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Temporal Relationship Between Depressive Symptoms and Cognition in Mid and Late Life: A Longitudinal Cohort Study

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Roopal Desai, Georgina M. Charlesworth, Helen J. Brooker, Henry W.W. Potts, Anne Corbett, Dag Aarsland, Clive G. Ballard

Original languageEnglish
Pages (from-to)1108-1113
Number of pages6
JournalJournal Of The American Medical Directors Association
Issue number8
Accepted/In press1 Jan 2020
PublishedAug 2020

King's Authors


Objectives: To examine the bidirectional temporal relationship between depressive symptoms and cognition in relation to risk, reaction, and prodrome. Design: Cross-lag analysis of longitudinal data collected online at baseline and 12-month follow-up. Setting and Participants: A United Kingdom population cohort of 11,855 participants aged 50 years and over. Measures: Patient Health Questionnaire-9 (depressive symptoms), cognitive measures: Paired Associate Learning, Verbal Reasoning, Spatial Working Memory, and Digit Span. Results: Depressive symptoms predicted a decline in paired associates learning [β = −.020, P =.013, (95% confidence interval [CI], ‒.036, −.004)] and verbal reasoning [β = −.014, P =.016, (95% CI ‒.025, −.003)] but not vice versa. Depressive symptoms predicted [β = −.043, P <.001, (95% CI ‒.060, −.026); β = −.029, P <.001, (95% CI ‒.043, −.015)] and were predicted by [β = −.030, P = <.001, (95% CI ‒.047, −.014); β = −.025, P =.003, (95% CI ‒.041, −.009)], a decline in spatial working memory and verbal digit span, respectively. Conclusions and Implications: Depressive symptoms may be either a risk factor or prodrome for cognitive decline. In addition, a decline in attention predicts depressive symptoms. Clinical implications and implications for further research are discussed.

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