P4‐138: Patterns of later‐life depression are differentially associated with decline in cognitive domains
Year: 2015
Type: article
Study design: Observational Study
Abstract: Depression frequently co-occurs with early symptoms of cognitive decline. However, it is unclear whether depression represents a risk factor or a prodromal manifestation of neurodegeneration. Understanding how patterns of depression (none, consistent, or fluctuating) relate to cognitive trajectories may help inform clinical prediction regarding older adults presenting with depressive symptomatology. We related depression, assessed over 4 to 8 years among 11,675 women from the Nurses’ Health Study, to subsequent cognitive trajectories over an average of 6 years. Depression was assessed 2-3 times prior to cognitive testing using the Mental Health Inventory–5 (MHI-5) from the Medical Outcomes Study Short-form-36, with a score≤52 indicating depression. Depression was categorized as: non-depressed (not depressed at any time point prior to cognitive testing), fluctuating (depressed at some but not all time points), and consistently depressed (depressed at all time points). Cognition was assessed up to 4 times using a validated telephone-based battery that included the Telephone Interview for Cognitive Status, immediate and delayed recall of the East Boston Memory Test, category fluency, delayed recall of a 10-word list, and digit span backwards. Primary outcomes of global, verbal memory, and executive function-attention composite z-scores were examined by depression category using linear mixed-effects models. Consistently depressed participants had worse mean decline in executive function and attention over follow-up compared to those with no depression (multivariable-adjusted mean difference= -0.032 units/year; p=0.003); this difference was similar to that for women aged 8 years apart at the start of testing (i.e., 8 added years of aging). However, being in the consistently depressed vs. non-depressed group was unrelated to decline in verbal memory (p=0.73) or global score (p=0.10). By contrast, those with fluctuating depression prior to cognitive testing had greater subsequent decline in verbal memory (multivariable-adjusted mean difference= -0.012 units/year; p=0.04), compared to the non-depressed group; yet, no significant differences in decline were observed for this group in global score or executive function-attention. Variably and consistently depressed participants showed declines in different cognitive domains compared to those with no depression. The results suggest that patterns of depression may relate to differential cognitive outcomes in older adults.
Source: Alzheimer s & Dementia
Institutions: Brigham and Women's Hospital, Harvard University
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2472064148