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Relationship Between Depressive Symptoms and Cognition in Older, Non-demented African Americans

Published online by Cambridge University Press:  19 May 2014

Jamie L. Hamilton
Affiliation:
Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
Adam M. Brickman
Affiliation:
Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York
Rosalyn Lang
Affiliation:
North Carolina Agricultural and Technical State University, Department of Biology, Greensboro, North Carolina
Goldie S. Byrd
Affiliation:
North Carolina Agricultural and Technical State University, Dean, College of Arts and Sciences, Greensboro, North Carolina
Jonathan L. Haines
Affiliation:
Center for Human Genetics Research, Vanderbilt University, Nashville, Tennessee
Margaret A. Pericak-Vance
Affiliation:
John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, Florida
Jennifer J. Manly*
Affiliation:
Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York
*
Correspondence and reprint requests to: Jennifer Manly, Columbia University, Taub Institute for Research on Alzheimer’s Disease, and the Aging Brain, College of Physicians and Surgeons, PH Building, Suite 19-321, 630 W 168th Street, New York, NY 10032. E-mail: [email protected]

Abstract

Knowledge of the relationship between depressive symptoms and cognition in older adults has primarily come from studies of clinically depressed, functionally impaired or cognitively impaired individuals, and in predominately White samples. Limited minority representation in depression research exposes the need to examine these associations in more ethnic/racially diverse populations. We sought to examine the relationship between depressive symptoms and cognition in a sample of non-demented older African Americans recruited from surrounding U.S. cities of New York, Greensboro, Miami, and Nashville (N=944). Depressive symptoms were evaluated with the Geriatric Depression Scale (GDS). Cognition was evaluated with a comprehensive neuropsychological battery. Test scores were summarized into attention, executive function, memory, language, and processing speed composites. Controlling for age, education, reading level, and sex, African American older adults who endorsed more symptoms obtained significantly lower scores on measures of memory, language, processing speed, and executive functioning. Further investigation of the causal pathway underlying this association, as well as potential mediators of the relationship between depressive symptoms and cognitive test performance among older African Americans, such as cardiovascular and cerebrovascular disease, may offer potential avenues for intervention. (JINS, 2014, 20, 1–8)

Type
Brief Communication
Copyright
Copyright © The International Neuropsychological Society 2014 

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References

Adams, K.B., & Moon, H. (2009). Subthreshold depression: characteristics and risk factors among vulnerable elders. Aging Ment Health, 13(5), 682692. doi:10.1080/13607860902774501 Google Scholar
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders, 4th ed. Washington, DC: American Psychiatric Association.Google Scholar
Antonogeorgos, G., Panagiotakos, D.B., Pitsavos, C., Papageorgiou, C., Chrysohoou, C., Papadimitriou, G.N., &Stefanadis, C. (2012). Understanding the role of depression and anxiety on cardiovascular disease risk, using structural equation modeling; the mediating effect of the Mediterranean diet and physical activity: The ATTICA study. Annals of Epidemiology, 22(9), 630637. doi:10.1016/j.annepidem.2012.06.103 Google Scholar
Austin, M.P., Mitchell, P., & Goodwin, G.M. (2001). Cognitive deficits in Depression: Possible implications for functional neuropathology. British Journal of Psychiatry, 178, 200206.Google Scholar
Barnes, D.E., Alexopoulos, G.S., Lopez, O.L., Williamson, J.D., & Yaffe, K. (2006). Depressive symptoms, vascular disease, and mild cognitive impairment: Findings from the Cardiovascular Health Study. Archives of General Psychiatry, 63(3), 273279. doi:10.1001/archpsyc.63.3.273 CrossRefGoogle ScholarPubMed
