Self-Reported Memory Problems, Depressive Symptoms, Mild Cognitive Impairment (MCI), and Age of Depression Onset in Older Adults with a History of Depression
Open Access
- Author:
- Bhang, In Young
- Graduate Program:
- Nursing
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- April 05, 2021
- Committee Members:
- Andrea Sillner, Major Field Member
Jacqueline Mogle, Outside Unit Member
Alyssa Gamaldo, Outside Field Member
Nikki Hill, Chair & Dissertation Advisor
Lisa Kitko, Program Head/Chair - Keywords:
- MCI
mild cognitive impairment
self-reported memory problems
age of depression onset
history of depression
depressive symptoms
older adults
cognitive impairment - Abstract:
- Background: With the rapid growth of the older population, there is a current need to identify subgroups of older adults who are at risk for dementia and lay out the possible early continuum of signs and symptoms associated with higher dementia risk. Four of the factors known to be associated with increased risk for dementia are: self-reported memory problems, depressive symptoms, later age of depression onset, and mild cognitive impairment (MCI). Although much research has been conducted to examine the associations between each of the four potential predictors of dementia and dementia independently, the links among these four potential and related predictors are understudied, especially in older adults with a history of depression. Understanding differential associations among these potential predictors of dementia may help refine risks for cognitive decline in older adults with a history of depression. Purpose: The purpose of this study was to examine the longitudinal associations among self-reported memory problems, depressive symptoms, and MCI in older adults with a history of depression. Specifically, differential effects by age of depression onset were investigated. Method: This study used data collected in the Einstein Aging Study (EAS), a longitudinal, cohort study of cognitive aging and dementia. The participants of this study were 70 years or older and community-dwelling from the Bronx, New York and have a history of depression. Participants who were diagnosed with dementia at baseline were excluded. Participants who met dementia criteria were excluded at the wave identified, and any subsequent waves were excluded. Three types of self-reported memory problems were used for this study: frequency of memory problems, and one-year and ten-year perceived memory decline. The Geriatric Depression Scale (GDS) was used to assess depressive symptoms. Participants who reported that they have had a history of depression treatment were asked a follow-up question about their age of depression onset. MCI required objective cognitive impairment, self- and/or informant-reported cognitive problems, absence of functional decline and absence of clinical diagnosis of dementia. Multilevel modelling (MLM) was used to examine within- and between-person associations among the key variables (i.e., self-reported memory problems, depressive symptoms, age of depression onset and MCI). Results: A total of 194 participants were included in this study. The mean age of depression onset in this sample was 55.73 years (SD=19.95). Participants with less than high school education reported less perceived ten-year memory decline, had higher prevalence of MCI and older age of depression onset than those with higher education. Depressive symptoms and self-reported memory problems did not change over time and age of depression onset did not moderate the association between depressive symptoms and time or self-reported memory problems and time. On average, reporting more memory problems was associated with more depressive symptoms and vice versa but they were not associated at the within-person level. Age of depression onset was not associated with self-reported memory problems and depressive symptoms and did not moderate the association between the two. Lastly, depressive symptoms and education were independently associated with MCI, but age of depression onset was not, and it did not moderate the association between depressive symptoms and MCI. Discussion: The findings from this study indicate that age of depression onset was not associated with potential risk factors of dementia (i.e., depressive symptoms, self-reported memory problems and MCI) in older adults with a history of depression. Furthermore, it had no effect on the association between depressive symptoms and self-reported memory problems and depressive symptoms and MCI.