Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-25T04:57:07.963Z Has data issue: false hasContentIssue false
  • English
  • Français

Amnestic mild cognitive impairment and incident dementia and Alzheimer's disease in geriatric depression

Published online by Cambridge University Press:  17 July 2014

David C Steffens ,
Douglas R McQuoid  and
Guy G Potter
David C Steffens*
Affiliation:
Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut, USA
Douglas R McQuoid
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
Guy G Potter
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
*
Correspondence should be addressed to: David C. Steffens, MD, MHS, Professor and Chair, Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-1410, USA. Phone: +860-679-4282; Fax: +860-679-1296. Email: steffens@uchc.edu.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Memory impairment in geriatric depression is understudied, but may identify individuals at risk for development of dementia and Alzheimer's disease (AD). Using a neuropsychologically based definition of amnestic mild cognitive impairment (aMCI) in patients with geriatric depression, we hypothesized that patients with aMCI, compared with those without it, would have increased incidence of both dementia and AD.

Methods:

Participants were aged 60 years and older and consisted of depressed participants and non-depressed volunteer controls. The depressed cohort met criteria for unipolar major depression. All participants were free of dementia and other neurological illness at baseline. At study entry, participants were administered a standardized clinical interview, a battery of neurocognitive tests, and provided a blood sample for determination of apolipoprotein E genotype. A cognitive diagnosis was assigned by a panel of experts who convened annually and reviewed available clinical, neuropsychological and laboratory data to achieve a consensus cognitive diagnosis to determine a consensus diagnosis. Survival analysis examined the association between aMCI and later dementia (all-cause) and AD.

Results:

Among 295 depressed individuals, 63 (21.36%) met criteria for aMCI. Among 161 non-depressed controls, four (2.48%) met aMCI criteria. Participants were followed for 6.28 years on average. Forty-three individuals developed dementia, including 40 (13.6%) depressed and three (1.9%) control participants. Both aMCI and age were associated with incident dementia and AD.

Conclusions:

The presence of aMCI is a poor prognostic sign among patients with geriatric depression. Clinicians should carefully screen elderly depressed adults for memory impairment.

