Sex Differences in the Relationship between Depressive Symptoms and Risk of Amnestic Mild Cognitive Impairment

Erin E. Sundermann, Mindy Joy Katz, Richard B. Lipton

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective The relationship between depressive symptoms and subsequent cognitive impairment in older adults is controversial. Sex differences and the differences in the method of categorizing depressive symptoms may contribute to the inconsistencies. The authors examined the effect of severity of baseline depressive symptoms on risk of incident amnestic mild cognitive impairment (aMCI) separately in men and women. Methods Community-dwelling and cognitively healthy older adults (aged ≥ 70 years) from the Einstein Aging Study completed the 15-item Geriatric Depression Scale (GDS-15) at their baseline visit. Participants were categorized into “no/low symptoms” (GDS-15 score = 0–2), “mild symptoms” (GDS-15 score = 3–5), and “moderate/severe symptoms” (GDS-15 score > 6) groups. Sex-stratified Cox proportional hazards models, adjusted for age, education, and antidepressant medication, estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for incident aMCI as a function of depressive symptoms group. Results We followed 572 women (mean age: 78) and 345 men (mean age: 77) for 4.2 years on average (range: 1.0–14.6 years). Ninety women and 64 men developed aMCI during follow-up. Cox models revealed that compared with no/low depressive symptoms, mild symptoms were associated with a two times greater risk of developing aMCI in men (HR: 2.22; 95% CI: 1.26–3.89) but not in women (HR: 1.26; 95% CI: 0.77–2.06). Conversely, moderate/severe depressive symptoms were associated with a two times greater risk of developing aMCI in women (HR: 1.99; 95% CI: 1.05–3.77) but not in men (HR: 0.28; 95% CI: 0.04–2.11), possibly because of low statistical power in this subgroup. Conclusion Results indicate that mild depressive symptoms in men and moderate/severe symptoms in women may represent a marker for future cognitive impairment.

Original languageEnglish (US)
Pages (from-to)13-22
Number of pages10
JournalAmerican Journal of Geriatric Psychiatry
Volume25
Issue number1
DOIs
StatePublished - Jan 1 2017

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Sex Characteristics
Depression
Confidence Intervals
Proportional Hazards Models
Independent Living
Cognitive Dysfunction
Geriatrics
Antidepressive Agents
Education

Keywords

  • Amnestic mild cognitive impairment
  • depressive symptoms
  • Geriatric Depression Scale
  • sex differences

