Depressive symptoms predict longitudinal change in executive control but not memory

Abstract

Objective: Depression in non-demented persons has been identified as a possible risk factor for incident Alzheimer's disease (AD).

Methods: Latent Growth Curve models were developed of baseline depressive symptoms as a predictor of longitudinal changes in cognition. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS). Memory was assessed by the California Verbal Learning Task (CVLT). Executive control function (ECF) was assessed by the Executive Interview (EXIT25) and Trail-Making Test Part B (Trails-B). Five hundred forty-seven non-institutionalized older retirees living in a single comprehensive care retirement community participated.

Results: Depressive symptoms were significantly associated only with the 3-year rate of decline in psychomotor speed, as measured by Trails A, and ECF, as measured by the EXIT25. Both associations withstood adjustment for age, gender, education, and baseline level of care.

Conclusions: Depressive symptoms are associated with longitudinal decline in cognition. However, this association selectively involves executive control, not memory, and possibly only a subset of 'executive' functions. Although depressive symptoms may hasten conversion from mild cognitive impairment (MCI) to dementia, depression-related conversion is not likely to be mediated by evolution of the AD pathological process.