Depressive Symptoms Imputed Across the Life Course Are Associated with Cognitive Impairment and Cognitive Decline

Background: Depressive symptoms may increase risk for dementia, but findings are controversial because late-life depression may be a prodromal dementia symptom. Life course data on depression and dementia risk may clarify this association; however, data is limited. Objective: To impute adult depressive symptoms trajectories across adult life stages and estimate the association with cognitive impairment and decline. Methods: Using a pooled study of 4 prospective cohorts (ages 20–89), we imputed adult life course depressive symptoms trajectories based on Center for Epidemiologic Studies Depression Scale-10 (CESD-10) and calculated time-weighted averages for early adulthood (ages 20–49), mid-life (ages 50–69), and late-life (ages 70–89) for 6,122 older participants. Adjusted pooled logistic and mixed-effects models estimated associations of imputed depressive symptoms with two cognitive outcomes: cognitive impairment defined by established criteria and a composite cognitive score. Results: In separate models, elevated depressive symptoms in each life stage were associated with cognitive outcomes: early adulthood OR for cognitive impairment = 1.59 (95%CI: 1.35,1.87); mid-life OR = 1.94 (95%CI:1.16, 3.26); and late-life OR = 1.77 (95%CI:1.42, 2.21). When adjusted for depressive symptoms in the other life-stages, elevated depressive symptoms in early adulthood (OR = 1.73; 95%CI: 1.42,2.11) and late-life (OR = 1.43; 95%CI: 1.08,1.89) remained associated with cognitive impairment and were also associated with faster rates of cognitive decline (p < 0.05). Conclusion: Imputing depressive symptom trajectories from pooled cohorts may help expand data across the life course. Our findings suggest early adulthood depressive symptoms may be a risk factor for cognitive impairment independent of mid- or late-life depressive symptoms.

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Cardiovascular Risk Factors Across the Life Course and Cognitive Decline

Neurology ◽

10.1212/wnl.0000000000011747 ◽

2021 ◽

Vol 96 (17) ◽

pp. e2212-e2219

Author(s):

Kristine Yaffe ◽

Eric Vittinghoff ◽

Tina Hoang ◽

Karen Matthews ◽

Sherita H. Golden ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Life Course ◽

Cognitive Decline ◽

Cardiovascular Risk Factors ◽

Early Adulthood ◽

Late Life ◽

Digit Symbol Substitution Test ◽

Increased Risk ◽

The Life Course

ObjectiveCardiovascular risk factors (CVRFs) are associated with increased risk of cognitive decline, but little is known about how early adult CVRFs and those across the life course might influence late-life cognition. To test the hypothesis that CVRFs across the adult life course are associated with late-life cognitive changes, we pooled data from 4 prospective cohorts (n = 15,001, ages 18–95).MethodsWe imputed trajectories of body mass index (BMI), fasting glucose (FG), systolic blood pressure (SBP), and total cholesterol (TC) for older adults. We used linear mixed models to determine the association of early adult, midlife, and late-life CVRFs with late-life decline on global cognition (Modified Mini-Mental State Examination [3MS]) and processing speed (Digit Symbol Substitution Test [DSST]), adjusting for demographics, education, and cohort.ResultsElevated BMI, FG, and SBP (but not TC) at each time period were associated with greater late-life decline. Early life CVRFs were associated with the greatest change, an approximate doubling of mean 10-year decline (an additional 3–4 points for 3MS or DSST). Late-life CVRFs were associated with declines in early late life (<80 years) but with gains in very late life (≥80 years). After adjusting for CVRF exposures at all time periods, the associations for early adult and late-life CVRFs persisted.ConclusionsWe found that imputed CVRFs across the life course, especially in early adulthood, were associated with greater late-life cognitive decline. Our results suggest that CVRF treatment in early adulthood could benefit late-life cognition, but that treatment in very late life may not be as helpful for these outcomes.

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CONTINUITY OF CAREER OVER THE LIFE COURSE ON LIFE SATISFACTION AND DEPRESSIVE SYMPTOMS IN LATER LIFE

Innovation in Aging ◽

10.1093/geroni/igz038.468 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S128-S129

Author(s):

Melanie S Hill ◽

James E Hill ◽

Stephanie Richardson ◽

Jessica Brown ◽

Jeremy B Yorgason ◽

...

