RT Journal Article
SR Electronic
T1 Greater depressive symptoms, cognition, and markers of brain aging
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP e2077
OP e2085
DO 10.1212/WNL.0000000000005639
VO 90
IS 23
A1 Zeki Al Hazzouri, Adina
A1 Caunca, Michelle R.
A1 Nobrega, Juan Carlos
A1 Elfassy, Tali
A1 Cheung, Ying Kuen
A1 Alperin, Noam
A1 Dong, Chuanhui
A1 Elkind, Mitchell S.V.
A1 Sacco, Ralph L.
A1 DeCarli, Charles
A1 Wright, Clinton B.
YR 2018
UL http://n.neurology.org/content/90/23/e2077.abstract
AB Objective We examined whether greater depressive symptoms were associated with domain-specific cognitive performance, change in cognition, and MRI markers of brain atrophy and subclinical cerebrovascular disease in a diverse sample of older adults from the Northern Manhattan Study.Methods Data were analyzed from the Northern Manhattan Study, a prospective cohort study of mostly Caribbean Hispanic, stroke-free, older adults. A total of 1,111 participants had baseline measures of depressive symptoms, measured as the Center of Epidemiological Studies–Depression Scale, MRI markers, and cognitive function. A Center of Epidemiological Studies–Depression score ≥16 was considered indicative of greater depressive symptoms. Multivariable linear and logistic regression models were used to examine the associations of interest.Results At baseline, 22% of participants had greater depressive symptoms. Greater depressive symptoms were significantly associated with worse baseline episodic memory in models adjusted for sociodemographic, vascular risk factor, behavioral, and antidepressive medication variables (β [95% confidence interval] = −0.21 [−0.33 to −0.10], p = 0.0003). Greater depressive symptoms were also associated with smaller cerebral parenchymal fraction (β [95% confidence interval] = −0.56 [−1.05 to −0.07], p = 0.02) and increased odds of subclinical brain infarcts (odds ratio [95% confidence interval] = 1.55 [1.00–2.42], p = 0.05), after adjustment for sociodemographic, behavioral, and vascular risk factor variables. Greater depressive symptoms were not significantly associated with white matter hyperintensity volume, hippocampal volume, or change in cognition over an average of 5 years. Results were unchanged when stabilized inverse probability weights were applied to address selective attrition during the study period.Conclusions In this sample of mostly Caribbean Hispanic, stroke-free, older adults, greater depressive symptoms were associated with worse episodic memory, smaller cerebral volume, and silent infarcts.CES-D=Center for Epidemiologic Studies–Depression; CI=confidence interval; DSM-V=Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition); NOMAS=Northern Manhattan Study; TIV=total intracranial volume; WMHV=white matter hyperintensity volume