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Late-Life Depression and Cognitive Decline: A Latent Growth Curve Modeling Analysis
Başlık:
Late-Life Depression and Cognitive Decline: A Latent Growth Curve Modeling Analysis
Yazar:
Tsoy, Elena, author.
ISBN:
9780438003590
Yazar Ek Girişi:
Fiziksel Tanımlama:
1 electronic resource (120 pages)
Genel Not:
Source: Dissertation Abstracts International, Volume: 79-10(E), Section: B.
Advisors: Boaz Levy Committee members: Takuya Minami; Paul Nestor.
Özet:
This study investigated the longitudinal causal relationships among depressive symptoms, cognitive functioning, and daily functional ability in older adults by means of a mediational analysis with latent growth curves. Two major hypotheses derived from the literature were investigated: risk factor hypothesis postulating that late-life depressive symptoms represent a risk factor for progressive decline in cognitive and daily functioning, and comorbidity hypothesis proposing that late-life depressive symptoms accompany and/or result from cognitive and functional decline.
The design of the study was a secondary data analysis from an ongoing longitudinal multicenter study, Alzheimer's Disease Neuroimaging Initiative (ADNI). The final sample used for the analysis was comprised on 690 participants (age: 73.6 +/- 7.02, education: 16.09 +/- 2.77). The analyses employed a stepwise procedure: first, first-order latent growth curves were modeled for each variable, then second-order models were analyzed for higher level latent constructs, and finally a full mediational analysis with first- and second-order latent growth curves was performed.
Results indicated a good fit for both the risk factor hypothesis (chi 2(df) = 919.79(352), p < .001, RMSEA = .048, CFI = .950, TLI = .944) and the comorbidity hypothesis (chi2(df) = 886.84(309), p < .001, RMSEA = .052, CFI = .966, TLI = .962). Significant indirect effect of depression on functional decline via executive functioning was found in the risk factor model (est. = .08, p < .001). An indirect effect of memory on functional ability via increased depression was also significant (est. = --.02, p < .05). The models controlled for the confounding variables of age, sex, educational level, and APOE status. Positive APOE status was significantly associated with greater functional impairment.
The limitations of the current study included limited generalizability to populations different from the ADNI cohort, invariability constraints, and limited number of observed variables for inclusion into latent constructs.
Our findings identified two distinguishable pathways, which deepen the understanding of the nature of longitudinal associations among affective symptoms, cognitive ability, and functional impairment in older adults. Regardless of whether late-life depression precedes or follows the onset of cognitive symptoms, it was found that its effect on the affected individual's daily functioning was substantial. Implications for clinical practice and future studies were discussed.
Notlar:
School code: 1074
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Yer Numarası | Demirbaş Numarası | Shelf Location | Lokasyon / Statüsü / İade Tarihi |
---|---|---|---|
XX(678887.1) | 678887-1001 | Proquest E-Tez Koleksiyonu | Arıyor... |
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