Trajectories of Depressive Symptoms and Risk of Cognitive Decline and Dementia in Older Women
Year: 2018
Type: conference-abstract
Abstract: Previous studies reported the association of increased dementia risk with depressive symptoms assessed at one-time point, neglecting the inter-individual differences and intra-individual variability in the profiles of symptoms over time. We examined the association between longitudinal trajectories of depressive symptoms and cognitive impairment among participants from the Women’s Health Initiative Study of Cognitive Aging without prior depression (n=2,081; aged 73.4 ± 3.8 years), including a subsample (n=1,050) with 1.5-T brain MRI measures of small-vessel-ischemic-diseases (SVID) and spatial patterns of grey matter atrophy in Alzheimer’s disease (i.e., AD pattern similarity [AD-PS] score; Casanova 2013). Latent-class mixed models (LCMMs) were used to identify clusters with similar individual trajectories of symptoms assessed annually by the 15-item Geriatric Depression Scale (GDS). Using Cox-proportional hazard regression, we estimated the association between GDS-defined classes and global cognitive decline in the Modified Mini-Mental State [3MS] score;>10-point drop) and incident dementia. Multinomial logistic regressions estimated the associations between GDS classes and brain MRI measures. Compared to the resilient group with minimal symptoms (N=739;35.5%), the other two clusters with low-levels of depressive symptoms that either emerged (N=314;15.1%) in late life or sustained (N=1028;49.4%) during the follow-up were at increased risks for 3MS decline (HRemerging=1.93, p=0.02; HRsustained=2.51,p<0.01) and dementia (HRemerging=2.45, p=0.02; HRsustained=2.72,p<0.01). These two groups also had increased SVID, but there was no between-group difference in AD-PS score. These findings suggest increased risks for clinically-significant cognitive decline and dementia among older women even with low levels of sustained or emerging depressive symptoms in late life, largely driven by the cerebrovascular damage.
Source: Innovation in Aging
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,977
OpenAlex ID: W2900381007