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

ABSTRACT: 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.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.Participants with persistent depressive symptoms had worse executive function-attention decline compared with non-depressed participants (multivariable-adjusted mean difference?=?-0.03 units/year, 95% CI: -0.05, -0.01; p?=?0.003); this difference was comparable with 8?years of aging. However, being in the persistent versus non-depressed group was not significantly related to verbal (p?=?0.71) or global score (p?=?0.09) decline. By contrast, compared with 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.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. Copyright © 2016 John Wiley & Sons, Ltd.

SUBMITTER: Gillis JC

PROVIDER: S-EPMC5712842 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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

Gillis J Cai JC Chang Shun-Chiao SC Devore Elizabeth E EE Rosner Bernard A BA Grodstein Francine F Okereke Olivia I OI

International journal of geriatric psychiatry 20161107 12

<h4>Background</h4>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.<h4>Methods</h4>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 cutpo ...[more]

PMID: 29193360

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Project description:ImportanceThe neurobiologic basis of late-life depressive symptoms is not well understood.ObjectiveTo test the hypothesis that neurodegeneration and neuronal density in brainstem aminergic nuclei are related to late-life depressive symptoms. DESIGN, SETTING, PARTICIPANTS, AND EXPOSURE: Longitudinal clinicopathological cohort study at residences of participants in the Chicago, Illinois, metropolitan area. Participants included 124 older persons without dementia in the Rush Memory and Aging Project who had annual evaluations for a mean (SD) of 5.7 (2.8) years, died, and underwent a postmortem neuropathological examination that provided estimates of the densities of Lewy bodies, neurofibrillary tangles, and aminergic neurons in the locus ceruleus, dorsal raphe nucleus, substantia nigra, and ventral tegmental area.Main outcomes and measuresThe number of depressive symptoms (mean [SD], 1.61 [1.48]; range, 0-6; skewness, 0.94) on the Center for Epidemiological Studies Depression Scale averaged across annual evaluations.ResultsBrainstem Lewy bodies were associated with depressive symptoms, and the association was attenuated in those taking antidepressant medication. Brainstem tangles were associated with more depressive symptoms in those without cognitive impairment but with fewer symptoms in those with mild cognitive impairment. Lower density of tyrosine hydroxylase-immunoreactive neurons in the ventral tegmental area was robustly associated with a higher level of depressive symptoms (mean [SE] estimate, -0.014 [0.003]; P < .001; 16.3% increase in adjusted R2). The association was not modified by medication use or cognitive impairment. Neither tyrosine hydroxlyase-immunoreactive neurons in the locus ceruleus nor tryptophan hydroxlyase-immunoreactive neurons in the dorsal raphe nucleus were related to depressive symptoms.Conclusions and relevanceThe results suggest that the mesolimbic dopamine system, especially the ventral tegmental area, has an important role in late-life depressive symptoms.

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

Publications

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

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