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Depressive symptoms with cognitive dysfunction increase the risk of cognitive impairment: analysis of the Korean Longitudinal Study of Aging (KLoSA), 2006–2018

Published online by Cambridge University Press:  16 November 2020

Minyoung Shin Open the ORCID record for Minyoung Shin [Opens in a new window]
Minyoung Shin*
Affiliation:
Department of Counseling Psychology, Yongmoon Graduate School of Counseling Psychology, Seoul, Republic of Korea
*
Correspondence should be addressed to: Minyoung Shin, Department of Counseling Psychology, Yongmoon Graduate School of Counseling Psychology, 154 Yulgok-ro, Jongro-gu, Seoul 03136, Republic of Korea. Phone +82 2 6964 7039; Fax: +82 2 3672 1012. Emails: mywindy@empal.com; shinminyoung@yongmoon.ac.kr.
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Abstract

Objectives:

Geriatric depression complicates cognitive health in older adults. This study aims to investigate the impact of depressive symptoms on cognitive impairment in community-dwelling older adults, depending on whether cognitive dysfunction accompanied.

Design:

A community-based longitudinal cohort study.

Setting:

This study analyzed data from the Korean Longitudinal Study of Aging (KLoSA) from 2006 to 2018.

Participants:

Among 10,254 individuals who were registered in the KLoSA study, a total of 9119 subjects met the criteria, and 4547 subjects were included in the final analysis. The subjects were grouped into 4 categories based on depressive symptoms and cognitive dysfunction at baseline assessment: “normal control” (NC, n = 3341), “depression only” (Dep-only, n = 652), “cognitive dysfunction only” (CD-only, n = 393), and “depression with cognitive dysfunction” (Dep-CD, n = 161).

Measurements:

Cognitive impairment 10 years later was defined as K-MMSE scores below two percentile on demographically adjusted norms.

Results:

Ten-year survival, that is, not experiencing cognitive impairment, was 80 $$ \pm \,$$1% in NC group, 72 $$ \pm $$ 2% in Dep-only group, 52 $$ \pm $$ 3% in CD-only group, and 44 $$ \pm $$ 5% in Dep-CD group. The hazard ratio (HR) of the Dep-only group (HR = 1.18, 95% CI, 0.97–1.43, n.s.) did not differ from that of the NC group, but the HR of the Dep-CD group was significantly higher (HR = 2.85, 95% CI, 2.23–3.66, p < 0.001) than the NC group. When the Dep-CD group was compared to the CD-only group, the HR was 1.13 (95% CI, 0.85–1.49, n.s.), which indicates that it did not significantly differ from the CD-only group.

Conclusions:

Our findings suggest that depressive symptoms with cognitive dysfunction are associated with a higher risk of cognitive impairment. Furthermore, cognitive dysfunction occurring with depressive symptoms is as much a risk for cognitive impairment as is pure cognitive dysfunction. Thus, healthcare providers should pay close attention to the community-dwelling elderly when depressive symptoms occur with cognitive dysfunction.

Keywords

depressive symptomspseudodementiacognitive impairmentKLoSA
Type
Original Research Article
Information
International Psychogeriatrics , Volume 33 , Special Issue 8: Issue Theme: Longitudinal Studies of Aging , August 2021 , pp. 791 - 801
Copyright
© International Psychogeriatric Association 2020

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