Depressive symptoms and cognitive change in older Mexican Americans.
To examine the association between presence of clinically relevant depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D] score >or= 16) and subsequent cognitive function (Mini-Mental State Examination [MMSE]) over a 7-year period in older Mexican Americans, a prospective cohort study was performed. Five south-western states contributed data to the Hispanic Established Populations for Epidemiologic Studies of the Elderly. Participants included 2812 noninstitutionalized Mexican Americans aged 65 and older followed from 1993-1994 until 2000-2001. Cognitive change was assessed using the MMSE at baseline and at 2, 5, and 7 years of follow-up. Independent variables were sociodemographics, CES-D >or= 16, medical conditions (hypertension, diabetes, coronary artery disease, and stroke), and activities of daily living (ADL) status. A general linear mixed model was used to estimate cognitive change. There was a cross-sectional association between CES-D >or= 16 and lower MMSE score (estimate = -0.48; standard error [SE] = 0.15; P < .01), independent of age, gender, education, marital status, time of interview, ADL limitations, vision impairment, and medical conditions. In the fully adjusted longitudinal model, subjects with clinically relevant depressive symptoms had a greater decline in MMSE score over 7 years than those without clinically relevant depressive symptoms (estimate = -0.17; SE = 0.05; P < .001), adjusting for sociodemographics, ADL and medical conditions. Each point increase in the CES-D score was associated with a decline of 0.010 point in MMSE score per year (SE = 0.002; P < 0.0001), adjusting for relevant confounders. Presence of clinically relevant depressive symptoms was associated with subsequent decline in cognitive function over 7 years in older Mexican Americans, independent of demographic and health factors.
Raji
Mukaila A
MA
Division of Geriatrics, Department of Internal Medicine University of Texas Medical Branch, TX 77555-0460, USA. muraji@utmb.edu
Reyes-Ortiz
Carlos A
CA
Kuo
Yong-Fang
YF
Markides
Kyriakos S
KS
Ottenbacher
Kenneth J
KJ
D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000523:psychology; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D015331:Cohort Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000523:psychology* / Q000706:statistics & numerical data; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012959:Socioeconomic Factors