Late-life depression is predictive of cognitive decline in elderly adults, according to study data published in the Journal of Affective Disorders. In addition, these results demonstrate that not only is cortisol an independent predictor of cognitive decline in older adults with and without Alzheimer disease, it is also associated with a risk for cognitive decline in late-life depression.

Researchers assessed global cognition over a 1-year period in older adults with (n=67) and without (n=81) late-life depression. Global cognitive function was captured per the Mini-Mental State Examination, and serum cortisol levels were taken at baseline. Investigators also obtained sociodemographic and clinical data at baseline, including age, gender, education level, and depressive episode duration and severity.

At 1-year follow-up, 19 individuals in the late-life depression group (28.4%) displayed global cognitive decline (odds ratio [OR], 6.4; 95% CI, 1.3-31.1; P =.021). In addition, elevated serum cortisol levels at baseline were predictive of cognitive decline in the adjusted model (OR, 1.6; 95% CI 1.07-2.5; P =.02). Older age was also associated with increased risk for cognitive decline (OR, 1.2; 95% CI, 1.04-1.4; P =.01). However, education level, age at depression onset, and baseline Mini-Mental State Examination scores were not significantly associated with global cognition outcome.

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Researchers noted that baseline serum cortisol levels were measured only in the morning and may not have been reflective of cortisol dysregulation in patients overall. Still, these data indicate that cortisol levels may contribute to the cognitive decline observed in elderly adults with late-life depression.


Zhong X, Ning Y, Gu Y, et al. A reliable global cognitive decline and cortisol as an associated risk factor for patients with late-life depression in the short term: a 1-year prospective study. J Affect Disord. 2018;240:(214-219).