Bassuk, S.S., Berkman, L.F., & Wypij, D. (1998). Depressive symptomatology and incident congitive decline in an elderly community sample. Archives of General Psychiatry, 55, 10731081.Google Scholar
Blazer, D.G. (2003). Depression in late life: Review and commentary. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 58(3), 249265.Google Scholar
Blazer, D.G., Landerman, L.R., Hays, J.C., Simonsick, E.M., & Saunders, W.B. (1998). Symptoms of depression among community-dwelling elderly African-American and white older adults. Psychological Medicine, 28(6), 13111320.Google Scholar
Boone, K.B., Lesser, I., Miller, B., Wohl, M., Berman, N., Lee, A., &Palmer, B. (1994). Cognitive functioning in a mildly to moderately depressed geriatric sample: Relationship to chronological age. The Journal of Neuropsychiatry and Clinical Neurosciences, 6(3), 267272.Google Scholar
Burt, D.B., Zembar, M.J., & Niederehe, G. (1995). Depression and memory impairment: A meta-analysis of the association, its pattern, and specificity. Psychol Bull, 117(2), 285305.CrossRefGoogle ScholarPubMed
Cohen, C.I., Magai, C., Yaffee, R., & Walcott-Brown, L. (2005). Racial differences in syndromal and subsyndromal depression in an older urban population. Psychiatric Services, 56(12), 15561563. doi:10.1176/appi.ps.56.12.1556 CrossRefGoogle Scholar
Comijs, H.C., Jonker, C., Beekman, A.T., & Deeg, D.J. (2001). The association between depressive symptoms and cognitive decline in community-dwelling elderly persons. International Journal of Geriatric Psychiatry, 16(4), 361367.Google Scholar
Dal Forno, G., Palermo, M.T., Donohue, J.E., Karagiozis, H., Zonderman, A.B., & Kawas, C.H. (2005). Depressive symptoms, sex, and risk for Alzheimer’s disease. Annals of Neurology, 57, 381387.Google Scholar
Delis, D.C., Kramer, J.H., Kaplan, E., & Ober, B.A. (2000). California Verbal Learning Test (2nd ed.). San Antonio, TX: Psychological Corporation.Google Scholar
Devanand, D.P., Sano, M., Tang, M.X., Taylor, S., Gurland, B.J., Wilder, D., …Mayeux, R. (1996). Depressed mood and incidence of Alzheimer’s disease in the elderly living in the community. Archives of General Psychiatry, 53, 175182.CrossRefGoogle ScholarPubMed
Dotson, V.M., Resnick, S.M., & Zonderman, A.B. (2008). Differential association of concurrent, baseline, and average depressive symptoms with cognitive decline in older adults. The American Journal of Geriatric Psychiatry, 16(4), 318330. doi:10.1097/JGP.0b013e3181662a9c Google Scholar
Dufouil, C., Fuhrer, R., Dartigues, J.F., & Alperovitch, A. (1996). A Longitudinal analysis of the association between depressive symptomatology and cognitive deterioration. Journal of Epidemiology, 144, 634641.Google Scholar
Elderkin-Thompson, V., Kumar, A., Bilker, W.B., Dunkin, J.J., Mintz, J., Moberg, P.J., …Gur, R.E. (2003). Neuropsychological deficits among patients with late-onset minor and major depression. Archives of Clinical Neuropscyhology, 18, 529549.Google Scholar
Espiritu, D.A., Rashid, H., Mast, B.T., Fitzgerald, J., Steinberg, J., & Lichtenberg, P.A. (2001). Depression, cognitive impairment and function in Alzheimer’s disease. International Journal of Geriatric Psychiatry, 16(11), 10981103.Google Scholar
Feng, L., Yap, K.B., & Ng, T.P. (2013). Depressive symptoms in older adults with chronic kidney-disease: Mortality, quality of life outcomes, and correlates. American Journal of Geriatric Psychiatry, 21, 570579.Google Scholar
Fillenbaum, G.G., Peterson, B., Welsh-Bohmer, K.A., Kukull, W.A., & Heyman, A. (1998). Progression of Alzheimer’s disease in black and white patients: The CERAD experience, part XVI. Consortium to Establish a Registry for Alzheimer’s Disease. Neurology, 51, 154158.CrossRefGoogle Scholar
Fiske, A., Wetherell, J.L., & Gatz, M. (2009). Depression in older adults. Annual Review of Clinical Psychology, 5, 363389. doi:10.1146/annurev.clinpsy.032408.153621 CrossRefGoogle ScholarPubMed
Gallo, J.J., Rabins, P.V., Lyketsos, C.G., Tien, A.Y., & Anthony, J.C. (1997). Depression without sadness: Functional outcomes of nondysphoric depression in later life. Journal of the American Geriatrics Society, 45(5), 570578.Google Scholar
