Affective problems and decline in cognitive state in older adults: a systematic review and meta-analysis

Evidence suggests that affective problems, such as depression and anxiety, increase risk for late-life dementia. However, the extent to which affective problems influence cognitive decline, even many years prior to clinical diagnosis of dementia, is not clear. The present study systematically reviews and synthesises the evidence for the association between affective problems and decline in cognitive state (i.e. decline in non-specific cognitive function) in older adults. An electronic search of PubMed, PsycInfo and ScienceDirect was conducted to identify studies of the association between depression and anxiety separately and decline in cognitive state. Key inclusion criteria were prospective, longitudinal designs with a minimum follow-up period of one year. Data extraction and methodological quality assessment using the STROBE checklist were conducted independently by two raters. A total of 34 studies (n=71,244) met eligibility criteria, with 32 studies measuring depression (n=68,793), and 5 measuring anxiety (n=4,698). A multi-level meta-analysis revealed that depression assessed as a binary predictor (OR=1.36, 95% CIs: 1.05-1.76, p=.02) or a continuous predictor (B=-0.008, 95% CIs: -0.015, -0.002, p=.012; OR=0.992, 95% CIs: 0.985-0.998) was significantly associated with decline in cognitive state. The number of anxiety studies were insufficient for meta-analysis and are instead described in a narrative review. Results of the present study improve current understanding of the temporal nature of the association between affective problems and decline in cognitive state. They also suggest that cognitive function need to be monitored closely in individuals with affective disorders, as these individuals may be at a particular risk of greater cognitive decline

Psychometric precision in phenotype definition is a useful step in molecular genetic investigation of psychiatric disorders.

Affective disorders are highly heritable, but few genetic risk variants have been consistently replicated in molecular genetic association studies. The common method of defining psychiatric phenotypes in molecular genetic research is either a summation of symptom scores or binary threshold score representing the risk of diagnosis. Psychometric latent variable methods can improve the precision of psychiatric phenotypes, especially when the data structure is not straightforward. Using data from the British 1946 birth cohort, we compared summary scores with psychometric modeling based on the General Health Questionnaire (GHQ-28) scale for affective symptoms in an association analysis of 27 candidate genes (249 single-nucleotide polymorphisms (SNPs)). The psychometric method utilized a bi-factor model that partitioned the phenotype variances into five orthogonal latent variable factors, in accordance with the multidimensional data structure of the GHQ-28 involving somatic, social, anxiety and depression domains. Results showed that, compared with the summation approach, the affective symptoms defined by the bi-factor psychometric model had a higher number of associated SNPs of larger effect sizes. These results suggest that psychometrically defined mental health phenotypes can reflect the dimensions of complex phenotypes better than summation scores, and therefore offer a useful approach in genetic association investigations.This work was supported by the Wellcome Trust [088869/Z/09/Z to M.R., P.B.J., D.G, and T. J. C,]; Medical Research Council [MC_UU_12019/1 and MC_UU_12019/3 to A.W, D.G., M.R]. Dr. Barnett is an employee of Cambridge Cognition, Ltd. This work forms part of the NIHR CLAHRC EoE that PBJ directs and the NIHR Cambridge Biomedical Research Centre.This is the author accepted manuscript. It is currently under an indefinite embargo pending publication by NPG

Bidirectional relation between affective symptoms and cognitive function from middle to late adulthood: a population-based birth cohort study

Objectives: There is an association between affective symptoms and cognition. However, the direction of this association remains unclear. This study aimed to test bidirectional relationships between affective symptoms and cognition from middle to late adulthood.Method: Data were available from the MRC National Survey of Health and Development (NSHD), a prospective birth cohort of 5362 people born in 1946. Affective symptoms and cognition were measured at ages 53, 60-64, and 69. Latent scores of affective symptoms were derived and cross-lagged models were fitted for affective symptoms with verbal memory and processing speed. Results: Results revealed an inverse cross-sectional association between affective symptoms and verbal memory (β=-0.18, SE=0.04, p<.001) and processing speed (β=-0.13, SE=0.06, p=.05) at age 53, but not at ages 60-64 or 69. Affective symptoms at age 53 predicted lower verbal memory at age 60-64 (β=-0.58, SE=0.27, p=.03), and affective symptoms at age 60-64 predicted lower verbal memory (β=-0.64, SE=0.29, p=.03) and processing speed (β=-1.27, SE=0.41, p=.002) at age 69. Verbal memory and processing speed did not predict subsequent affective symptoms.Conclusion: Affective symptoms predict poorer verbal memory and processing speed over a period of 16 years, but not vice versa

