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Trajectories of Depressive Symptoms in Older Adults and Risk of Dementia

Published on May 1, 2016in JAMA Psychiatry15.92
· DOI :10.1001/jamapsychiatry.2016.0004
Allison R. Kaup12
Estimated H-index: 12
(UCSF: University of California, San Francisco),
Amy L. Byers25
Estimated H-index: 25
(UCSF: University of California, San Francisco)
+ 6 AuthorsKristine Yaffe113
Estimated H-index: 113
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Abstract
Importance Depression has been identified as a risk factor for dementia. However, most studies have measured depressive symptoms at only one time point, and older adults may show different patterns of depressive symptoms over time. Objective To investigate the association between trajectories of depressive symptoms and risk of dementia in older adults. Design, Setting, and Participants This was a prospective cohort investigation of black and white community-dwelling older adults in the Health, Aging, and Body Composition study. Participants were enrolled between May 1997 and June 1998 and followed up through 2001-2002. The dates of this analysis were September 2014 to December 2015. The setting was community research centers in Memphis, Tennessee, and Pittsburgh, Pennsylvania. Trajectories of depressive symptoms were assessed from baseline to year 5. Symptoms were measured with the Center for Epidemiologic Studies Depression Scale Short Form, and trajectories were calculated using latent class growth curve analysis. Main Outcomes and Measures Incident dementia through year 11, determined by dementia medication use, hospital records, or significant cognitive decline (≥1.5 SD race-specific decline on the Modified Mini-Mental State Examination). We examined the association between depressive symptom trajectories and dementia incidence using Cox proportional hazards regression models adjusted for demographics, health factors that differed between groups, and cognition during the depressive symptom assessment period (baseline to year 5). Results The analytic cohort included 2488 black and white older adults with repeated depressive symptom assessments from baseline to year 5 who were free of dementia throughout that period. Their mean (SD) age at baseline was 74.0 (2.8) years, and 53.1% (n = 1322) were female. The following 3 depressive symptom trajectories were identified: consistently minimal symptoms (62.0% [n = 1542] of participants), moderate and increasing symptoms (32.2% [n = 801] of participants), and high and increasing symptoms (5.8% [n = 145] of participants). Compared with the consistently minimal trajectory, having a high and increasing depressive symptom trajectory was associated with significantly increased risk of dementia (fully adjusted hazard ratio, 1.94; 95% CI, 1.30-2.90), while the moderate and increasing trajectory was not associated with risk of dementia after full adjustment. Sensitivity analyses indicated that the high and increasing trajectory was associated with dementia incidence, while depressive symptoms at individual time points were not. Conclusions and Relevance Older adults with a longitudinal pattern of high and increasing depressive symptoms are at high risk for dementia. Individuals’ trajectory of depressive symptoms may inform dementia risk more accurately than one-time assessment of depressive symptoms.
  • References (36)
  • Citations (50)
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References36
Newest
Published on May 7, 2015in Journal of Alzheimer's Disease3.70
Nancy J. Donovan14
Estimated H-index: 14
,
David C. Hsu3
Estimated H-index: 3
+ 8 AuthorsReisa A. Sperling87
Estimated H-index: 87
Even low levels of depressive symptoms are associated with an increased risk of cognitive decline in older adults without overt cognitive impairment (CN). Our objective was to examine whether very low, “subthreshold symptoms of depression” (SSD) are associated with Alzheimer’s disease (AD) biomarkers of neurodegeneration in CN adults and whether these associations are specific to particular depressive symptoms. We analyzed data from 248 community-dwelling CN older adults, including measurements ...
Published on Apr 1, 2015in Neurobiology of Aging4.40
Ida K. Karlsson7
Estimated H-index: 7
(KI: Karolinska Institutet),
Anna M. Bennet24
Estimated H-index: 24
(KI: Karolinska Institutet)
+ 4 AuthorsNancy L. Pedersen102
Estimated H-index: 102
(SC: University of Southern California)
Abstract To investigate how apolipoprotein E ( APOE ) affects the temporal relationship between depression and dementia, we conducted a nested case-control study with longitudinal depression and dementia evaluations from several population studies by using 804 dementia cases and 1600 matched controls, totaling 1519 unique individuals. Depression within 10 years of onset of dementia was strongly associated with dementia diagnosis regardless of APOE status (incidence rate ratio [IRR] 5.25, 95% con...
