Depressive symptoms and cognitive decline in community-dwelling older adults

J Am Geriatr Soc. 2010 May;58(5):873-9. doi: 10.1111/j.1532-5415.2010.02807.x. Epub 2010 Mar 30.


Objectives: To examine the temporal association between depressive symptoms and cognitive functioning and estimate the effect measure modification of the apolipoprotein E (APOE) epsilon4 allele on this relationship.

Design: Prospective cohort study.

Setting: General community.

Participants: Population-based sample of 598 cognitively intact older adults aged 60 and older, with re-assessments after 3 (N=479) and 6 years (N=412).

Measurements: Depressive symptoms (Symptom Checklist) and neurocognitive functioning (memory, Visual Verbal Learning Test; attention, Stroop Color-Word Test; processing speed, Letter Digit Substitution Test; general cognition, Mini-Mental State Examination). Longitudinal associations were assessed using linear mixed models. The risk for cognitive impairment, no dementia (CIND) was examined using logistic regression.

Results: Adjusting for age, sex, education, and baseline cognition, the rate of change in memory z-scores was 0.00, -0.11, -0.20, and -0.37 for those in the lowest (reference group), second, third, and highest depressive symptom quartiles at baseline, respectively (P<.001 for highest vs lowest quartile). The odds ratios for developing CIND with amnestic features were 1.00, 0.87, 0.69, and 2.98 for the four severity groups (P=.05 for highest vs lowest quartile). Associations were strongest for those with persistent depressive symptoms, defined as high depressive symptoms at baseline and at least one follow-up visit. Results were similar for processing speed and global cognitive function but were not as strong for attention. No APOE interaction was observed.

Conclusion: Depression and APOE act independently to increase the risk for cognitive decline and may provide targets for prevention and early treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Apolipoproteins E / genetics
  • Cognition*
  • Cohort Studies
  • Depression / psychology*
  • Exophthalmos
  • Female
  • Genotype
  • Humans
  • Independent Living
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors


  • Apolipoproteins E