Clinical-pathologic study of depressive symptoms and cognitive decline in old age
Neurology 10.1212/WNL.0000000000000715
Published online before print July 30, 2014, doi: 10.1212/WNL.0000000000000715
Robert S. Wilson, PhD, Ana W. Capuano, PhD, Patricia A. Boyle, PhD, George M. Hoganson, MD, Loren P. Hizel, BA, Raj C. Shah, MD, Sukriti Nag, MD, Julie A. Schneider, MD, Steven E. Arnold, MD and David A. Bennett, MD
From the Rush Alzheimer's Disease Center (R.S.W., A.W.C., P.A.B., G.M.H., L.P.H., R.C.S., S.N., J.A.S., D.A.B.) and Departments of Behavioral Sciences (R.S.W., P.A.B.), Neurological Sciences (R.S.W., A.W.C., J.A.S., D.A.B.), Pathology (S.N., J.A.S.), and Family Medicine (R.C.S.), Rush University Medical Center, Chicago, IL; and Departments of Psychiatry and Neurology (S.E.A.), University of Pennsylvania, Philadelphia.
Correspondence to Dr. Wilson: rwilson at rush.edu
Objective: To clarify the relationship between depressive symptoms and the clinical and neuropathologic manifestations of dementia.
Methods: In a clinical-pathologic cohort study, 1,764 older persons without cognitive impairment at enrollment completed annual clinical evaluations for a mean of 7.8 years. The evaluations included assessment of depressive symptoms (10-item Center for Epidemiological Studies Depression Scale) and cognitive function (battery of 17 performance tests). A total of 582 individuals died during follow-up and underwent a uniform neuropathologic examination to quantify β-amyloid plaques and tau tangle density in multiple brain regions and identify neocortical Lewy bodies, hippocampal sclerosis, and gross and microscopic cerebral infarcts.
Results: Level of depressive symptoms slightly increased during follow-up. Incident mild cognitive impairment (52.2%) was associated with higher level of depressive symptoms before the diagnosis but not with change in symptoms after the diagnosis; incident dementia (17.9%) was associated with higher symptom level before dementia onset and with more rapid decline in symptoms after dementia onset. None of the neuropathologic markers was related to level of depressive symptoms or change in symptoms over time. In a mixed-effects model adjusted for the neuropathologic markers, higher level of depressive symptoms averaged over evaluations was associated with more rapid global cognitive decline, accounting for 4.4% of the variability in decline not attributable to the neuropathologic markers. Depressive symptoms did not modify the association of the neuropathologic markers with cognitive decline.
Conclusion: In old age, depressive symptoms have an association with cognitive decline that is independent of the neuropathologic hallmarks of dementia.
See also VitaminDWiki
- Diseases that may be related via low vitamin D
- Many articles on Senior depression - 35 percent with less than 10 ng – Sept 2010
- Much less depression if higher than 43 ng of vitamin D – Oct 2012
- Depression might be reduced by vitamin D – meta-analysis March 2014
- 99 percent of psychiatric population had less than 30 ng of vitamin D – June 2013
- Cognition and vitamin D – summary of expert opinions – July 2014
- Cognitive Impairment 2.4X more likely if low vitamin D – meta-analysis July 2012
- Overview Alzheimer's-Cognition and Vitamin D
items in both Depression AND Cognitive
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- Hypothesis – Brain plasticity improved by Vitamin D – Feb 2019
- If struggling with mental health you may need Omega-3, Vitamin D. Iron, Probiotics, etc. – US News Sept 2018
- Off Topic: Fewer mental health problems if eat fermented foods (since ancient times) and microbiota – 2014
- 91 percent of psychiatric hospital admissions had less than 20 ng of vitamin D – May 2018
- Omega-3 and Vitamin D each treat many mental health problems - April 2018
- Mentally ill patients using clozapine were 16 X more likely have low vitamin D – 2017
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- Omega-3 reduces many psychiatric disorders – 2 reviews 2016
- Schizophrenia sometimes associated with depression (both associated with low Vitamin D) – Dec 2015
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- Adults with intellectual disabilities under psychiatric care have low levels of vitamin D – Sept 2014
- The Single Vitamin That's a Double Whammy Against Both Depression and Dementia (Mercola) – Aug 2014
- More depression associated with more dementia in seniors (vitamin D not mentioned) – July 2014
- Children with mental disorders have somewhat less vitamin D levels (graph) Jan 2014
- Fewest Google searches for Mental Health when there is lots of vitamin D from the sun – May 2013
- Psychiatric disorders in a few elderly associated with insufficient vitamin D – Sept 2012