Published on Jan 1, 2015in Australian and New Zealand Journal of Psychiatry5.00
Karra Harrington18
Estimated H-index: 18
(Deakin University),
Yen Ying Lim23
Estimated H-index: 23
(Brown University)
+ 1 AuthorsPaul Maruff70
Estimated H-index: 70
(Florey Institute of Neuroscience and Mental Health)
Objective:Depression has been shown to be a risk factor for Alzheimer’s disease (AD), and in older adults may provide a marker for the beginning of the prodromal phase of AD. The purpose of this systematic review is to examine the relationship between amyloid-β (Aβ), a key biomarker of AD, and depression in older adults.Method:The literature search was limited to studies conducted from 2006 to 2014 that were published in English in peer-reviewed journals. Studies were selected if they included a...
Published on Oct 1, 2014in Maturitas3.65
Sophia Bennett1
Estimated H-index: 1
(Newcastle University),
Alan J. Thomas40
Estimated H-index: 40
(Newcastle University)
Abstract The relationship between depression and dementia is complex and still not well understood. A number of different views exist regarding how the two conditions are linked as well as the underlying neurobiological mechanisms at work. This narrative review examined longitudinal and cross sectional studies in the existing literature and determined the evidence supporting depression being a risk factor, a prodrome, a consequence, or an independent comorbidity in dementia. Overall there is con...
Allison R. Kaup12
Estimated H-index: 12
(UCSF: University of California, San Francisco),
Eleanor Marie Simonsick89
Estimated H-index: 89
(NIH: National Institutes of Health)
+ 5 AuthorsKristine Yaffe113
Estimated H-index: 113
Low educational attainment, generally measured by years of school completed, is a well-established risk factor for dementia among older adults, with higher education being thought to contribute to cognitive reserve (1). Literacy may be more reflective of educational attainment than years of school completed and thus a more sensitive indicator of risk for the development of dementia. Low literacy is common among elderly adults compared with other age groups (2). In the 2003 National Assessment of...
Published on Jun 1, 2014in Journal of Geriatric Psychiatry and Neurology2.75
Joseph S. Goveas20
Estimated H-index: 20
(MCW: Medical College of Wisconsin),
Mark A. Espeland68
Estimated H-index: 68
(Wake Forest University)
+ 6 AuthorsSusan M. Resnick70
Estimated H-index: 70
(NIH: National Institutes of Health)
Elevated depressive symptoms (DS) are associated with incident mild cognitive impairment and probable dementia in postmenopausal women. We examined the association of elevated DS with domain-specific cognitive changes and the moderating role of cardiovascular risk factor severity and cardiovascular disease (CVD). A total of 2221 elderly women who participated in the Women’s Health Initiative Study of Cognitive Aging were separated into those with (N = 204) and without (N = 2017) elevated DS. The...
Published on Dec 19, 2013in BMJ27.60
Kristine Yaffe113
Estimated H-index: 113
(UCSF: University of California, San Francisco),
Cherie Falvey7
Estimated H-index: 7
(UCSF: University of California, San Francisco)
+ 5 AuthorsEleanor Marie Simonsick89
Estimated H-index: 89
(NIH: National Institutes of Health)
Objective To examine whether observed differences in dementia rates between black and white older people living in the community could be explained by measures of socioeconomic status (income, financial adequacy, education, and literacy) and health related factors. Design Prospective cohort study. Setting General community from two clinic sites in the United States (Pittsburgh, Pennsylvania and Memphis, Tennessee). Participants 2457 older people (mean age 73.6 years; 1019 (41.5%) black; 1233 (50...
Published on Sep 1, 2013in Molecular Psychiatry11.97
Warren D. Taylor37
Estimated H-index: 37
,
Howard J. Aizenstein50
Estimated H-index: 50
,
George S. Alexopoulos70
Estimated H-index: 70
The ‘Vascular Depression’ hypothesis posits that cerebrovascular disease may predispose, precipitate, or perpetuate some geriatric depressive syndromes. This hypothesis stimulated much research that has improved our understanding of the complex relationships between late-life depression (LLD), vascular risk factors, and cognition. Succinctly, there are well-established relationships between late-life depression, vascular risk factors, and cerebral hyperintensities, the radiological hallmark of v...
Published on Aug 6, 2013in Neurology8.69
Chang Hyung Hong1
Estimated H-index: 1
(Ajou University),
Cherie Falvey7
Estimated H-index: 7
(UCSF: University of California, San Francisco)
+ 6 AuthorsKristine Yaffe113
Estimated H-index: 113
(UCSF: University of California, San Francisco)
Objective: To determine whether anemia is associated with incident dementia in older adults. Methods: We studied 2,552 older adults (mean age 76.1 years; 38.9% black; 51.8% female) participating in the Health, Aging, and Body Composition study and free of dementia at baseline. We defined anemia using WHO criteria (hemoglobin concentration Results: Of 2,552 participants, 392 (15.4%) older adults had anemia at baseline. Over 11 years of follow-up, 455 (17.8%) participants developed dementia. In th...
