Depression-->Mild Cognitive Impairment and Dementia in the "Oldest Old" (84+y: liveonearth

The finding of this new evaluation of the oldest old is in line with previous studies which have found that being severely depressed is correlated with three times higher risk losing your mind permanently (MCI or dementia). No causal factors were investigated here, but the association is significant and persistent. I suspect that the patients who were depressed were subsequently put on meds which impacted their cognitive function, and I also believe that depression is associated with brain processes that probably do cause degradation of our cognitive function. That causality is yet to be understood.

PREVALENCE OF DEPRESSION AND MCI
depression is common among older adults
1-month prevalence of depression among adults older than 70 years is as high as 11%
higher among women vs men

Cognitive impairment is also common among older adults
14% in those older than 70 years
37% in those older than 90 years with dementia

PREVIOUS STUDIES
3%-26% of older adults have significant levels of depressive symptoms
2%-4% of adults older than 64 years
11% of those older than 70 years have major depression
14% of those older than 70 years have dementia
37% of those older than 90 years have dementia

THIS STUDY
Am J Geriatr Psychiatry. 2012;20:1001-1005;1006-1015.
examine the association between depression at baseline
and development of mild cognitive impairment (MCI) or dementia 5 years later
published in the December issue of the American Journal of Geriatric Psychiatry
n = 302 women who were 85+yoa, mean age 86.9, all but one white
No nursing home residents or meds for Alz at baseline
oldest old women from the Study of Osteoporotic Fractures (SOF)
"oldest old" = over 84 years, one of the fastest growing segments of the US population
(SOF has enrolled 9704 women from Pennsylvania, Oregon, Maryland, and Minnesota)
GDS = Geriatric Depression Scale with 15 items, positive for six or more = depression
study also used: cognitive assessments and 7 neuropsychological tests at the 5-year follow-up visit

RESULTS
70% w elevated depressive symptoms at baseline-->MCI at the 5-year follow-up
37.4% of the women with lower GDS scores (P = .005)-->MCI
Adjusted for: age, education, and use of alcohol or benzodiazepines: still sig correl
19% of pts w score of 6 or higher on the GDS showed normal cognitive functioning 5 years later
64.7% of the women with higher depression scores-->dementia
37.1% of those with lower scores (not so depressed)-->dementia
those w elevated depressive symptoms also had decr global cognition and working memory
depression is of prognostic value
mb a marker of abnormal process that should be addressed

SOURCE
http://www.medscape.org/viewarticle/775314?src=cmemp

Depression-->Mild Cognitive Impairment and Dementia in the "Oldest Old" (84+yoa)

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