Dual Trajectories of Depression and Cognition: A Longitudinal Population-Based Study

Abstract

Objectives To examine the relationships over time between dual trajectories of depressive symptoms and several cognitive domains. Design 5-year longitudinal study. Setting Population-based cohort. Participants 1978 randomly selected individuals aged 65+ years at recruitment and assessed annually. Measurements Repeated measures of (1) depressive symptoms on the modified Center for Epidemiologic Studies-Depression Scale; (2) composite scores in the cognitive domains of attention, executive function, memory, language, and visuospatial function. Latent class trajectories were identified for depression and for each cognitive domain, and their associations investigated using dual trajectory modeling. Cognitive trajectories with z scores below −1 were designated as persistently low. Results Five depressive symptom trajectories were observed: rarely depressed (60.5%); low-grade, decreasing symptoms (18.5%); low-grade, increasing symptoms (9.6%); moderate-grade symptoms (7.4%); and consistent higher-grade symptoms (4.0%). For each cognitive domain, six trajectories were observed. The rarely depressed and low-grade decreasing symptom groups were the least likely to have persistently low cognition. The symptom trajectory most strongly associated with persistently low functioning in each domain was not the higher-grade group, but rather the low-grade increasing group in the case of attention, and the moderate-grade trajectory in the other four domains. Conclusions Consistently higher-grade depressive symptoms are less strongly associated with poor cognitive functioning than with either moderate or low-grade increasing depressive symptom trajectories, over time and across different domains. Examining both depression and cognition longitudinally allows heterogeneity of both to be addressed, revealing latent groups with potential diagnostic and prognostic implications.

Normative data of the Brazilian elderly in Logical Memory subtest of WMS-R

“…Furthermore, immediate recall score classified correctly 56% of the participants according to the absence or presence of depressive symptoms. Some studies highlight the effect of depressive symptoms in cognition (Graziane, Beer, Snitz, Chang, & Ganguli, 2016). Depressive symptoms may be correlated to a lower attention level, which directly impacts acquisition and storage of verbal information, and attention level.…”

Association of long-term patterns of depressive symptoms and attention/executive function among older men with and without human immunodeficiency virus

“…To identify distinct trajectory patterns of depressive symptoms and attention/executive function, we used a latent group-based dual trajectory modeling approach under the assumption that the sample is drawn from a discrete set of subpopulations, each one having a distinct trajectory pattern, to approximate an underlying continuous distribution with a complex structure (Graziane et al 2016; Jones and Nagin 2007; Jones et al 2001; Nagin and Odgers 2010; Nagin and Tremblay 2001). …”

“…Depressive symptoms are risk factors for cognitive impairment (Barnes et al 2006; Saczynski et al 2010; Rosenberg et al 2010). Graziane et al (2016) found that those with moderate-grade depressive symptoms were at high risk of persistently lower cognitive function over a 5-year period. While the relationship between depressive symptoms and cognitive deficit in older adults is established, the effect of depression on cognitive function in vulnerable populations, such as persons living with HIV (PLWH), has not been well described.…”

“…The relationship between depressive symptoms and cognitive impairment has been extensively studied in older adults (Andreescu et al 2008; Graziane et al 2016). Depressive symptoms are risk factors for cognitive impairment (Barnes et al 2006; Saczynski et al 2010; Rosenberg et al 2010).…”

Patterns of late‐life depressive symptoms and subsequent declines in cognitive domains

“…If late‐life depression is a prodromal indicator of underlying neuropathology, then differences in patterns of antecedent depressive symptoms may relate to different subtypes of cognitive decline (e.g., amnestic vs. dysexecutive). However, few studies (Paterniti et al ; Singh‐Manoux et al ; Kohler et al ; Graziane et al ) have examined how LLD patterns relate to subsequent cognitive decline by domain. In one example (Paterniti et al ), cognitively normal older adults with persistent, but not variable, depressive symptoms showed greater cognitive decline compared with those with no depression; however, domain‐specific associations were not examined.…”