Published on Oct 1, 2012in Archives of General Psychiatry
Amy L. Byers25
Estimated H-index: 25
(UCSF: University of California, San Francisco),
Eric Vittinghoff101
Estimated H-index: 101
(UCSF: University of California, San Francisco)
+ 8 AuthorsLisa Fredman24
Estimated H-index: 24
(BU: Boston University)
Context: Despite the frequent occurrence of depressive symptoms among older adults, especially women, little is known about the long-term course of late-life depressive symptoms. Objective: To characterize the natural course of depressive symptoms among older women (from the young old to the oldest old) followed up for almost 20 years. Design: Using latent-class growth-curve analysis, we analyzed women enrolled in an ongoing prospective cohort study (1988 through 2009). Setting: Clinic sites in ...
Cited By50
Newest
Published on Dec 1, 2019in Alzheimer's Research & Therapy
Elizabeth Kuhn (UNICAEN: University of Caen Lower Normandy), Inès Moulinet (UNICAEN: University of Caen Lower Normandy)+ 10 AuthorsBéatrice Desgranges58
Estimated H-index: 58
(UNICAEN: University of Caen Lower Normandy)
Background Subjective cognitive decline (SCD) defines a heterogeneous population, part of which having Alzheimer’s disease (AD). We aimed at characterizing SCD populations according to whether or not they referred to a memory clinic, by assessing the factors associated with increased AD risk.
Published on Dec 15, 2018in Diabetic Medicine3.11
Karen A. Nunley6
Estimated H-index: 6
(University of Pittsburgh),
J. F. Karp (University of Pittsburgh)+ 4 AuthorsCaterina Rosano43
Estimated H-index: 43
(University of Pittsburgh)
Published on Apr 1, 2019in Biological Psychiatry11.50
Bret R. Rutherford18
Estimated H-index: 18
(Columbia University),
Mark Slifstein53
Estimated H-index: 53
(SBU: Stony Brook University)
+ 8 AuthorsEmily Valente
Abstract Background A high-risk subgroup of older patients with depression has slowed processing and gait speeds. This study examined whether carbidopa/levodopa (L-DOPA) monotherapy increased dopamine availability, increased processing/gait speed, and relieved depressive symptoms. Methods Adult outpatients with depression >59 years old underwent baseline [ 11 C]raclopride positron emission tomography followed by open L-DOPA for 3 weeks (1 week each of 150 mg, 300 mg, and 450 mg). Generalized est...
Published on May 16, 2019in Journal of Alzheimer's Disease3.70
Richard J. Elsworthy (University of Birmingham), Sarah Aldred19
Estimated H-index: 19
(University of Birmingham)
Sang-Woo Lee , Jae-Sung Choi (Yonsei University), Minhong Lee3
Estimated H-index: 3
(Dong-eui University)
This study aimed to analyze the effect of individual differences and family variables on life satisfaction and depression in the oldest old compared with the young-old. A total of 1,799 cases from an 8-year period of the Korean Welfare Panel Study (2006–2013) were analyzed. A key finding was that life satisfaction significantly increased with time for the two groups of older adults while depression decreased. Moreover, family relationship satisfaction significantly affected both life satisfactio...
Published on Apr 3, 2019in Aging & Mental Health2.96
Nicole M. Armstrong2
Estimated H-index: 2
(Johns Hopkins University),
Pamela J. Surkan28
Estimated H-index: 28
(Johns Hopkins University)
+ 6 AuthorsAlison Gump Abraham21
Estimated H-index: 21
(Johns Hopkins University)
ABSTRACTObjectives: Center of Epidemiologic Studies–Depression Scale (CES-D) provides a snapshot of symptom severity at a single point in time. However, the best way of using CES-D to classify long-term depression is unclear.Method: To identify long-term depression among HIV-infected and HIV–uninfected 50+ year-old men who have sex with men (MSM) with at least 5 years of follow-up, we compared sensitivities and specificities of CES-D–based metrics (baseline CES-D; four consecutive CES-Ds; group-...
Published on Apr 1, 2019in SSM-Population Health
Leah R Abrams (UM: University of Michigan), Neil Mehta22
Estimated H-index: 22
(UM: University of Michigan)
Abstract Despite concerns about recent trends in the health and functioning of older Americans, little is known about dynamics of depression among recent cohorts of U.S. older adults and how these dynamics differ across sociodemographic groups. This study examined sociodemographic differences in mid- and late-life depressive symptoms over age, as well as changes over time. Using nationally representative data from the Health and Retirement Study (1994–2014), we estimated mixed effects models to ...