By Nicholas Roznovsky
In a new study published online March 16, 2016 by JAMA Psychiatry, a research team led by UCSF Psychiatry faculty members has found that patients with high-and-increasing depressive trajectories were almost twice as likely to develop dementia than those with minimal symptoms, even when accounting for other important factors.
“Previous research has shown that older adults with depression are more likely to develop dementia, but most studies have only examined an older adult’s depressive symptoms at one point in time,” said Allison R. Kaup, PhD, an assistant professor of psychiatry at UCSF and lead author of the study. “This is an important limitation because we know that depressive symptoms change over time and that older adults show different patterns of depressive symptoms over time.”
For their study, the researchers followed older adults for several years. After assessing which patterns of depressive symptoms subjects tended to have during the early years of the study, they then investigated whether these differing patterns were associated with participants who developed dementia during the study’s later years.
Older adults in the study tended to show one of three different patterns of depressive symptoms, with 62 percent tending to show few (if any) symptoms over time. Nearly one-third of participants tended to show a moderate level of depressive symptoms at the beginning of the study which increased over time, and approximately 6 percent of the study population tended to have high levels of depressive symptoms which increased over time.
After adjusting for individuals’ cognitive functioning at the beginning of the study, participants with a high trajectory of depressive symptoms were associated with a strong increased risk of dementia. In contrast, depressive symptoms observed at individual time points were not correlated with incidence of dementia.
“Our findings are further evidence that it is important for clinicians to regularly evaluate whether their older adult patients are experiencing depressive symptoms. Not only is this important for good mental health care practice, but it may also help identify individuals who are at high risk for cognitive decline,” said Kaup. “If patients are experiencing symptoms of depression, they are encouraged to bring this to their doctors’ attention, and clinicians should be helping their patients get connected with mental health care.”
Additional authors of the study included UCSF faculty members Kristine Yaffe, MD (senior author), and Amy L. Byers, PhD, MPH, as well as researchers from the University of Tennessee, University of Pittsburgh, and the National Institute on Aging.
Read the study
Further coverage
- Healio Psychiatric Annals: Depressive symptom trajectories signify dementia risk more accurately than single assessments
- APA Psychiatric News Alert: Depression trajectories may help identify older adults at greatest risk of dementia
About UCSF Psychiatry
The UCSF Department of Psychiatry and the Langley Porter Psychiatric Institute are among the nation's foremost resources in the fields of child, adolescent, adult and geriatric mental health. Together they constitute one of the largest departments in the UCSF School of Medicine, with a mission focused on research (basic, translational, clinical), teaching, patient care, and public service. UCSF Psychiatry has an organizational structure that crosses all major UCSF sites - Parnassus, Mission Bay, Laurel Heights, Mt. Zion, Zuckerberg San Francisco General Hospital and Trauma Center, the San Francisco VA Health Care System, and UCSF Fresno.
About UCSF
UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences; and a preeminent biomedical research enterprise. It also includes UCSF Health, which comprises two top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospital San Francisco, and other partner and affiliated hospitals and healthcare providers throughout the Bay Area.
