期刊
CANADIAN GERIATRICS JOURNAL
卷 18, 期 2, 页码 43-50出版社
MULTIMED INC
DOI: 10.5770/cgj.18.134
关键词
psychosocial risk factors; late-life depression; cognition; dementia; mild cognitive impairment; medical illness burden
资金
- NIH [R01 MH043823, R01 MH037869, P30 MH090333]
- UPMC Endowed Chair in Geriatric Psychiatry (Reynolds)
- Canadian Institutes of Health Research (CIHR)
- Federation de Recherche en Sante Quebec (FRSQ)
- [R01 MH072947]
- [R01 MH080240]
- [R01 MH084921]
- [P50 AG05133]
Background Cognitive impairment and depression frequently co-occur in late life. There remains a need to better characterize psychosocial risk factors of cognitive decline in older adults with depression. We hypothesized that certain psychosocial factors would be associated with higher risk of cognitive decline in individuals with late-life depression. Methods 130 individuals aged >= 65 years who had achieved remission from a major depressive episode were randomized to donepezil or placebo and then closely followed for two years. Using Cox proportional hazard models, we examined the association between baseline median household income, education level, race, marital status, and social support and cognitive decline over the follow-up. Results Lower interpersonal support (OR= 0.86 [0.74-0.99], p=.04) and lower baseline global neuropsychological score (OR= 0.56 [0.36-0.87], p=.001) predicted shorter time to conversion to MCI or dementia in univariate models. These exposures did not remain significant in multivariate analyses. Neither socioeconomic status nor other psychosocial factors independently predicted cognitive diagnostic conversion (p>.05). Conclusions We did not find reliable associations between cognitive outcome and any of the psychosocial factors examined. Future large-scale, epidemiological studies, ideally using well-validated subjective measures, should better characterize psychosocial risk factors for cognitive decline in late-life depression.
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