Temporal course of depressive symptoms during the development of Alzheimer disease

Wilson, Robert S.; Hoganson, George M.; Rajan, Kumar B.; Barnes, Lisa L.; Leon, Carlos F. Mendes de; Evans, Denis A.

doi:10.1212/wnl.0b013e3181e620c5

Cited by 51 publications

(46 citation statements)

References 41 publications

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“…First, depressive symptoms did not increase with the onset of MCI and slightly decreased after dementia onset. Although this is not consistent with prior reports of a very slight increase in depressive symptoms before dementia onset, 13,14 it is consistent with reports of stable 14 or declining 36 depressive symptoms after dementia onset and the lack of an association of cognitive level [37][38][39] and cognitive change 40 with change in depressive symptoms. Second, neither level of depressive symptoms nor change in symptoms over time was related to common neuropathologic lesions associated with cognitive decline and dementia.…”

Section: Model B)contrasting

confidence: 94%

“…Use of a brief self-report scale may have led us to underestimate depressive symptoms especially as cognition became impaired, although informant report does not suggest that depressive symptoms increase in MCI or dementia. 14 …”

Section: Model B)mentioning

confidence: 99%

“…This 10-item measure predicts morbidity 1 and mortality. 12 It is psychometrically similar to the original version of the scale, including the ability to capture change in symptoms over time, 13,14 but differs in 2 important respects: it does not include cognitive symptoms (i.e., "I had trouble keeping my mind on what I was doing," "I talked less than usual") and reduces participant burden (i.e., fewer items, yes/no response format).…”

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confidence: 99%

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Clinical-pathologic study of depressive symptoms and cognitive decline in old age

Kunte¹,

Wilson²,

Kronenberg³

et al. 2015

Neurology

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Objective: To clarify the relationship between depressive symptoms and the clinical and neuropathologic manifestations of dementia. Methods:In a clinical-pathologic cohort study, 1,764 older persons without cognitive impairment at enrollment completed annual clinical evaluations for a mean of 7.8 years. The evaluations included assessment of depressive symptoms (10-item Center for Epidemiological Studies Depression Scale) and cognitive function (battery of 17 performance tests). A total of 582 individuals died during follow-up and underwent a uniform neuropathologic examination to quantify b-amyloid plaques and tau tangle density in multiple brain regions and identify neocortical Lewy bodies, hippocampal sclerosis, and gross and microscopic cerebral infarcts.Results: Level of depressive symptoms slightly increased during follow-up. Incident mild cognitive impairment (52.2%) was associated with higher level of depressive symptoms before the diagnosis but not with change in symptoms after the diagnosis; incident dementia (17.9%) was associated with higher symptom level before dementia onset and with more rapid decline in symptoms after dementia onset. None of the neuropathologic markers was related to level of depressive symptoms or change in symptoms over time. In a mixed-effects model adjusted for the neuropathologic markers, higher level of depressive symptoms averaged over evaluations was associated with more rapid global cognitive decline, accounting for 4.4% of the variability in decline not attributable to the neuropathologic markers. Depressive symptoms did not modify the association of the neuropathologic markers with cognitive decline. Conclusion:In old age, depressive symptoms have an association with cognitive decline that is independent of the neuropathologic hallmarks of dementia. Late-life depressive symptoms are associated with an increased rate of cognitive decline 1,2 and risk of mild cognitive impairment (MCI) 3,4 and dementia. 1,5,6 The main hypotheses about the association, which are not mutually exclusive, are that depressive symptoms are a consequence of cognitive decline; depressive symptoms and cognitive decline are manifestations of the same underlying neuropathology; depressive symptoms alter the association of pathology with declining cognition; and depressive symptoms have an independent association with cognitive decline.

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Section: Model B)contrasting

confidence: 94%

Section: Model B)mentioning

confidence: 99%

mentioning

confidence: 99%

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Clinical-pathologic study of depressive symptoms and cognitive decline in old age

Kunte¹,

Wilson²,

Kronenberg³

et al. 2015

Neurology

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“…The positive affect subscale was reverse coded to signify lower levels of positive affect for higher scores, hence, providing a score for lack of positive affect. Supported by previous factor analyses of the CES-D scale (36,37), we formed sub-scores for lack of positive affect (2 items: I was happy, I enjoyed life; score range: 0-2); negative affect (3 items: I felt sad, I felt lonely, I felt depressed; score range: 0-3); somatic symptoms (3 items: I could not get going, My sleep was restless, I felt like everything I did was an effort; score range: 0-3); and interpersonal problems (2 items: I felt that people disliked me, People were unfriendly; score range:0-2). The discriminant validity of these subscales is supported by evidence that they might be differentially related to dementia (37) and to postmortem measures of the density of dopaminergic neurons in the brainstem (38).…”

