title: Late-life depression, mild cognitive impairment, and dementia.
abstract: OBJECTIVE
  To evaluate the association of late-life depression with mild cognitive impairment (MCI) and dementia in a multiethnic community cohort.
  
  
  METHODS
  A cohort study was conducted in Northern Manhattan, New York, New York.
  
  
  METHODS
  A total of 2160 community-dwelling Medicare recipients aged 65 years or older were included in the study.
  
  
  METHODS
  Depression was assessed using the 10-item version of the Center for Epidemiological Studies Depression scale (CES-D) and defined by a CES-D score of 4 or more. We used logistic regression for cross-sectional association analyses and proportional hazards regression for longitudinal analyses.
  
  
  METHODS
  Mild cognitive impairment dementia, and progression from MCI to dementia were the main outcome measures. We also used subcategories of MCI (amnestic and nonamnestic), and dementia (probable Alzheimer disease and vascular dementia, including possible Alzheimer disease with stroke).
  
  
  RESULTS
  Baseline depression was associated with prevalent MCI (odds ratio, 1.4; 95% CI, 1.1-1.9) and dementia (2.2; 1.6-3.1). Baseline depression was associated with an increased risk of incident dementia (hazard ratio [HR], 1.7; 95% CI, 1.2-2.3) but not with incident MCI (0.9; 0.7-1.2). Persons with MCI and coexisting depression at baseline had a higher risk of progression to dementia (HR, 2.0; 95% CI, 1.2-3.4), especially vascular dementia (4.3; 1.1-17.0), but not Alzheimer disease (1.9; 1.0-3.6).
  
  
  CONCLUSIONS
  The association of depression with prevalent MCI and with progression from MCI to dementia, but not with incident MCI, suggests that depression accompanies cognitive impairment but does not precede it.
authors.affiliation: Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Edo
authors.initials: E
authors.lastname: Richard
authors.forename: Christiane
authors.initials: C
authors.lastname: Reitz
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Honig
authors.forename: Nicole
authors.initials: N
authors.lastname: Schupf
authors.forename: Ming X
authors.initials: MX
authors.lastname: Tang
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Manly
authors.forename: Richard
authors.initials: R
authors.lastname: Mayeux
authors.forename: Devangere
authors.initials: D
authors.lastname: Devanand
authors.forename: José A
authors.initials: JA
authors.lastname: Luchsinger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012111:Residence Characteristics