Is there a bidirectional relationship between depressive symptoms and cognitive ability in older people? A prospective study using the English Longitudinal Study of Ageing

Background Cross-sectional surveys of older people commonly find associations between higher levels of depressive symptoms and poorer cognitive performance, but the direction of effect is unclear. We examined whether there was a bidirectional relationship between depressive symptoms and general cognitive ability in non-demented older people, and explored the role of physical health, smoking, exercise, social class and education as potential confounders of this association and as possible determinants of the rate of change of cognitive decline and depressive symptoms. Method The English Longitudinal Study of Ageing consists of people aged 50 years and over. Cognitive function and self-reported depressive symptoms were measured in 2002–2003, 2004–2005, 2006–2007 and 2008–2009. We fitted linear piecewise models with fixed knot positions to allow different slopes for different age groups. Analyses are based on 8611 people. Results Mean cognitive function declined with age; there was no trend in the trajectory of depressive symptoms. Better cognitive function was associated with less depression up to the age of 80 years. Greater depression was associated with a slightly faster rate of cognitive decline but only in people aged 60–80 years. There were no consistent associations across age groups between sex, smoking, education, social class, exercise or number of chronic physical illnesses and the rate of change of cognitive decline or depressive symptoms. Conclusions In this longitudinal study of older people, there was no consistent evidence that being more depressed led to an acceleration in cognitive decline and no support for the hypothesis that there might be reciprocal dynamic influences between cognitive ability and depressive symptoms.

[1]  Carole Dufouil,et al.  Depressive symptoms and cognitive decline in elderly people. Longitudinal study. , 2002, The British journal of psychiatry : the journal of mental science.

[2]  B. Ripley,et al.  Semiparametric Regression: Preface , 2003 .

[3]  Patterns and risk factors of change in somatic and mood symptoms among older adults. , 2001, Annals of epidemiology.

[4]  Luc Vanhees,et al.  Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. , 2008, The Cochrane database of systematic reviews.

[5]  M. Salah,et al.  Methodology , 2003 .

[6]  D. Carmelli,et al.  Cognition and depression in a cohort of aging men: results from the Western Collaborative Group Study. , 1995, Psychology and aging.

[7]  L R White,et al.  Correlates of cognitive function in an elderly community population. , 1988, American journal of epidemiology.

[8]  J. Jolles,et al.  No protective effects of education during normal cognitive aging: results from the 6-year follow-up of the Maastricht Aging Study. , 2008, Psychology and aging.

[9]  D. Bennett,et al.  Depressive symptoms, cognitive decline, and risk of AD in older persons , 2002, Neurology.

[10]  D. Kay,et al.  Dementia and depression among the elderly living in the Hobart community: the effect of the diagnostic criteria on the prevalence rates , 1985, Psychological Medicine.

[11]  H. Christensen,et al.  A quantitative review of cognitive deficits in depression and Alzheimer-type dementia , 1997, Journal of the International Neuropsychological Society.

[12]  Arthur F Kramer,et al.  Exercise, cognition, and the aging brain. , 2006, Journal of applied physiology.

[13]  S. Rubin,et al.  Socioeconomic differences in cognitive decline and the role of biomedical factors. , 2005, Annals of epidemiology.

[14]  Donald Hedeker,et al.  Application of random-efiects pattern-mixture models for miss-ing data in longitudinal studies , 1997 .

[15]  C. Turvey,et al.  A Revised CES-D Measure of Depressive Symptoms and a DSM-Based Measure of Major Depressive Episodes in the Elderly , 1999, International Psychogeriatrics.

[16]  S. Wood.  Generalized Additive Models: An Introduction with R , 2006 .

[17]  G. Huba,et al.  A Short Depression Index for Women , 1993 .

[18]  A. Mackinnon,et al.  Age is no kinder to the better educated: absence of an association investigated using latent growth techniques in a community sample , 2001, Psychological Medicine.

[19]  R B Wallace,et al.  Longitudinal application of cognitive function measures in a defined population of community-dwelling elders. , 1991, Annals of epidemiology.

[20]  P.4.014 Correlation of depressive symptoms and cognitive decline in elderly people , 2003, European Neuropsychopharmacology.

[21]  D. Bennett,et al.  Depressive symptoms and cognitive decline in a community population of older persons. , 2004, Journal of neurology, neurosurgery, and psychiatry.

[22]  James Nazroo.  Health, wealth and lifestyles of the older population in England: The 2002 English Longitudinal Study of Ageing , 2003 .

[23]  L. Berkman,et al.  Depressive symptomatology and incident cognitive decline in an elderly community sample. , 1998, Archives of general psychiatry.

[24]  Ian J. Deary,et al.  Intelligence in childhood and risk of psychological distress in adulthood: The 1958 National Child Development Survey and the 1970 British Cohort Study , 2009 .

[25]  P. Cuijpers,et al.  Two-year course of depressive and anxiety disorders: results from the Netherlands Study of Depression and Anxiety (NESDA). , 2011, Journal of affective disorders.

