Temporal relation between depression and cognitive impairment in old age: prospective population based study

doi:10.1136/bmj.38216.604664.DE

BMJ, doi: 10.1136/bmj.38216.604664.DE, (Published 2 September 2004)

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Temporal relation between depression and cognitive impairment in old age: prospective population based study

David J Vinkers ¹, Jacobijn Gussekloo ¹, Max L Stek ¹, Rudi G J Westendorp ¹, Roos C van der Mast ²

¹ Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, Netherlands
² Department of Psychiatry, Leiden University Medical Centre, Netherlands

Objective To examine the temporal relation between depressionand cognitive impairment in old age.

Design Prospective, populationbased study with four years of follow up.

Setting City of Leiden,the Netherlands.

Participants 500 people aged 85 years at recruitment.

Mainoutcome measures Annual assessments of depressive symptoms (15item geriatric depression scale), global cognitive function(mini-mental state examination), attention (Stroop test), processingspeed (letter digit coding test), and immediate and delayedrecall (12 word learning test).

Results At 85 years old, participants'depressive symptoms and cognitive impairment were highly significantlycorrelated (P<0.001). During follow up, an accelerated annualincrease of depressive symptoms was associated with impairedattention (0.08 points (95% confidence interval 0.01 to 0.16)),immediate recall (0.17 points (0.09 to 0.25)), and delayed recall(0.10 points (0.02 to 0.18)) at baseline. In contrast, depressivesymptoms at baseline were not related to an accelerated cognitivedecline during follow up (P>0.05).

Conclusion Caregivers shouldbe aware of the development of depressive symptoms when cognitiveimpairment is present. However, the presence of depression onlydoes not increase the risk of cognitive decline.

(Accepted 19 July 2004)

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