Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Geriatrics
Published in: BMC Geriatrics 1/2016

Open Access 01-12-2016 | Research article

Mid-life socioeconomic status, depressive symptomatology and general cognitive status among older adults: inter-relationships and temporal effects

Authors: Chi Chiao, Li-Jen Weng

Published in: BMC Geriatrics | Issue 1/2016

Login to get access

Abstract

Background

Few longitudinal studies have analyzed how socioeconomic status (SES) influences both depressive and cognitive development over an individual’s life course. This study investigates the change trajectories of both depressive symptomatology and general cognitive status, as well as their associations over time, focusing on the effects of mid-life SES.

Methods

Data were obtained from the Taiwan Longitudinal Study on Aging (1993–2007), a nationally representative cohort study of older adults in Taiwan. The short form of the Center of Epidemiological Studies-Depression (CES-D) scale that measures depressive symptomatology in two domains (negative affect and lack of positive affect) was used. General cognitive status was assessed using the brief Short Portable Mental Status Questionnaire scale. Assessments of the subjects’ mid-life SES included measurement of the participant’s education and occupation. Analyses were conducted by the parallel latent growth curve modeling.

Results

The participants’ initial levels of depressive symptomatology and general cognitive status were significantly and negatively correlated; furthermore, any changes in these two outcomes were also correlated over time. The initial assessment of general cognitive status significantly contributed to any advancement towards more severe depressive symptomatology over time, particularly when this occurred in a negative manner. Furthermore, a mid-life SES advantage resulted in a significant reduction in late-life depressive symptomatology and also produced a slower decline in general cognitive status during later life. In contrast, lower mid-life SES exacerbated depressive symptomatology during old age, both at the initial assessment and in terms of the change over time. In addition, female gender was significantly associated with lower general cognitive status and more severe depressive symptomatology in negative affect.

