Association Between Depression and Subjective Cognitive Function: The Emory Healthy Aging Study Open Access

Davidson, Priscilla E. (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/cz30pt61r?locale=en
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Abstract

Depression and cognitive impairment, including dementia, frequently co-occur. It is unclear whether depression is a risk factor, a consequenceof cognitive impairment, an independent comorbidity, or a prodrome. Evaluating this association may help clarify the association between depression and cognitive health. We evaluated this association with data from the Emory Healthy Aging Study, a prospective cohort of community-dwelling adults primarily in the Atlanta area aimed at identifying predictors of healthy aging and age-related diseases. An online survey collected baseline information on demographic, socioeconomic, health behavior factors, and personal health history. Current depression was measured using the validated Patient Health Questionnaire-8 with scores ranging between 0-24 (≥10 indicating current depression). Age at depression diagnosis was self-reported and categorized as age ≥30, 31-50, or ≥51 years. Subjective cognitive function (CFI) was measured using the validated Cognitive Function Instrument with scores ranging between 0-14 (lower scores suggesting less impairment). The association between current depression and CFI score, excluding people with a history of depression, mild cognitive impairment or Alzheimer's disease, was assessed using linear regression, adjusting for demographic, socioeconomic, health behaviors, cardiovascular disease and risk factors, concussion history, and kidney disease. The association between a history of depression by age at diagnosis and CFI score, excluding people with mild cognitive impairment or Alzheimer's disease, was assessed using linear regression, adjusting for demographic, socioeconomic, health behaviors, cardiovascular disease and risk factors, concussion history, and kidney disease. In 3,187 participants, current depression was associated with a 3.41 greater CFI score as compared to those without current depression (95% CI 3.07, 3.74). In the final models, age at depression diagnosis at ≤ 30 years old, 31-50, or ≥ 51 years old, was associated with a 1.30 (95% CI 0.88, 1.71), 0.74 (95% CI 0.39, 1.10), or 0.91 (95% CI 0.35, 1.47) higher CFI score, respectively. There is an association between both current and history of depression, at any age, with subjective cognitive function. There appears to be no linear association between age at depression diagnosis and subjective cognitive function. We did not definitively identify the direction of the relationship between depression and cognitive function.

Table of Contents

Table of Contents

1. Background 1

1.1. Depression 1

1.2. Cognitive Impairment 2

1.3.Association between Depression and Cognitive Impairment 4

2. Methods 13

2.1. Data Collection 13

2.2. Assessment of Depression 14

2.3.Assessment of Subjective Cognitive Function 15

2.4.Assessment of Covariates 15 2.5.Participants 17

2.6.Analysis 18

3. Results 20

3.1.Characteristics of Participants without History of Depression 20

3.2.Characteristics of Participants without History of Dementia 22

3.3.Association between Current Depression and Subjective Cognitive Impairment 25

3.4.Association between Age at Depression Diagnosis and Cognitive Impairment 26

4. Discussion 28 5. References 34 6. Tables 37 7. Figures 43 8. Appendices 46

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