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P3‐264: Cognitive and socioeconomic predictors of survival in dementia
Author(s) -
Russ Tom,
Batty David,
Starr John
Publication year - 2011
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.2011.05.1705
Subject(s) - dementia , covariate , confounding , verbal fluency test , cognition , proportional hazards model , medicine , survival analysis , demography , psychology , gerontology , clinical psychology , psychiatry , neuropsychology , disease , statistics , mathematics , sociology
pairment and dementia. It is currently unclear whether depression is a true risk factor for cognitive impairment, or an early symptom of cognitive impairment. Our objective was to explore the association of late life depression with mild cognitive impairment (MCI) and dementia in cross-sectional and longitudinal analyses and to explore whether this association is different for Alzheimer’s disease (AD) and vascular dementia (VD). Methods: We analyzed data from a cohort of 2160 elderly community-dwelling participants 65 years and older with an average follow-up of 5.4 years. Depression was assessed using the 10 item CES-D with a cut-off for depression of1⁄4 4 points. Cross-sectional associations were assessed using logistic regression models and longitudinal analyses were assessed using Cox proportional hazards models. Results: Depression was cross-sectionally associated with higher risk of MCI (OR1⁄41.44;95% CI:1.11-1.86) and dementia (OR1⁄42.22;95%CI:1.60-3.06). Depression was longitudinally associated with an increased risk of incident dementia (HR1⁄41.68;95%CI: 1.22-2.32), but not with incident MCI (HR 1⁄4 0.90; 95% CI: 0.66-1.23). Cross-sectional and longitudinal results were similar for AD and VD. Persons with MCI at baseline with co-existing depression had a higher risk of progression to dementia (HR1⁄42.34;95%CI: 1.43-3.84), which was limited to VD (HR1⁄44.30;95%CI: 1.09-17.03; HR for AD1⁄4 1.07; 95% CI: 0.47-2.45). Conclusions: Late life depression was cross-sectionally associated with MCI and dementia and longitudinally with increased dementia risk only. Persons with MCI and co-existing depression have a higher risk of progressing to VD but not AD, suggesting a cerebrovascular mechanism.. The association of depression with prevalent MCI and with progression from MCI to dementia, but not with incident MCI suggests that depression accompanies cognitive impairment but does not precede it.