Conclusions

These findings suggest a complex and longitudinal association between depressive symptomatology and general cognitive status in later life and this complicated relationship seems to be affected by mid-life SES over time.
Literature
1.
Baune BT, Suslow T, Engelien A, Arolt V. The association between depressive mood and cognitive performance in an elderly general population – The MEMO study. Dement Geriatr Cogn Disord. 2006;22:142–9.CrossRefPubMed
2.
3.
Ganguli M, Du Y, Dodge HH, Ratcliff GG, Chang CC. Depressive symptoms and cognitive decline in late life: a prospective epidemiological study. Arch Gen Psychiatry. 2006;63:153–60.CrossRefPubMed
4.
Lichtenberg PA, Ross T, Millis SR, Manning CA. The relationship between depression and cognition in older adults: A cross-validation study. J Gerontol B Psychol Sci Soc Sci. 1995;50:25–32.CrossRef
5.
Vinkers DJ, Gussekloo J, Stek ML, Westerndrop RG, van der Mast RC. Temporal relation between depression and cognitive impairment in old age: prospective population based study. BMJ. 2004;329:1–4.CrossRef
6.
Yaffe K, Blackwell T, Gore R, Sands L, Reus V, Browner WS. Depressive symptoms and cognitive decline in nondemented elderly women: a prospective study. Arch Gen Psychiatry. 1999;56:425–30.CrossRefPubMed
7.
Gale CR, Allerhand M, Deary IJ, HALCyon Study Team. Is there a bidirectional relationship between depressive symptoms and cognitive ability in older people? A prospective study using the English Longitudinal Study of Ageing. Psychol Med. 2012;42:2057–69.CrossRefPubMedPubMedCentral
8.
Perrino T, Mason CA, Brown SC, Spokane A, Szapocznik J. Longitudinal relationships between cognitive functioning and depressive symptoms among Hispanic older adults. J Gerontol B Psychol Sci Soc Sci. 2008;63:309–17.CrossRef
9.
10.
Cole MG, Dendukuri N. Risk factors for depression among elderly community subjects: a systematic review and meta-analysis. Am J Psychiat. 2003;160:1147–56.CrossRefPubMed
11.
Lorant V, Deliège D, Eaton W, Robert A, Philippot P, Ansseau M. Socioeconomic inequalities in depression: A meta-analysis. Am J Epidemiol. 2003;157:98–112.CrossRefPubMed
12.
O’Shea DM, Fieo RA, Hamilton JL, Zahodne LB, Manly JJ, Stern Y. Examining the association between late-life depressive symptoms, cognitive function, and brain volumes in the context of cognitive reserve. Int J Geriatr Psychiatry. 2014;30(6):614–22.CrossRefPubMedPubMedCentral
13.
Plassman BL, Williams Jr JW, Burke JR, Holsinger T, Benjamin S. Systematic review: factors associated with risk for and possible prevention of cognitive decline in later life. Ann Intern Med. 2010;153:182–93.CrossRefPubMed
14.
Opdebeeck C, Nelis SM, Quinn C, Clare L. How does cognitive reserve impact on the relationships between mood, rumination, and cognitive function in later life? Aging Ment Health. 2015;19(8):705–12.CrossRefPubMed
15.
Antonucci TC, Lansford JE, Akiyama H, Smith J, Baltes MM, Takahashi K, Dartigues JF. Differences between men and women in social relations, resource deficits, and depressive symptomatology during later life in four nations. J Soc Issues. 2002;58:767–83.CrossRef
16.
Christensen H, Hofer SM, Mackinnon AJ, Korten AE, Jorm AF, Henderson AS. Age is no kinder to the better educated: absence of an association investigated using latent growth techniques in a community sample. Psychol Med. 2001;31:15–28.CrossRefPubMed
17.
Finkel D, Reynolds CA, McArdle JJ, Gatz M, Pederson NL. Latent growth curve analyses of accelerating decline in cognitive abilities in late adulthood. Dev Psychol. 2003;39:535–50.CrossRefPubMed
18.
Gerstorf D, Herlitz A, Smith J. Stability of sex differences in cognition in advanced old age: the role of education and attrition. J Gerontol B Psychol Sci Soc Sci. 2006;61:245–9.CrossRef
19.
Singer T, Verhaeghen P, Ghisletta P, Lindenberger U, Baltes PB. The fate of cognition in very old age: six-year longitudinal findings in the Berlin Aging Study (BASE). Psychol Aging. 2003;18:318–31.CrossRefPubMed
20.
Wiggins RD, Erzberger C, Hyde M, Higgs P, Blane D. Optimal matching analysis using ideal types to describe the lifecourse: an illustration of how histories of work, partnerships and housing relate to quality of life in early old age. Int J Soc Res Method. 2007;10:259–78.CrossRef
21.
Blane D. The life course, the social gradient, and health. In: Marmot MG, Wilkinson RG, Brunner E, editors. Social Determinants of Health. New York: Oxford University Press; 2006. p. 54–77.
22.
Kuh D, Ben-Shlomo Y. A life course approach to chronic disease epidemiology. New York: Oxford University Press; 2004.CrossRef
23.
Chen YY, Chiao C, Ksobiech K. The effects of mid-life socioeconomic disadvantage and perceived social support on trajectories of subsequent depressive symptoms among older Taiwanese women. BMC Public Health. 2014;14:384–93.CrossRefPubMedPubMedCentral
24.
Chiao C, Weng LJ, Botticello A. Do older adults become more depressed with age in Taiwan? The role of social position and birth cohort. J Epidemiol Community Health. 2009;63:625–32.CrossRefPubMed
25.
Clarke P, Marshall V, House J, Lantz P. The social structuring of mental health over the adult life course: advancing theory in the sociology of aging. Soc Forces. 2011;89:1287–313.CrossRefPubMedPubMedCentral
26.
Wickrama KK, Mancini JA, Kwag K, Kwon J. Heterogeneity in multidimensional health trajectories of late old years and socioeconomic stratification: a latent trajectory class analysis. J Gerontol B Psychol Sci Soc Sci. 2013;68:290–7.CrossRefPubMed
27.
28.
Hazzouri AZ, Haan MN, Kalbfeisch JD, Galea S, Lisabeth LD, Aiello AE. Life-course socioeconomic position and incidence of dementia and cognitive impairment without dementia in older Mexican Americans: results from the Sacramento Area Latino Study on Aging. Am J Epidemiol. 2011;173:1148–58.CrossRef
29.
