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P3‐123: Spousal dementia caregiving as a risk factor for incident dementia
Author(s) -
Norton Maria C.,
Smith Ken R.,
Ostbye Truls,
Corcoran Christopher,
Schwartz Sarah,
Piercy Kathleen W.,
Rabins Peter V.,
Steffens David C.,
Breitner John C.S.,
WelshBohmer Kathleen A.
Publication year - 2009
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2009.04.1098
Subject(s) - dementia , spouse , medicine , proportional hazards model , hazard ratio , psychosocial , population , cohort , gerontology , psychiatry , psychology , disease , confidence interval , environmental health , sociology , anthropology
cognitive impairment (MCI) or dementia. Less is known about the degree to which depression predicts cognitive decline in older adults who do not necessarily meet criteria for MCI. Methods: Subjects were 444 women age 60+ and cognitively intact at baseline, recruited from a single site of the Women’s Health Initiative. Cognitive testing was performed at 2 time points, 3 years apart, with 13 tests of a variety of cognitive domains, yielding 17 cognitive test scores (5 from memory tests). A global Z-score was created for both baseline and 3-year time points by averaging all Z-scores for each study participant, at each time point. A similar procedure was done separately for memory scores. Cognitive change was defined as the difference between follow-up and baseline Z-score for global function and memory, respectively. Scores from the Geriatric Depression Scale (GDS), administered at baseline, were categorized as 0-2, 3-5, 6-9, and 10+ points. Linear regression models were run to determine extent to which GDS score predicted global cognitive or memory change over 3 years, adjusting for age, education, reading ability, ApoE e4 allele, and baseline cognitive z-score. Results: GDS score was a significant predictor of decline in both global and memory z-scores. Women with GDS score of 0-2 had a mean decline of 0.083 (global) and 0.088 (memory) standard deviations, while those with GDS score of 10+ had a mean decline of 0.262 SD for global (p1⁄4.004 for difference between means) and 0.290 SD for memory (p1⁄4.038 for difference between means). Those with GDS scores of 6-9 showed mean cognitive decline of 0.160 (Global, p1⁄4.08) and 0.203 (memory, p1⁄4.09). Conclusions: Women with GDS scores of 10 or greater at baseline had significantly greater 3-year decline in both memory and global cognitive function, compared to those with baseline GDS scores of 0-2. The mean degree of excess decline was 0.202 SD for memory and 0.178 SD for global cognitive function. Future studies are needed to determine potential mechanisms and mediating factors for this association.