Cognitive performance in depression in low- and middle-income countries: A systematic review with meta-analytic components

Pauline Thibaut; Rukudzo Mwamuka; Primrose Nyamayaro; Leah H. Rubin; Noeline Nakasujja; Scott Langenecker; Melanie Abas

doi:10.1016/j.jad.2023.09.007

Cognitive performance in depression in low- and middle-income countries: A systematic review with meta-analytic components

Pauline Thibaut^*, Rukudzo Mwamuka, Primrose Nyamayaro, Leah H. Rubin, Noeline Nakasujja, Scott Langenecker, Melanie Abas

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

1 Citation (Scopus)

Abstract

Background: Depression is highly prevalent in low- and middle- income countries (LMIC) and associated with significant cognitive dysfunction across multiple domains. However, little is known about neurocognitive tests used in people with depression in LMIC. We aimed to investigate cognitive performance and cognitive tests in depression research in LMIC. Methods: APA PsycInfo, Embase, Ovid MEDLINE, and Global Health were systematically searched for studies that implemented a cognitive performance test in a depressed, LMIC population. Tool quality was assessed using an adapted scale for quality of measures in cross-cultural settings. Data extracted included demographics, depression and cognitive performance measures, and cognitive performance comparisons between depression and control groups. Results: 29 studies met eligibility criteria, involving a total of 19,100 participants from 11 LMIC. 93.1 % of studies were conducted in upper middle-income countries. 67 cognitive performance tools were implemented. Reliability was reported for 5.6 % of cognitive performance tests and validity was reported for 8.3 %. 36.1 % of tests used were culturally adapted. 75.9 % of included studies implemented at least one memory test. Cognitive deficits were observed in all depressed groups, especially in memory (Cohen's d = −1.60, 95 % CI -2.02 to −1.18). Limitations: Heterogeneity between studies; averaged results across memory subtypes; no assessment of depression severity and cognitive deficits associations; restrictive search terms. Conclusions: Cognitive impairments in depression, especially in memory, are prevalent in LMIC. This research has drawn attention to the burden of cognitive dysfunction in depression in LMIC, and to the disparate research gap in LMIC. PROSPERO registration CRD42022315397.

Original language	English
Pages (from-to)	16-32
Number of pages	17
Journal	Journal of Affective Disorders
Volume	342
DOIs	https://doi.org/10.1016/j.jad.2023.09.007
Publication status	Published - 1 Dec 2023

Keywords

Cognitive impairment
Cognitive performance measures
Low- and middle- income countries
Major depressive disorder

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jad.2023.09.007

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title = "Cognitive performance in depression in low- and middle-income countries: A systematic review with meta-analytic components",

abstract = "Background: Depression is highly prevalent in low- and middle- income countries (LMIC) and associated with significant cognitive dysfunction across multiple domains. However, little is known about neurocognitive tests used in people with depression in LMIC. We aimed to investigate cognitive performance and cognitive tests in depression research in LMIC. Methods: APA PsycInfo, Embase, Ovid MEDLINE, and Global Health were systematically searched for studies that implemented a cognitive performance test in a depressed, LMIC population. Tool quality was assessed using an adapted scale for quality of measures in cross-cultural settings. Data extracted included demographics, depression and cognitive performance measures, and cognitive performance comparisons between depression and control groups. Results: 29 studies met eligibility criteria, involving a total of 19,100 participants from 11 LMIC. 93.1 % of studies were conducted in upper middle-income countries. 67 cognitive performance tools were implemented. Reliability was reported for 5.6 % of cognitive performance tests and validity was reported for 8.3 %. 36.1 % of tests used were culturally adapted. 75.9 % of included studies implemented at least one memory test. Cognitive deficits were observed in all depressed groups, especially in memory (Cohen's d = −1.60, 95 % CI -2.02 to −1.18). Limitations: Heterogeneity between studies; averaged results across memory subtypes; no assessment of depression severity and cognitive deficits associations; restrictive search terms. Conclusions: Cognitive impairments in depression, especially in memory, are prevalent in LMIC. This research has drawn attention to the burden of cognitive dysfunction in depression in LMIC, and to the disparate research gap in LMIC. PROSPERO registration CRD42022315397.",

keywords = "Cognitive impairment, Cognitive performance measures, Low- and middle- income countries, Major depressive disorder",

author = "Pauline Thibaut and Rukudzo Mwamuka and Primrose Nyamayaro and Rubin, {Leah H.} and Noeline Nakasujja and Scott Langenecker and Melanie Abas",

note = "Publisher Copyright: {\textcopyright} 2023 The Authors",

year = "2023",

month = dec,

day = "1",

doi = "10.1016/j.jad.2023.09.007",

language = "English",

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T1 - Cognitive performance in depression in low- and middle-income countries

