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Objective: To determine the relationship between affective measures and cognition before and after non-cardiac surgery in older adults. Methods: Observational prospective cohort study in 103 surgical patients age ≥ 60 years old. All participants underwent cognitive testing, Center for Epidemiologic Studies-Depression, and State Anxiety Inventory screening before and 6 weeks after surgery. Cognitive test scores were combined by factor analysis into 4 cognitive domains, whose mean was defined as the continuous cognitive index (CCI). Postoperative global cognitive change was defined by CCI change from before to after surgery, with negative CCI change indicating worsened postoperative global cognition and vice versa. Results: Lower global cognition before surgery was associated with greater baseline depression severity (Spearman's r = −0.30, p = 0.002) and baseline anxiety severity (Spearman's r = −0.25, p = 0.010), and these associations were similar following surgery (r = −0.36, p < 0.001; r = −0.26, p = 0.008, respectively). Neither baseline depression or anxiety severity, nor postoperative changes in depression or anxiety severity, were associated with pre- to postoperative global cognitive change. Conclusions: Greater depression and anxiety severity were each associated with poorer cognitive performance both before and after surgery in older adults. Yet, neither baseline depression or anxiety symptoms, nor postoperative change in these symptoms, were associated with postoperative cognitive change. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine the association between physical frailty and neurocognitive performance in late-life depression (LLD).Methods: Cross-sectional design using baseline data from a treatment study of late-life depression was used in this study. Individuals aged 60 years and older were diagnosed with major depressive disorder at time of assessment (N = 173). All participants received clinical assessment of depression and completed neuropsychological testing during a depressive episode. Physical frailty was assessed using an adaptation of the FRAIL scale. Neuropsychological domains were derived from a factor analysis that yielded three factors: (i) speeded executive and fluency, (ii) episodic memory, and (iii) working memory. Associations were examined with bivariate tests and multivariate models.Results: Depressed individuals with a FRAIL score >1 had worse performance than nonfrail depressed across all three factors; however, speeded executive and fluency was the only factor that remained significant after controlling for depression symptom severity and demographic characteristics.Conclusions: Although physical frailty is associated with broad neurocognitive deficits in LLD, it is most robustly associated with deficits in speeded executive functions and verbal fluency. Causal inferences are limited by the cross-sectional design, and future research would benefit from a comparison group of nondepressed older adults with similar levels of frailty. Research is needed to understand the mechanisms underlying associations among depression symptoms, physical frailty, and executive dysfunction and how they are related to the cognitive and symptomatic course of LLD. [ABSTRACT FROM AUTHOR]

Objectives To describe the association between an increasing number of coexisting conditions and locus of control ( LOC), a psychological construct reflecting the degree to which one perceives circumstances to be controlled by personal actions (internal LOC) versus outside factors (external LOC) in older adults. Design Cross-sectional study using survey data from the North Carolina Established Population for Epidemiologic Studies of the Elderly ( NC EPESE) data set. Setting Community. Participants Three thousand two hundred twelve community-dwelling adults aged 68 and older. Measurements Nine common medical conditions were assessed according to self-report. LOC was measured using a standard questionnaire. Analyses were adjusted for demographics, functional status (self-reported activities of daily living), cognition (Short Portable Mental Status Questionnaire), and depression score (Center for Epidemiologic Studies Depression Scale). Results A higher number of chronic conditions was associated with external LOC (β = 0.37, P < .001). This relationship persisted after adjustment for age, race, sex, functional status, cognition, and depression (β = 0.17, P < .001). Most individual conditions were not associated with LOC, although vision impairment ( P < .001) and arthritis ( P = .02) were associated with more-internal LOC. Conclusion These results suggest that medically complex patients tend to exhibit a more-external LOC, meaning that they perceive little personal control over circumstances and environment. Clinicians should be aware of this tendency, because external LOC may impede an older adult's willingness to engage in the considerable task of managing multiple chronic conditions. [ABSTRACT FROM AUTHOR]

The article investigates the association of selective serotonin reuptake inhibitors (SSRIs) on the risk of fracture. Depression and osteoporotic fractures are common ailments among elderly patients. SSRIs are frequently used in the treatment of depression in this population. This study was undertaken to examine the effect of daily SSRI use on the risk of incident clinical fragility fracture.