title: Psychiatric disorders and cognitive dysfunction among older, postmenopausal women: results from the Women's Health Initiative Memory Study.
abstract: 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.
authors.affiliation: Texas A&M Health Science Center, TX, USA.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Colenda
authors.forename: Claudine
authors.initials: C
authors.lastname: Legault
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Rapp
authors.forename: Margaret W
authors.initials: MW
authors.lastname: DeBon
authors.forename: Patricia
authors.initials: P
authors.lastname: Hogan
authors.forename: Robert
authors.initials: R
authors.lastname: Wallace
authors.forename: Linda
authors.initials: L
authors.lastname: Hershey
authors.forename: Judith
authors.initials: J
authors.lastname: Ockene
authors.forename: Rachael
authors.initials: R
authors.lastname: Whitmer
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Phillips
authors.forename: Gloria E
authors.initials: GE
authors.lastname: Sarto
mesh_terms: 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