title: The nuances of cognition and depression in older adults: the need for a comprehensive assessment.
abstract: OBJECTIVE
  This study aimed to examine the confluence of depression, cognitive impairment, and vascular risk factors in older individuals.
  
  
  METHODS
  The study uses baseline data from the National Alzheimer's Coordinating Center. Data were collected across Alzheimer's Disease Centers in the USA. The sample included 12,634 individuals (cognitive intact = 8022; amnestic mild cognitive impairment [aMCI] = 3652; nonamnestic MCI [nonaMCI] = 960). The Geriatric Depression Scale assessed depression; the Trail Making Test assessed executive function.
  
  
  RESULTS
  The proportion of participants with depression was higher in the aMCI (18%) and nonaMCI group (21%) as compared with that in the cognitively intact group (8%); there was no difference in rates of depression between aMCI and nonaMCI groups. The proportion of participants with executive dysfunction differed between nondepressed and depressed individuals for the cognitively intact (8% vs. 12%) and aMCI groups (28% vs. 35%), but not for the nonaMCI group (37% vs. 41%). Nine percent of the cognitively intact group had executive dysfunction compared with 31% of the aMCI group and 40% of the nonaMCI group. The proportion of participants with hypertension was greater in individuals with executive dysfunction compared with those with no executive deficits; the presence of hypertension was not associated with depression severity.
  
  
  CONCLUSIONS
  The confluence of vascular risk factors, episodic memory impairment, and depression and executive dysfunction highlights the need for comprehensive assessment of depressed older adults that can aid clinicians in the formulation of treatment planning and inform clinicians and researchers about long-term prognosis.
authors.affiliation: Geriatric Psychiatry, Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Brown
authors.forename: Joel R
authors.initials: JR
authors.lastname: Sneed
authors.forename: Bret R
authors.initials: BR
authors.lastname: Rutherford
authors.forename: D P
authors.initials: DP
authors.lastname: Devanand
authors.forename: Steven P
authors.initials: SP
authors.lastname: Roose
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000503:physiopathology / Q000523:psychology*; D003866:Depressive Disorder / Q000503:physiopathology / Q000523:psychology*; D056344:Executive Function / Q000502:physiology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008569:Memory Disorders / Q000503:physiopathology / Q000523:psychology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales
keywords: depression; geriatrics; mild cognitive impairment; vascular risk factors