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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 [1]. 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.

Author(s)

  • Amos Pines
    Department of Medicine T, Ichilov Hospital, Tel-Aviv, Israel

Citations

  1. Goveas JS, Espeland MA, Woods NF, Wassertheil-Smoller S, Kotchen JM. Depressive symptoms and incidence of mild cognitive impairment and probable dementia in elderly women: the Womens Health Initiative Memory Study. J Am Geriatr Soc 2011;59:57-66.
    http://www.ncbi.nlm.nih.gov/pubmed/21226676
  2. Wilson RS, Barnes LL, Mendes de Leon CF, et al. Depressive symptoms, cognitive decline, and risk of AD in older persons. Neurology 2002;59:364-70.
    http://www.ncbi.nlm.nih.gov/pubmed/12177369
  3. Irie F, Masaki KH, Petrovitch H, et al. Apolipoprotein E epsilon4 allele genotype and the effect of depressive symptoms on the risk of dementia in men: the Honolulu-Asia Aging Study. Arch Gen Psychiatry 2008;65:906-12.
    http://www.ncbi.nlm.nih.gov/pubmed/18678795
  4. Bell-McGinty S, Butters MA, Meltzer CC, et al. Brain morphometric abnormalities in geriatric depression: long-term neurobiological effects of illness duration. Am J Psychiatry 2002;159:1424-7.
    http://www.ncbi.nlm.nih.gov/pubmed/12153839
  5. Goveas JS, Espeland MA, Hogan P, et al. Depressive symptoms, brain volumes and subclinical cerebrovascular disease in postmenopausal women: The Womens Health Initiative MRI Study. J Affect Disord 2011 Feb 23. Epub ahead of print.
    http://www.ncbi.nlm.nih.gov/pubmed/21349587
  6. Kessing LV, Sndergrd L, Forman JL, Andersen PK. Antidepressants and dementia. J Affect Disord 2009;117:24-9.
    http://www.ncbi.nlm.nih.gov/pubmed/19138799
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