title: Late-Life Depressive Symptoms and Lifetime History of Major Depression: Cognitive Deficits are Largely Due to Incipient Dementia rather than Depression.
abstract: Late-life depression is frequently accompanied by cognitive impairments.
  
  
  
  Whether these impairments indicate a prodromal state of dementia, or are a symptomatic expression of depression per se is not well-studied.
  
  
  
  In a cohort of very old initially non-demented primary care patients (n = 2,709, mean age = 81.1 y), cognitive performance was compared between groups of participants with or without elevated depressive symptoms and with or without subsequent dementia using ANCOVA (adjusted for age, sex, and education). Logistic regression analyses were computed to predict subsequent dementia over up to six years of follow-up. The same analytical approach was performed for lifetime major depression.
  
  
  
  Participants with elevated depressive symptoms without subsequent dementia showed only small to medium cognitive deficits. In contrast, participants with depressive symptoms with subsequent dementia showed medium to very large cognitive deficits. In adjusted logistic regression models, learning and memory deficits predicted the risk for subsequent dementia in participants with depressive symptoms. Participants with a lifetime history of major depression without subsequent dementia showed no cognitive deficits. However, in adjusted logistic regression models, learning and orientation deficits predicted the risk for subsequent dementia also in participants with lifetime major depression.
  
  
  
  Marked cognitive impairments in old age depression should not be dismissed as "depressive pseudodementia", but require clinical attention as a possible sign of incipient dementia. Non-depressed elderly with a lifetime history of major depression, who remained free of dementia during follow-up, had largely normal cognitive performance.
authors: Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
authors: Kathrin
authors: K
authors: Heser
authors: Department of General Practice and Family Medicine, University of Bonn, Bonn, Germany.
authors: Markus
authors: M
authors: Bleckwenn
authors: Working Group Medical Statistics and IT Infrastructure, Institute of General Practice, Hannover Medical School, Hannover, Germany.
authors: Birgitt
authors: B
authors: Wiese
authors: Working Group Medical Statistics and IT Infrastructure, Institute of General Practice, Hannover Medical School, Hannover, Germany.
authors: Silke
authors: S
authors: Mamone
authors: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
authors: Steffi G
authors: SG
authors: Riedel-Heller
authors: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
authors: Janine
authors: J
authors: Stein
authors: Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Dagmar
authors: D
authors: Lühmann
authors: Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Tina
authors: T
authors: Posselt
authors: Institute of General Practice, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
authors: Angela
authors: A
authors: Fuchs
authors: Institute of General Practice, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
authors: Michael
authors: M
authors: Pentzek
authors: Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
authors: Siegfried
authors: S
authors: Weyerer
authors: Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
authors: Jochen
authors: J
authors: Werle
authors: Department of Psychiatry, Technical University Munich, Munich, Germany.
authors: Dagmar
authors: D
authors: Weeg
authors: Department of Psychiatry, Technical University Munich, Munich, Germany.
authors: Horst
authors: H
authors: Bickel
authors: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Christian
authors: C
authors: Brettschneider
authors: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Hans-Helmut
authors: HH
authors: König
authors: Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.|DZNE, Center for Neurodegenerative Diseases, Bonn, Germany.
authors: Wolfgang
authors: W
authors: Maier
authors: Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Martin
authors: M
authors: Scherer
authors: Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.|DZNE, Center for Neurodegenerative Diseases, Bonn, Germany.
authors: Michael
authors: M
authors: Wagner
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000453:epidemiology* / Q000209:etiology*; D003704:Dementia / Q000453:epidemiology*; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D000073216:Mental Status and Dementia Tests; D009483:Neuropsychological Tests; D016017:Odds Ratio; D062706:Prodromal Symptoms; D011446:Prospective Studies; D012737:Sex Factors
keywords: Cognition; dementia; depression; depressive symptoms; executive function; memory