03506nas a2200373 4500008004100000022001400041245016100055210006900216260001300285300001100298490000700309520239700316653003102713653000902744653002502753653002402778653002102802653001102823653001102834653002502845653000902870653002602879653000902905653001802914100001902932700002002951700002102971700002002992700001803012700001903030700002303049700002503072856003503097 2005 eng d a0002-861400aThe course of functional decline in older people with persistently elevated depressive symptoms: longitudinal findings from the Cardiovascular Health Study.0 acourse of functional decline in older people with persistently e c2005 Apr a569-750 v533 a

OBJECTIVES: To examine the relationship between persistently high depressive symptoms and long-term changes in functional disability in elderly persons.

DESIGN: A community-based, prospective, observational study.

SETTING: Participant data from the Cardiovascular Health Study.

PARTICIPANTS: From the overall sample of 5,888 subjects, three types of participants were identified for this study: (1) persistently depressed individuals, who experienced an onset of depressive symptoms that persisted over 4 years (n=119); (2) temporarily depressed individuals, who experienced an onset of depressive symptoms that resolved over time (n=259); and (3) nondepressed individuals, with persistently low depressive symptoms throughout the follow-up period who were matched on baseline activity of daily living (ADL) scores, sex, and age to the previous two groups combined (n=378).

MEASUREMENTS: Four consecutive years of data were assessed: validated measures of depression (10-item CES-D), functional disability (10-item ADL/instrumental ADL measure), physical performance, medical illness, and cognition.

RESULTS: The persistently depressed group showed a greater linear increase in functional disability ratings than the temporarily depressed and nondepressed groups. This association between persistent depression and functional disability was robust even when controlling for baseline demographic and clinical/performance measures, including cognition. The persistently depressed group had an adjusted odds ratio (OR) of 5.27 (95% confidence interval (CI) 3.03-9.16) for increased functional disability compared with the nondepressed group over 3 years of follow-up, whereas the temporarily depressed group had an adjusted OR of 2.39 (95% CI=1.55-3.69) compared with the nondepressed group.

CONCLUSION: Persistently elevated depressive symptoms in elderly persons are associated with a steep trajectory of worsening functional disability, generating the hypothesis that treatments for late-life depression need to be assessed on their efficacy in maintaining long-term functional status as well as remission of depressive symptoms. These results also demonstrate the need for studies to differentiate between persistent and temporary depressive symptoms when examining their relationship to disability.

10aActivities of Daily Living10aAged10aCase-Control Studies10aDepressive Disorder10aDisabled Persons10aFemale10aHumans10aLongitudinal Studies10aMale10aMultivariate Analysis10aRisk10aUnited States1 aLenze, Eric, J1 aSchulz, Richard1 aMartire, Lynn, M1 aZdaniuk, Bozena1 aGlass, Thomas1 aKop, Willem, J1 aJackson, Sharon, A1 aReynolds, Charles, F uhttps://chs-nhlbi.org/node/82803445nas a2200469 4500008004100000022001400041245009100055210006900146260001300215300001100228490000700239520212400246653000902370653002202379653002202401653002402423653001302447653001502460653001102475653002202486653001102508653001402519653002502533653003102558653000902589653002702598653002402625653003702649653003002686653001702716100002102733700002002754700002002774700002202794700002102816700002002837700002002857700001902877700001802896700002502914856003602939 2009 eng d a1545-721400aDepressed mood is not a risk factor for incident dementia in a community-based cohort.0 aDepressed mood is not a risk factor for incident dementia in a c c2009 Aug a653-630 v173 a

OBJECTIVES: To determine the relationship between depressed mood and the development of Alzheimer disease in cognitively normal individuals.

DESIGN: Longitudinal and observational.

SETTING: Community-based cohort study.

PARTICIPANTS: A total of 288 participants in the Cardiovascular Health Study-Cognition Study (mean age: 77.52, SD =3.65, range: 70-89). All of the participants were adjudicated as cognitively normal in 1998/1999, and all had at least three visits before 1998/1999 with measures of cognition and mood state. The mean length of follow-up from 1998-1999 to 2007 was 7.1 years (range: 1-9 years, median =9 years).

MEASUREMENTS: The Center for Epidemiological Studies-Depression Scale (CESD) was used to index mood state, and the Modified Mini-Mental State Examination (3MSE) was the index of cognitive function among participants before 1998/1999. These measures were considered in two ways: participants were classified according to: 1) whether they showed a high-negative correlation between their CESD and 3MSE scores (i.e., indicating that greater depression was linked to poorer cognition) and 2) whether they showed persistently elevated CESD scores. The study outcome, development of dementia (N = 48), was based on consensus classifications, which was based on detailed neuropsychological and neurological exams.

RESULTS: The authors could find no consistent relationship between mood state, either alone or in relation to cognitive status, and the subsequent development of dementia. Those individuals whose cognitive functions were highly correlated with their mood state were no more likely to develop dementia than other participants. Those who had persistently depressed mood were also no more likely to develop dementia than those without persistently depressed mood.

CONCLUSION: Within the confines of this prospective, community-based study of elderly adults, the authors could not find strong evidence to support the hypothesis that mood disturbance was linked with the development of dementia.

10aAged10aAged, 80 and over10aAlzheimer Disease10aCognition Disorders10aDementia10aDepression10aFemale10aFollow-Up Studies10aHumans10aIncidence10aLongitudinal Studies10aMagnetic Resonance Imaging10aMale10aMental Status Schedule10aProspective Studies10aPsychiatric Status Rating Scales10aResidence Characteristics10aRisk Factors1 aBecker, James, T1 aChang, Yue-Fang1 aLopez, Oscar, L1 aDew, Mary, Amanda1 aSweet, Robert, A1 aBarnes, Deborah1 aYaffe, Kristine1 aYoung, Jeffrey1 aKuller, Lewis1 aReynolds, Charles, F uhttps://chs-nhlbi.org/node/1118