Long-term cumulative depressive symptom burden and risk of cognitive decline and dementia among very old women

Adina Zeki Al Hazzouri, Eric Vittinghoff, Amy Byers, Ken Covinsky, Dan Blazer, Susan Diem, Kristine E. Ensrud, Kristine Yaffe

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background.Depressive symptoms and cognitive outcomes are strongly interrelated. Despite that rates of depressive symptoms fluctuate during late life, little is known about the impact of long-term cumulative depressive symptom burden on cognitive decline and dementia in older adults. This study examines the association of nearly 20 years of cumulative depressive symptoms with cognitive outcomes in a cohort of older women.Methods.We assessed depressive symptoms in 7,240 women using the Geriatric Depression scale (GDS) at serial visits. We used a Poisson model with random slopes to estimate GDS trajectories for each participant from baseline to death or end of follow-up, and then characterized depressive symptom burden by quartile of the area under the curve. We assessed cognitive outcomes using repeated measures of the Mini-Mental State Examination (MMSE) and Trails B score over 20 years, Year-20 neuropsychological test battery, and adjudicated dementia and mild cognitive impairment (MCI).Results.Adjusting for potential confounders, compared with women in the lowest quartile of cumulative depressive symptoms burden, women in the highest quartile had 21% more MMSE errors over time (95% CI = 17%, 26%), 20% worse Trails B score over time (95% CI = 17%, 23%), worse scores on most of the Year-20 cognitive tests, and a twofold greater likelihood of developing dementia or MCI (95% CI = 1.48, 3.11).Conclusions.Long-term cumulative depressive symptom burden was associated with cognitive decline and risk of dementia or MCI. Older adults with a history of depression should be closely monitored for recurrent episodes or unresolved depressive symptoms as well as any cognitive deficits.

Original languageEnglish (US)
Pages (from-to)595-601
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume69 A
Issue number5
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Dementia
Depression
Geriatrics
Cognitive Dysfunction
Neuropsychological Tests
Area Under Curve

Keywords

  • Alzheimer's
  • Cognition
  • Depression

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology
  • Medicine(all)

Cite this

Long-term cumulative depressive symptom burden and risk of cognitive decline and dementia among very old women. / Zeki Al Hazzouri, Adina; Vittinghoff, Eric; Byers, Amy; Covinsky, Ken; Blazer, Dan; Diem, Susan; Ensrud, Kristine E.; Yaffe, Kristine.

In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 69 A, No. 5, 2014, p. 595-601.

Research output: Contribution to journalArticle

Zeki Al Hazzouri, Adina ; Vittinghoff, Eric ; Byers, Amy ; Covinsky, Ken ; Blazer, Dan ; Diem, Susan ; Ensrud, Kristine E. ; Yaffe, Kristine. / Long-term cumulative depressive symptom burden and risk of cognitive decline and dementia among very old women. In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences. 2014 ; Vol. 69 A, No. 5. pp. 595-601.
@article{26749f5485a041bcb81e234a0fe1177d,
title = "Long-term cumulative depressive symptom burden and risk of cognitive decline and dementia among very old women",
abstract = "Background.Depressive symptoms and cognitive outcomes are strongly interrelated. Despite that rates of depressive symptoms fluctuate during late life, little is known about the impact of long-term cumulative depressive symptom burden on cognitive decline and dementia in older adults. This study examines the association of nearly 20 years of cumulative depressive symptoms with cognitive outcomes in a cohort of older women.Methods.We assessed depressive symptoms in 7,240 women using the Geriatric Depression scale (GDS) at serial visits. We used a Poisson model with random slopes to estimate GDS trajectories for each participant from baseline to death or end of follow-up, and then characterized depressive symptom burden by quartile of the area under the curve. We assessed cognitive outcomes using repeated measures of the Mini-Mental State Examination (MMSE) and Trails B score over 20 years, Year-20 neuropsychological test battery, and adjudicated dementia and mild cognitive impairment (MCI).Results.Adjusting for potential confounders, compared with women in the lowest quartile of cumulative depressive symptoms burden, women in the highest quartile had 21{\%} more MMSE errors over time (95{\%} CI = 17{\%}, 26{\%}), 20{\%} worse Trails B score over time (95{\%} CI = 17{\%}, 23{\%}), worse scores on most of the Year-20 cognitive tests, and a twofold greater likelihood of developing dementia or MCI (95{\%} CI = 1.48, 3.11).Conclusions.Long-term cumulative depressive symptom burden was associated with cognitive decline and risk of dementia or MCI. Older adults with a history of depression should be closely monitored for recurrent episodes or unresolved depressive symptoms as well as any cognitive deficits.",
keywords = "Alzheimer's, Cognition, Depression",
author = "{Zeki Al Hazzouri}, Adina and Eric Vittinghoff and Amy Byers and Ken Covinsky and Dan Blazer and Susan Diem and Ensrud, {Kristine E.} and Kristine Yaffe",
year = "2014",
doi = "10.1093/gerona/glt139",
language = "English (US)",
volume = "69 A",
pages = "595--601",
journal = "Journals of Gerontology - Series A Biological Sciences and Medical Sciences",
issn = "1079-5006",
publisher = "Oxford University Press",
number = "5",