Section: Methodsmentioning

confidence: 63%

Gene-Behavior Interaction of Depressive Symptoms and the Apolipoprotein E [Latin Small Letter Open E]4 Allele on Cognitive Decline

Rajan

Wilson

Skarupski

et al. 2014

Psychosomatic Medicine

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Objective Depressive symptoms and the APOE ε4 allele are independent risk factors for cognitive decline. However, it is not clear whether the presence of both depressive symptoms and the APOE ε4 allele increases cognitive decline. Methods A prospective study of a population-based sample of 4,150 (70% African American and 63% women) participants, aged 65 years and older, who were interviewed at 3-year intervals. Depressive symptoms were measured using the 10-item version of the Center for Epidemiologic Studies Depression scale, with each item coded as presence or absence of a symptom. The APOE genotype was ascertained by DNA samples collected during follow-up. Cognitive function was assessed at the initial and follow-up interviews (average follow-up of 9.2 years), using a standardized global cognitive score. Results There were 1405 (34%) participants with one or more copies of the APOE ε4 allele. In participants with no depressive symptoms, cognitive function decreased by 0.0412-unit per year among those with no copies and 0.0704-unit per year among those with one or more copies of the APOE ε4 allele. For each additional symptom of depression, cognitive decline increased by 0.0021-unit per year among those with no copies and 0.0051-unit per year among those with one or more copies of the APOE ε4 allele. The three-way interaction of depressive symptoms, APOE ε4 allele, and time was significant (p=0.021). Conclusions The association of depressive symptoms on cognitive decline was increased among participants with one or more copies of the APOE ε4 allele compared to those without the allele.

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“…Small overall change [12] and low persistence of depression have been reported in dementia [13,14,15,16]. In one of the few longitudinal studies of depression in DLB, major depression or dysthymia were present in 19% at baseline and 21% at 1-year follow-up, and the proportion with depression did not differ between AD and DLB at baseline or at 1-year follow-up [17].…”

Section: Introductionmentioning

confidence: 99%

Depressive Symptoms in Alzheimer’s Disease and Lewy Body Dementia: A One-Year Follow-Up Study

Fritze

Ehrt

Hortobágyi

et al. 2011

Dement Geriatr Cogn Disord

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Objective: To explore the course of depression in people with mild dementia and identify predictors for depression at 1-year follow-up. Methods: Patients with mild dementia (n = 199) were assessed using Montgomery and Åsberg Depression Rating Scale (MADRS) and the depression item from Neuropsychiatric Inventory (NPI) at baseline and after 1 year. A score above 6 on MADRS indicates at least mild depression. Linear and logistic regression analyses were performed to identify predictors of change in depression scores. Results: Among subjects with depression at baseline, 68.1% remained depressed at follow-up, whereas 31.9% had remitted, based on MADRS. Among patients without depression at baseline, 77.1% remained non-depressed at follow-up, whereas 22.9% had incident depression. The proportion with persistent depression was higher in the combined dementia with Lewy bodies (DLB)/Parkinson’s disease with dementia (PDD) group (45.5%) compared to AD (28%) (p < 0.05). Greater decline on the Mini Mental State Examination (p < 0.001) and higher baseline MADRS score (p < 0.001) were significant predictors of increased MADRS score. Conclusion: Two thirds of patients with depression at baseline were still depressed at follow-up, more so in DLB with PDD compared to AD. Cognitive decline was associated with worsening of depressive symptoms.

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Temporal course of depressive symptoms during the development of Alzheimer disease

Cited by 51 publications

References 41 publications

Clinical-pathologic study of depressive symptoms and cognitive decline in old age

Clinical-pathologic study of depressive symptoms and cognitive decline in old age

Gene-Behavior Interaction of Depressive Symptoms and the Apolipoprotein E [Latin Small Letter Open E]4 Allele on Cognitive Decline

Depressive Symptoms in Alzheimer’s Disease and Lewy Body Dementia: A One-Year Follow-Up Study

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