Results of a cohort study published in Neurology indicate that greater depressive symptoms in stroke-free older adults were associated with worse episodic memory, smaller cerebral volume, and silent infarcts.  

Researchers extracted data from the existing Northern Manhattan Study, a prospective cohort of mostly Caribbean Hispanic, stroke-free, older adults. A total of 1111 participants were assessed for magnetic resonance imaging (MRI) markers and cognitive function. Baseline depressive symptoms were assessed using the Center of Epidemiological Studies-Depression Scale, with scores ≥16 considered indicative of greater depressive symptoms. Multivariable linear and logistic regression models were used to quantify associations between depressive symptoms and markers of brain aging.

At baseline, 22% of participants had greater depressive symptoms, which were significantly associated with worse baseline episodic memory after adjusting for sociodemographic factors, vascular risk factor, behavioral, and antidepressive medication variables (β [95% CI], -0.21 [0.33 to -0.10]; P =.0003). Greater depressive symptoms were also associated with smaller cerebral parenchymal fraction (β [95% CI], -0.56 [-1.05 to -0.07]; P =.02) and increased likelihood of subclinical brain infarcts (odds ratio [OR] 1.55; 95% CI, 1.00-2.42; P =.05). Greater depressive symptoms were not significantly associated with white matter hyperintensity volume, hippocampal volume, or change in cognition over an average of 5 years. These results remained significant after correcting for selective attrition during the study period.

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These findings suggest a strong association between greater depressive symptoms and markers of brain aging, as well as impaired episodic memory. Researchers noted that the lack of association between depressive symptoms and cognition may be a result of a mixed cognitive sample and suggested that future studies include a longer follow-up time to elucidate the impact of depression on cognition in older adults. These data may be useful in developing targeted intervention for older adults with depression.


Zeki Al Hazzouri A, Caunca MR, Nobrega JC, et al. Greater depressive symptoms, cognition, and markers of brain aging: Northern Manhattan Study [published online May 9, 2018]. Neurology. doi:10.1212/WNL.0000000000005639