20‐year depressive symptoms, dementia, and structural neuropathology in older women

Author:

Petkus Andrew J.1ORCID,Wang Xinhui1,Younan Diana2,Salminen Lauren E.3,Resnick Susan M.4,Rapp Stephen R.56,Espeland Mark A.78,Gatz Margaret9,Widaman Keith F.10,Casanova Ramon7,Chui Helena1,Barnard Ryan T.7,Gaussoin Sarah A.7,Goveas Joseph S.11,Hayden Kathleen M.6,Henderson Victor W.12,Sachs Bonnie C.5,Saldana Santiago7,Shadyab Aladdin H.13,Shumaker Sally A.5,Chen Jiu‐Chiuan12

Affiliation:

1. Department of Neurology University of Southern California Los Angeles California USA

2. Department of Population and Public Health Sciences University of Southern California Los Angeles California USA

3. Mark and Mary Stevens Neuroimaging and Informatics Institute University of Southern California Marina del Rey California USA

4. Laboratory of Behavioral Neuroscience National Institute on Aging Baltimore Maryland USA

5. Department of Neurology Wake Forest School of Medicine Winston‐Salem North Carolina USA

6. Department of Social Sciences and Health Policy Wake Forest School of Medicine Winston‐Salem North Carolina USA

7. Department of Biostatistics and Data Sciences Wake Forest School of Medicine Winston‐Salem North Carolina USA

8. Department of Internal Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA

9. Center for Economic and Social Research University of Southern California Los Angeles California USA

10. Graduate School of Education University of California, Riverside Riverside California USA

11. Department of Psychiatry and Behavioral Medicine Medical College of Wisconsin Milwaukee Wisconsin USA

12. Departments of Epidemiology and Population Health and of Neurology and Neurological Sciences Stanford University Palo Alto California USA

13. Herbert Wertheim School of Public Health and Human Longevity Science University of California, San Diego La Jolla California USA

Abstract

AbstractINTRODUCTIONThe course of depressive symptoms and dementia risk is unclear, as are potential structural neuropathological common causes.METHODSUtilizing joint latent class mixture models, we identified longitudinal trajectories of annually assessed depressive symptoms and dementia risk over 21 years in 957 older women (baseline age 72.7 years old) from the Women's Health Initiative Memory Study. In a subsample of 569 women who underwent structural magnetic resonance imaging, we examined whether estimates of cerebrovascular disease and Alzheimer's disease (AD)‐related neurodegeneration were associated with identified trajectories.RESULTSFive trajectories of depressive symptoms and dementia risk were identified. Compared to women with minimal symptoms, women who reported mild and stable and emerging depressive symptoms were at the highest risk of developing dementia and had more cerebrovascular disease and AD‐related neurodegeneration.DISCUSSIONThere are heterogeneous profiles of depressive symptoms and dementia risk. Common neuropathological factors may contribute to both depression and dementia.Highlights The progression of depressive symptoms and concurrent dementia risk is heterogeneous. Emerging depressive symptoms may be a prodromal symptom of dementia. Cerebrovascular disease and AD are potentially shared neuropathological factors.

Funder

Wake Forest University

National Institute on Aging

Publisher

Wiley

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