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Cognitive performance and the course of depressive symptoms over 7 years of follow-up: the SMART-MR study

Published online by Cambridge University Press:  11 December 2014

M. Kooistra ,
N. P. A. Zuithoff ,
A. M. Grool ,
M. Zinsmeester ,
G. J. Biessels ,
Y. van der Graaf  and
M. I. Geerlings
M. Kooistra
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands
N. P. A. Zuithoff
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
A. M. Grool
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
M. Zinsmeester
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
G. J. Biessels
Affiliation:
Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands
Y. van der Graaf
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
M. I. Geerlings*
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
*
*Address for correspondence: M. I. Geerlings, Ph.D., Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Stratenum 6.131, PO Box 85500, Utrecht 3508 GA, The Netherlands. (Email: [email protected])
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Abstract

Background

Depressive symptoms and cognitive impairment often co-occur, but their interactive relationship is complex and the direction of causation is still a topic of research. We examined the influence of cognitive performance on the course of depressive symptoms during 7 years of follow-up in patients with vascular disease.

Method

Within the SMART-MR study, 736 patients (mean age 62 ± 10 years) had neuropsychological assessment on four cognitive domains at baseline [memory (MEM), working memory (WMEM), executive functioning (EXEC), and information processing speed (SPEED)]. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9) at baseline and every 6 months during 7 years of follow-up. Generalized Estimating Equation (GEE) models were used to assess the association between cognitive performance with depressive symptoms at multiple time points during follow-up. Interaction terms between the respective cognitive domains and time was included to examine if the course of depressive symptoms differed according to baseline cognitive performance.

Results

The GEE analyses showed no significant interactions between the respective cognitive domains and time indicating no different course of depressive symptoms according to baseline cognitive performance. Lower MEM, EXEC or SPEED, but not WMEM performance, was significantly associated with more depressive symptoms during follow-up per z score decrease: MEM [B = 0.70, 95% confidence interval (CI) 0.35–1.05]; EXEC (B = 0.88, 95% CI 0.41–1.36), and SPEED (B = 0.57, 95% CI 0.21–0.92).

Conclusions

Poorer cognitive performance on the domains MEM, EXEC and SPEED, but not WMEM, was associated with higher levels of depressive symptoms over 7 years of follow-up, but not with a different course of depressive symptoms over time.

Keywords

Atheroscleroticcognitiondepressionepidemiologylongitudinal
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 8 , June 2015 , pp. 1741 - 1750
Copyright
Copyright © Cambridge University Press 2014 

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