title: Appetite and Weight Loss Symptoms in Late-Life Depression Predict Dementia Outcomes.
abstract: Identify depression symptoms during active late-life depression (LLD) that predict conversion to dementia.
  
  
  
  The authors followed a cohort of 290 participants from the Neurocognitive Outcomes of Depression in the Elderly study. All participants were actively depressed and cognitively normal at enrollment. Depression symptom factors were derived from prior factor analysis: anhedonia and sadness, suicidality and guilt, appetite and weight loss, sleep disturbance, and anxiety and tension. Cox regression analysis modeled time to Alzheimer disease (AD) and non-AD dementia onset on depression symptom factors, along with age, education, sex, and race. Significant dementia predictors were tested for interaction with age at depression onset.
  
  
  
  Higher scores on the appetite and weight loss symptom factor were associated with an increased hazard of both AD and non-AD dementia. This factor was moderated by age at first depression onset, such that higher scores were associated with higher risk of non-AD dementia when depression first occurred earlier in life. Other depression symptom factors and overall depression severity were not related to risk of AD or non-AD dementia.
  
  
  
  Results suggest greater appetite/weight loss symptoms in active episodes of LLD are associated with increased likelihood of AD and non-AD dementia, but possibly via different pathways moderated by age at first depression onset. Results may help clinicians identify individuals with LLD at higher risk of developing AD and non-AD dementia and design interventions that reduce this risk.
authors.affiliation: Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Duke University, Durham, NC.
authors.forename: Sayoni
authors.initials: S
authors.lastname: Saha
authors.affiliation: Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Duke University, Durham, NC; Center for the Study of Aging and Human Development, Duke University, Durham, NC.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Hatch
authors.affiliation: Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Hayden
authors.affiliation: Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT.
authors.forename: David C
authors.initials: DC
authors.lastname: Steffens
authors.affiliation: Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Duke University, Durham, NC; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. Electronic address: guy.potter@duke.edu.
authors.forename: Guy G
authors.initials: GG
authors.lastname: Potter
mesh_terms: D000368:Aged; D059445:Anhedonia; D000855:Anorexia / Q000453:epidemiology* / Q000523:psychology; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D016022:Case-Control Studies; D003704:Dementia / Q000453:epidemiology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006167:Guilt; D006801:Humans; D000067562:Late Onset Disorders; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012893:Sleep Wake Disorders / Q000453:epidemiology; D059020:Suicidal Ideation; D015431:Weight Loss
keywords: Alzheimer disease; appetite loss; dementia; late-life depression