The aim of this recent analysis from the Women’s Health Initiative Memory Study (WHIMS) was to examine whether significant depressive symptoms in postmenopausal women increase the risk of subsequent mild cognitive impairment (MCI) and probable dementia . Participants were 6376 postmenopausal women without cognitive impairment aged 65–79 years at baseline (mean 70 years), who were assigned either to receive hormone therapy (conjugated equine estrogens alone (CEE) or CEE + medroxyprogesterone acetate) or placebo. Depressive disorders were assessed using an eight-item Burnam algorithm and the women were followed annually for a mean period of 5.4 years. A central adjudication committee classified the presence of MCI and probable dementia based on an extensive neuropsychiatric examination. About 8% of the postmenopausal women in this sample reported depressive symptoms above a 0.06 cut-point on the Burnam algorithm. Depressive disorder at baseline was associated with greater risk of incident MCI (hazard ratio (HR) 1.98, 95% confidence interval (CI) 1.33–2.94), probable dementia (HR 2.03, 95% CI 1.15–3.60), and MCI or probable dementia (HR 1.92, 95% CI 1.35–2.73) after controlling for sociodemographic characteristics, lifestyle and vascular risk factors, cardiovascular and cerebrovascular disease, antidepressant use, and current and past hormone therapy status. Assignment to hormone therapy and baseline cognitive function did not affect these relationships. Women without depression who endorsed a remote history of depression had a higher risk of developing dementia. Thus, the conclusion of this WHIMS analysis was that clinically significant depressive symptoms in women aged 65 and older are independently associated with greater incidence of future MCI and probable dementia.
Department of Medicine T, Ichilov Hospital, Tel-Aviv, Israel
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