Disability but not social support predicts cognitive deterioration in late-life depression.
Int Psychogeriatr
; 27(5): 707-14, 2015 May.
Article
in En
| MEDLINE
| ID: mdl-25475430
ABSTRACT
BACKGROUND:
Depression in late life is a risk factor for cognitive decline. Depression is also associated with increased disability and social support deficits; these may precede conversion to dementia and inform risk. In this study, we examined if baseline or one-year change in disability and social support predicted later cognitive deterioration.METHODS:
299 cognitively intact depressed older adults were followed for an average of approximately seven years. Participants received antidepressant treatment according to a standardized algorithm. Neuropsychological testing and assessment of disability and social support were assessed annually. Cognitive diagnosis was reviewed annually at a consensus conference to determine if participants remained cognitively normal, or if they progressed to either dementia or cognitively impaired, no dementia (CIND).RESULTS:
During study participation, 167 individuals remained cognitively normal (56%), 83 progressed to CIND (28%), and 49 progressed to dementia (16%). Greater baseline instrumental activities of daily living (IADL) deficits predicted subsequent conversion to a cognitive diagnosis (CIND or dementia). However, neither baseline measures nor one-year change in basic ADLs (BADLs) and social support predicted cognitive conversion. In post hoc analyses, two IADL measures (managing finances, preparing meals) significantly increased the odds of cognitive conversion.CONCLUSIONS:
Greater IADL deficits predicted increased risk of cognitive conversion. Assessment of IADL deficits may provide clues about risk of later cognitive decline.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Social Support
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Disabled Persons
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Cognition Disorders
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Depressive Disorder, Major
Type of study:
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
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Female
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Humans
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Male
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Middle aged
Language:
En
Year:
2015
Type:
Article