The Total CES‐D score from the 14‐item version as a predictor of cognitive decline

Abstract

Background: Depressive symptomatology is associated with cognitive decline and greater risk for dementia. Studies have examined this association using self-report measures such as the Centre for Epidemiologic Studies-Depression Scale (CES-D; Radloff, 1991). Although the CES-D was originally designed as a 20-item scale, certain items have been reported to misrepresent depressive symptoms due to sex and cultural differences, which are addressed in the 14-item version of this measure (Carleton et al., 2013). The aim of this study was to examine how the CES-D total score from the 14-item version compared to the 20-item version in predicting progression to cognitive decline from a cognitively unimpaired baseline, across genders.Method: Data were extracted from the Wisconsin Registry for Alzheimer's Prevention.A total of 1,055 participants were included who were cognitively unimpaired and stable at baseline and had at least one follow-up assessment. Bivariate logistic regression analyses were conducted using follow-up consensus diagnosis as outcome (cognitively unimpaired stable vs. cognitive unimpaired declining, mild cognitive impairment or dementia); baseline total CES-D scores from either the 14-item or 20-item version were used as predictors in separate analyses; age at last follow-up assessment, age difference between baseline and last follow-up assessment, years of education, and polygenic risk score were covariates (see Table 1). Result:In female participants, we observed that the logistic regression model with the total CES-D score from the 14-item version was statistically significant (χ2(5) = 54.674, p = .001) and explained 15.2% (Nagelkerke R 2 ) of the variance in predicting cognitive decline; this result was comparable to that with the 20-item version, which was also statistically significant (χ2(5) = 53.276, p = .001) and explained 14.8% of the variance. In male participants, the model with the total score from the 14-item version was statistically significant (χ2(5) = 14.846, p = .011) and explained 9.9% of the variance, whereas the model with the total score from the 20-item version was statistically significant (χ2(5) = 14.070, p = .015) and explained 9.4% of the variance. Conclusion:Our findings suggest that the total CES-D score from the 14-item version is comparable to, if not slightly better than, the score from the 20-item version in predicting progression to a clinical level of cognitive decline in both males and females.