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• What is the primary question addressed by this study? Can depression influence the progression of multimorbidity in community-dwelling older adults? • What is the main finding of this study? This prospective cohort study found that late-life depression was associated with a more rapid progression of multimorbidity and the risk of developing highly complex multimorbidity. This association might be pronounced when depression was severe or anhedonic. • What is the meaning of the finding? Additional investigation is required to ascertain if managing depression can mitigate the development of multimorbidity in older adults. The relationship between depression and the risk of multimorbidity progression has rarely been studied in older adults. This study was aimed to determine whether depression is associated with progression in the severity and complexity of multimorbidity, considering the influence of depression's severity and subtype. As a part of the Korean Longitudinal Study on Cognitive Aging and Dementia, this population-based cohort study followed a random sample of community-dwelling Koreans aged 60 and older for 8 years at 2-year intervals starting in 2010. Participants included those who completed mood and multimorbidity assessments and did not exhibit complex multimorbidity at the study's outset. Depression was assessed using the Geriatric Depression Scale, while multimorbidity was evaluated using the Cumulative Illness Rating Scale. The study quantified multimorbidity complexity by counting affected body systems and measured multimorbidity severity by averaging scores across 14 body systems. The 2,486 participants (age = 69.1 ± 6.5 years, 57.6% women) were followed for 5.9 ± 2.4 years. Linear mixed models revealed that participants with depression had a faster increase in multimorbidity complexity score (β =.065, SE = 0.019, p = 0.001) than those without depression, but a comparable increase in multimorbidity severity score (β =.001, SE =.009, p = 0.870) to those without depression. Cox proportional hazard models revealed that depression was associated with the risk of developing highly complex multimorbidity affecting five or more body systems, particularly in severe or anhedonic depression. Depression was associated with the worsening of multimorbidity in Korean older adults, particularly when severe or anhedonic. Early screening and management of depression may help to reduce the burden of multimorbidity in older adults. [ABSTRACT FROM AUTHOR]

Background: Hypertension is associated with white matter hyperintensity (WMH) and cognitive impairment. Further, WMH is associated with cognitive impairment including executive, attention and visuospatial functions. The aim of this study was to investigate the effects of controlled hypertension (cHT) and previously developed concept, 'WMH age' on cognitive function and the mediating role of WMH in the effect of cHT on cognitive impairment. Method: We enrolled 855 Koreans without dementia aged 60 years or older, 326 of whom completed 2‐year follow‐up assessment. We measured their blood pressure thrice in a sitting position using an automated blood pressure monitoring device. We estimated 'WMH age' of every participant using previously developed WMH probability map of healthy older Koreans. We analyzed the mediating effect of WMH age in the association of cHT and cognitive function using the PROCESS Macro model. Result: Old WMH age was associated with a faster decline in the Mini‐Mental Status Examination (MMSE; p =.003), Consortium to Establish a Registry for Alzheimer's Disease total score (CERAD‐TS; p =.003), and Frontal Assessment Battery (FAB; p =.007). Old WMH age showed an approximately‐six times higher risk of incident mild cognitive impairment (OR = 6.47, 95% CI = 1.37 – 9.50, p =.024) compared to young or normal WMH age over the 2‐year follow‐up period in the cHT group. WMH age mediated the effects of cHT on the MMSE, CERAD‐TS, and FAB scores at baseline and two‐year follow‐up period. Conclusion: WMH mediates the adverse effect of hypertension on cognitive function. Elders with cHT who have older WMH age may be at a higher risk of cognitive decline. [ABSTRACT FROM AUTHOR]

Background: Although previously constructed white matter hyperintensity (WMH) probability maps of healthy older adults exist, they have several limitations in representing the distribution of WMH in healthy older adults, especially Asian older adults. We developed and validated a WMH probability map (WPM) of healthy older Koreans and examined the age‐associated differences of WMH. Method: We constructed WPM using development dataset that consisted of high‐resolution 3D fluid‐attenuated inversion recovery images of 5 age groups (60–64 years, 65–69 years, 70–74 years, 75–79 years, and 80+ years). Each age group included 30 age‐matched men and women each. We tested the validity of the WPM by comparing WMH ages estimated by the WPM and the chronological ages of 30 healthy controls, 30 hypertension patients, and 30 stroke patients. Result: Older age groups showed a higher volume of WMH in both hemispheres (p < 0.001). About 90% of the WMH were located in periventricular space in all age groups. With advancing age, the peak of the distance histogram from the ventricular wall of the periventricular WMH shifted away from the ventricular wall, while that of deep WMH shifted toward the ventricular wall. The estimated WMH ages were comparable to the chronological ages in the healthy controls, while being higher than the chronological ages in hypertension and stroke patients. Conclusion: The WPM may serve as a standard atlas in research on WMH of older adults, especially Asians. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that vitamins might have a beneficial effect for cognition. The current systematic review aims to investigate the effect of B vitamins, antioxidant vitamins, and vitamin D on cognitive function in the non‐demented middle‐aged or older people. Method: Randomized, or quasi‐randomized clinical trials comparing vitamin supplementation with a control group were included in the standard inverse‐variance random‐effects meta‐analyses. We searched PubMed/MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library databases for articles until November 2019, and used Risk of Bias tool to evaluate methodological quality of them. Result: A total of twenty‐three studies for B vitamins (n = 22 – 1,053), five studies for antioxidant vitamins (n = 185 – 5,226), and six studies for vitamin D (n = 55 – 4,122) were included in the meta‐analyses. We found that B vitamins had a beneficial effect on global cognitive function (Standardized mean difference [SMD] ‐0.23, 95% CI ‐0.35 to ‐0.10) which effect remained significant over 3‐11 months (SMD ‐0.80, 95% CI ‐1.03 to ‐0.56) and 12 or more months (SMD ‐0.12, 95% CI ‐0.22 to ‐0.01) of supplementation, for those from North America / Europe / Australia (SMD ‐0.07, 95% CI ‐0.11 to ‐0.03), and for those with mild cognitive impairment (SMD ‐0.51, 95% CI ‐0.81 to ‐0.22). B vitamins also showed a significant benefit on episodic memory (SMD ‐0.23, 95% CI ‐0.35 to ‐0.10). Antioxidant and vitamin D revealed no significant benefit on cognitive function compared to control groups. Conclusion: Our findings indicated that B vitamins might have a therapeutic effect on global cognitive function and episodic memory domain. More life‐span studies are warranted to identify the most effective timing and duration of the vitamin supplementation. [ABSTRACT FROM AUTHOR]