Racial and ethnic differences in the association between depressive symptoms and cognitive outcomes in older adults: Findings from KHANDLE and STAR.

Journal: Alzheimer's & dementia : the journal of the Alzheimer's Association

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Affiliated Institutions:  Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA. Center for Climate and Health, Boston University School of Public Health, Boston, Massachusetts, USA. Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA. Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA. Department of Neurology, University of California, Davis, California, USA. Department of Neurology, Columbia University, New York, New York, USA. Division of Research, Kaiser Permanente, Oakland, California, USA. Department of Epidemiology, University of California Irvine School of Medicine, Irvine, California, USA. Department of Public Health Sciences and Neurology, University of California Davis School of Medicine, Davis, California, USA.

Abstract summary 

Depressive symptoms are associated with higher risk of dementia, but how they impact cognition in diverse populations is unclear.Asian, Black, Latino, or White participants (n = 2227) in the Kaiser Healthy Aging and Diverse Life Experiences (age 65+) and the Study of Healthy Aging in African Americans (age 50+) underwent up to three waves of cognitive assessments over 4 years. Multilevel models stratified by race/ethnicity were used to examine whether depressive symptoms were associated with cognition or cognitive decline and whether associations differed by race/ethnicity.Higher depressive symptoms were associated with lower baseline verbal episodic memory scores (-0.06, 95% CI: -0.12, -0.01; -0.15, 95% CI: -0.25, -0.04), and faster decline annually in semantic memory (-0.04, 95% CI: -0.07, -0.01; -0.10, 95% CI: -0.15, -0.05) for Black and Latino participants. Depressive symptoms were associated with lower baseline but not decline in executive function.Depressive symptoms were associated with worse cognitive outcomes, with some evidence of heterogeneity across racial/ethnic groups.We examined whether baseline depressive symptoms were differentially associated with domain-specific cognition or cognitive decline by race/ethnicity. Depressive symptoms were associated with worse cognitive scores for all racial/ethnic groups across different domains examined. Higher depressive symptoms were associated with faster cognitive decline for semantic memory for Black and Latino participants. The results suggest a particularly harmful association between depressive symptoms and cognition in certain racial/ethnic groups.

Authors & Co-authors:  Jimenez Gause Sims Hayes-Larson Morris Fletcher Manly Gilsanz Soh Corrada Whitmer Glymour

Study Outcome 

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Statistics
Citations :  Colby SL, Ortman JM. Projections of the Size and Composition of the U.S. Population: 2014 to 2060. U.S. Department of Commerce Economics and Statistics Administration. U.S. Census Bureau; 2014:p25-1143. Accessed October 2, 2023. https://www.census.gov/content/dam/Census/library/publications/2015/demo/p25-1143.pdf
Authors :  12
Identifiers
Doi : 10.1002/alz.13768
SSN : 1552-5279
Study Population
Male,Female
Mesh Terms
Other Terms
Alzheimer's disease;cognitive function;depressive symptoms;longitudinal data;mental health;race and ethnicity
Study Design
Study Approach
Country of Study
Publication Country
United States