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Directional associations between memory impairment and depressive symptoms: data from a longitudinal sample and meta-analysis

Published online by Cambridge University Press:  08 November 2017

Junhong Yu*
Department of Psychological Medicine, National University Hospital, Singapore, Singapore
Michael John Power
Department of Psychology, National University of Singapore, Singapore, Singapore
Lei Feng*
Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Address for correspondence: Junhong Yu. E-mail: and Lei Feng. E-mail:
Address for correspondence: Junhong Yu. E-mail: and Lei Feng. E-mail:



Previous cross-lagged studies on depression and memory impairment among the elderly have revealed conflicting findings relating to the direction of influence between depression and memory impairment. The current study aims to clarify this direction of influence by examining the cross-lagged relationships between memory impairment and depression in an Asian sample of elderly community dwellers, as well as synthesizing previous relevant cross-lagged findings via a meta-analysis.


A total of 160 participants (Mage = 68.14, s.d. = 5.34) were assessed across two time points (average of 1.9 years apart) on measures of memory and depressive symptoms. The data were then fitted to a structural equation model to examine two cross-lagged effects (i.e. depressive symptoms→memory; memory→depressive symptoms). A total of 14 effect-sizes for each of the two cross-lagged directions were extracted from six studies (including the present; total N = 8324). These effects were then meta-analyzed using a three-level mixed effects model.


In the current sample, lower memory ability at baseline was associated with worse depressive symptoms levels at follow-up, after controlling for baseline depressive symptoms. However, the reverse effect was not significant; baseline depressive symptoms did not predict subsequent memory ability after controlling for baseline memory. The results of the meta-analysis revealed the same pattern of relationship between memory and depressive symptoms.


These results provide robust evidence that the relationship between memory impairment and depressive symptoms is unidirectional; memory impairment predicts subsequent depressive symptoms but not vice-versa. The implications of these findings are discussed