Ganguli, M., Snitz, B., Vander Bilt, J., & Chang, C.C. (2009). How much do depressive symptoms affect cognition at the population level? The Monongahela-Youghiogheny Healthy Aging Team (MYHAT) study. International Journal of Geriatric Psychiatry, 24(11), 12771284. doi:10.1002/gps.2257 Google Scholar
Geerlings, M.I., Shoever, R.A., Beekman, A.T., Jonker, C., Deeg, D.J., Schmand, B., …Van Tilburg, W. (2000). Depression and risk of cognitive decline and Alzheimer’s disease. Results of two prospective community-based studies in the Netherlands. The British Journal of Psychiatry, 176, 568575.CrossRefGoogle ScholarPubMed
Gerety, M.B., Williams, J.W. Jr., Mulrow, C.D., Cornell, J.E., Kadri, A.A., Rosenberg, J., …Long, M. (1994). Performance of case-finding tools for depression in the nursing home: Influence of clinical and functional characteristics and selection of optimal threshold scores. Journal of the American Geriatric Society, 42(10), 11031109.Google Scholar
Gitlin, L.N., Hauck, W.W., Dennis, M.P., & Schulz, R. (2007). Depressive symptoms in older African-American and white adults with functional difficulties: The role of control strategies. Journal of the American Geriatric Society, 55(7), 10231030. doi:10.1111/j.1532-5415.2007.01224.x Google Scholar
Godin, O., Dufouil, C., Ritchie, K., Dartigues, J.F., Tzourio, C., Peres, K., …Alperovitch, A. (2007). Depressive symptoms, major depressive episode and cognition in the elderly: The three-city study. Neuroepidemiology, 28, 101108.Google Scholar
Goodglass, H., & Kaplan, E. (1983). The assessment of aphasia and related disorders. Philadelphia: Lea & Febiger.Google Scholar
Goveas, J.S., Espeland, M.A., Hogan, P.E., Tindle, H.A., Shih, R.A., Kotchen, J.M., …Resnick, S.M. (2014). Depressive symptoms and longitudinal changes in cognition: Women’s health initiative study of cognitive aging. Journal of Geriatric Psychiatry and Neurology. doi:10.1177/0891988714522697 CrossRefGoogle Scholar
Hasin, D.S., Goodwin, R.D., Stinson, F.S., & Grant, B.F. (2005). Epidemiology of major depressive disorder: Results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Archives of General Psychiatry, 62(10), 10971106. doi:10.1001/archpsyc.62.10.1097 Google Scholar
Horwath, E., Johnson, J., Klerman, G.L., & Weissman, M.M. (1992). Depressive symptoms as relative and attributable risk factors for first-onset major depression. Archives of General Psychiatry, 49(10), 817823.Google Scholar
Jorm, A.F. (2001). History of depression as a risk factor for dementia: An updated review. The Australian and New Zealand Journal of Psychiatry, 35(6), 776781.Google Scholar
Kane, K.D., Yochim, B.P., & Lichtenberg, P.A. (2010). Depressive symptoms and cognitive impairment predict all-cause mortality in long-term care residents. Psychology and Aging, 25(2), 446452. doi:10.1037/a0019032 Google Scholar
Kaplan, E., Goodglass, H., & Weintraub, S. (1983). Boston Naming Test. Philadelphia: Lea and Febiger.Google Scholar
Kessler, R.C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K.R., … National Comorbidity Survey, R. (2003). The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association, 289(23), 30953105. doi:10.1001/jama.289.23.3095 Google Scholar
Lebowitz, B.D., Pearson, J.L., Schneider, L.S., Reynolds, C.F. III, Alexopoulos, G.S., Bruce, M.L., …Parmelee, P. (1997). Diagnosis and treatment of depression in late life. Consensus statement update. Journal of the American Medical Association, 278(14), 11861190.Google Scholar
Lichtenberg, P.A., Ross, T., Millis, S.R., & Manning, C.A. (1995). The relationship between depression and cognition in older adults: A cross-validation study. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 50(1), P25P32.Google Scholar
Livney, M.G., Clark, C.M., Karlawish, J.H., Cartmell, S., Negron, M., Nunez, J., …Arnold, S.E. (2011). Ethnoracial differences in the clinical characteristics of Alzheimer’s disease at initial presentation at an urban Alzheimer’s disease center. American Journal of Geriatric Psychiatry, 19(5), 430439. doi:10.1097/JGP.0b013e3181f7d881 Google Scholar
