title: Disability but not social support predicts cognitive deterioration in late-life depression.
abstract: BACKGROUND
  Depression in late life is a risk factor for cognitive decline. Depression is also associated with increased disability and social support deficits; these may precede conversion to dementia and inform risk. In this study, we examined if baseline or one-year change in disability and social support predicted later cognitive deterioration.
  
  
  METHODS
  299 cognitively intact depressed older adults were followed for an average of approximately seven years. Participants received antidepressant treatment according to a standardized algorithm. Neuropsychological testing and assessment of disability and social support were assessed annually. Cognitive diagnosis was reviewed annually at a consensus conference to determine if participants remained cognitively normal, or if they progressed to either dementia or cognitively impaired, no dementia (CIND).
  
  
  RESULTS
  During study participation, 167 individuals remained cognitively normal (56%), 83 progressed to CIND (28%), and 49 progressed to dementia (16%). Greater baseline instrumental activities of daily living (IADL) deficits predicted subsequent conversion to a cognitive diagnosis (CIND or dementia). However, neither baseline measures nor one-year change in basic ADLs (BADLs) and social support predicted cognitive conversion. In post hoc analyses, two IADL measures (managing finances, preparing meals) significantly increased the odds of cognitive conversion.
  
  
  CONCLUSIONS
  Greater IADL deficits predicted increased risk of cognitive conversion. Assessment of IADL deficits may provide clues about risk of later cognitive decline.
authors.affiliation: The Center for Cognitive Medicine,Department of Psychiatry,Vanderbilt University Medical Center,Nashville,TN,37212,USA.
authors.forename: Meghan
authors.initials: M
authors.lastname: Riddle
authors.affiliation: Department of Psychiatry,Duke University Medical Center,Durham,NC,27710,USA.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: McQuoid
authors.affiliation: Department of Psychiatry,Duke University Medical Center,Durham,NC,27710,USA.
authors.forename: Guy G
authors.initials: GG
authors.lastname: Potter
authors.affiliation: Department of Psychiatry,University of Connecticut Health Center,Farmington,CT,06030,USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Steffens
authors.affiliation: The Center for Cognitive Medicine,Department of Psychiatry,Vanderbilt University Medical Center,Nashville,TN,37212,USA.
authors.forename: Warren D
authors.initials: WD
authors.lastname: Taylor
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000209:etiology*; D003704:Dementia / Q000209:etiology; D003865:Major Depressive Disorder / Q000150:complications* / Q000523:psychology; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors; D012944:Social Support
keywords: memory