18 Mar Older Adults with Chronically High Depressive Symptoms May Be At Higher Risk of Dementia
MedicalResearch.com Interview with:
Allison R. Kaup, PhD
Assistant Adjunct Professor, UCSF Department of Psychiatry
Clinical Research Psychologist / Clinical Neuropsychologist and
Kristine Yaffe MD
Professor of Psychiatry, Neurology and Epidemiology
Chief of Geriatric Psychiatry and Director of the Memory Evaluation Clinic
San Francisco VA Medical Center
MedicalResearch.com: What is the background for this study?
Response: Previous research has shown that older adults with depression are more likely to develop dementia. But, most studies have only examined an older adult’s depressive symptoms at one point in time. This is an important limitation because we know that depressive symptoms change over time and that older adults show different patterns of depressive symptoms over time. For the present study, older adults were followed for several years. We assessed what patterns of depressive symptoms they tended to have during the early years of the study, and then investigated whether these different patterns were associated with who developed dementia during the later years of the study.
MedicalResearch.com: What are the main findings?
Response: Older adults in this study tended to show one of 3 different patterns of depressive symptoms. Most tended to have few, if any, symptoms over time. Some tended to have a moderate level of depressive symptoms at the beginning of the study, which increased over time. And others tended to have a high level of depressive symptoms at the beginning of the study, which increased over time.
We found that older adults with the high-and-increasing depressive symptoms pattern were almost twice as likely to develop dementia than those with minimal symptoms, even when accounting for other important factors. While older adults with the moderate-and-increasing depressive symptom pattern were also somewhat more likely to develop dementia, this association was not as strong and did not hold up in our statistical models when we accounted for what individuals’ cognitive functioning was like during the early years of the study.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: Our findings are further evidence that it is important for clinicians to regularly evaluate whether their older adult patients are experiencing depressive symptoms. Not only is this important for good mental health care practice, but it may also help identify individuals who are at high risk for cognitive decline. While our study was not designed to investigate how depression treatment might influence cognitive functioning, our results at least raise the possibility that treatment for depression may have the potential to improve cognitive outcomes in older adults. If patients are experiencing symptoms of depression, they are encouraged to bring this to their doctors’ attention, and clinicians should be helping their patients get connected with mental health care.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: It’s still unclear whether depression might contribute to causing cognitive decline, or whether older adults might simply start to have symptoms of depression at the same time as they begin to experience symptoms of cognitive decline. This is something that needs to be further investigated in future studies. As mentioned above, future studies are also needed to understand whether treatments for depression, whether medications or psychotherapy interventions, may help to improve cognition or prevent dementia in older adults with depressive symptoms.
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Dr. Allison R. Kaup and Dr. Kristine Yaffe (2016). Older Adults With Severe Depression May Be At Higher Risk of Dementia MedicalResearch.com