番茄社区

Greater social support for older adults with depression helped boost verbal functioning, researchers reported.

In a cross-sectional study, seniors with major depressive disorder tended to score higher on phonemic fluency -- measured by Controlled Oral Word Association Test (FAS) -- when they had higher levels of perceived social support, according to Nili Solomonov, PhD, of Weill Cornell Medicine in White Plains, New York, and colleagues.

This association went both ways, Solomonov's group explained in a research letter in .

Even after adjusting for age, education, and severity of depression measured by Montgomery-Åsberg Depression Rating Scale (MADRS) score, higher perceived social support was linked with higher FAS scores (B=1.51, P=0.005). Likewise, higher FAS scores were also significantly associated with higher social support (B=0.11, P=0.005).

Education as a stand-alone variable was also significantly linked with higher FAS scores, but sex, MADRS score, and age were not.

"Older adults with poorer cognitive performance may be less likely to feel supported by others and thus may benefit from interventions that increase social engagement," the researchers explained. "[O]ur findings could inform intervention development for older adults with depression that target social support to increase cognitive resilience."

That being said, there was no link seen between perceived social support with other measures of cognitive performance. These other measures looked at inhibitory control, set-shifting, semantic fluency, memory, processing speed, and self-reported executive function.

"Clinical and neuroimaging studies suggest that semantic fluency tasks rely more on lexical access and language abilities, while phonemic fluency places greater demands on executive processes," Solomonov's group pointed out.

Because of this, they suggested these findings "indicate that perceived social isolation may be selectively associated with executive processes that support initiation and persistence of behavior, underscoring the important role of social support in this population."

Poor support often hinders depression treatment response and recovery, the researchers added.

The small study included 54 participants with an average age of 72. All met the DSM-IV criteria for major depressive disorder without psychotic features or dementia. Participants were not currently on an antidepressant, as they were analyzed prior to treatment initiation in a trial on escitalopram (Lexapro).

Perceived social support was quantified using the Duke Social Support Index Scale, which ranges on a scale from 7 to 21, with higher scores indicating greater perceived support (average 16).

Cognitive functioning was measured with the Dementia Rating Scale, semantic verbal fluency was assessed with the Animal Naming Test, cognitive inhibition with Stroop Interference, set-shifting and processing speed with Trail Making Test part B-A, memory with Hopkins Verbal Learning Test delayed recall, and self-reported executive function with the Frontal Systems Behavior Scale-Executive Dysfunction subscale.

Solomonov's group suggested that future studies in this area home in on more "complex" patient populations within this one, like older adults with comorbid psychiatric conditions or those on antidepressants, to see if the findings still hold true.

Comment