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

Abstract

Background Depression frequently co-occurs with cognitive decline, but the nature of this association is unclear. We examined relations of late-life depressive symptom patterns to subsequent domain-specific cognitive changes. Methods Depressive symptoms were measured at up to 3 timepoints among 11,675 Nurses’ Health Study participants prior to cognitive testing. Depressive symptom patterns were categorized as non-depressed, variable, or persistent, based on published severity cutpoints. Outcomes were global, verbal, and executive function-attention composite scores. Results Participants with persistent depressive symptoms had worse executive function-attention decline compared to non-depressed participants (multivariable-adjusted mean difference=-0.03 units/year, 95% CI: −0.05, −0.01; p=0.003); this difference was comparable to 8 years of aging. However, being in the persistent vs. non-depressed group was not significantly related to verbal (p=0.71) or global score (p=0.09) decline. By contrast, compared to the non-depressed group, those with variable depressive symptoms had worse verbal memory decline (multivariable-adjusted mean difference=−0.01 units/year, 95% CI: −0.02, −0.002; p=0.03); this group showed no differences for global or executive function-attention decline. Conclusions A variable pattern of depressive symptom severity related to subsequent decline in verbal memory, while a persistent pattern related to decline in executive function-attention. Findings could signal differences in underlying neuropathologic processes among persons with differing depression patterns and late-life cognitive decline.

Mental Health Conditions and Nonpersistence of Direct Oral Anticoagulant Use in Patients With Incident Atrial Fibrillation: A Nationwide Cohort Study

“…The social and cognitive difficulties sometimes associated with MHCs may influence communication between patients and health care professionals, possibly impairing patients’ understanding of the purpose and importance of OAT as well as its lifelong nature. 24 , 25 In addition, deficits in self‐care resources likely impair the commitment to continuous lifelong therapies in patients with MHCs. 23 Excessive alcohol consumption, which is more common among patients with MHCs than in those without MHCs (Table 1 ), has been associated with poor persistence to prescribed therapies.…”

Non-adherence to cardiovascular drugs in older patients with depression: A population-based cohort study

“…Thus, prescription of more than a single daily dose is an unlikely reason why patients did not adhere to beta-blockers and calcium antagonists in particular. Depression is associated with cognitive decline [34], and cognitive decline has been associated with non-adherence as well [35,36], yet no studies have examined whether this is the driver of non-adherence in depressed patients. It is important that we understand these reasons for nonadherence, because non-adherence is known to worsen the prognosis of CVD.…”

Beyond the dichotomy: Incarceration dosage and mental health*

“…This cutpoint of 60 is consistent with much psychological research in which the MHI‐5 is used to predict depression (Friedman, Heisel, & Delavan, ; Goral, Lipsitz, Muhsen, & Gross, ; Kelly et al., ; Silveira et al., ). More recently, however, Cuijpers and colleagues () found that the MHI‐5 is a “good screener for mood disorders in the general population,” but they suggest that a score of 54 may be a better and more conservative cutpoint (see also Gillis et al., ; Hammersen, Niemann, & Hoebel, ) . We also take the more conservative path and choose a cutpoint of 54 to measure depression in our sample.…”