[26]  Scott C Brown,et al.  Longitudinal relationships between cognitive functioning and depressive symptoms among Hispanic older adults. , 2008, The journals of gerontology. Series B, Psychological sciences and social sciences.

[27]  P. Touboul,et al.  Ultrasonographic assessment of carotid wall characteristics and cognitive functions in a community sample of 59- to 71-year-olds. The EVA Study Group. , 1996, Stroke.

[28]  M. Marmot.  English Longitudinal Study of Ageing: Wave 0 (1998, 1999 and 2001) and Waves 1-5 (2002-2011) , 2013 .

[29]  Hiroko H Dodge,et al.  Depressive symptoms and cognitive decline in late life: a prospective epidemiological study. , 2006, Archives of general psychiatry.

[30]  Eileen Crimmins,et al.  Education and Cognitive Decline in Older Americans , 2007, Research on aging.

[31]  P. Rabbitt,et al.  Unique and interactive effects of depression, age, socioeconomic advantage, and gender on cognitive performance of normal healthy older people. , 1995, Psychology and aging.

[32]  Ian J. Deary,et al.  The Stability of Individual Differences in Mental Ability from Childhood to Old Age: Follow-up of the 1932 Scottish Mental Survey , 2000 .

[33]  R S Wilson,et al.  Educational attainment and cognitive decline in old age , 2009, Neurology.

[34]  B. Dong,et al.  Health status and risk for depression among the elderly: a meta-analysis of published literature. , 2010, Age and ageing.

[35]  W. van Tilburg,et al.  On becoming depressed or anxious in late life: similar vulnerability factors but different effects of stressful life events , 2001, British Journal of Psychiatry.

[36]  H. Christensen,et al.  Education, Activity, Health, Blood Pressure and Apolipoprotein E as Predictors of Cognitive Change in Old Age: A Review , 2000, Gerontology.

[37]  J. Dartigues,et al.  Longitudinal analysis of the association between depressive symptomatology and cognitive deterioration. , 1996, American journal of epidemiology.

[38]  S. Bahn,et al.  Functional genomics and proteomics: application in neurosciences , 2004, Journal of Neurology, Neurosurgery & Psychiatry.

[39]  I. Deary,et al.  Intelligence in Early Adulthood and Subsequent Hospitalization for Mental Disorders , 2010, Epidemiology.

[40]  Alan Y. Chiang,et al.  Generalized Additive Models: An Introduction With R , 2007, Technometrics.

[41]  John Barefoot,et al.  Cognitive ability in early adulthood and risk of 5 specific psychiatric disorders in middle age: the Vietnam experience study. , 2008, Archives of general psychiatry.

[42]  J. Gallacher,et al.  Factors associated with symptoms of anxiety and depression in five cohorts of community based older people : the HALCyon ( Healthy Ageing across the Life Course ) , 2013 .

[43]  E. Kua,et al.  Depressive Symptoms and Incident Cognitive Impairment in Cognitively Well‐Functioning Older Men and Women , 2009, Journal of the American Geriatrics Society.

[44]  R. Glynn,et al.  Correlates of Cognitive Function Scores in Elderly Outpatients , 1993, Journal of the American Geriatrics Society.

[45]  Ons,et al.  The National Statistics Socio-economic Classification User Manual , 2002 .

[46]  P. Barberger‐Gateau,et al.  Depressive symptomatology and cognitive functioning: an epidemiological survey in an elderly community sample in France , 1992, Psychological Medicine.

[47]  D. Bennett,et al.  Change in depressive symptoms during the prodromal phase of Alzheimer disease. , 2008, Archives of general psychiatry.

[48]  W. Verschuren,et al.  Smoking and cognitive decline among middle-aged men and women: the Doetinchem Cohort Study. , 2008, American journal of public health.

[49]  A. Mackinnon,et al.  The course of depression in the elderly: a longitudinal community-based study in Australia , 1997, Psychological Medicine.

[50]  A. Beekman,et al.  Depression and risk of cognitive decline and Alzheimer's disease , 2000, British Journal of Psychiatry.

[51]  A. Beekman,et al.  Socioeconomic differences in incident depression in older adults: the role of psychosocial factors, physical health status, and behavioral factors. , 2006, Journal of psychosomatic research.

[52]  Sumaira Malik,et al.  How effective are physical activity interventions for alleviating depressive symptoms in older people? A systematic review , 2009, Clinical rehabilitation.

[53]  P. S. St John,et al.  Do depressive symptoms predict Alzheimer's disease and dementia? , 2005, The journals of gerontology. Series A, Biological sciences and medical sciences.

[54]  K Yaffe,et al.  Depressive symptoms and cognitive decline in nondemented elderly women: a prospective study. , 1999, Archives of general psychiatry.

[55]  R. Tibshirani,et al.  Generalized Additive Models , 1986 .

[56]  J. Bond,et al.  Self-rated health status as a predictor of death, functional and cognitive impairment: a longitudinal cohort study , 2006, European journal of ageing.