Correlation between depression, loneliness, challenging behavior and MRI findings among persons with high‐risk for cognitive impairment (PWHRCIs)

Abstract Background this study explored the relationships between depression, loneliness, challenging behaviors among persons with high‐risk for cognitive impairment (PWHRCIs). MRI findings were collected as well. Method This was a secondary analysis of a cross‐sectional study. Primary data were collected from the mother project “ Social Cognition, Nutrition and Cognitive Function in Middle Life: A Longitudinal Study ” (MOST‐107‐2314‐B‐182076) between 2018 to 08/14/2021. 176 participants were recruited, among which 24 participants had received MRI examination. Test battery included: Taiwanese version of Frontal Behavioral Inventory (TFBI) for challenging behaviors, the Geriatric Depression Scale Short Form (GDS‐SF) for depressive symptoms, the short‐form UCLA Loneliness scale (ULS‐8) for loneliness, the Mini‐Mental State Examination (MMSE) for global cognition, while MRI indicators included T1‐weighted image (T1W1), Resting‐state functional MRI (RS‐fMRI) and Diffusion Weighted Image (DWI). Result hierarchical regression model results show: Model I, depressive symptoms predicted challenging behavior, explaining 12% of variance (R 2 = .12). Model II, loneliness was added and significantly predicted challenging behavior with an 8% of increased variance. In total, Model II explained 20% of variance. Therefore, loneliness is a mediator between depressive symptoms and challenging behavior. 2. Loneliness was significantly correlated with the Brain Structural Networks (normalized characteristic path length) (r = ‐.47*, p<.05). 3. Challenging behavior was significantly correlated with the Brain Structural Networks (normalized characteristic clustering coefficient and normalized characteristic path length) (r = .78, p<.01; r = .83, p<.01, respectively). 4. Challenging behavior was significantly correlated with the Brain Functional Networks (Small‐world index and normalized characteristic clustering coefficient) (r = ‐.57, p<.05; r = ‐.49, p<.05, respectively), while the network indicator was thought to be random. Conclusion The results indicated that depression and loneliness an affect challenging behavior in PWHRCIs. The results of MRI findings also highlight the importance of loneliness which may slow down the structural connections in the brain to transmit messages. Challenging behavior is also associated with functional brain connectivity. Therefore, it is necessary to regularly assess the emotional factors of PWHRCIs and provide individualized care to avoid further damage to their brain.