Heterogenous Subtypes of Late-Life Depression and Their Cognitive Patterns: A Latent Class Analysis

Li-Qi Wang; Tian-Hong Zhang; Wei Dang; Sha Liu; Zi-Li Fan; Li-Hui Tu; Ming Zhang; Hua-Ning Wang; Nan Zhang; Qin-Ying Ma; Ying Zhang; Hui-Zi Li; Lu-Chun Wang; Yao-Nan Zheng; Huali Wang; Xin Yu

doi:10.3389/fpsyt.2022.917111

Heterogenous Subtypes of Late-Life Depression and Their Cognitive Patterns: A Latent Class Analysis

Front Psychiatry. 2022 Jul 6:13:917111. doi: 10.3389/fpsyt.2022.917111. eCollection 2022.

Authors

Li-Qi Wang^{1

2}, Tian-Hong Zhang³, Wei Dang⁴, Sha Liu⁵, Zi-Li Fan^{1

2

6}, Li-Hui Tu^{1

2

6}, Ming Zhang^{1

2

7}, Hua-Ning Wang⁸, Nan Zhang⁹, Qin-Ying Ma¹⁰, Ying Zhang^{1

2}, Hui-Zi Li^{1

2}, Lu-Chun Wang^{1

2}, Yao-Nan Zheng^{1

2}, Huali Wang^{1

2}, Xin Yu^{1

2}

Affiliations

¹ Clinical Research Division, Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China.
² Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders (Peking University), NHC Key Laboratory of Mental Health, Beijing, China.
³ Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁴ Department of Psychiatry, Xi'an Mental Health Center, Xi'an, China.
⁵ Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.
⁶ Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
⁷ Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁸ Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
⁹ Department of Neurology, General Hospital of Tianjin Medical University, Tianjin, China.
¹⁰ Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China.

Abstract

Background: Late-life depression (LLD), characterized by cognitive deficits, is considered heterogeneous across individuals. Previous studies have identified subtypes with diverse symptom profiles, but their cognitive patterns are unknown. This study aimed to investigate the subtypes of LLD and the cognitive profile of each group.

Methods: In total, 109 depressed older adults were enrolled. We performed latent class analysis using Geriatric Depression Scale items as indicators to generate latent classes. We compared the sociodemographic and clinical characteristics with cognitive functions between groups and conducted regression analysis to investigate the association between class membership and variables with significant differences.

Results: Two classes were identified: the "pessimistic" group was characterized by pessimistic thoughts and the "worried" group with a relatively high prevalence of worry symptoms. The two groups did not differ in sociodemographic characteristics. The "pessimistic" group showed a higher rate of past history of depression and lower age of onset. The "worried" group had more physical comorbidities and a higher rate of past history of anxiety. The "pessimistic" group was more impaired in general cognitive function, executive function, information processing speed, and attention. Lower general and executive functions were associated with the membership in the "pessimistic" group.

Conclusions: Subjects with pessimistic symptoms and subjects with a propensity to worry may form two distinct subtypes of late-life depression with different cognitive profiles. Further, the cognitive evaluation of subjects with pessimistic symptoms is of utmost importance.

Keywords: cognitive impairments; depression subtypes; depressive disorder; late-life depression; latent class analysis.