Abstract
BackgroundDepression often co-occurs in late-life in the context of declining cognitive functions, but it is not clear whether specific depression symptom dimensions are differentially associated with cognitive abilities. MethodsThe study sample comprised 3107 community-dwelling older adults from the Longitudinal Aging Study Amsterdam (LASA). We applied a Multiple Indicators Multiple Causes (MIMIC) model to examine the association between cognitive abilities and latent dimensions of the Center for Epidemiologic Studies Depression Scale (CES-D), while accounting for differential item functioning (DIF) due to age, gender and cognitive function levels. ResultsA factor structure consisting of somatic symptoms, positive affect, depressed affect, and interpersonal difficulties fitted the data well. Higher levels of inductive reasoning were significantly associated with lower levels of depressed affect and somatic symptoms, whereas faster processing speed was significantly associated with lower levels of somatic symptoms. DIF due to age and gender was found, but the magnitude of the effects was small and did not alter substantive conclusions. LimitationsDue to the cross-sectional context of this investigation, the direction of influence between depression symptom levels and cognitive function levels cannot be established. Furthermore, findings are relevant to non-clinical populations, and they do not clarify whether certain DIF effects may be found only at high or low levels of depression. ConclusionsOur findings suggest differential associations between late-life depression dimensions and cognitive abilities in old age, and point towards potential etiological mechanisms that may underline these associations. These findings carry implications for the prognosis of cognitive outcomes in depressed older adults.
Highlights
According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, depression is a multi-dimensional construct consisting of depressed affect, low positive affect, and somatic symptoms (American Psychiatric Association, 2000)
The main aim of this study is to examine whether Center for Epidemiologic Studies Depression Scale (CES-D) depression symptom dimensions are differentially associated with performance in specific cognitive domains which are typically altered in late life depression
Using data from a large nationally representative sample of Longitudinal Aging Study Amsterdam (LASA) and an analytic strategy that adjusted for the influence of measurement bias, our findings provide partial support for a differential association between depression symptom dimensions and cognitive abilities, while adding evidence for the measurement invariance of CES-D across age, gender and cognitive function levels in older adults
Summary
According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, depression is a multi-dimensional construct consisting of depressed affect (i.e., dysphoria), low positive affect (i.e., anhedonia), and somatic symptoms (American Psychiatric Association, 2000) Compared to their younger counterparts, older adults have a lower prevalence of Major Depressive Disorder (Kessler et al, 2010), but a higher prevalence of subsyndromal depression (Meeks et al, 2011). Conclusions: Our findings suggest differential associations between late-life depression dimensions and cognitive abilities in old age, and point towards potential etiological mechanisms that may underline these associations. These findings carry implications for the prognosis of cognitive outcomes in depressed older adults
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