Psychiatric disorders and cognitive dysfunction among older, postmenopausal women: results from the Women's Health Initiative Memory Study.
OBJECTIVE
To estimate the frequency of depressive symptoms and selected psychiatric disorders in the Women's Health Initiative Memory Study (WHIMS) cohort and related them to cognitive syndromes.


METHODS
WHIMS was a randomized, double-blinded, placebo-controlled prevention clinical trial examining whether opposed and unopposed hormone therapy reduced the risk of dementia in healthy postmenopausal women. Participants scoring below a designated cutpoint on a cognitive screener received a comprehensive neuropsychiatric workup and adjudicated outcome of no cognitive impairment, mild cognitive impairment, or probable dementia.


METHODS
Seven thousand four hundred seventy-nine WHIMS participants between age 65 and 79 years and free of dementia at the time of enrollment in WHIMS. Five hundred twenty-one unique participants contributed complete data required for these analyses.


METHODS
Depressive symptoms were measured with the 15-item Geriatric Depression Scale and the presence of selected psychiatric disorders (major depression, generalized anxiety, and panic and alcohol abuse) was made using the PRIME-MD.


RESULTS
The 18% of women had at least one psychiatric disorder with depression being the most common (16%) followed by general anxiety or panic (6%) and alcohol abuse (1%). Depression and the presence of a psychiatric disorder were associated with impaired cognitive status. Participants having a psychiatric disorder were more than twice as likely to be diagnosed with cognitive impairment as those with no psychiatric disorder (odds ratio = 2.06, 95% confidence interval = 1.17-3.60). Older age, white race, and diabetes were also associated with cognitive impairment.


CONCLUSIONS
The frequency of a psychiatric disorder is associated with poorer cognitive functioning among older women enrolled in WHIMS. That approximately one in five women had a probable psychiatric disorder, most typically depression, highlights the need for greater detection and treatment efforts in this population.
Colenda
Christopher C
CC
Texas A&M Health Science Center, TX, USA.
Legault
Claudine
C
Rapp
Stephen R
SR
DeBon
Margaret W
MW
Hogan
Patricia
P
Wallace
Robert
R
Hershey
Linda
L
Ockene
Judith
J
Whitmer
Rachael
R
Phillips
Lawrence S
LS
Sarto
Gloria E
GE
D000368:Aged; D003072:Cognition Disorders / Q000150:complications / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology*; D017698:Postmenopause / Q000523:psychology*; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016387:Women's Health