Depressive Symptoms and Cognitive Decline in Late Life

Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
Archives of General Psychiatry (Impact Factor: 14.48). 03/2006; 63(2):153-60. DOI: 10.1001/archpsyc.63.2.153
Source: PubMed


Depression is associated with cognitive impairment and dementia. It is less clear whether depression contributes to further cognitive decline over time, independently of incipient dementia.
To examine the relationship between depressive symptoms and subsequent cognitive decline in a cohort of nondemented older adults, some of whom remained dementia free during follow-up and others in whom incident dementia eventually developed.
Twelve-year prospective epidemiological study, including biennial measurement of cognition and depressive symptoms, biennial assessment of dementia, and comparison of cognitive function at baseline and over time in persons with and without baseline depressive symptoms in the dementia-free and eventual-dementia groups, using random-effects models.
A largely blue-collar rural community.
Population-based sample of 1265 adults 67 years and older without dementia at baseline.
Scores over time on each of several cognitive test composites.
Among 1094 participants who remained dementia free, those with baseline depressive symptoms had significantly lower baseline scores on all cognitive composites than the nondepressed participants. Among the 171 individuals in whom dementia later developed, depression was associated with worse performance in some but not all baseline cognitive composites. Cognitive decline over time was minimal in the dementia-free group, whereas marked decline was seen in the eventual-dementia group. Depressive symptoms were not associated with rate of cognitive decline over time in either group.
Depressive symptoms are cross-sectionally associated with cognitive impairment but not subsequent cognitive decline. Substantial cognitive decline over time cannot be explained by depression and most likely reflects incipient dementia.

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    • "However, memory (Biringer et al., 2005) and visual–spatial ability (Hart et al., 1987) have also been found to be impaired in other studies. Furthermore, some investigations suggest that LLD increases the risk for continued cognitive decline and subsequent dementia, even after symptoms remit (Green et al., 2003; Ownby et al., 2006; Lee et al., 2007), while in other studies, these associations were not found (Lindsay et al., 2002; Ganguli et al., 2006; Becker et al., 2009). The question as to why depression in late life can have a pervasive negative influence on cognition in some individuals but not all remains to be reconciled. "
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    Full-text · Article · Aug 2014 · International Journal of Geriatric Psychiatry
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    • "The relationship between depression and concurrent cognitive function is now indisputable. Most studies have found depressive symptoms or disorders to be associated with poor cognitive test performance (Nebes et al., 2000; Sheline et al., 2006; Butters et al., 2004; Bhalla et al., 2006; Ganguli et al., 2006). Depression should be actively recognized and appropriately treated because it is a significant source of morbidity and mortality in its own right. "
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    • "Some studies have found that high scores on the CES-D are associated with an increased risk of developing dementia (Wilson et al. 2002 ; Gatz et al. 2005), but evidence that elevated levels of depressive symptoms are predictive of cognitive decline in older people without dementia is inconsistent. Ganguli et al. (2006) studied over 1200 such individuals using the CES-D and composite scores from a battery of cognitive tests, all of which were administered biennially, and found no link between depressive symptoms and rate of cognitive decline over 12 years. In a study of 1600 people using the CES-D and a cruder measure of cognitive decline, decrease in MMSE score of o5 points over 3 years, Dufouil et al. (1996) found no association between depressive symptoms and risk of cognitive deterioration. "
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