T2 - A systematic review with meta-analytic components

AU - Thibaut, Pauline

AU - Mwamuka, Rukudzo

AU - Nyamayaro, Primrose

AU - Rubin, Leah H.

AU - Nakasujja, Noeline

AU - Langenecker, Scott

AU - Abas, Melanie

PY - 2023/12/1

Y1 - 2023/12/1

N2 - Background: Depression is highly prevalent in low- and middle- income countries (LMIC) and associated with significant cognitive dysfunction across multiple domains. However, little is known about neurocognitive tests used in people with depression in LMIC. We aimed to investigate cognitive performance and cognitive tests in depression research in LMIC. Methods: APA PsycInfo, Embase, Ovid MEDLINE, and Global Health were systematically searched for studies that implemented a cognitive performance test in a depressed, LMIC population. Tool quality was assessed using an adapted scale for quality of measures in cross-cultural settings. Data extracted included demographics, depression and cognitive performance measures, and cognitive performance comparisons between depression and control groups. Results: 29 studies met eligibility criteria, involving a total of 19,100 participants from 11 LMIC. 93.1 % of studies were conducted in upper middle-income countries. 67 cognitive performance tools were implemented. Reliability was reported for 5.6 % of cognitive performance tests and validity was reported for 8.3 %. 36.1 % of tests used were culturally adapted. 75.9 % of included studies implemented at least one memory test. Cognitive deficits were observed in all depressed groups, especially in memory (Cohen's d = −1.60, 95 % CI -2.02 to −1.18). Limitations: Heterogeneity between studies; averaged results across memory subtypes; no assessment of depression severity and cognitive deficits associations; restrictive search terms. Conclusions: Cognitive impairments in depression, especially in memory, are prevalent in LMIC. This research has drawn attention to the burden of cognitive dysfunction in depression in LMIC, and to the disparate research gap in LMIC. PROSPERO registration CRD42022315397.

AB - Background: Depression is highly prevalent in low- and middle- income countries (LMIC) and associated with significant cognitive dysfunction across multiple domains. However, little is known about neurocognitive tests used in people with depression in LMIC. We aimed to investigate cognitive performance and cognitive tests in depression research in LMIC. Methods: APA PsycInfo, Embase, Ovid MEDLINE, and Global Health were systematically searched for studies that implemented a cognitive performance test in a depressed, LMIC population. Tool quality was assessed using an adapted scale for quality of measures in cross-cultural settings. Data extracted included demographics, depression and cognitive performance measures, and cognitive performance comparisons between depression and control groups. Results: 29 studies met eligibility criteria, involving a total of 19,100 participants from 11 LMIC. 93.1 % of studies were conducted in upper middle-income countries. 67 cognitive performance tools were implemented. Reliability was reported for 5.6 % of cognitive performance tests and validity was reported for 8.3 %. 36.1 % of tests used were culturally adapted. 75.9 % of included studies implemented at least one memory test. Cognitive deficits were observed in all depressed groups, especially in memory (Cohen's d = −1.60, 95 % CI -2.02 to −1.18). Limitations: Heterogeneity between studies; averaged results across memory subtypes; no assessment of depression severity and cognitive deficits associations; restrictive search terms. Conclusions: Cognitive impairments in depression, especially in memory, are prevalent in LMIC. This research has drawn attention to the burden of cognitive dysfunction in depression in LMIC, and to the disparate research gap in LMIC. PROSPERO registration CRD42022315397.

KW - Cognitive impairment

KW - Cognitive performance measures

KW - Low- and middle- income countries

KW - Major depressive disorder

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DO - 10.1016/j.jad.2023.09.007

M3 - Review article

C2 - 37690541

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SN - 0165-0327

VL - 342

SP - 16

EP - 32

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -

Cognitive performance in depression in low- and middle-income countries: A systematic review with meta-analytic components

Abstract

Keywords

UN SDGs

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