Abstract
Cognitive impairment and depression often co-occur in older adults, but it is not clear whether depression is a risk factor for cognitive decline, a psychological reaction to cognitive decline, or whether changes in depressive symptoms correlate with changes in cognitive performance over time. The co-morbid manifestation of depression and cognitive impairment may reflect either a causal effect or a common cause, depending on the specific symptoms experienced and the cognitive functions affected. The study sample comprised 1506 community-dwelling older adults aged ⩾65 years from the Longitudinal Aging Study Amsterdam (LASA). We conducted cross-domain latent growth curve analyses to examine longitudinal associations between late-life depression dimensions (i.e. depressed affect, positive affect, and somatic symptoms) and specific domains of cognitive functioning (i.e. processing speed, inductive reasoning, immediate recall, and delayed recall). Poorer delayed recall performance at baseline predicted a steeper increase in depressed affect over time. Steeper decline in processing speed correlated with a steeper increase in somatic symptoms of depression over time. Our findings suggest a prospective association between memory function and depressed affect, whereby older adults may experience an increase in depressed affect in reaction to poor memory function. Somatic symptoms of depression increased concurrently with declining processing speed, which may reflect common neurodegenerative processes. Our findings do not support the hypothesis that depression symptoms may be a risk factor for cognitive decline in the general population. These findings have potential implications for the treatment of late-life depression and for the prognosis of cognitive outcomes.
Highlights
Extensive evidence suggests that late-life depression co-occurs with cognitive dysfunctions affecting in particular fluid cognitive abilities such as processing speed, executive function, and episodic memory (e.g. Comijs et al 2001; Lockwood et al 2002; Baudic et al.2004; Sheline et al 2006; Morimoto & Alexopoulos, 2013; Koenig et al 2014)
In terms of the association between changes in depressive symptoms and changes in cognitive functioning over time, we only found that decline in processing speed performance was related to an increase in somatic symptoms over time
Our findings suggest significant cross-sectional associations between baseline depression dimensions and cognitive performance on processing speed, inductive reasoning and immediate recall tasks
Summary
Extensive evidence suggests that late-life depression co-occurs with cognitive dysfunctions affecting in particular fluid cognitive abilities such as processing speed, executive function, and episodic memory (e.g. Comijs et al 2001; Lockwood et al 2002; Baudic et al.2004; Sheline et al 2006; Morimoto & Alexopoulos, 2013; Koenig et al 2014). The direction of influence remains unclear, leaving an unresolved question of whether depression is a risk factor for cognitive impairment, a psychological reaction to cognitive impairment, or a prodromal syndrome of dementia. Some studies found that higher baseline levels of depressive symptoms predicted steeper decline in general cognitive performance. Cognitive impairment and depression often co-occur in older adults, but it is not clear whether depression is a risk factor for cognitive decline, a psychological reaction to cognitive decline, or whether changes in depressive symptoms correlate with changes in cognitive performance over time. The co-morbid manifestation of depression and cognitive impairment may reflect either a causal effect or a common cause, depending on the specific symptoms experienced and the cognitive functions affected
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