Keyword(s):

High School ◽

Life Satisfaction ◽

Depressive Symptoms ◽

Life Course ◽

Career Choice ◽

Early Adulthood ◽

Later Life ◽

Well Being ◽

The Life Course ◽

The Impact

Abstract Identity scholars have suggested that having a unified sense of past, present, and future is related to positive well-being outcomes (Whitbourne, Sneed & Skultety, 2009). One’s occupation can have a profound influence on an individual’s identity throughout the life course (Nazar & van der Heijden, 2012). Research has looked at career mobility among younger age groups (Baiyun, Ramkissoon, Greenwood, & Hoyte, 2018); however, less is known about the impact of career stability later in life. Consistency in career choice over the life course may have positive outcomes down the line as career becomes part of an individual's identity. The current study uses the Life and Family Legacies dataset, a longitudinal state-representative sample of 3,348, to examine individual’s careers at three points in the life course: high school (projected career choice), early adulthood, and later life. Results revealed that a match of desired career in high school and actual career in early adulthood was not predictive of life satisfaction or depressive symptoms in later life. However, a match of career in early adulthood and later life was significantly related to better life satisfaction and less depressive symptoms, which was explained through higher levels of job satisfaction. This study highlights the importance of acquiring and maintaining a career that is fulfilling to the individual over the course of early adulthood to later life.

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Optimizing cognitive development over the life course and preventing cognitive decline: Introducing the Cognitive Health Environment Life Course Model (CHELM)

International Journal of Behavioral Development ◽

10.1177/0165025413512255 ◽

2013 ◽

Vol 38 (1) ◽

pp. 1-10 ◽

Cited By ~ 17

Author(s):

Kaarin J. Anstey

Keyword(s):

Cognitive Function ◽

Cognitive Development ◽

Life Course ◽

Cognitive Decline ◽

Adult Life ◽

Cognitive Domain ◽

Cognitive Health ◽

Differential Development ◽

Theoretical Perspectives ◽

The Life Course

Optimal cognitive development is defined in this article as the highest level of cognitive function reached in each cognitive domain given a person’s biological and genetic disposition, and the highest possible maintenance of cognitive function over the adult life course. Theoretical perspectives underpinning the development of a framework for understanding optimal cognitive development are described, including differential development, intra-individual dynamics, cascades, biological mechanisms, reserve capacity, and plasticity. The Cognitive Health and Environment Life Course Model (CHELM) is proposed as a means to provide a framework for understanding the socio-demographic, lifestyle, and health factors influencing cognitive development and decline. The CHELM may guide framing of policy and interventions to optimize cognitive development and minimize cognitive decline in late-life.

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New Issues in Life Course Research: Which Early-Life Factors Matter for Late-Life Outcomes?

Innovation in Aging ◽

10.1093/geroni/igab046.101 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 28-28

Author(s):

Jacqui Smith ◽

Katrina Walsemann

Keyword(s):

Life Course ◽

Cognitive Aging ◽

Early Adulthood ◽

Late Life ◽

Work And Family ◽

Poor Health ◽

Relative Role ◽

Life Outcomes ◽

Social Adversity ◽

The Life Course

Abstract The increased availability of retrospective information about the lives of participants in population panel studies has expanded the range of precursors to include in life course research. However, this also challenges researchers to select among many potential precursors to a late-life outcome and to determine the relative role of factors from different periods in the life course. Each paper in this symposium uses life course information from the Health and Retirement Study (HRS) to examine different late-life outcomes. Speakers will discuss what guided the particular selection of factors and outcome to examine in their study. Sonnega, Helppie-McFall, and Lee focus on indicators of childhood financial and social adversity as potential predictors of early retirement due to poor health. Park, Larkina, and Smith ask if decisions taken in early adulthood about how to balance work-and family-life by individuals and their partners are related to the categories of important life accomplishments older adults report in their life review. Two papers examine precursors of late-life health outcomes. Williams-Farrelly and Smith identified different profiles of physical activity in early- and mid-adulthood. They discuss associations between these profiles and cognitive aging. Whereas social losses, relocation, and multimorbidity are well-documented precursors of Major Depression in old age, Bergmans and Smith asked if poor health in childhood played a distal role. The session concludes with an integrative discussion of issues by Walsemann.

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Life course analysis on income and incident AMI: a Danish register-based cohort study

Journal of Epidemiology & Community Health ◽

10.1136/jech-2018-212043 ◽

2019 ◽

Vol 73 (9) ◽

pp. 810-816 ◽

Cited By ~ 2

Author(s):

Margit Kriegbaum ◽

Charlotte Ørsted Hougaard ◽

Ingelise Andersen ◽

Henrik Brønnum-Hansen ◽

Rikke Lund

Keyword(s):