Lockwood, K.A., Alexopoulos, G.S., & van Gorp, W.G. (2002). Executive dysfunction in geriatric depression. American Journal of Psychiatry, 159, 11191126.Google Scholar
Lopez, O.L., Jagust, W.J., Dulberg, C., Becker, J.T., DeKosky, S.T., Fitzpatrick, A., …Kuller, L.H. (2003). Risk factors for mild cognitive impairment in the Cardiovascular Health Study Cognition Study: Part 2. Archives of Neurology, 60(10), 13941399. doi:10.1001/archneur.60.10.1394 Google Scholar
McDougall, G.J. Jr., Morgan, S., & Vaughan, P.W. (2012). Sixteen-month evaluation of depressive symptomatology in older adults. Archives of Psychiatric Nursing, 26(2), e13e21. doi:10.1016/j.apnu.2011.12.004 Google Scholar
McKhann, G.M., Knopman, D.S., Chertkow, H., Hyman, B.T., Jack, C.R. Jr., Kawas, C.H., …Phelps, C.H. (2011). The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers & Dementia, 7(3), 263269. doi:10.1016/j.jalz.2011.03.005 Google Scholar
Miller, D.K., Malmstrom, T.K., Joshi, S., Andresen, E.M., Morley, J.E., & Wolinsky, F.D. (2004). Clinically relevant levels of depressive symptoms in community-dwelling middle-aged African Americans. Journal of the American Geriatrics Society, 52(5), 741748. doi:10.1111/j.1532-5415.2004.52211.x Google Scholar
Morris, J.C., Heyman, A., Mohs, R.C., Hughes, J.P., van Belle, G., Fillenbaum, G., …Clark, C. (1989). The consortium to establish a registry for Alzheimer’s disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer’s disease. Neurology, 39, 11591165.Google Scholar
Nebes, R.D., Butters, M.A., Mulsant, B.H., Pollock, B.G., Zmuda, M.D., Houck, P.R., …Reynolds, C.F. III. (2000). Decreased working memory and processing speed mediate cognitive impairment in geriatric depression. Psychological Medicine, 30(3), 679691.Google Scholar
Norris, J.T., Gallagher, D., Wilson, A., & Winograd, C.H. (1987). Assessment of depression in geriatric medical outpatients: The validity of two screening measures. Journal of the American Geriatrics Society, 35(11), 989995.Google Scholar
Ogunniyi, A., Hall, K.S., Gureje, O., Baiyewu, O., Gao, S., Unverzagt, F.W., …Hendrie, H.C. (2006). Risk factors for incident Alzheimer’s disease in African Americans and Yoruba. Metabolic Brain Disease, 21(2-3), 235240. doi:10.1007/s11011-006-9017-2 Google Scholar
Ownby, R.L., Crocco, E., Acevedo, A., John, V., & Loewenstein, D. (2006). Depression and risk for Alzheimer disease: Systematic review, meta-analysis, and metaregression analysis. Archives of General Psychiatry, 63(5), 530538. doi:10.1001/archpsyc.63.5.530 Google Scholar
Pedraza, O., Dotson, V.M., Willis, F.B., Graff-Radford, N.R., & Lucas, J.A. (2009). Internal consistency and test-retest stability of the geriatric depression scale-short form in African American older adults. Journal of Psychopathology and Behavioral Assessment, 31(4), 412416. doi:10.1007/s10862-008-9123-z CrossRefGoogle ScholarPubMed
Petersen, R.C., Smith, G.E., Waring, S.C., Ivnik, R.J., Tangalos, E.G., & Kokmen, E. (1999). Mild cognitive impairment: Clinical characterization and outcome. Archives of Neurology, 56, 303308.Google Scholar
Pincus, H.A., Davis, W.W., & McQueen, L.E. (1999). 'Subthreshold' mental disorders. A review and synthesis of studies on minor depression and other ‘brand names’. British Journal of Psychiatry, 174, 288296.Google Scholar
Ravdin, L.D., Mattis, P.J., & Lachs, M.S. (2004). Assessment of cognition in primary care: Neuropsychological evaluation of the geriatric patient. Geriatrics, 59(2), 3740, 42, 44.Google Scholar
Reitan, R. (1978). Manual for administration of neuropsychological test batteries for adults and children. Tucson, AZ: Reitan Neuropsychological Laboratories Incorporated.Google Scholar
Roger, V.L., Go, A.S., Lloyd-Jones, D.M., Benjamin, E.J., Berry, J.D., Borden, W.B., …Turner, M.B. (2012). On behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2012 update: A report from the American Heart Association. Circulation, 225, e2e220.Google Scholar
Roman, G.C., Tatemichi, T.K., Erkinjuntti, T., Cummings, J.L., Masdeu, J.C., Garcia, J.H., …Hofman, A. (1993). Vascular dementia: Diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology, 43(2), 250260.Google Scholar
