Journal
JOURNAL OF ALZHEIMERS DISEASE
Volume 83, Issue 3, Pages 1379-1389Publisher
IOS PRESS
DOI: 10.3233/JAD-210588
Keywords
Cognitive impairment; dementia; depression; imputation; life course
Categories
Funding
- National Institutes of Health, National Institute on Aging [1RF1AG054443]
- National Heart, Lung, and Blood Institute (NHLBI) [HHSN2682 01800003I, HHSN268201800004I, HHSN2682018 00005I, HHSN268201800006I, HHSN2682018 00007I]
- National Heart, Lung, and Blood Institute [75N92020D00 001, HHSN268201500003I, N01-HC-95159, 75N9 2020D00005, N01-HC-95160, 75N92020D00002, N01-HC-95161, 75N92020D00003, N01-HC-951 62, 75N92020D00006, N01-HC-95163]
- National Institute of Neurological Disorders and Stroke (NINDS)
- National Institute on Aging (NIA) [R01AG023629, N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106]
- NIA [R01AG028050]
- NINR [R01-NR012459]
- Intramural Research Program of the NIH, National Institute on Aging
- .National Heart, Lung, and Blood Institute (NHLBI) [75N9202 0D00004, N01-HC-95164, 75N92020D00007, N01HC-95165, N01-HC-95166, N01-HC-95167, N01HC-95168, N01-HC-95169]
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This study examined data from 4 prospective cohorts to estimate depressive symptoms trajectories across different adult life stages, finding that depressive symptoms in early adulthood may independently contribute to cognitive impairment risk, regardless of mid- or late-life depressive symptoms.
Background: Depressive symptoms may increase risk for dementia, but findings are controversial because late-life depression may be a prodromal dementia symptom. Life course data on depression and dementia risk may clarify this association; however, data is limited. Objective: To impute adult depressive symptoms trajectories across adult life stages and estimate the association with cognitive impairment and decline. Methods: Using a pooled study of 4 prospective cohorts (ages 20-89), we imputed adult life course depressive symptoms trajectories based on Center for Epidemiologic Studies Depression Scale-10 (CESD-10) and calculated time-weighted averages for early adulthood (ages 20-49), mid-life (ages 50-69), and late-life (ages 70-89) for 6,122 older participants. Adjusted pooled logistic and mixed-effects models estimated associations of imputed depressive symptoms with two cognitive outcomes: cognitive impairment defined by established criteria and a composite cognitive score. Results: In separate models, elevated depressive symptoms in each life stage were associated with cognitive outcomes: early adulthood OR for cognitive impairment = 1.59 (95% CI: 1.35,1.87); mid-life OR =1.94 (95%CI:1.16, 3.26); and late-life OR = 1.77 (95%CI:1.42, 2.21). When adjusted for depressive symptoms in the other life-stages, elevated depressive symptoms in early adulthood (OR = 1.73; 95%CI: 1.42,2.11) and late-life (OR = 1.43; 95%CI: 1.08,1.89) remained associated with cognitive impairment and were also associated with faster rates of cognitive decline (p < 0.05). Conclusion: Imputing depressive symptom trajectories from pooled cohorts may help expand data across the life course. Our findings suggest early adulthood depressive symptoms may be a risk factor for cognitive impairment independent of mid- or late-life depressive symptoms.
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