Long-term cumulative depressive symptom burden and risk of cognitive decline and dementia among very old women.

Journal Article (Journal Article)

BACKGROUND: Depressive symptoms and cognitive outcomes are strongly interrelated. Despite that rates of depressive symptoms fluctuate during late life, little is known about the impact of long-term cumulative depressive symptom burden on cognitive decline and dementia in older adults. This study examines the association of nearly 20 years of cumulative depressive symptoms with cognitive outcomes in a cohort of older women. METHODS: We assessed depressive symptoms in 7,240 women using the Geriatric Depression scale (GDS) at serial visits. We used a Poisson model with random slopes to estimate GDS trajectories for each participant from baseline to death or end of follow-up, and then characterized depressive symptom burden by quartile of the area under the curve. We assessed cognitive outcomes using repeated measures of the Mini-Mental State Examination (MMSE) and Trails B score over 20 years, Year-20 neuropsychological test battery, and adjudicated dementia and mild cognitive impairment (MCI). RESULTS: Adjusting for potential confounders, compared with women in the lowest quartile of cumulative depressive symptoms burden, women in the highest quartile had 21% more MMSE errors over time (95% CI = 17%, 26%), 20% worse Trails B score over time (95% CI = 17%, 23%), worse scores on most of the Year-20 cognitive tests, and a twofold greater likelihood of developing dementia or MCI (95% CI = 1.48, 3.11). CONCLUSIONS: Long-term cumulative depressive symptom burden was associated with cognitive decline and risk of dementia or MCI. Older adults with a history of depression should be closely monitored for recurrent episodes or unresolved depressive symptoms as well as any cognitive deficits.

Full Text

Duke Authors

Cited Authors

  • Zeki Al Hazzouri, A; Vittinghoff, E; Byers, A; Covinsky, K; Blazer, D; Diem, S; Ensrud, KE; Yaffe, K

Published Date

  • May 2014

Published In

Volume / Issue

  • 69 / 5

Start / End Page

  • 595 - 601

PubMed ID

  • 24097423

Pubmed Central ID

  • PMC3991142

Electronic International Standard Serial Number (EISSN)

  • 1758-535X

Digital Object Identifier (DOI)

  • 10.1093/gerona/glt139


  • eng

Conference Location

  • United States