Rovner, B.M., Casten, R.J., & Leiby, B.E. (2012). Cognitive and noncognitive determinants of everyday activities in a racially diverse population of older persons receiving health services. The Journal of Nervous and Mental Disease, 200(7), 627631.Google Scholar
Sachs-Ericsson, N., Burns, A.B., Gordon, K.H., Eckel, L.A., Wonderlich, S.A., Crosby, R.D., …Blazer, D.G. (2007). Body mass index and depressive symptoms in older adults: The moderating roles of race, sex, and socioeconomic status. The American Journal of Geriatric Psychiatry, 15(9), 815825. doi:10.1097/JGP.0b013e3180a725d6 Google Scholar
Sims, R., Madhere, S., Callender, C., & Campbell, A. Jr. (2008). Patterns of relationships between cardiovascular disease risk factors and neurocognitive function in African Americans. Ethnicity & Disease, 18(4), 471476.Google ScholarPubMed
Steffens, D.C., Otey, E., Alexopoulos, G.S., Butters, M.A., Cuthbert, B., Ganguli, M., …Yesavage, J. (2006). Perspectives on depression, mild cognitive impairment, and cognitive decline. Archives of General Psychiatry, 63(2), 130138. doi:10.1001/archpsyc.63.2.130 CrossRefGoogle ScholarPubMed
Stoudemire, A., Hill, C.D., Morris, R., Martino-Saltzman, D., & Lewison, B. (1993). Long-term affective and cognitive outcome in depressed older adults. American Journal of Psychiatry, 150, 896900.Google Scholar
Tang, M.X., Cross, P., Andrews, H., Jacobs, D.M., Small, S., Bell, K., …Mayeux, R. (2001). Incidence of AD in African-Americans, Caribbean Hispanics, and Caucasians in northern Manhattan. Neurology, 56(1), 4956.Google Scholar
Unverzagt, F.W., Gao, S., Baiyewu, O., Ogunniyi, A.O., Gureje, O., Perkins, A., …Hendrie, H.C. (2001). Prevalence of cognitive impairment: Data from the Indianapolis Study of Health and Aging. Neurology, 57(9), 16551662.Google Scholar
U.S. Census Bureau. (2001). Census of Population and Housing. Summary Population and Housing Characteristics. Washington, DC: Bureau of the Census.Google Scholar
Wechsler, D. (1997). WMS-III administration and scoring manual. San Antonio, TX: Psychological Corporation.Google Scholar
Weintraub, S., Salmon, D., Mercaldo, N., Ferris, S., Graff-Radford, N.R., Chui, H., &Morris, J.C. (2009). The Alzheimer’s Disease Centers’ Uniform Data Set (UDS): The neuropsychological test battery. Alzheimer’s Disease and Associated Disorders, 23(2), 91101.Google Scholar
Wessels, A.M., Lane, K.A., Gao, S., Hall, K.S., Unverzagt, F.W., & Hendrie, H.C. (2011). Diabetes and cognitive decline in elderly African Americans: A 15-year follow-up study. Alzheimers & Dementia, 7(4), 418424. doi:10.1016/j.jalz.2010.07.003 Google Scholar
Wilkinson, G.S. (1993). Wide range achievement test: WRAT3. Wilmington, DE: Wide Range, Inc.Google Scholar
Williams, D.R., Gonzalez, H.M., Neighbors, H., Nesse, R., Abelson, J.M., Sweetman, J., &Jackson, J.S. (2007). Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks, and non-Hispanic whites: Results from the National Survey of American Life. Archives of General Psychiatry, 64(3), 305315. doi:10.1001/archpsyc.64.3.305 Google Scholar
Wilson, R.S., Mendes De Leon, C.F., Bennett, D.A., Bienias, J.L., & Evans, D.A. (2004). Depressive symptoms and cognitive decline in a community population of older persons. J Neurol Neurosurg Psychiatry, 75(1), 126129.Google Scholar
Wilson, R.S., Barnes, L.L., Mendes, C.F., Agarwal, N.T., Schneider, J.S., Bach, J., …Bennett, D.A. (2002). Depressive symptoms, cognitive decline, and risk of AD in older person. Neurology, 59, 364370.Google Scholar
Yaffe, K., Blackwell, T., Gore, R., Sands, L., Reus, V., & Browner, W.S. (1999). Depressive symptoms and cognitive decline in nondemented elderly women. Archives of General Psychiatry, 56, 425430.Google Scholar
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M., &Leirer, V.O. (1983). Development and validation of a geriatric depression scale: A preliminary report. Journal of Psychiatric Research, 17, 3749.Google Scholar
Zahodne, L.B., Devanand, D.P., & Stern, Y. (2013). Coupled cognitive and functional change in Alzheimer’s disease and the influence of depressive symptoms. Journal of Alzheimers Disease, 34(4), 851860. doi:10.3233/JAD-121921 Google Scholar