Saturday, December 23, 2017

Prolonged grief and cognitive decline. A prospective population-based study in middle-aged and older persons

Your doctor needs to address your grief as part of preventing your cognitive decline. The best and only way to do that is have protocols that get you 100% recovered. You don't have time for grief if you have a defined path to recovery. How fucking stupid is your doctor if s/he can't understand that logic?

Five Stages of Grief

Prolonged grief and cognitive decline. A prospective population-based study in middle-aged and older persons

Heidi C. Saavedra Pérez, MD, PhD
,
M. Arfan Ikram, MD, PhD
,
Nese Direk, MD
,
Henning Tiemeier, MD, PhD'Correspondence information about the author MD, PhD Henning Tiemeier
DOI: http://dx.doi.org/10.1016/j.jagp.2017.12.003





Highlights

Bereavement can result in unresolved and prolonged grief.
Prolonged grief is defined as present when mourners have symptoms of separation distress (e.g., yearning, searching) and traumatic distress (e.g., disbelief, troubling accepting the death, bitterness) for at least 6 months, to the point of functional impairment.
Prolonged grief is a condition that has a great impact on the quality of life, but the impact of prolonged grief on cognitive functioning is poorly understood.
The aim of the current study was to compare the cognitive decline, assessed by repeated measures of different cognition domains, between persons with normal and prolonged grief, and a non-grieving reference population in a 7-year follow-up study.
Our results demonstrate that prolonged grief is a risk factor for cognitive decline.

Abstract




Objective

Bereavement can result in unresolved and prolonged grief, often termed prolonged grief disorder (PGD). The impact of PGD on cognitive functioning is poorly understood. The aim of the study was to compare the cognitive decline, assessed by repeated measures of different cognition domains, between persons with normal and PGD, and a non-grieving reference population in a 7-year follow-up study.



Method

The study sample comprised 3126 non-demented persons, mean age: 64 years, of the Rotterdam Study. Participants were classified into three groups: no grief (reference group, N=2582), normal grief (N=418), prolonged grief disorder (N=126). Participants were assessed with the Complicated Grief Inventory and underwent cognitive testing (Mini Mental State Examination (MMSE), Letter-Digit Substitution test, Stroop test, Word fluency task, Word learning test). Analyses were adjusted for baseline cognition, depressive symptoms; persons with major depressive disorders were excluded.



Results

Compared to the reference group, participants with PGD showed a decrease in global cognitive function, MMSE scores, and World learning test (immediate and delayed) over time. Participants with normal grief did not show a stronger cognitive decline in any of cognitive tests than the reference group.



Conclusions

Participants with PGD showed a stronger cognitive decline than the reference group during 7 years of follow-up. This suggests that PGD is a risk factor for cognitive decline, but this study cannot detect the psychobiological mechanism underlying this longitudinal association.

Key Words:

Grief, prolonged grief disorder, cognition, cognitive decline, elderly persons, population-based

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Previous Presentation: None
© 2017 Published by Elsevier Inc. on behalf of American Association for Geriatric Psychiatry.
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