TY - JOUR
T1 - Are subtypes of affective symptoms differentially associated with change in cognition over time
T2 - A latent class analysis
AU - Singham, Timothy
AU - Saunders, Rob
AU - Brooker, Helen
AU - Creese, Byron
AU - Aarsland, Dag
AU - Hampshire, Adam
AU - Ballard, Clive
AU - Corbett, Anne
AU - Desai, Roopal
AU - Stott, Joshua
N1 - Funding Information:
Funding Sources for Dr. Joshua Stott: Alzheimer's Society (AS PG 18 013), NIHR (NIHR130914), Dunhill Medical Trust (RPGF1910\191), ESRC-NIHR (ES/S010467/1).
Funding Information:
This paper represents independent research coordinated by the University of Exeter and King's College London, and is funded in part by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. This research was also supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula and the National Institute for Health Research (NIHR) Exeter Clinical Research Facility. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health.
Publisher Copyright:
© 2022
PY - 2022/7/15
Y1 - 2022/7/15
N2 - 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.
AB - 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.
KW - Affective symptoms
KW - Anxiety
KW - Depression
KW - Heterogeneity
KW - Latent class analysis
KW - Sleep
UR - http://www.scopus.com/inward/record.url?scp=85129463009&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2022.04.139
DO - 10.1016/j.jad.2022.04.139
M3 - Article
C2 - 35490883
AN - SCOPUS:85129463009
SN - 0165-0327
VL - 309
SP - 437
EP - 445
JO - Journal of affective disorders
JF - Journal of affective disorders
ER -