Karlamangla AS, Miller-Martinez D, Aneshensel CS, Seeman TE, Wight RG, Chodosh J. Trajectories of cognitive function in late life in the United States: demographic and socioeconomic predictors. Am J Epidemiol. 2009;170:331–42. 29.CrossRefPubMedPubMedCentral
30.
Pearlin LI, Schieman S, Fazio EM, Meersman SC. Stress, health, and the life course: some conceptual perspectives. J Health Soc Behav. 2005;46:205–19.CrossRefPubMed
31.
Wu MS, Lan TH, Chen CM, et al. Socio-demographic and health-related factors associated with cognitive impairment in the elderly in Taiwan. BMC Public Health. 2011;11:22–9.CrossRefPubMedPubMedCentral
32.
Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.CrossRef
33.
Cheng ST, Chan AC. The Center for Epidemiologic Studies Depression Scale in older Chinese: thresholds for long and short forms. Int J Geriatr Psychiatry. 2005;20:465–70.CrossRefPubMed
34.
Edwards MC, Cheavens JS, Heiy JE, Cukrowicz KC. A reexamination of the factor structure of the center for epidemiologic studies depression scale: Is a one-factor model plausible? Psychol Assess. 2010;22:711–5.CrossRefPubMedPubMedCentral
35.
Lee KL, Ou YL, Chen SH, Weng LJ. The psychometric properties of a short form of the CES-D used in the Taiwan longitudinal study on aging. J Formos Ment Health. 2009;22:383–410.
36.
Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975;10:433–41.CrossRef
37.
Glei DA, Landau DA, Goldman N, et al. Participating in social activities helps preserve cognitive function: an analysis of a longitudinal, population-based study of the elderly. Int J Epidemiol. 2005;34:864–71.CrossRefPubMed
38.
Katzman R, Zhang M, Qu OU, et al. A Chinese version of the Mini-Mental state examination: impact of illiteracy in a Shanghai dementia survey. J Clin Epidemiol. 1988;41:971–8.CrossRefPubMed
39.
Salmon DP, Riekkinen PJ, Katzman R, Zhang M, Jih H, Yu E. A comparison of Mini-Mental state examination performance in Finland and China. Arch Neurol. 1989;46:769–72.CrossRefPubMed
40.
Zhang M, Katzman R, Salmon D, et al. The prevalence of dementia and Alzheimer’s disease in Shanghai, China: impact of age, gender and education. Ann Neurol. 1990;27:428–37.CrossRefPubMed
41.
Elstad JI, Krokstad S. Social causation, health-selective mobility, and the reproduction of socioeconomic health inequalities over time: panel study of adult men. Soc Sci Med. 2003;57:1475–89.CrossRefPubMed
42.
Muthén LK, Muthén BO. Mplus user’s guide. 4th ed. Los Angeles: Muthén & Muthén; 2006.
43.
Preacher KJ, Wichman AL, MacCallum RC, Briggs NE. Latent growth curve modeling. Thousand Oaks: Sage Publication; 2008.
44.
Chen R, Hu Z, Wei L, Qin X, Copeland JR. Is the relationship between syndromes of depression and dementia temporal? The MRC-ALPHA and Hefei-China studies. Psychol Med. 2009;39:425–30.CrossRefPubMed
45.
Luppa M, Sikorski C, Luck T, Ehreke L, Konnopka A, Wiese B, König HH, Riedel-Heller SG. Age- and gender-specific prevalence of depression in latest-life – Systematic review and meta-analysis. J Affect Disord. 2012;136:212–21.CrossRefPubMed
46.
Ferreira L, Santos RFG, Ferri CP, Galduroz J. Rate of cognitive decline in relation to sex after 60 years-of-age: A systematic review. Geriatr Gerontol Int. 2014;14:23–31.CrossRefPubMed
47.
Bassuk SS, Berkman LF, Wypij D. Depressive symptomatology and incident cognitive decline in an elderly community sample. Arch Gen Psychiatry. 1998;55:1073–81.CrossRefPubMed
48.
Chen R, Hu Z, Wei L, Qin X, McCracken C, Copeland JR. Severity of depression and risk for subsequent dementia: cohort studies in China and the UK. Br J Psychiatry. 2008;193:373–7.CrossRefPubMed
49.
Chodosh J, Miller-Martinez D, Aneshensel CS, Richard GW, Karlamangla AS. Depressive symptoms, chronic diseases, and physical disabilities as predictors of cognitive functioning trajectories in older Americans. J Am Geriatr Soc. 2010;58:2350–7.CrossRefPubMedPubMedCentral
50.
Royall DR, Palmer RF. Alzheimer’s disease pathology does not mediate the association between depressive symptoms and subsequent cognitive decline. Alz Dis & Dementia. 2013;9:318–25.CrossRef
51.
52.
Stansfeld SA, Clark C, Rodgers B, Caldwell T, Power C. Repeated exposure to socioeconomic disadvantage and health selection as life course pathways to mid-life depressive and anxiety disorders. Soc Psych Psych Epidemol. 2011;46:549–58.CrossRef
53.
Sapolsky RM. Glucocorticoids, stress, and their adverse neurological effects: relevance to aging. Exp Gerontol. 1999;34:721–32.CrossRefPubMed
54.
Shea M, Wong YJ. Femininity and women’s psychological well-being. In: Lundberg-Love PK, Nadal KL, Paludi MA, editors. Women and Mental Disorders, vol. 1. Santa Barbara: Praeger; 2011. p. 17–35.
Metadata
Title
Mid-life socioeconomic status, depressive symptomatology and general cognitive status among older adults: inter-relationships and temporal effects
Authors
Chi Chiao
Li-Jen Weng
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2016
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-016-0257-7

Other articles of this Issue 1/2016

BMC Geriatrics 1/2016 Go to the issue

Research article

The effects of a life goal-setting technique in a preventive care program for frail community-dwelling older people: a cluster nonrandomized controlled trial

Research article

How the perspectives of nursing assistants and frail elderly residents on their daily interaction in nursing homes affect their interaction: a qualitative study

Research article

Effect of diabetes on caregiver burden in an observational study of individuals with Alzheimer’s disease

Research article

Predicting the role of assistive technologies in the lives of people with dementia using objective care recipient factors

Research article

A review of the implementation and research strategies of advance care planning in nursing homes

Research article

Baseline participation in a health examination survey of the population 65 years and older: who is missed and why?

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits