Depressive symptoms in Chinese-American subjects with cognitive impairment

Steven Z. Chao, Brandy Matthews, Jennifer S. Yokoyama, Ngan Betty Lai, Hilary Ong, Marian Tse, Runfen Frances Yuan, Amy Lin, Joel Kramer, Kristine Yaffe, John Kornak, Bruce L. Miller, Howard J. Rosen

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objectives: To compare the prevalence of depressive symptoms and frequency of antidepressant use between a group of elderly Chinese-American subjects with and without cognitive impairment and a group of matched white subjects. A secondary aim was to examine the clinical and demographic predictors of depressive symptoms across these groups. Methods: The study was conducted at an academic neurology subspecialty clinic. This was a caseecontrol study with 140 Chinese-American subjects and 140 demographically and cognitively matched white subjects. In each group, there were 48 cognitively normal and 92 cognitively impaired participants (49 with mild cognitive impairment, 43 with Alzheimer disease). The proportion of individuals with significant depressive symptoms, as indicated by a Geriatric Depression Scale score ≥6 of 15, and frequency of antidepressant use were compared across groups by using Χ2 analysis. Factors predicting depressive symptoms, including racial and diagnostic group, age, gender, Mini-Mental State Examination score, level of functional impairment, education level, and medical comorbidities, were assessed by using linear regression analysis. Results: Significant depressive symptoms were more common in cognitively impaired Chinese-American (35%) than cognitively impaired white (15%; Χ2[1] = 9.4; p = 0.004) subjects. Chinese-American subjects with cognitive impairment were less likely to be receiving treatment for depression (12%) than white subjects with cognitive impairment (37%; Χ2[1] = 15.6; p = 0.002). Racial and diagnostic group, age, level of functional impairment, Mini-Mental State Examination score, and education level were all statistically significant independent predictors of Geriatric Depression Scale score. Conclusions: Elderly Chinese- American subjects with cognitive impairment are at increased risk for unrecognized and untreated depressive symptoms compared with elderly white subjects with cognitive impairment. Education level may contribute to this risk or it may be a surrogate marker for other factors contributing to depressive symptoms in this group.

Original languageEnglish
Pages (from-to)642-652
Number of pages11
JournalAmerican Journal of Geriatric Psychiatry
Volume22
Issue number7
DOIs
StatePublished - 2014

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Asian Americans
Depression
Geriatrics
Antidepressive Agents
Age Groups
Cognitive Dysfunction
Education
Neurology
Medical Education
Comorbidity
Linear Models
Alzheimer Disease
Research Design
Biomarkers
Regression Analysis
Demography

Keywords

  • Chinese American
  • Dementia
  • Geriatric depression

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology

Cite this

Depressive symptoms in Chinese-American subjects with cognitive impairment. / Chao, Steven Z.; Matthews, Brandy; Yokoyama, Jennifer S.; Lai, Ngan Betty; Ong, Hilary; Tse, Marian; Yuan, Runfen Frances; Lin, Amy; Kramer, Joel; Yaffe, Kristine; Kornak, John; Miller, Bruce L.; Rosen, Howard J.

In: American Journal of Geriatric Psychiatry, Vol. 22, No. 7, 2014, p. 642-652.

Research output: Contribution to journalArticle

Chao, SZ, Matthews, B, Yokoyama, JS, Lai, NB, Ong, H, Tse, M, Yuan, RF, Lin, A, Kramer, J, Yaffe, K, Kornak, J, Miller, BL & Rosen, HJ 2014, 'Depressive symptoms in Chinese-American subjects with cognitive impairment', American Journal of Geriatric Psychiatry, vol. 22, no. 7, pp. 642-652. https://doi.org/10.1016/j.jagp.2012.10.029
Chao, Steven Z. ; Matthews, Brandy ; Yokoyama, Jennifer S. ; Lai, Ngan Betty ; Ong, Hilary ; Tse, Marian ; Yuan, Runfen Frances ; Lin, Amy ; Kramer, Joel ; Yaffe, Kristine ; Kornak, John ; Miller, Bruce L. ; Rosen, Howard J. / Depressive symptoms in Chinese-American subjects with cognitive impairment. In: American Journal of Geriatric Psychiatry. 2014 ; Vol. 22, No. 7. pp. 642-652.
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abstract = "Objectives: To compare the prevalence of depressive symptoms and frequency of antidepressant use between a group of elderly Chinese-American subjects with and without cognitive impairment and a group of matched white subjects. A secondary aim was to examine the clinical and demographic predictors of depressive symptoms across these groups. Methods: The study was conducted at an academic neurology subspecialty clinic. This was a caseecontrol study with 140 Chinese-American subjects and 140 demographically and cognitively matched white subjects. In each group, there were 48 cognitively normal and 92 cognitively impaired participants (49 with mild cognitive impairment, 43 with Alzheimer disease). The proportion of individuals with significant depressive symptoms, as indicated by a Geriatric Depression Scale score ≥6 of 15, and frequency of antidepressant use were compared across groups by using Χ2 analysis. Factors predicting depressive symptoms, including racial and diagnostic group, age, gender, Mini-Mental State Examination score, level of functional impairment, education level, and medical comorbidities, were assessed by using linear regression analysis. Results: Significant depressive symptoms were more common in cognitively impaired Chinese-American (35{\%}) than cognitively impaired white (15{\%}; Χ2[1] = 9.4; p = 0.004) subjects. Chinese-American subjects with cognitive impairment were less likely to be receiving treatment for depression (12{\%}) than white subjects with cognitive impairment (37{\%}; Χ2[1] = 15.6; p = 0.002). Racial and diagnostic group, age, level of functional impairment, Mini-Mental State Examination score, and education level were all statistically significant independent predictors of Geriatric Depression Scale score. Conclusions: Elderly Chinese- American subjects with cognitive impairment are at increased risk for unrecognized and untreated depressive symptoms compared with elderly white subjects with cognitive impairment. Education level may contribute to this risk or it may be a surrogate marker for other factors contributing to depressive symptoms in this group.",
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AU - Chao, Steven Z.