Research Review: Childhood chronic physical illness and adult emotional health - a systematic review and meta-analysis

Background Childhood chronic physical illness is associated with a greater vulnerability for emotional problems (i.e. depression and anxiety) in childhood. However, little is known about life‐long effects of childhood chronic physical illness on mental health. The present study aims to systematically review evidence for associations between eight chronic physical illnesses with childhood onset (arthritis, asthma, cancer, chronic renal failure, congenital heart disease, cystic fibrosis, type 1 diabetes, and epilepsy) and adult emotional problems. Methods A database search of MEDLINE, PsycARTICLES, PsycINFO, and ScienceDirect was undertaken, and random effects meta‐analyses were used to synthesise evidence from eligible studies. Results In total, 37 studies were eligible for the systematic review (n = 45,733) and of these, 34 studies were included in the meta‐analyses (n = 45,358). There were overall associations between childhood chronic physical illness and adult depression (OR = 1.31; 95% CI [1.12, 1.54]) and anxiety (OR = 1.47; 95% CI [1.13, 1.92]). Separate meta‐analyses for childhood asthma, type 1 diabetes and cancer were also conducted, with cancer being significantly associated with adult depression (OR = 1.19; 95% CI [1.00, 1.42]). Conclusions The effects of childhood chronic physical illness on the risk of emotional problems persist beyond childhood and adolescence. Mental health prevention and intervention strategies targeting children with chronic physical illnesses can have long‐term benefits

Including quaternary ammonium compounds in the composition of silers based on epoxy resins. literature review

The literature review presents the experience of introducing quaternary ammonium compounds into sealers based on epoxy resin - AH-Plus, AH26. Antibacterial effect of endo-sealants modified by the substances most common in dentistry of this class are consideredВ литературном обзоре представлен опыт введения четвертичных аммониевых соединений в состав силеров на основе эпоксидной смолы. Рассмотрен антибактериальный эффект эндогерметиков, модифицированных наиболее распространенными в стоматологии представителями данного класса вещест

Literature review: influence of an insufficient quantity of vitamins on the development of diseases of the hard tooth tissues, oral mucosa and parodentium

A lack of vitamins in the human body leads to the development of metabolic processes disrupt and the reactivity of the body decreases. In the initial stages of hypovitaminosis, symptoms manifest as structural and functional disruptions of cells and tissues of the oral cavity`s organs. The article presents relevant data on the mechanisms of action of vitamins in the structure of the organs of the oral cavity and the development of pathological processes in case of hypovitaminosisНедостаток витаминов в организме человека приводит к нарушению обменных процессов и понижению реактивности организма в целом. Симптомы гиповитаминоза на начальных этапах развития проявляются в виде нарушений структуры и функционирования клеток и тканей органов полости рта. В статье приведены актуальные данные о механизмах действия витаминов в структурах органов полости рта и развитии патологических процессов при гиповитаминоза

Lifetime affective problems and later-life cognitive state: over 50 years of follow-up in a British Birth Cohort Study

BACKGROUND: Affective problems increase the risk of dementia and cognitive impairment, yet the life course dimension of this association is not clearly understood. We aimed to investigate how affective problems across the life course relate to later-life cognitive state. METHODS: Data from 1269 participants from the Medical Research Council National Survey of Health and Development (NSHD, the British 1946 birth cohort) were used. Prospectively-assessed measures of affective symptoms spanning ages 13-69 were used and categorised into case-level thresholds. Outcomes consisted of a comprehensive measure of cognitive state (Addenbrooke's Cognitive Examination (ACE-III)), verbal memory, and letter search speed and accuracy at age 69. RESULTS: Complementary life course models demonstrated that having 2 or more case-level problems across the life course was most strongly associated with poorer cognitive outcomes, before and after adjusting for sex, childhood cognition, childhood and midlife occupational position and education. LIMITATIONS: A disproportionate loss to follow-up of those who had lower childhood cognitive scores may have led to underestimation of the strength of associations. DISCUSSION: Using a population-based prospective study we provide evidence that recurrent lifetime affective problems predicts poorer later-life cognitive state, and this risk can be already manifest in early old age (age 69). Our findings raise the possibility that effective management to minimise affective problems reoccurring across the life course may reduce the associated risk of cognitive impairment and decline

