Long-term Cumulative Depressive Symptom Burden and Risk of Cognitive Decline and Dementia Among Very Old Women

Hazzouri, Adina Zeki Al; Vittinghoff, Eric; Byers, Amy L.; Covinsky, Ken; Blazer, Dan G.; Diem, Susan J.; Ensrud, Kristine E.; Yaffe, Kristine

doi:10.1093/gerona/glt139

Cited by 61 publications

(50 citation statements)

References 36 publications

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“…Moreover, we excluded possible genetic bias that could influence the response to SSRIs treatment and we verified all possible confounders that could affect statistical analysis. However, we did not consider significant MMSE score differences at follow-up as a confounder because a long-term cumulative depressive symptom burden on cognitive decline has been already described [76]. Notwithstanding these strengths, some limitations of the present study should be acknowledged.…”

Section: Discussionmentioning

confidence: 89%

Klotho Gene and Selective Serotonin Reuptake Inhibitors: Response to Treatment in Late-Life Major Depressive Disorder

et al. 2016

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Klotho protein, encoded by the Klotho gene (KL) at locus 13q12, is an antiaging hormone-like protein playing a pivotal role in cell metabolism homeostasis and associated to longevity and age-related diseases. In particular, altered cell metabolism in central nervous system may influence the behavior of serotoninergic neurons. The role of KL in the response to treatment with selective serotonin reuptake inhibitors (SSRIs) in late-life depressive syndromes and late-life major depressive disorder (MDD) is unclear. We genotyped three single-nucleotide polymorphisms (SNPs) of KL in 329 older patients with diagnosis of late-life MDD, treated with SSRIs and evaluated with the Hamilton Rating Scale for Depression 21-items (HRSD-21) at baseline and after 6 months. A reduction ≥50 and <10 % in HDRS-21 score was considered as response or nonresponse to therapy, respectively, and the values of reduction between 10 and 49 % as poor responders. After 6 months of SSRI treatment, 176 patients responded, 54 patients did not respond and 99 patients showed a poor response. Ordinal logistic models showed a significant association between mutation of SNP rs1207568 and responders and, similarly, for each unitary risk allele increase overlapping results were found. Conversely, a significantly higher frequency of the minor genotype of SNP rs9536314 was found in nonresponders. Considering the pre-post differences of HRSD-21 scores as a continue variable, we confirmed a significant improvement of depressive symptoms after treatment in patients carrying at least one minor allele at rs1207568 and a worse response in patients homozygous for the minor allele at rs9536314. Our results were the first that suggested a possible role of KL in the complex pathway of SSRI response in late-life MDD.

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Section: Discussionmentioning

confidence: 89%

Klotho Gene and Selective Serotonin Reuptake Inhibitors: Response to Treatment in Late-Life Major Depressive Disorder

et al. 2016

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“…One found an association between depressive symptoms and change in MMSE scores over 13 years; however, this association lost significance when adjusted for potential confounders (13). Other studies have found associations between persistent depressive scores over time and greater risk of cognitive decline (18, 20), specifically, with declines in verbal knowledge and fluency, attention, and memory (8, 10). Unlike ours, these previous studies either dichotomized depression scores from the CES-D or the Geriatric Depression Scale (8, 10) or examined measures of global cognitive function rather than specific cognitive domains (18, 20).…”

Section: Discussionmentioning

confidence: 94%

“…Other studies have found associations between persistent depressive scores over time and greater risk of cognitive decline (18, 20), specifically, with declines in verbal knowledge and fluency, attention, and memory (8, 10). Unlike ours, these previous studies either dichotomized depression scores from the CES-D or the Geriatric Depression Scale (8, 10) or examined measures of global cognitive function rather than specific cognitive domains (18, 20). Conversely, associations have been found between baseline levels of immediate and short-term verbal memory, verbal abilities, and mental tracking with persistent depression (17).…”

Section: Discussionmentioning

confidence: 94%

“…A more dynamic view of the relationship is provided by studies which examine both depression and cognition longitudinally (4, 8, 10, 13, 16, 17, 18, 19, 20). In one study, a prominent association was found between depressive symptoms and cognitive decline amongst individuals who had already experienced cognitive decline, suggesting that depression was a possible reaction to worsening cognitive abilities (16).…”

Section: Objectivesmentioning

confidence: 99%

“…Clinical studies usually focus on mood disorders rather than on depressive symptoms. The majority of studies examining the relationship between depression and cognition longitudinally have been based on community samples (4, 8, 9, 13, 16, 17, 18, 19, 20). We built on this body of research by investigating trajectories of depressive symptoms and cognitive function in a prospective study of an aging population-based cohort, over five years of follow-up, with the aim of determining whether any particular depressive symptom trajectory was associated with poor cognitive outcome.…”

Section: Objectivesmentioning

confidence: 99%

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

Graziane

Beer

Snitz

et al. 2016

The American Journal of Geriatric Psychiatry

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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.

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Association of Racial Residential Segregation Throughout Young Adulthood and Cognitive Performance in Middle-aged Participants in the CARDIA Study

et al. 2020

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IMPORTANCE Neighborhood-level residential segregation is implicated as a determinant for poor health outcomes in black individuals, but it is unclear whether this association extends to cognitive aging, especially in midlife. OBJECTIVE To examine the association between cumulative exposure to residential segregation during 25 years of young adulthood among black individuals and cognitive performance in midlife. DESIGN, SETTING, AND PARTICIPANTS The ongoing prospective cohort Coronary Artery Risk Development in Young Adults (CARDIA) Study recruited 5115 black and white participants aged 18 to 30 years from 4 field centers at the

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Long-term Cumulative Depressive Symptom Burden and Risk of Cognitive Decline and Dementia Among Very Old Women

Abstract: Long-term cumulative depressive symptom burden was associated with cognitive decline and risk of dementia or MCI. Older adults with a history of depression should be closely monitored for recurrent episodes or unresolved depressive symptoms as well as any cognitive deficits.

Cited by 61 publications

References 36 publications

Klotho Gene and Selective Serotonin Reuptake Inhibitors: Response to Treatment in Late-Life Major Depressive Disorder

Klotho Gene and Selective Serotonin Reuptake Inhibitors: Response to Treatment in Late-Life Major Depressive Disorder

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

Association of Racial Residential Segregation Throughout Young Adulthood and Cognitive Performance in Middle-aged Participants in the CARDIA Study

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