Depressive symptoms predict incident cognitive impairment in cognitive healthy older women.
OBJECTIVE
There is an increasing evidence that depressive symptoms are associated with the development of cognitive impairment and dementia in late life. The authors sought to examine whether depression increased the risk of incident cognitive impairment in a longitudinal study of older women.


METHODS
Observational study, up to six examinations spanning up to 9 years.


METHODS
University-based Division of Geriatric Medicine.


METHODS
Community-based sample of 436 older, nondemented women.


METHODS
Participants were followed up with regular medical and neuropsychiatric evaluations. Cognitive assessment included episodic immediate and delayed memory, psychomotor speed, and executive functioning. Participants were characterized as having incident impairment on a cognitive test when scores fell below the 10th percentile on age-adjusted norms. Baseline depressive symptoms were measured using the Geriatric Depression Scale (GDS) (30-item). Discrete-time Cox proportional hazards regression with generalized linear models were used to determine whether baseline risk factors predicted incident impairment on each cognitive test, defined as performance below the tenth percentile on age-adjusted norms.


RESULTS
Baseline GDS was highly associated with incident impairment on all cognitive tests (p <0.03). These associations were unaffected by vascular conditions except diabetes, which was associated with incident impairment in delayed recall and psychomotor speed.


CONCLUSIONS
These data suggest that depression may be the risk factors for cognitive decline, and thus a potential target for diagnostic and therapeutic interventions.
Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins Bayview Medical Center, Baltimore MD 21224, USA. prosenb9@jhmi.edu
Paul B
PB
Rosenberg
Michelle M
MM
Mielke
Qian-Li
QL
Xue
Michelle C
MC
Carlson
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications; D003072:Cognition Disorders / Q000150:complications* / Q000523:psychology; D003863:Depression / Q000150:complications* / Q000175:diagnosis; D048909:Diabetes Complications / Q000523:psychology; D056344:Executive Function; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008137:Longitudinal Studies; D008568:Memory; D011597:Psychomotor Performance; D012307:Risk Factors; D016387:Women's Health