1~18 (2012)
- Van Borkulo CD, "A new method for constructing networks from binary data", Sci Rep, 4, pp.5918~ (2014)
- Fruchterman TM, "Graph drawing by force-directed place ment", Software : practice and experience, 21, pp.1129~1164 (1991)
- Opsahl T, "Node centrality in weighted net works : generalizing degree and shortest paths", Social networks, 32, pp.245~251 (2010)
- Hevey D, "Network analysis : a brief overview and tutorial", Health Psy chol Behav Med, 6, pp.301~328 (2018)
- Epskamp S, "Estimating psychological networks and their accuracy : a tutorial paper", Behav Res Methods, 50, pp.195212~ (2018)
- Flannery RB Jr, "Treating learned helplessness in the elderly dementia pa tient : preliminary inquiry", Am J Alzheimers Dis Other Demen, 17, pp.345~349 (2002)
- Júnior JASH, "Hopelessness in the elderly : a sys tematic review", MOJ Gerontology & Geriatrics, 3, pp.273~278 (2018)
- van Wanrooij LL, "A network approach on the relation between apathy and depression symptoms with dementia and functional disability", Int Psy chogeriatr, 31, pp.1655~1663 (2019)
- Kim D, "Network analysis of central symp toms of depression in elderly cognitive disorder patients", J Korean Neurol Assoc, 61, pp.38~44 (2022)
- Joosten-Weyn Banningh LW, "Group therapy for patients with mild cognitive impairment and their significant others : results of a waiting-list controlled trial", Gerontology, 57, pp.444~454 (2011)
- Mänty M, "Fatigue and depressive symp toms in older people", J Appl Gerontol, 33, pp.505~514 (2014)
- Abramson LY, "Learned helplessness in hu mans : critique and reformulation", J Abnorm Psychol, 87, pp.49~74 (1978)
- Targum SD, "The complexity of"mixed"depression : a common clinical presentation", Innov Clin Neurosci, 8, pp.38~42 (2011)
- Blazer DG, "Depression in late life : review and commentary", J Gerontol A Biol Sci Med Sci, 58, pp.249~265 (2003)
- Spoletini I, "Depression and cancer : an unexplored and unresolved emergent issue in elderly patients", Crit Rev Oncol Hematol, 65, pp.143~155 (2008)
- Hegeman JM, "Phenomenology of depression in older compared with younger adults : meta-analysis", Br J Psychiatry, 200, pp.275~281 (2012)
- Volicer L, "Relationship between symp toms of depression and agitation in nursing home residents with de mentia", Int J Geriatr Psychiatry, 27, pp.749~754 (2012)
- Livingston G, "Non-pharmacological interventions for agitation in dementia : systemat ic review of randomised controlled trials", Br J Psychiatry, 205, pp.436442~ (2014)