Ecological features of cyanobacteria and algae communities of the littoral of the meromictic Lake Shira (Khakassia Republic, Russia)

During the study of cyanobacteria and algae from littoral of the meromictic Lake Shira (Republic of Khakas- sia, Russia) forty-eight taxa were identified: Cyanobacteria – 7, Chlorophyta – 5, and Bacillariophyta – 36 species. Cyanobacteria were represented by cosmopolitan taxa Leptolyngbya voronichiniana, cf. Trichocoleus hospitus and widely distributed in the freshwater ecosystems species Phormidium cf. paulsenianum, Pseudophormidium cf. golenkinianum, P. pauciramosum, Leptolyngbya perforans, and L. subtilissima. Among green algae typical freshwater taxa Chloroidium saccharophilum, Desmodesmus abundans, Oocystis lacustris, Chlorella sp., Stigeoclonium sp. were detected. Among Bacillariophyta the most frequent species were Amphora ovalis, Cymbella affinis, Encyonema silesiacum, Eunotia fallax, Gomphonella olivacea, G. parvulum, Kobayasiella subtilissima, Navicula minima, N. radiosa, N. veneta, Nitzchia fonti- cola, N. palea, Grunowia tabellaria, Surirella undulata. Several rare species cf. Fragilaria tenera, Grunowia tabellaria and cf. Ulnaria capitata were found. In relation to mineralization indifferents was the largest group (73%). In relation to pH, a unique feature of the investigated lake was the predominance of alkaliphilic species of diatoms (56%), such as Amphora ovalis, Cymbella affinis, Gomphonema truncatum, Hantzschia amphioxys, Navicula minima, N. veneta, Nitzschia cf. linearis, N. palea, Planothidium lanceolatum and other. In the geographic structure cosmopolitan group included 25 species (69%), boreal group – 4 species (11%), arcto-apline group – 2 species (6%). To obtain more accurate informa- tion on the biodiversity of cyanobacteria and algae of Lake Shira further studies using molecular-genetic and electron microscopic methods are needed

Pathogenetic therapy of multiple sclerosis

Relevance. Multiple sclerosis is accompanied by rapid progression of the disease, the development of early disability and a violation of the patient's quality of life. In recent years, advances in understanding the etiology and pathogenesis of this disease have led to the expansion of therapeutic approaches, it has become possible to influence the course of the disease. Objective - to study the effectiveness of the use of drugs that change the course of multiple sclerosis in patients registered at the center of multiple sclerosis of the Udmurt Republic.Materials and methods. The statistical analysis was performed on 45 patients of the neurological department of the "First Republican Clinical Hospital" of the Ministry of Health of the Udmurt Republic, diagnosed with multiple sclerosis, using immunomodulatory or immunosuppressive therapy.Results. At the beginning of the study, the group of patients using immunomodulatory therapy included 31 patients (68.89 %), the group of immunosuppressors -14 patients (31.11 %). The average time from the onset of the disease to the start of therapy was 1.64 ± 5.71 months. 42 patients (93.33 %) out of 45 included in the study started therapy with an immunomodulator. The average time from the start of therapy to inclusion in the study was 113.00 ± 47.52 months in the immunomodulatory therapy group. 11 patients (78.57 %) out of 14 taking immunosuppressive therapy at the start of the study switched to it after previous immunomodulatory therapy. 3 patients (6.67 %) out of 45 included in the study started treatment with immunosuppressive therapy. In the immunosuppressive therapy group, the duration of treatment was 62.57 ± 74.52 months. Progression of the disease from the moment of initiation of therapy to inclusion in the study was observed in 19 patients - 42.22 %. An increase in the EDSS index was recorded by an average of 1.82 ± 0.31 points. Improvement of clinical condition was observed in 6 patients - 13.33 %. A decrease in the EDSS index was recorded by an average of 0.91 ± 0.22 points. The difference in the EDSS index in the groups of immunomodulators and immunosuppressors is insignificant. There was no dependence of the patient's clinical condition on the number and activity of foci of demyelination.Conclusions. The objective clinical condition of the patient has no significant difference in the groups of immunomodulatory and immunosuppressive therapy, which suggests that the correct selection of a particular drug by the attending physician and its constant use by the patient is important in order to reduce the risks of complications, slow down the progression of the disease and preserve the quality of life of the patient