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

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title = "Sex Differences in the Relationship between Depressive Symptoms and Risk of Amnestic Mild Cognitive Impairment",
abstract = "Objective The relationship between depressive symptoms and subsequent cognitive impairment in older adults is controversial. Sex differences and the differences in the method of categorizing depressive symptoms may contribute to the inconsistencies. The authors examined the effect of severity of baseline depressive symptoms on risk of incident amnestic mild cognitive impairment (aMCI) separately in men and women. Methods Community-dwelling and cognitively healthy older adults (aged ≥ 70 years) from the Einstein Aging Study completed the 15-item Geriatric Depression Scale (GDS-15) at their baseline visit. Participants were categorized into “no/low symptoms” (GDS-15 score = 0–2), “mild symptoms” (GDS-15 score = 3–5), and “moderate/severe symptoms” (GDS-15 score > 6) groups. Sex-stratified Cox proportional hazards models, adjusted for age, education, and antidepressant medication, estimated hazard ratios (HRs) and 95{\%} confidence intervals (CIs) for incident aMCI as a function of depressive symptoms group. Results We followed 572 women (mean age: 78) and 345 men (mean age: 77) for 4.2 years on average (range: 1.0–14.6 years). Ninety women and 64 men developed aMCI during follow-up. Cox models revealed that compared with no/low depressive symptoms, mild symptoms were associated with a two times greater risk of developing aMCI in men (HR: 2.22; 95{\%} CI: 1.26–3.89) but not in women (HR: 1.26; 95{\%} CI: 0.77–2.06). Conversely, moderate/severe depressive symptoms were associated with a two times greater risk of developing aMCI in women (HR: 1.99; 95{\%} CI: 1.05–3.77) but not in men (HR: 0.28; 95{\%} CI: 0.04–2.11), possibly because of low statistical power in this subgroup. Conclusion Results indicate that mild depressive symptoms in men and moderate/severe symptoms in women may represent a marker for future cognitive impairment.",
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N2 - Objective The relationship between depressive symptoms and subsequent cognitive impairment in older adults is controversial. Sex differences and the differences in the method of categorizing depressive symptoms may contribute to the inconsistencies. The authors examined the effect of severity of baseline depressive symptoms on risk of incident amnestic mild cognitive impairment (aMCI) separately in men and women. Methods Community-dwelling and cognitively healthy older adults (aged ≥ 70 years) from the Einstein Aging Study completed the 15-item Geriatric Depression Scale (GDS-15) at their baseline visit. Participants were categorized into “no/low symptoms” (GDS-15 score = 0–2), “mild symptoms” (GDS-15 score = 3–5), and “moderate/severe symptoms” (GDS-15 score > 6) groups. Sex-stratified Cox proportional hazards models, adjusted for age, education, and antidepressant medication, estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for incident aMCI as a function of depressive symptoms group. Results We followed 572 women (mean age: 78) and 345 men (mean age: 77) for 4.2 years on average (range: 1.0–14.6 years). Ninety women and 64 men developed aMCI during follow-up. Cox models revealed that compared with no/low depressive symptoms, mild symptoms were associated with a two times greater risk of developing aMCI in men (HR: 2.22; 95% CI: 1.26–3.89) but not in women (HR: 1.26; 95% CI: 0.77–2.06). Conversely, moderate/severe depressive symptoms were associated with a two times greater risk of developing aMCI in women (HR: 1.99; 95% CI: 1.05–3.77) but not in men (HR: 0.28; 95% CI: 0.04–2.11), possibly because of low statistical power in this subgroup. Conclusion Results indicate that mild depressive symptoms in men and moderate/severe symptoms in women may represent a marker for future cognitive impairment.

AB - Objective The relationship between depressive symptoms and subsequent cognitive impairment in older adults is controversial. Sex differences and the differences in the method of categorizing depressive symptoms may contribute to the inconsistencies. The authors examined the effect of severity of baseline depressive symptoms on risk of incident amnestic mild cognitive impairment (aMCI) separately in men and women. Methods Community-dwelling and cognitively healthy older adults (aged ≥ 70 years) from the Einstein Aging Study completed the 15-item Geriatric Depression Scale (GDS-15) at their baseline visit. Participants were categorized into “no/low symptoms” (GDS-15 score = 0–2), “mild symptoms” (GDS-15 score = 3–5), and “moderate/severe symptoms” (GDS-15 score > 6) groups. Sex-stratified Cox proportional hazards models, adjusted for age, education, and antidepressant medication, estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for incident aMCI as a function of depressive symptoms group. Results We followed 572 women (mean age: 78) and 345 men (mean age: 77) for 4.2 years on average (range: 1.0–14.6 years). Ninety women and 64 men developed aMCI during follow-up. Cox models revealed that compared with no/low depressive symptoms, mild symptoms were associated with a two times greater risk of developing aMCI in men (HR: 2.22; 95% CI: 1.26–3.89) but not in women (HR: 1.26; 95% CI: 0.77–2.06). Conversely, moderate/severe depressive symptoms were associated with a two times greater risk of developing aMCI in women (HR: 1.99; 95% CI: 1.05–3.77) but not in men (HR: 0.28; 95% CI: 0.04–2.11), possibly because of low statistical power in this subgroup. Conclusion Results indicate that mild depressive symptoms in men and moderate/severe symptoms in women may represent a marker for future cognitive impairment.

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