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Depressive symptoms and cognitive decline in nondemented elderly women: a prospective study.

Abstract

BACKGROUND

The association between depressive disorders and subsequent cognitive decline is controversial. We tested the hypothesis that elderly women (aged 65 years and older) without dementia but with depressive symptoms have worse cognitive function and greater cognitive decline than women with few or no symptoms.

METHODS

As part of an ongoing prospective study, we evaluated 5781 elderly, mostly white, community-dwelling women. Women completed the Geriatric Depression Scale short form. Three cognitive tests--Trails B, Digit Symbol, and a modified Mini-Mental State Examination--were administered at baseline and approximately 4 years later. Baseline, follow-up, and change scores for the cognitive tests were analyzed by analysis of covariance and Kruskal-Wallis analysis; the odds of cognitive deterioration (> or =3-point decline on the modified Mini-Mental State Examination) were determined by logistic regression.

RESULTS

At baseline, 211 (3.6%) of the women had 6 or more depressive symptoms. Only 16 (7.6%) of these women were receiving antidepressant medication. Increasing symptoms of depression were associated with worse performance at baseline and follow-up on all 3 tests of cognitive function (P<.001 for all comparisons). For example, the baseline Digit Symbol score (mean +/- SD) was 45.5 +/- 10.7 among women with 0 to 2 symptoms of depression, 40.3 +/- 10.7 for women with 3 to 5 symptoms, and 39.0 +/- 11.3 for women with 6 or more symptoms. After adjusting for the baseline score, cognitive change scores were also inversely associated with the number of depressive symptoms (P<.001 for all comparisons). Odds ratios for cognitive deterioration using 0 to 2 symptoms as the reference were 1.6 (95% confidence interval, 1.3-2.1) for 3 to 5 symptoms and 2.3 (95% confidence interval, 1.6-3.3) for 6 or more symptoms. Results were similar after being adjusted for education, age, health status, exercise, alcohol use, functional status, and clinic site.

CONCLUSIONS

Depressive symptoms in older women are associated with both poor cognitive function and subsequent cognitive decline. Mechanisms underlying the association between these 2 common conditions need further exploration.

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  • Authors+Show Affiliations

    ,

    Department of Psychiatry, University of California-San Francisco School of Medicine, and the Veterans Affairs Medical Center, 94121, USA.

    , , , ,

    Source

    Archives of general psychiatry 56:5 1999 May pg 425-30

    MeSH

    Age Factors
    Aged
    Cognition Disorders
    Comorbidity
    Confidence Intervals
    Dementia
    Depressive Disorder
    Educational Status
    Female
    Follow-Up Studies
    Geriatric Assessment
    Humans
    Marital Status
    Neuropsychological Tests
    Odds Ratio
    Prospective Studies
    Psychiatric Status Rating Scales
    Regression Analysis

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    10232297

    Citation

    Yaffe, K, et al. "Depressive Symptoms and Cognitive Decline in Nondemented Elderly Women: a Prospective Study." Archives of General Psychiatry, vol. 56, no. 5, 1999, pp. 425-30.
    Yaffe K, Blackwell T, Gore R, et al. Depressive symptoms and cognitive decline in nondemented elderly women: a prospective study. Arch Gen Psychiatry. 1999;56(5):425-30.
    Yaffe, K., Blackwell, T., Gore, R., Sands, L., Reus, V., & Browner, W. S. (1999). Depressive symptoms and cognitive decline in nondemented elderly women: a prospective study. Archives of General Psychiatry, 56(5), pp. 425-30.
    Yaffe K, et al. Depressive Symptoms and Cognitive Decline in Nondemented Elderly Women: a Prospective Study. Arch Gen Psychiatry. 1999;56(5):425-30. PubMed PMID: 10232297.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Depressive symptoms and cognitive decline in nondemented elderly women: a prospective study. AU - Yaffe,K, AU - Blackwell,T, AU - Gore,R, AU - Sands,L, AU - Reus,V, AU - Browner,W S, PY - 1999/5/8/pubmed PY - 1999/5/8/medline PY - 1999/5/8/entrez SP - 425 EP - 30 JF - Archives of general psychiatry JO - Arch. Gen. Psychiatry VL - 56 IS - 5 N2 - BACKGROUND: The association between depressive disorders and subsequent cognitive decline is controversial. We tested the hypothesis that elderly women (aged 65 years and older) without dementia but with depressive symptoms have worse cognitive function and greater cognitive decline than women with few or no symptoms. METHODS: As part of an ongoing prospective study, we evaluated 5781 elderly, mostly white, community-dwelling women. Women completed the Geriatric Depression Scale short form. Three cognitive tests--Trails B, Digit Symbol, and a modified Mini-Mental State Examination--were administered at baseline and approximately 4 years later. Baseline, follow-up, and change scores for the cognitive tests were analyzed by analysis of covariance and Kruskal-Wallis analysis; the odds of cognitive deterioration (> or =3-point decline on the modified Mini-Mental State Examination) were determined by logistic regression. RESULTS: At baseline, 211 (3.6%) of the women had 6 or more depressive symptoms. Only 16 (7.6%) of these women were receiving antidepressant medication. Increasing symptoms of depression were associated with worse performance at baseline and follow-up on all 3 tests of cognitive function (P<.001 for all comparisons). For example, the baseline Digit Symbol score (mean +/- SD) was 45.5 +/- 10.7 among women with 0 to 2 symptoms of depression, 40.3 +/- 10.7 for women with 3 to 5 symptoms, and 39.0 +/- 11.3 for women with 6 or more symptoms. After adjusting for the baseline score, cognitive change scores were also inversely associated with the number of depressive symptoms (P<.001 for all comparisons). Odds ratios for cognitive deterioration using 0 to 2 symptoms as the reference were 1.6 (95% confidence interval, 1.3-2.1) for 3 to 5 symptoms and 2.3 (95% confidence interval, 1.6-3.3) for 6 or more symptoms. Results were similar after being adjusted for education, age, health status, exercise, alcohol use, functional status, and clinic site. CONCLUSIONS: Depressive symptoms in older women are associated with both poor cognitive function and subsequent cognitive decline. Mechanisms underlying the association between these 2 common conditions need further exploration. SN - 0003-990X UR - https://www.unboundmedicine.com/medline/citation/10232297/Depressive_symptoms_and_cognitive_decline_in_nondemented_elderly_women:_a_prospective_study_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=10232297.ui DB - PRIME DP - Unbound Medicine ER -