Psychology Research and Behavior Management (Jan 2024)
Distress Symptoms of Old Age and Mild Cognitive Impairment are Two Distinct Dimensions in Older Adults Without Major Depression
Abstract
Vinh-Long Tran-Chi,1,2,* Michael Maes,3– 9,* Gallayaporn Nantachai,2,10 Solaphat Hemrungrojn,2,9 Marco Solmi,11– 14 Chavit Tunvirachaisakul2,8 1Ph.D. Program in Clinical Sciences, School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 2Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 3Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China; 4Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, People’s Republic of China; 5Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria; 6Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria; 7Kyung Hee University, Dongdaemun-gu, Seoul, South Korea; 8Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 9Cognitive Fitness and Biopsychiatry Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 10Somdet Phra Sungharaj Nyanasumvara Geriatric Hospital, Department of Medical Services, Ministry of Public Health, Chon Buri Province, Thailand; 11Department of Psychiatry, University of Ottawa, Ontario, Canada; 12Regional Centre for the Treatment of Eating Disorders and on Track, The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada; 13Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, Ontario, Canada; 14Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany*These authors contributed equally to this workCorrespondence: Michael Maes, Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, People’s Republic of China, Email [email protected] Chavit Tunvirachaisakul, Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand, Email [email protected]: Studies in old adults showed bidirectional interconnections between amnestic mild cognitive impairment (aMCI) and affective symptoms and that adverse childhood experiences (ACE) may affect both factors. Nevertheless, these associations may be confined to older adults with clinical depression.Aim: To delineate the relationship between clinical symptoms of aMCI and affective symptoms in older adults without major depression (MDD) or dysfunctions in activities of daily living (ADL).Methods: This case-control study recruited 61 participants with aMCI (diagnosed using Petersen’s criteria) and 59 older adults without aMCI and excluded subjects with MDD and ADL dysfunctions.Results: We uncovered 2 distinct dimensions, namely distress symptoms of old age (DSOA), comprising affective symptoms, perceived stress and neuroticism, and mild cognitive dysfunctions, comprising episodic memory test scores, the total Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. A large part of the variance (37.9%) in DSOA scores was explained by ACE, negative life events (health and financial problems), a subjective feeling of cognitive decline, and education (all positively). ACE and NLE have a highly significant impact on the DSOA score and are not associated with aMCI or its severity. Cluster analysis showed that the diagnosis of aMCI is overinclusive because some subjects with DSOA symptoms may be incorrectly classified as aMCI.Conclusion: The clinical impact is that clinicians should carefully screen older adults for DSOA after excluding MDD. DSOA might be misinterpreted as aMCI.Keywords: depression, adverse childhood experiences, mild cognitive impairments, affective disorders, negative life events, neurocognitive deficits
