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
Language
- eng
Conference Location
- United States