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Depressive symptoms in relation to clinical symptom onset of mild cognitive impairment

Published online by Cambridge University Press:  10 October 2018

Carol K. Chan*
Affiliation:
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Anja Soldan
Affiliation:
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Corinne Pettigrew
Affiliation:
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Mei-Cheng Wang
Affiliation:
Department of Biostatistics, Johns Hopkins University School of Public Health, Baltimore, MD, USA
Jiangxia Wang
Affiliation:
Department of Biostatistics, Johns Hopkins University School of Public Health, Baltimore, MD, USA
Marilyn S. Albert
Affiliation:
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Paul B. Rosenberg
Affiliation:
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
BIOCARD Research Team
Affiliation:
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Biostatistics, Johns Hopkins University School of Public Health, Baltimore, MD, USA
*
Correspondence should be addressed to: Carol Chan, Department of Psychiatry, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA. Phone: 443-343-2060; Fax: 410-614-5914. Email: cchan46@jhmi.edu.

Abstract

Objective:

There is increasing evidence of an association between depressive symptoms and mild cognitive impairment (MCI) in cross-sectional studies, but the longitudinal association between depressive symptoms and risk of MCI onset is less clear. The authors investigated whether baseline symptom severity of depression was predictive of time to onset of symptoms of MCI.

Method:

These analyses included 300 participants from the BIOCARD study, a cohort of individuals who were cognitively normal at baseline (mean age = 57.4 years) and followed for up to 20 years (mean follow-up = 2.5 years). Depression symptom severity was measured using the Hamilton Depression Scale (HAM-D). The authors assessed the association between dichotomous and continuous HAM-D and time to onset of MCI within 7 years versus after 7 years from baseline (reflecting the mean time from baseline to onset of clinical symptoms in the cohort) using Cox regression models adjusted for gender, age, and education.

Results:

At baseline, subjects had a mean HAM-D score of 2.2 (SD = 2.8). Higher baseline HAM-D scores were associated with an increased risk of progression from normal cognition to clinical symptom onset ≤ 7 years from baseline (p = 0.043), but not with progression > 7 years from baseline (p = 0.194). These findings remained significant after adjustment for baseline cognition.

Conclusions:

These results suggest that low levels of depressive symptoms may be predictive of clinical symptom onset within approximately 7 years among cognitively normal individuals and may be useful in identifying persons at risk for MCI due to Alzheimer’s disease.

Type
Original Research Article
Copyright
© International Psychogeriatric Association 2018 

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