Depressive symptoms as a predictor of cognitive decline: MacArthur Studies of Successful Aging.
ABSTRACT The prevalence of dementia continues to rise, and yet, there are few known modifiable risk factors. Depression, as a treatable condition, may be important in the development of dementia. Our objective was to examine the association between depressive symptoms and longitudinal cognitive changes in older adults who were high-functioning at baseline.
The authors analyzed data from a community-based cohort (aged 70-79 at baseline), who, at study entry, scored 7 or more (out of 9) on the Short Portable Mental Status Questionnaire (SPMSQ). Depressive symptoms were assessed at baseline using the depression subscale of the Hopkins Symptom Check List. Cognitive performance was measured at baseline and at seven-year follow up by the SPMSQ and by summary scores from standard tests of naming, construction, spatial recognition, abstraction, and delayed recall.
After adjusting for potential confounders, including age, education, and chronic health conditions such as diabetes, heart attack, stroke, and hypertension, a higher number of baseline depressive symptoms were strongly associated with greater seven-year decline in cognitive performance and with higher odds of incident cognitive impairment, i.e., decline in SPMSQ score to < or = 6 (adjusted odds ratio per quartile of depressive symptoms score: 1.34, 95% confidence interval: 1.10-1.68).
Depressive symptomatology independently predicts cognitive decline and incident cognitive impairment in previously high-functioning older persons.
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ABSTRACT: India is experiencing a rapid demographic and epidemiologic transition. Among a growing aging population, non-communicable diseases, including dementia, are increasingly prevalent, but our understanding of cognitive health is quite limited. Recent studies suggest that women in developed countries perform as well or better than men on cognitive functioning tests, though research from developing countries shows the opposite. This gender disparity in developing settings may be attributable to that fact that women are traditionally not given equal access to education, health services, economic opportunity, and social engagement. Furthermore, in countries such as India, discrimination against women may play a role in the gender disparity. To address this issue, the authors examine cognitive function of older Indians, using cross-sectional data from the 2010 pilot round of the Longitudinal Aging Study in India, fielded across Punjab and Rajasthan in the north and Kerala and Karnataka in the south. They found gender disparities in cognitive function and suggest that female cognitive disadvantage could be explained by disparities in education, health and social engagement in southern India. However, female disadvantage persisted in northern states where discrimination against women has been notably acute even after controlling for education and other key risk factors of poor cognitive function.SSRN Electronic Journal 10/2011; DOI:10.2139/ssrn.1970045
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ABSTRACT: Objectives. Determine the relationship between depressive symptom clusters and neuropsychological test performance in an elderly cohort of cognitively normal controls and mild Alzheimer's disease (AD). Design. Cross-sectional analysis. Setting. Four health science centers in Texas. Participants. 628 elderly individuals (272 diagnosed with mild AD and 356 controls) from ongoing longitudinal study of Alzheimer's disease. Measurements. Standard battery of neuropsychological tests and the 30-item Geriatric Depression Scale with regressions model generated on GDS-30 subscale scores (dysphoria, apathy, meaninglessness and cognitive impairment) as predictors and neuropsychological tests as outcome variables. Follow-up analyses by gender were conducted. Results. For AD, all symptom clusters were related to specific neurocognitive domains; among controls apathy and cognitive impairment were significantly related to neuropsychological functioning. The relationship between performance and symptom clusters was significantly different for males and females in each group. Conclusion. Findings suggest the need to examine disease status and gender when considering the impact of depressive symptoms on cognition.Depression research and treatment 08/2011; 2011(2090-1321):396958. DOI:10.1155/2011/396958
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ABSTRACT: Based in successful aging theory and terminal cognitive drop research, this paper investigates cerebrovascular burden (CVB), depressive symptoms, and cognitive decline as threats to longevity. A subsample of stroke-free women over the age of 80 was identified in the Health and Retirement Survey (years 2000-2008). Mortality at 2, 6, and 8 year intervals was predicted using CVB (diabetes, heart disease, hypertension), depressive symptoms (Center for Epidemiological Studies Depression Scale), and cognitive decline (decline of 1 standard deviation or more on the 35-point Telephone Interview for Cognitive Status over 2 years). At most waves (2002, 2004, and 2006) mortality was predicted by CVB, depressive symptoms, and cognitive drop measured 2 years prior. CVB and depressive symptoms at the 2000 wave predicted mortality at 6 and 8 years. Older women with the greatest longevity had low CVB, robust cognitive functioning, and few depression symptoms, supporting successful aging theory and terminal cognitive drop.Journal of aging research 07/2011; 2011:912680. DOI:10.4061/2011/912680