Dotson, V. M. et al. Recurrent depressive symptoms and the incidence of dementia and mild cognitive impairment. Neurology 75, 27-34

National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA.
Neurology (Impact Factor: 8.29). 07/2010; 75(1):27-34. DOI: 10.1212/WNL.0b013e3181e62124
Source: PubMed


A history of depression has been linked to an increased dementia risk. This risk may be particularly high in recurrent depression due to repeated brain insult. We investigated whether there is a dose-dependent relationship between the number of episodes of elevated depressive symptoms (EDS) and the risk for mild cognitive impairment (MCI) and dementia.
A total of 1,239 older adults from the Baltimore Longitudinal Study of Aging were followed for a median of 24.7 years. Diagnoses of MCI and dementia were made based on prospective data. Participants completed the Center for Epidemiologic Studies Depression Scale at 1- to 2-year intervals and were considered to have an EDS if their score was > or = 16. Kaplan-Meier survival curves, log-rank test for trend for survivor functions, and Cox proportional hazards models were conducted to examine the risk of MCI and dementia by number of EDS.
We observed a monotonic increase in risk for all-cause dementia and Alzheimer disease as a function of the number of EDS. Each episode was associated with a 14% increase in risk for all-cause dementia. Having 1 EDS conferred an 87%-92% increase in dementia risk, while having 2 or more episodes nearly doubled the risk. Recurrence of EDS did not increase the risk of incident MCI.
Our findings support the hypothesis that depression is a risk factor for dementia and suggest that recurrent depression is particularly pernicious. Preventing the recurrence of depression in older adults may prevent or delay the onset of dementia.

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    • "Importantly, our findings add further to population-based empirical evidence that in addition to healthy exercise and diet behaviors, psychosocial factors—including lowered stress and fewer depressive symptoms—each was independently associated with lower levels of cognitive function 3 or 4 years later. This finding extends one existing study[24]finding the effects of stress on cognitive decline by showing that depressive symptom had similar independent effects; other studies have shown links between depressive symptoms and cognitive impairment but not in the presence of stress454647484950. Because how these two factors are associated with each other is not yet clear, future work should examine whether a reduction in one variable will lead to a reduction in the other and, in turn, to better cognitive function. "
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    ABSTRACT: Background/Purpose The short- and long-term impacts of behavioral and psychological factors on the diabetes and cognitive function relationship are not fully understood. This study examined levels and rates of change in age trajectories of cognitive function in middle-aged and older adults with and without diabetes who participated in different health behaviors. Methods Participants aged 53 and above with and without diabetes were drawn from the 1999 Taiwan Longitudinal Study of Aging (N = 4076, mean age 69.3, SD = 9.1). Cognitive function was measured with the 9-item Short Portable Mental Status Questionnaire (SPMSQ) in 1999, 2003, and 2007. Lifestyle and psychosocial variables were measured in 1996, 1999, and 2003 as lagged time-varying covariates in random effects model analyses. Results Adults with diabetes had significantly lower levels of (βdiabetes = −.212, p < .001) cognitive function, compared to those without diabetes, net of the effects of key sociodemographic and comorbidity covariates. The addition of exercise, social support, and depressive symptoms to the analytic models reduced the diabetes impact to non-significance. Exercise alone explained 33 % of the variation in the age trajectory. Only diet behavior showed a significant interaction effect with age (βdiet*age = .011, p < .05). Conclusions This population-based longitudinal study provides evidence for the prospective effects of psychobehavioral factors in preserving cognitive function for at least 3 to 4 years in adults with or without diabetes, a result supporting psychoneuroendocrinology studies linking stress and stress hormones to cognitive function, potentially informing treatment options for diabetes care.
    Full-text · Article · Jan 2016 · Annals of Behavioral Medicine
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    • "Depressive symptoms in later life are associated with a number of negative outcomes; these can include increased disability, frailty and loss of independence in older age (Agüero-Torres et al. 2002; Covinsky et al. 2010; Lenze et al. 2001; Mezuk et al. 2012; Reynolds et al. 2008). In addition, the experience of depression in later life is associated with poorer cognitive function and increased risk of developing cognitive impairment and dementia (Reppermund et al. 2011; Dotson et al. 2010; Yates et al. 2013). However, the association between depression and cognitive impairment and dementia is complex and it currently remains unclear whether depression is a risk factor for dementia or a prodromal symptom, or whether there is some underlying mechanism that is shared between depression and dementia (Byers and Yaffe 2011; Korczyn and Halperin 2009; Leonard 2007). "
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    ABSTRACT: Key components of cognitive lifestyle are educational attainment, occupational complexity and engagement in cognitively stimulating leisure activities. Each of these factors is associated with experiencing fewer depressive symptoms in later life, but no study to date has examined the relationship between overall cognitive lifestyle and depressive symptoms. This task is made more complex because relatively few older participants in cross-sectional studies will be currently experiencing depression. However, many more will show evidence of a depressive thinking style that predisposes them towards depression. This study aimed to investigate the extent to which cognitive lifestyle and its individual components are associated with depressive thoughts and symptoms. Two hundred and six community-dwelling participants aged 65+ completed the depressive cognitions scale, the geriatric depression scale and the lifetime of experiences questionnaire, which assesses cognitive lifestyle. Correlational analysis indicated that each of the individual lifestyle factors—education, occupational complexity and activities in young adulthood, mid-life and later life—and the combined cognitive lifestyle score was positively associated with each other and negatively with depressive symptoms, while all except education were negatively associated with depressive thoughts. Depressive thoughts and symptoms were strongly correlated. Cognitive lifestyle score explained 4.6 % of the variance in depressive thoughts and 10.2 % of the variance in depressive symptoms. The association of greater participation in cognitive activities, especially in later life, with fewer depressive symptoms and thoughts suggests that preventive interventions aimed at increasing participation in cognitively stimulating leisure activity could be beneficial in decreasing the risk of experiencing depressive thoughts and symptoms in later life.
    Full-text · Article · Dec 2015 · European Journal of Ageing
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    • "The number of previous episodes of depression positively correlates with serum IL-1β, TNF-α and neopterin levels, suggesting a role for CMI interactions with O&NS in the aetiology and course of recurrent depression and neuroprogression. This is important given the data showing that recurrent depression increases the risk of Alzheimer's disease [68]. However, it should be noted that changes in plasma IL-2 and IFN-ү levels are not always evident in depression [69], perhaps indicative of the heterogeneous nature of the disorder or of different stages of chronicity and neuroprogression. "

    Full-text · Dataset · Aug 2015
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