Depressive symptoms in oldest-old women:  risk of mild cognitive impairment and dementia.
OBJECTIVE
Increasing evidence suggests that depression is a risk factor for cognitive impairment, but it is unclear if this is true among the oldest old. We determined whether elevated depressive symptoms predicted 5-year incident mild cognitive impairment (MCI) or dementia, and neuropsychological test performance among oldest-old women.


METHODS
Prospective.


METHODS
Three study sites.


METHODS
302 women ≥85 years (mean, 87 ± 2).


METHODS
Depressive symptoms were measured with the 15-item Geriatric Depression Scale (GDS); scores of 6 or more indicated elevated symptoms. Five years later, participants completed neuropsychological testing and clinical cognitive status was adjudicated.


RESULTS
In analyses of MCI versus normal cognition, 70% of women with GDS score 6 or more at baseline developed MCI versus 37% with GDS score less than 6. After adjustment for age, education, alcohol, and benzodiazepine use, and study site, GDS score 6 or more remained independently associated with much greater likelihood of developing MCI (multivariable odds ratio [MOR] = 3.71, 95% confidence interval (CI): 1.30-10.59). In analyses of dementia versus normal cognition, 65% of women with GDS score 6 or more developed dementia compared with 37% of those with GDS score less than 6 (MOR = 3.15, 95% CI: 1.03-9.65). Only 19% of women with GDS score 6 or more had normal cognitive status 5 years later, compared with 46% of those with GDS score less than 6 (MOR = 0.28, 95% CI: 0.11-0.73). Women with elevated depressive symptoms had worse scores on tests of global cognition and working memory.


CONCLUSIONS
Elevated depressive symptoms are an important risk factor for cognitive disorders and lower cognitive performance among women living to their ninth and tenth decades.
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. aspira@jhsph.edu
Adam P
AP
Spira
George W
GW
Rebok
Katie L
KL
Stone
Joel H
JH
Kramer
Kristine
K
Yaffe
D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000209:etiology*; D003704:Dementia / Q000175:diagnosis / Q000209:etiology*; D003863:Depression / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D009483:Neuropsychological Tests; D016017:Odds Ratio; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012307:Risk Factors