}

TY - JOUR

T1 - Long-term cumulative depressive symptom burden and risk of cognitive decline and dementia among very old women

AU - Zeki Al Hazzouri, Adina

AU - Vittinghoff, Eric

AU - Byers, Amy

AU - Covinsky, Ken

AU - Blazer, Dan

AU - Diem, Susan

AU - Ensrud, Kristine E.

AU - Yaffe, Kristine

PY - 2014

Y1 - 2014

N2 - Background.Depressive symptoms and cognitive outcomes are strongly interrelated. Despite that rates of depressive symptoms fluctuate during late life, little is known about the impact of long-term cumulative depressive symptom burden on cognitive decline and dementia in older adults. This study examines the association of nearly 20 years of cumulative depressive symptoms with cognitive outcomes in a cohort of older women.Methods.We assessed depressive symptoms in 7,240 women using the Geriatric Depression scale (GDS) at serial visits. We used a Poisson model with random slopes to estimate GDS trajectories for each participant from baseline to death or end of follow-up, and then characterized depressive symptom burden by quartile of the area under the curve. We assessed cognitive outcomes using repeated measures of the Mini-Mental State Examination (MMSE) and Trails B score over 20 years, Year-20 neuropsychological test battery, and adjudicated dementia and mild cognitive impairment (MCI).Results.Adjusting for potential confounders, compared with women in the lowest quartile of cumulative depressive symptoms burden, women in the highest quartile had 21% more MMSE errors over time (95% CI = 17%, 26%), 20% worse Trails B score over time (95% CI = 17%, 23%), worse scores on most of the Year-20 cognitive tests, and a twofold greater likelihood of developing dementia or MCI (95% CI = 1.48, 3.11).Conclusions.Long-term cumulative depressive symptom burden was associated with cognitive decline and risk of dementia or MCI. Older adults with a history of depression should be closely monitored for recurrent episodes or unresolved depressive symptoms as well as any cognitive deficits.

AB - Background.Depressive symptoms and cognitive outcomes are strongly interrelated. Despite that rates of depressive symptoms fluctuate during late life, little is known about the impact of long-term cumulative depressive symptom burden on cognitive decline and dementia in older adults. This study examines the association of nearly 20 years of cumulative depressive symptoms with cognitive outcomes in a cohort of older women.Methods.We assessed depressive symptoms in 7,240 women using the Geriatric Depression scale (GDS) at serial visits. We used a Poisson model with random slopes to estimate GDS trajectories for each participant from baseline to death or end of follow-up, and then characterized depressive symptom burden by quartile of the area under the curve. We assessed cognitive outcomes using repeated measures of the Mini-Mental State Examination (MMSE) and Trails B score over 20 years, Year-20 neuropsychological test battery, and adjudicated dementia and mild cognitive impairment (MCI).Results.Adjusting for potential confounders, compared with women in the lowest quartile of cumulative depressive symptoms burden, women in the highest quartile had 21% more MMSE errors over time (95% CI = 17%, 26%), 20% worse Trails B score over time (95% CI = 17%, 23%), worse scores on most of the Year-20 cognitive tests, and a twofold greater likelihood of developing dementia or MCI (95% CI = 1.48, 3.11).Conclusions.Long-term cumulative depressive symptom burden was associated with cognitive decline and risk of dementia or MCI. Older adults with a history of depression should be closely monitored for recurrent episodes or unresolved depressive symptoms as well as any cognitive deficits.

KW - Alzheimer's

KW - Cognition

KW - Depression

UR - http://www.scopus.com/inward/record.url?scp=84899045676&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899045676&partnerID=8YFLogxK

U2 - 10.1093/gerona/glt139

DO - 10.1093/gerona/glt139

M3 - Article

C2 - 24097423

AN - SCOPUS:84899045676

VL - 69 A

SP - 595

EP - 601

JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

SN - 1079-5006

IS - 5

ER -