title: Cognitive performance in depressed older persons: the impact of vascular burden and remission. A two-year follow-up study.
abstract: Depression is associated with an increased risk of cognitive decline. The present study compared two-year change in cognitive performance between depressed older persons and a non-depressed control group, between remitted and non-remitted patients, and evaluated whether vascular burden at baseline was associated with more cognitive decline in depressed older persons.
  
  
  
  Depressed patients (n = 378) aged ≥60 were recruited from mental healthcare institutes and general practices, and a non-depressed control group (n = 132) was recruited from general practices. A DSM-IV depressive episode was established with the Composite International Diagnostic Interview, and processing speed, working memory, verbal memory and interference control were evaluated with three neurocognitive tasks at baseline and 2 years later. A modified Framingham Risk Score, ankle-brachial index, and history of a vascular event defined vascular burden at baseline.
  
  
  
  After adjusting for baseline cognitive performance, age, sex, and education level, depressed older persons had worse processing speed and verbal memory scores at follow-up than controls (regression coefficients: -0.172; p = 0.042 and -0.309; p = 0.001, respectively) but did not differ in the other two-cognitive outcomes. In the sample of depressed patients, remission status at 2 years follow-up and baseline vascular burden did not predict cognitive performance at follow-up, after adjustment for baseline cognitive performance, age, sex and education level.
  
  
  
  Our findings suggest that cognitive deficits in depressed older persons are not just a manifestation of depression. In addition, vascular burden was not associated with worse cognitive decline in a sample of depressed older persons. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: University Center of Psychiatry & Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Marij
authors.initials: M
authors.lastname: Zuidersma
authors.affiliation: Department of Psychiatry/EMGO Institute for Care and Research, VU University Medical Center, Amsterdam, The Netherlands.|GGZ inGeest, Amsterdam, The Netherlands.
authors.forename: Hannie C
authors.initials: HC
authors.lastname: Comijs
authors.affiliation: Department of Old Age Psychiatry, GGNet Center for Mental Health, Apeldoorn, The Netherlands.|Department of Psychiatry, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Naarding
authors.affiliation: University Center of Psychiatry & Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Oude Voshaar
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications; D016022:Case-Control Studies; D003071:Cognition / Q000502:physiology*; D003866:Depressive Disorder / Q000503:physiopathology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D008875:Middle Aged; D009426:Netherlands; D012307:Risk Factors; D014706:Verbal Learning / Q000502:physiology
keywords: depression remission; interference control; processing speed; vascular risk; verbal memory; working memory