title: Cognitive decline in patients with dementia as a function of depression.
abstract: OBJECTIVE
  There is evidence that major depression increases the risk for dementia, but there is conflicting evidence as to whether depression may accelerate cognitive decline in dementia. The authors tested the hypothesis that decline in cognitive function over time is more pronounced in patients with dementia with comorbid depression, when compared with patients with dementia without depression history.
  
  
  METHODS
  Prospective, longitudinal cohort study of aging.
  
  
  METHODS
  Nursing home.
  
  
  METHODS
  Three hundred thirteen elderly nursing home residents (mean age at baseline: 86.99 years, standard deviation = 6.7; 83.1% women). At baseline, 192 residents were diagnosed with dementia, and another 27 developed dementia during follow-up. Thirty residents suffered from major depression at any point during the study, and 48 residents had a history of depression.
  
  
  METHODS
  The authors measured cognitive decline using change in Mini-Mental State Examination (MMSE) scores over up to 36 months. The authors calculated multilevel regression models to estimate the effects of age, gender, education, dementia status, depression, depression history, and an interaction between dementia and depression, on change in MMSE scores over time.
  
  
  RESULTS
  Beyond the effects of age, gender, and education, residents showed steeper cognitive decline in the presence of dementia (β = -13.69, standard error = 1.38) and depression (β = -4.16, SE = 1.2), which was further accelerated by the presence of both depression and dementia (β = -2.72, SE = 0.65).
  
  
  CONCLUSIONS
  In dementia, the presence of depression corresponds to accelerated cognitive decline beyond gender and level of education, suggesting a unique influence of depression on the rate of cognitive decline in dementia.
authors.affiliation: Department of Psychiatry, Mount Sinai School of Medicine, NY, USA. michael.rapp@charite.de
authors.forename: Michael A
authors.initials: MA
authors.lastname: Rapp
authors.forename: Michal
authors.initials: M
authors.lastname: Schnaider-Beeri
authors.forename: Michael
authors.initials: M
authors.lastname: Wysocki
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Guerrero-Berroa
authors.forename: Hillel T
authors.initials: HT
authors.lastname: Grossman
authors.forename: Andreas
authors.initials: A
authors.lastname: Heinz
authors.forename: Vahram
authors.initials: V
authors.lastname: Haroutunian
mesh_terms: D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D003072:Cognition Disorders / Q000150:complications / Q000523:psychology*; D015331:Cohort Studies; D003704:Dementia / Q000150:complications / Q000523:psychology*; D003865:Major Depressive Disorder / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Arch Neurol. 2003 May;60(5):753-9
references.pmid: 12756140
references.citation: Am J Geriatr Psychiatry. 2010 Feb;18(2):98-116
references.pmid: 20104067
references.citation: Am J Geriatr Psychiatry. 2009 Jan;17(1):30-42
references.pmid: 19001356
references.citation: Arch Gen Psychiatry. 2003 Aug;60(8):804-15
references.pmid: 12912764
references.citation: Arch Gen Psychiatry. 1992 Aug;49(8):624-9
references.pmid: 1637252
references.citation: Am J Geriatr Psychiatry. 2005 Jun;13(6):441-9
references.pmid: 15956263
references.citation: Am J Psychiatry. 2003 May;160(5):857-66
references.pmid: 12727688
references.citation: J Psychiatr Res. 2003 Mar-Apr;37(2):99-108
references.pmid: 12842163
references.citation: Am J Psychiatry. 2008 Feb;165(2):229-37
references.pmid: 17986679
references.citation: J Am Geriatr Soc. 2005 Dec;53(12):2083-9
references.pmid: 16398891
references.citation: Dement Geriatr Cogn Disord. 2005;19(1):46-50
references.pmid: 15383746
references.citation: Arch Gen Psychiatry. 2006 Feb;63(2):153-60
references.pmid: 16461857
references.citation: Am J Psychiatry. 2005 Apr;162(4):691-8
references.pmid: 15800140
references.citation: Neurology. 2002 Aug 13;59(3):364-70
references.pmid: 12177369
references.citation: Am J Psychiatry. 2003 Aug;160(8):1516-8
references.pmid: 12900317
references.citation: Br J Psychiatry. 1996 Mar;168(3):287-91
references.pmid: 8833681
references.citation: Psychopharmacol Bull. 1988;24(4):637-9
references.pmid: 3249765
references.citation: Biol Psychiatry. 2004 Feb 15;55(4):390-7
references.pmid: 14960292
references.citation: Am J Psychiatry. 2002 Aug;159(8):1424-7
references.pmid: 12153839
references.citation: Am J Geriatr Psychiatry. 2002 Mar-Apr;10(2):129-41
references.pmid: 11925274
references.citation: Epidemiology. 1995 Jul;6(4):366-9
references.pmid: 7548342
references.citation: Psychol Med. 1998 Sep;28(5):1007-13
references.pmid: 9794008
references.citation: Arch Gen Psychiatry. 2008 May;65(5):542-50
references.pmid: 18458206
references.citation: Am J Geriatr Psychiatry. 1997 Spring;5(2):116-25
references.pmid: 9106375
references.citation: Am J Psychiatry. 2003 Oct;160(10):1751-6
references.pmid: 14514484
references.citation: Alzheimer Dis Assoc Disord. 2008 Jul-Sep;22(3):261-8
references.pmid: 18580591
references.citation: Neurology. 1991 Sep;41(9):1393-7
references.pmid: 1891088
references.citation: Am J Geriatr Psychiatry. 2002 Jan-Feb;10(1):62-71
references.pmid: 11790636
references.citation: Alzheimer Dis Assoc Disord. 2006 Jul-Sep;20(3 Suppl 2):S69-74
references.pmid: 16917199
references.citation: Arch Gen Psychiatry. 1998 Dec;55(12):1073-81
references.pmid: 9862549
references.citation: Arch Gen Psychiatry. 1996 Feb;53(2):175-82
references.pmid: 8629893
references.citation: Am J Geriatr Psychiatry. 2009 Aug;17(8):653-63
references.pmid: 19634208
references.citation: Genet Epidemiol. 1994;11(6):539-51
references.pmid: 7713394
references.citation: Gen Hosp Psychiatry. 2004 May-Jun;26(3):190-8
references.pmid: 15121347
references.citation: Int J Epidemiol. 1991;20 Suppl 2:S43-7
references.pmid: 1917269
references.citation: Psychosom Med. 2007 Jan;69(1):47-53
references.pmid: 17244848
references.citation: Am J Geriatr Psychiatry. 2008 Feb;16(2):168-74
references.pmid: 18239198
references.citation: Arch Gen Psychiatry. 2006 Feb;63(2):161-7
references.pmid: 16461859
references.citation: Arch Gen Psychiatry. 1999 Mar;56(3):261-6
references.pmid: 10078504