AU - Matthews, Brandy

AU - Yokoyama, Jennifer S.

AU - Lai, Ngan Betty

AU - Ong, Hilary

AU - Tse, Marian

AU - Yuan, Runfen Frances

AU - Lin, Amy

AU - Kramer, Joel

AU - Yaffe, Kristine

AU - Kornak, John

AU - Miller, Bruce L.

AU - Rosen, Howard J.

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N2 - Objectives: To compare the prevalence of depressive symptoms and frequency of antidepressant use between a group of elderly Chinese-American subjects with and without cognitive impairment and a group of matched white subjects. A secondary aim was to examine the clinical and demographic predictors of depressive symptoms across these groups. Methods: The study was conducted at an academic neurology subspecialty clinic. This was a caseecontrol study with 140 Chinese-American subjects and 140 demographically and cognitively matched white subjects. In each group, there were 48 cognitively normal and 92 cognitively impaired participants (49 with mild cognitive impairment, 43 with Alzheimer disease). The proportion of individuals with significant depressive symptoms, as indicated by a Geriatric Depression Scale score ≥6 of 15, and frequency of antidepressant use were compared across groups by using Χ2 analysis. Factors predicting depressive symptoms, including racial and diagnostic group, age, gender, Mini-Mental State Examination score, level of functional impairment, education level, and medical comorbidities, were assessed by using linear regression analysis. Results: Significant depressive symptoms were more common in cognitively impaired Chinese-American (35%) than cognitively impaired white (15%; Χ2[1] = 9.4; p = 0.004) subjects. Chinese-American subjects with cognitive impairment were less likely to be receiving treatment for depression (12%) than white subjects with cognitive impairment (37%; Χ2[1] = 15.6; p = 0.002). Racial and diagnostic group, age, level of functional impairment, Mini-Mental State Examination score, and education level were all statistically significant independent predictors of Geriatric Depression Scale score. Conclusions: Elderly Chinese- American subjects with cognitive impairment are at increased risk for unrecognized and untreated depressive symptoms compared with elderly white subjects with cognitive impairment. Education level may contribute to this risk or it may be a surrogate marker for other factors contributing to depressive symptoms in this group.

AB - Objectives: To compare the prevalence of depressive symptoms and frequency of antidepressant use between a group of elderly Chinese-American subjects with and without cognitive impairment and a group of matched white subjects. A secondary aim was to examine the clinical and demographic predictors of depressive symptoms across these groups. Methods: The study was conducted at an academic neurology subspecialty clinic. This was a caseecontrol study with 140 Chinese-American subjects and 140 demographically and cognitively matched white subjects. In each group, there were 48 cognitively normal and 92 cognitively impaired participants (49 with mild cognitive impairment, 43 with Alzheimer disease). The proportion of individuals with significant depressive symptoms, as indicated by a Geriatric Depression Scale score ≥6 of 15, and frequency of antidepressant use were compared across groups by using Χ2 analysis. Factors predicting depressive symptoms, including racial and diagnostic group, age, gender, Mini-Mental State Examination score, level of functional impairment, education level, and medical comorbidities, were assessed by using linear regression analysis. Results: Significant depressive symptoms were more common in cognitively impaired Chinese-American (35%) than cognitively impaired white (15%; Χ2[1] = 9.4; p = 0.004) subjects. Chinese-American subjects with cognitive impairment were less likely to be receiving treatment for depression (12%) than white subjects with cognitive impairment (37%; Χ2[1] = 15.6; p = 0.002). Racial and diagnostic group, age, level of functional impairment, Mini-Mental State Examination score, and education level were all statistically significant independent predictors of Geriatric Depression Scale score. Conclusions: Elderly Chinese- American subjects with cognitive impairment are at increased risk for unrecognized and untreated depressive symptoms compared with elderly white subjects with cognitive impairment. Education level may contribute to this risk or it may be a surrogate marker for other factors contributing to depressive symptoms in this group.

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KW - Dementia

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