Keywords

DepressiondementiaAlzheimer’s disease
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Special Issue 12: young onset dementia , December 2014 , pp. 2029 - 2036
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexopoulos, G. S., Meyers, B. S., Young, R. C., Mattis, S. and Kakuma, T. (1993). The course of geriatric depression with “reversible dementia”: a controlled study. American Journal of Psychiatry, 150, 1693–1699.Google ScholarPubMed
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.Google Scholar
Benton, A. (1974). Revised Visual Retention Test, 4th Edn, New York, NY: The Psychological Corporation.Google Scholar
Bhalla, R. K. et al. (2009). Patterns of mild cognitive impairment after treatment of depression in the elderly. American Journal of Geriatric Psychiatry, 17, 308–316.Google Scholar
Diniz, B. S., Butters, M. A., Albert, S. M., Dew, M. A. and Reynolds, C. F. 3rd. (2013). Late-life depression and risk of vascular dementia and Alzheimer's disease: systematic review and meta-analysis of community-based cohort studies. British Journal of Psychiatry, 202, 329–335.Google Scholar
Folstein, M., Folstein, S. and Fanjiang, G. (2001). Mini-Mental State Examination: Clinical Guide and User's Guide. Lutz, FL: Psychological Assessment Resources.Google Scholar
Gabryelewicz, T. M. et al. (2007). The rate of conversion of mild cognitive impairment to dementia: predictive role of depression. International Journal of Geriatric Psychiatry, 22, 563–567.Google Scholar
Green, R. C. et al. (2003). Depression as a risk factor for Alzheimer disease: the MIRAGE Study. Archives of Neurology, 60, 753–759.Google Scholar
Jorm, A. F. (2001). History of depression as a risk factor for dementia: an updated review. Australian and New Zealand Journal of Psychiatry, 35, 776–781.Google Scholar
Kokmen, E., Beard, C. M., Chandra, V., Offord, K. P., Schoenberg, B. S. and Ballard, D. J. (1991). Clinical risk factors for Alzheimer's disease: a population-based case-control study. Neurology, 41, 1393–1397.CrossRefGoogle ScholarPubMed
Landerman, R., George, L. K., Campbell, R. T. and Blazer, D. G. (1989). Alternative models of the stress buffering hypothesis. American Journal of Community Psychology, 17, 626–642.Google Scholar
Lee, J. S., Potter, G. G., Wagner, H. R., Welsh-Bohmer, K. A. and Steffens, D. C. (2007). Persistent mild cognitive impairment in geriatric depression. International Psychogeriatrics, 19, 125–135.CrossRefGoogle ScholarPubMed
Modrego, P. J., and Ferrandez, J. (2004). Depression in patients with mild cognitive impairment increases the risk of developing dementia of Alzheimer's type: a prospective cohort study. Archives of Neurology, 61, 1290–1293.Google Scholar
Montgomery, S. A. and Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.CrossRefGoogle ScholarPubMed
Morris, J. C. et al. (1989). The consortium to establish a registry for Alzheimer's disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer's disease. Neurology, 39, 1159–1165.Google Scholar
Nebes, R. D. et al. (2003). Persistence of cognitive impairment in geriatric patients following antidepressant treatment: a randomized, double-blind clinical trial with nortriptyline and paroxetine. Journal of Psychiatric Research, 37, 99–108.Google Scholar
Park, B., Park, J. and Jun, J. K. (2013). Cognitive impairment, depression, comorbidity of the two and associated factors among the early sixties in a rural Korean community. PLoS ONE, 8, e79460.Google Scholar
Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Tangalos, E. G. and Kokmen, E. (1999). Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology, 56, 303–308.Google Scholar
Reding, M., Haycox, J. and Blass, J. (1985). Depression in patients referred to a dementia clinic: a three-year prospective study. Archives of Neurology, 42, 894–896.Google Scholar
Richard, E. et al. (2013). Late-life depression, mild cognitive impairment, and dementia. JAMA Neurology, 70, 374–382.Google Scholar
Robins, N., Helzer, J. E., Croughan, J. and Ratcliff, K. S. (1981). National Institute of Mental Health diagnostic interview schedule. Archives of General Psychiatry, 38, 381–389.Google Scholar
Rosenberg, P. B., Mielke, M. M., Appleby, B. S., Oh, E. S., Geda, Y. E. and Lyketsos, C. G. (2013). The association of neuropsychiatric symptoms in MCI with incident dementia and Alzheimer's disease. American Journal of Geriatric Psychiatry, 21, 685–695.Google Scholar
Saunders, A. M. et al. (1993). Association of apolipoprotein E allele E4 with late-onset familial and sporadic Alzheimer's disease. Neurology, 43, 1467–1472.Google Scholar
Sheline, Y. I. et al. (2006). Cognitive function in late life depression: relationships to depression severity, cerebrovascular risk factors and processing speed. Biological Psychiatry, 60, 58–65.Google Scholar
Speck, C. E. et al. (1995). History of depression as a risk factor for Alzheimer's disease. Epidemiology, 6, 366–369.CrossRefGoogle ScholarPubMed
Steffens, D. C., Plassman, B. L., Helms, M. J., Welsh-Bohmer, K. A., Saunders, A. M. and Breitner, J. C. (1997). A twin study of late-onset depression and apolipoprotein E epsilon 4 as risk factors for Alzheimer's disease. Biological Psychiatry, 41, 851–856.Google Scholar
Steffens, D. C. et al. (1999). The effect of major depression on functional status in patients with coronary artery disease. Journal of the American Geriatrics Society, 47, 319–322.Google Scholar
Steffens, D. C. et al. (2000). Hippocampal volume in geriatric depression. Biological Psychiatry, 48, 301–309.CrossRefGoogle ScholarPubMed
Steffens, D. C. et al. (2002). Hippocampal volume and incident dementia in geriatric depression. American Journal of Geriatric Psychiatry, 10, 62–71.Google Scholar
Steffens, D. C. et al. (2004). Methodology and preliminary results from the neurocognitive outcomes of depression in the elderly study. Journal of Geriatric Psychiatry and Neurology, 17, 202–211.Google Scholar
Steffens, D. C. et al. (2007). Longitudinal magnetic resonance imaging vascular changes, apolipoprotein E genotype, and development of dementia in the neurocognitive outcomes of depression in the elderly study. American Journal of Geriatric Psychiatry, 15, 839–849.Google Scholar
Steffens, D. C. and Potter, G. G. (2008). Geriatric depression and cognitive impairment. Psychological Medicine, 32, 163–175.Google Scholar
Steffens, D. C., McQuoid, D. R., Payne, M. E. and Potter, G. G. (2012). Change in hippocampal volume on magnetic resonance imaging and cognitive decline among older depressed and nondepressed subjects in the neurocognitive outcomes of depression in the elderly study. American Journal of Geriatric Psychiatry, 19, 4–12.Google Scholar
Taylor, W. D., Steffens, D. C. and Krishnan, K. R. (2006). Psychiatric disease in the twenty-first century: the case for subcortical ischemic depression. Biological Psychiatry, 60, 1299–1303.Google Scholar
Wechsler, D. (1987). Wechsler Memory Scale-Revised Manual. San Antonio: Psychological Corporation.Google Scholar
Yuspeh, R. L., Vanderploeg, R. D. and Kershaw, A. J. (1998). CERAD praxis memory and recognition in relation to other measures of memory. The Clinical Neuropsychologist, 12, 468–474.Google Scholar