Original Articles
Copyright © Cambridge University Press 2017 

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Basso, MR and Bornstein, RA (1999) Relative memory deficits in recurrent versus first-episode major depression on a word-list learning task. Neuropsychology 13, 557563.CrossRefGoogle ScholarPubMed
Bassuk, SS, Berkman, LF and Wypij, D (1998) Depressive symptomatology and incident cognitive decline in an elderly community sample. Archives of General Psychiatry 55, 10731081.CrossRefGoogle Scholar
Baune, BT, Fuhr, M, Air, T and Hering, C (2014) Neuropsychological functioning in adolescents and young adults with major depressive disorder – a review. Psychiatry Research 218, 261271.CrossRefGoogle Scholar
Becker, BJ and Wu, M-J (2007) The synthesis of regression slopes in meta-analysis. Statistical Science 22, 414429.CrossRefGoogle Scholar
Bieman-Copland, S and Ryan, EB (1998) Age-biased interpretation of memory successes and failures in adulthood. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 53, P105P111.CrossRefGoogle ScholarPubMed
Bowman, NA (2012) Effect sizes and statistical methods for meta-analysis in higher education. Research in Higher Education 53, 375382.CrossRefGoogle Scholar
Brailean, A, Aartsen, MJ, Muniz-Terrera, G, Prince, M, Prina, AM, Comijs, HC, Huisman, M and Beekman, A (2017) Longitudinal associations between late-life depression dimensions and cognitive functioning: a cross-domain latent growth curve analysis. Psychological Medicine 47, 690702.CrossRefGoogle ScholarPubMed
Browne, MW and Cudeck, R (1993) Alternative ways of assessing model fit. In Bollen, KA, Long, JS (eds). Testing Structural Equation Models, vol 154, California: Sage Publications, p. 136.Google Scholar
Bunce, D, Batterham, PJ, Christensen, H and Mackinnon, AJ (2014) Causal associations between depression symptoms and cognition in a community-based cohort of older adults. The American Journal of Geriatric Psychiatry 22, 15831591.CrossRefGoogle Scholar
Cheung, MW-L (2015) metaSEM: an R package for meta-analysis using structural equation modeling. Frontiers in Psychology 5, 1521.CrossRefGoogle Scholar
de Paula, JJ, Diniz, BS, Bicalho, MA, Albuquerque, MR, Nicolato, R, de Moraes, EN, Romano-Silva, MA and Malloy-Diniz, LF (2015) Specific cognitive functions and depressive symptoms as predictors of activities of daily living in older adults with heterogeneous cognitive backgrounds. Frontiers in Aging Neuroscience 7, 139.CrossRefGoogle ScholarPubMed
Feng, L (2015) Ageing in a community environment study (ACES) cohort. In Pachana, NA (ed.). Encyclopedia of Geropsychology, Singapore: Springer Singapore, pp. 16.Google Scholar
Feng, L, Li, J, Yap, K-B, Kua, E-H and Ng, T-P (2009) Vitamin B-12, apolipoprotein E genotype, and cognitive performance in community-living older adults: evidence of a gene-micronutrient interaction. The American Journal of Clinical Nutrition 89, 12631268.CrossRefGoogle ScholarPubMed
Feng, L, Ng, T-P, Chuah, L, Niti, M and Kua, E-H (2006) Homocysteine, folate, and vitamin B-12 and cognitive performance in older Chinese adults: findings from the Singapore longitudinal ageing study. The American Journal of Clinical Nutrition 84, 15061512.CrossRefGoogle ScholarPubMed
Gavett, BE, Gurnani, AS, Saurman, JL, Chapman, KR, Steinberg, EG, Martin, B, Chaisson, CE, Mez, J, Tripodis, Y and Stern, RA (2016) Practice effects on story memory and list learning tests in the neuropsychological assessment of older adults. PLoS ONE 11, e0164492.CrossRefGoogle ScholarPubMed
Gerstorf, D, Hoppmann, CA, Kadlec, KM and McArdle, JJ (2009) Memory and depressive symptoms are dynamically linked among married couples: longitudinal evidence from the AHEAD study. Developmental Psychology 45, 15951610.CrossRefGoogle ScholarPubMed
Guerra, M, Prina, AM, Ferri, CP, Acosta, D, Gallardo, S, Huang, Y, Jacob, KS, Jimenez-Velazquez, IZ, Llibre Rodriguez, JJ, Liu, Z, Salas, A, Sosa, AL, Williams, JD, Uwakwe, R and Prince, M (2016) A comparative cross-cultural study of the prevalence of late life depression in low and middle income countries. Journal of Affective Disorders 190, 362368.CrossRefGoogle ScholarPubMed
Hasselbalch, BJ, Knorr, U and Kessing, LV (2011) Cognitive impairment in the remitted state of unipolar depressive disorder: a systematic review. Journal of Affective Disorders 134, 2031.CrossRefGoogle ScholarPubMed
Hu, L and Bentler, PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Routledge Structural Equation Modeling: A Multidisciplinary Journal 6, 155.CrossRefGoogle Scholar
Janzing, J, Teunisse, R, Bouwens, P, van ‘t Hof, M and Zitman, F (2000) The course of depression in elderly subjects with and without dementia. Journal of Affective Disorders 57, 4954.CrossRefGoogle ScholarPubMed
Konstantopoulos, S (2011) Fixed effects and variance components estimation in three-level meta-analysis. Research Synthesis Methods 2, 6176.CrossRefGoogle ScholarPubMed
Lebowitz, BD, Pearson, JL, Schneider, LS, Reynolds, CF, Alexopoulos, GS, Bruce, ML, Conwell, Y, Katz, IR, Meyers, BS and Morrison, MF (1997) Diagnosis and treatment of depression in late life: consensus statement update. Journal of the American Medical Association 278, 11861190.CrossRefGoogle ScholarPubMed
