The relationship between depressive symptoms and subtypes of mild cognitive impairment in post-menopausal women: Results from the Women's Health Initiative Memory Study

Laura E Korthauer; Joseph S Goveas; Stephen R Rapp; Mark A Espeland; Sally A Shumaker; Katelyn R Garcia; Rebecca C Rossom; Lorena Garcia; Hilary A Tindle; Elena Salmoirago-Blotcher; Sylvia Wassertheil-Smoller; Oleg Zaslavsky; Barbara Cochrane; Kaycee M Sink; Kamal Masaki; Ira Driscoll

doi:10.1002/gps.5817

The relationship between depressive symptoms and subtypes of mild cognitive impairment in post-menopausal women: Results from the Women's Health Initiative Memory Study

Int J Geriatr Psychiatry. 2022 Nov;37(11):10.1002/gps.5817. doi: 10.1002/gps.5817.

Authors

Laura E Korthauer¹, Joseph S Goveas², Stephen R Rapp³, Mark A Espeland⁴, Sally A Shumaker⁵, Katelyn R Garcia⁶, Rebecca C Rossom⁷, Lorena Garcia⁸, Hilary A Tindle⁹, Elena Salmoirago-Blotcher¹, Sylvia Wassertheil-Smoller¹⁰, Oleg Zaslavsky¹¹, Barbara Cochrane¹², Kaycee M Sink¹³, Kamal Masaki¹⁴, Ira Driscoll¹⁵

Affiliations

¹ Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.
² Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
³ Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
⁴ Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
⁵ Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
⁶ Department of Biostatistics and Data Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
⁷ HealthPartners Institute, Minneapolis, Minnesota, USA.
⁸ Department of Public Health Sciences, University of California-Davis, Davis, California, USA.
⁹ Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
¹⁰ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, New York, USA.
¹¹ Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, Washington, USA.
¹² Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA.
¹³ Genentech Inc, South San Francisco, Carolina, USA.
¹⁴ Department of Geriatric Medicine, University of Hawaii, Honolulu, Hawaii, USA.
¹⁵ Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.

Abstract

Background: Depressive symptoms are associated with age-related cognitive impairment, but the relative risk of specific subtypes of mild cognitive impairment (MCI) conferred by depressive symptoms is unclear. The purpose of this exploratory study was to determine the longitudinal association between baseline depressive symptoms and incident cases of MCI subtypes (amnestic vs. non-amnestic) and probable dementia (PD) (Alzheimer's disease, vascular, mixed) among postmenopausal women.

Methods: Depressive symptoms were assessed at study baseline using an 8-item Burnam algorithm in 7043 postmenopausal women who participated in the Women's Health Initiative Memory Study (WHIMS) and the WHIMS-Epidemiology of Cognitive Health Outcomes (WHIMS-ECHO) extension study. During the median 9.4-year follow-up interval, the presence of MCI and PD was classified by a central adjudication committee. Classification of participants by MCI subtype (amnestic single and multi-domain, non-amnestic single and multi-domain) was done algorithmically based on established criteria using data from annual cognitive testing.

Results: At baseline, 557 women (7.9%) had clinically significant depressive symptoms based on Burnam algorithm cut-point of 0.06. Depressive symptoms at baseline were associated with an increased risk of incident amnestic MCI (hazard ratio [HR] = 1.91, 95% confidence interval [CI] 1.32-2.78, p < 0.0001), but not non-amnestic MCI (HR = 1.39, 95% CI 0.91-2.14, p = 0.13) after controlling for demographic factors. This relationship between depressive symptoms and amnestic MCI remained consistent after controlling for lifestyle variables, cardiovascular risk factors, antidepressant use, and history of hormone therapy. There were no significant associations between depressive symptoms and incidence of PD.

Conclusion: Depressive symptoms at baseline among postmenopausal older women are associated with higher incidence of amnestic MCI, suggesting that they may be an independent risk factor or part of the early prodrome of dementia.

Keywords: Alzheimer's disease; MCI subtypes; dementia; depression; mild cognitive impairment.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Antidepressive Agents
Cognitive Dysfunction* / diagnosis
Cognitive Dysfunction* / epidemiology
Dementia* / diagnosis
Dementia* / epidemiology
Depression / epidemiology
Female
Hormones
Humans
Neuropsychological Tests
Postmenopause
Risk Factors
Women's Health

Substances

Antidepressive Agents
Hormones

Abstract

Publication types

MeSH terms

Substances

Grants and funding