03476nas a2200409 4500008004100000022001400041245012100055210006900176260001300245300001000258490000700268520227900275653000902554653003002563653002402593653001602617653001302633653002302646653002402669653001102693653002202704653002502726653001102751653002502762653000902787653002402796653003702820653001702857653002102874653002202895100002302917700002702940700002002967700002402987700002003011856003503031 2006 eng d a0003-990X00aDepressive symptoms, vascular disease, and mild cognitive impairment: findings from the Cardiovascular Health Study.0 aDepressive symptoms vascular disease and mild cognitive impairme c2006 Mar a273-90 v633 a

CONTEXT: Depressive symptoms are common in patients with dementia and may be associated with increased risk of developing dementia. It has been hypothesized that depressive symptoms and dementia may be attributable to underlying vascular disease in some older persons.

OBJECTIVES: To test the hypotheses (1) that depressive symptoms are associated with increased risk of developing mild cognitive impairment (MCI), a preclinical state that often precedes dementia, and (2) that the association between depressive symptoms and MCI is attributable to underlying vascular disease.

DESIGN: Prospective, population-based, longitudinal study.

SETTING: Random sample of adults 65 years or older recruited from 4 US communities.

PARTICIPANTS: Subjects were 2220 participants in the Cardiovascular Health Study Cognition Study with high cognitive function at baseline. Depressive symptoms were measured at baseline using the 10-item Center for Epidemiological Studies Depression Scale and were classified as none (0-2 points), low (3-7 points), and moderate or high (>/=8 points). Vascular disease measures at baseline included confirmed history of stroke, transient ischemic attack, diabetes mellitus, or hypertension; carotid artery stenosis; ankle-arm blood pressure index; and small or large infarcts or white matter disease on cerebral magnetic resonance imaging. Mild cognitive impairment was diagnosed after 6 years of follow-up based on the consensus of a team of dementia experts using standard clinical criteria.

MAIN OUTCOME MEASURE: Diagnosis of MCI.

RESULTS: Depressive symptoms at baseline were associated with increased risk of MCI (10.0%, 13.3%, and 19.7% for those with no, low, and moderate or high depressive symptoms, respectively). This association was diminished only slightly by adjustment for vascular disease measures and demographics. Vascular disease measures also were associated with increased risk of MCI, and these associations were not diminished by adjustment for depressive symptoms or demographics.

CONCLUSION: Depressive symptoms were associated with increased risk of MCI, and this association was independent of underlying vascular disease.

10aAged10aCerebrovascular Disorders10aCognition Disorders10aComorbidity10aDementia10aDementia, Vascular10aDepressive Disorder10aFemale10aFollow-Up Studies10aGeriatric Assessment10aHumans10aLongitudinal Studies10aMale10aProspective Studies10aPsychiatric Status Rating Scales10aRisk Factors10aSampling Studies10aVascular Diseases1 aBarnes, Deborah, E1 aAlexopoulos, George, S1 aLopez, Oscar, L1 aWilliamson, Jeff, D1 aYaffe, Kristine uhttps://chs-nhlbi.org/node/891