Leonard, BE (2007) Inflammation, depression and dementia: are they connected? Neurochemical Research 32, 17491756.CrossRefGoogle ScholarPubMed
Li, D, Zhang, D, Shao, J, Qi, X and Tian, L (2014) A meta-analysis of the prevalence of depressive symptoms in Chinese older adults. Archives of Gerontology and Geriatrics 58, 19.CrossRefGoogle ScholarPubMed
Lopez, OL, Jagust, WJ, Dulberg, C, Becker, JT, DeKosky, ST, Fitzpatrick, A, Breitner, J, Lyketsos, C, Jones, B, Kawas, C, Carlson, M and Kuller, LH (2003) Risk factors for mild cognitive impairment in the cardiovascular health study cognition study: part 2. Archives of Neurology 60, 13941399.CrossRefGoogle ScholarPubMed
Maalouf, FT, Brent, D, Clark, L, Tavitian, L, McHugh, RM, Sahakian, BJ and Phillips, ML (2011) Neurocognitive impairment in adolescent major depressive disorder: state vs. Trait illness markers. Journal of Affective Disorders 133, 625632.CrossRefGoogle ScholarPubMed
McDermott, LM and Ebmeier, KP (2009) A meta-analysis of depression severity and cognitive function. Journal of Affective Disorders 119, 18.CrossRefGoogle ScholarPubMed
Nie, H, Xu, Y, Liu, B, Zhang, Y, Lei, T, Hui, X, Zhang, L and Wu, Y (2011) The prevalence of mild cognitive impairment about elderly population in China: a meta-analysis. International Journal of Geriatric Psychiatry 26, 558563.CrossRefGoogle ScholarPubMed
Nyunt, MSZ, Fones, C, Niti, M and Ng, T-P (2009) Criterion-based validity and reliability of the geriatric depression screening scale (GDS-15) in a large validation sample of community-living Asian older adults. Aging & Mental Health 13, 376382.CrossRefGoogle Scholar
Paige, LE, Ksander, JC, Johndro, HA and Gutchess, AH (2017) Cross-cultural differences in the neural correlates of specific and general recognition. Cortex 91, 250261.CrossRefGoogle ScholarPubMed
Panza, F, D'Introno, A, Colacicco, AM, Capurso, C, Del Parigi, A, Caselli, RJ, Todarello, O, Pellicani, V, Santamato, A and Scapic-chio, P (2008) Italian Longitudinal Study on Aging Working Group. Depressive symptoms, vascular risk factors and mild cognitive impairment. The Italian longitudinal study on aging. Dementia and Geriatric Cognitive Disorders 25, 336346.CrossRefGoogle Scholar
Panza, F, Frisardi, V, Capurso, C, D'Introno, A, Colacicco, AM, Imbimbo, BP, Santamato, A, Vendemiale, G, Seripa, D, Pilotto, A, Capurso, A and Solfrizzi, V (2010) Late-life depression, mild cognitive impairment, and dementia: possible continuum? The American Journal of Geriatric Psychiatry 18, 98116.CrossRefGoogle ScholarPubMed
Perrino, T, Mason, CA, Brown, SC, Spokane, A and Szapocznik, J (2008) Longitudinal relationships between cognitive functioning and depressive symptoms among Hispanic older adults. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 63, 309317.CrossRefGoogle ScholarPubMed
Petersen, RC, Caracciolo, B, Brayne, C, Gauthier, S, Jelic, V and Fratiglioni, L (2014) Mild cognitive impairment: a concept in evolution. Journal of Internal Medicine 275, 214228.CrossRefGoogle Scholar
Peterson, RA and Brown, SP (2005) On the Use of beta coefficients in meta-analysis. Journal of Applied Psychology 90, 175181.CrossRefGoogle ScholarPubMed
Rey, A (1941) L'examen psychologique dans les cas d'enc{é}phalopathie traumatique. (Les problems.). Editions Médecine et Hygiène Archives de Psychologie 28, 215285.Google Scholar
Rock, PL, Roiser, JP, Riedel, WJ and Blackwell, AD (2014) Cognitive impairment in depression: a systematic review and meta-analysis. Psychological Medicine 44, 20292040.CrossRefGoogle ScholarPubMed
Rosseel, Y (2012) Lavaan: an R package for structural equation modeling. Journal of Statistical Software 1, 136.Google Scholar
Saczynski, JS, Beiser, A, Seshadri, S, Auerbach, S, Wolf, PA and Au, R (2010) Depressive symptoms and risk of dementia: the Framingham Heart Study (Podcast). Neurology 75, 3541.CrossRefGoogle Scholar
Sheikh, JI and Yesavage, JA (1986) Geriatric depression scale (GDS): recent evidence and development of a shorter version. Routledge Clinical Gerontologist 5, 165173.Google Scholar
Snowden, MB, Atkins, DC, Steinman, LE, Bell, JF, Bryant, LL, Copeland, C and Fitzpatrick, AL (2015) Longitudinal association of dementia and depression. The American Journal of Geriatric Psychiatry 23, 897905.CrossRefGoogle ScholarPubMed
Wang, S and Blazer, DG (2015) Depression and cognition in the elderly. Annual Review of Clinical Psychology 11, 331360.CrossRefGoogle ScholarPubMed
Yu, J, Mahendran, R, Rawtaer, I, Kua, E-H and Feng, L (2016) Poor sleep quality is observed in mild cognitive impairment and is largely unrelated to depression and anxiety. Aging & Mental Health.Google ScholarPubMed
Zahodne, LB, Stern, Y and Manly, JJ (2014) Depressive symptoms precede memory decline, but not vice versa, in non-demented older adults. Journal of the American Geriatrics Society 62, 130134.CrossRefGoogle Scholar
Zahodne, LB, Wall, MM, Schupf, N, Mayeux, R, Manly, JJ, Stern, Y and Brickman, AM (2015) Late-life memory trajectories in relation to incident dementia and regional brain atrophy. Journal of Neurology 262, 24842490.CrossRefGoogle ScholarPubMed
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