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Complaints about memory are common in older people but their relationship
with underlying brain changes is controversial.
To investigate the relationship between subjective memory impairment and
previous or subsequent changes in white matter lesions and brain
In a community cohort study of 1336 people without dementia, 4-year
changes in brain magnetic resonance imaging measures were investigated as
correlates of subjective memory impairment at baseline and follow-up.
Subjective memory impairment at baseline was associated with subsequent
change in hippocampal volume and at follow-up impairment was associated
with previous change in hippocampal, cerebrospinal fluid and grey matter
volume and with subcortical white matter lesion increases. All
associations with volume changes were U-shaped with significant quadratic
terms – associations between least decline and subjective memory
impairment were potentially explained by lower baseline hippocampal
volumes in the groups with least volume change. Associations between
hippocampal volume change and subjective memory impairment at follow-up
were independent of cognitive decline and depressive symptoms, they were
stronger in participants with the apolipoprotein E (APOE) ∊4 allele and
in those without baseline subjective memory impairment.
Complaints of poor memory by older people, particularly when new, may be
a realistic subjective appraisal of recent brain changes independent of
observed cognitive decline.
Depressive symptoms are associated with cognitive decline in elderly people, but the nature of their temporal relationship remains equivocal.
To test whether depressive symptoms predict cognitive decline in elderly people with normal cognition.
The Center for Epidemiologic Study depression scale (CES – D) and the Mini-Mental State Examination (MMSE) were used to evaluate depressive symptomatology and cognitive functioning, respectively. A sample of 1003 persons aged 59–71 years and with a MMSE score of 26 or over was selected. Cognitive decline was defined as a drop of at least 3 points on the MMSE at 4-year follow-up.
Baseline high levels of depressive symptoms predicted a higher risk of cognitive decline at 4-year follow-up. The MMSE score of participants with depression was more likely to fall below 26 at 2-year follow-up and to remain below at 4-year follow-up than the MMSE score of those without depressive symptoms. Persistent but not episodic depressive episodes were associated with cognitive decline.
High levels of depressive symptoms, when persistent, are associated with cognitive decline in a sample of elderly people.
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