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Patterns of late‐life depressive symptoms and subsequent declines in cognitive domains
Author(s) -
Gillis J. Cai,
Chang ShunChiao,
Devore Elizabeth E.,
Rosner Bernard A.,
Grodstein Francine,
Okereke Olivia I.
Publication year - 2017
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4618
Subject(s) - cognition , depression (economics) , executive dysfunction , cognitive decline , late life depression , psychology , depressive symptoms , clinical psychology , psychiatry , medicine , disease , dementia , neuropsychology , economics , macroeconomics
Background Depression frequently co‐occurs with cognitive decline, but the nature of this association is unclear. We examined relations of late‐life depressive symptom patterns to subsequent domain‐specific cognitive changes. Methods Depressive symptoms were measured at up to 3 timepoints among 11,675 Nurses' Health Study participants prior to cognitive testing. Depressive symptom patterns were categorized as non‐depressed, variable or persistent, based on published severity cutpoints. Outcomes were global, verbal, and executive function‐attention composite scores. Results Participants with persistent depressive symptoms had worse executive function‐attention decline compared with non‐depressed participants (multivariable‐adjusted mean difference = −0.03 units/year, 95% CI: −0.05, −0.01; p = 0.003); this difference was comparable with 8 years of aging. However, being in the persistent versus non‐depressed group was not significantly related to verbal ( p = 0.71) or global score ( p = 0.09) decline. By contrast, compared with the non‐depressed group, those with variable depressive symptoms had worse verbal memory decline (multivariable‐adjusted mean difference = −0.01 units/year, 95% CI: −0.02, −0.002; p = 0.03); this group showed no differences for global or executive function‐attention decline. Conclusions A variable pattern of depressive symptom severity related to subsequent decline in verbal memory, while a persistent pattern related to decline in executive function‐attention. Findings could signal differences in underlying neuropathologic processes among persons with differing depression patterns and late‐life cognitive decline. Copyright © 2016 John Wiley & Sons, Ltd.