Life Course ◽

Early Adulthood ◽

Age Groups ◽

Adult Life ◽

Social Gradient ◽

Relative Level ◽

Gender And Age ◽

The Social ◽

The Life Course ◽

The Impact

BackgroundSocial inequality in ischaemic heart disease has been related to socioeconomic position in childhood, early adulthood and late adulthood. However, the impact of relative level of accumulated income periods across adult life course and the potential gender and age differences have not been investigated. The aim was to investigate the association between relative level of accumulated income across the life course and acute myocardial infarction (AMI) from age 60+ years and to study if the associations differ by gender and in different age groups (30–39 years, 40–49 years and 50–59 years).MethodsAll Danes born 1935–1954 (N=1 235 139) were followed up in registers for incident AMI (42 669 cases). The accumulated proportional deviation from median equivalised income (APDMEI) for each gender/age/calendar year strata was constructed and divided in quartiles. The associations were analysed by means of Cox’s proportional hazard models.ResultsAmong men, those in the lowest APDMEI quartile had an HR 1.40 (1.35–1.45) of AMI compared with the highest quartile. Those in the second and third highest quartiles had HR of 1.24 (1.20–1.28) and 1.14 (1.10–1.18), respectively. Among women, the lowest quartile had an HR of 1.78 (1.69–1.88), the second 1.45 (1.37–1.53) and the third 1.19 (1.13–1.26). The social gradient was similar across the different age groups.ConclusionThe risk of AMI increased with lower levels of relative accumulated income across the life course. While men generally had a higher risk of AMI, the social gradient was steeper in women. There was no indication of a specific sensitive age period for exposure to relative level of accumulated income.

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Depressive symptoms modeled across the life‐course are associated with higher risk of dementia and cognitive decline: A pooled cohort analysis

Alzheimer s & Dementia ◽

10.1002/alz.038053 ◽

2020 ◽

Vol 16 (S10) ◽

Author(s):

Willa D Brenowitz ◽

Adina Zeki Al Hazzouri ◽

Eric Vittinghoff ◽

Karen A Matthews ◽

Sherita H Golden ◽

...

Keyword(s):

Depressive Symptoms ◽

Life Course ◽

Cognitive Decline ◽

Cohort Analysis ◽

The Life Course

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Body size throughout the life-course and incident benign prostatic hyperplasia-related outcomes and nocturia

BMC Urology ◽

10.1186/s12894-021-00816-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Saira Khan ◽

K. Y. Wolin ◽

R. Pakpahan ◽

R. L. Grubb ◽

G. A. Colditz ◽

...

Keyword(s):

Body Size ◽

Benign Prostatic Hyperplasia ◽

Life Course ◽

Early Life ◽

Prostate Volume ◽

Late Life ◽

Later Life ◽

Normal Weight ◽

Prostatic Hyperplasia ◽

The Life Course

Abstract Background Existing evidence suggests that there is an association between body size and prevalent Benign Prostatic Hyperplasia (BPH)-related outcomes and nocturia. However, there is limited evidence on the association between body size throughout the life-course and incident BPH-related outcomes. Methods Our study population consisted of men without histories of prostate cancer, BPH-related outcomes, or nocturia in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (n = 4710). Associations for body size in early- (age 20), mid- (age 50) and late-life (age ≥ 55, mean age 60.7 years) and weight change with incident BPH-related outcomes (including self-reported nocturia and physician diagnosis of BPH, digital rectal examination-estimated prostate volume ≥ 30 cc, and prostate-specific antigen [PSA] concentration > 1.4 ng/mL) were examined using Poisson regression with robust variance estimation. Results Men who were obese in late-life were 25% more likely to report nocturia (Relative Risk (RR): 1.25, 95% Confidence Interval (CI): 1.11–1.40; p-trendfor continuous BMI < 0.0001) and men who were either overweight or obese in late-life were more likely to report a prostate volume ≥ 30 cc (RRoverweight: 1.13, 95% CI 1.07–1.21; RRobese: 1.10, 95% CI 1.02–1.19; p-trendfor continuous BMI = 0.017) as compared to normal weight men. Obesity at ages 20 and 50 was similarly associated with both nocturia and prostate volume ≥ 30 cc. Considering trajectories of body size, men who were normal weight at age 20 and became overweight or obese by later-life had increased risks of nocturia (RRnormal to overweight: 1.09, 95% CI 0.98–1.22; RRnormal to obese: 1.28, 95% CI 1.10–1.47) and a prostate volume ≥ 30 cc (RRnormal to overweight: 1.12, 95% CI 1.05–1.20). Too few men were obese early in life to examine the independent effect of early-life body size. Later-life body size modified the association between physical activity and nocturia. Conclusions We found that later-life body size, independent of early-life body size, was associated with adverse BPH outcomes, suggesting that interventions to reduce body size even late in life can potentially reduce the burden of BPH-related outcomes and nocturia.

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Depressive Symptoms and Cognitive Decline in Late Life

Archives of General Psychiatry ◽

10.1001/archpsyc.63.2.153 ◽

2006 ◽

Vol 63 (2) ◽

pp. 153 ◽

Cited By ~ 180

Author(s):

Mary Ganguli ◽

Yangchun Du ◽

Hiroko H. Dodge ◽

Graham G. Ratcliff ◽

Chung-Chou H. Chang

Keyword(s):

Depressive Symptoms ◽

Cognitive Decline ◽

Late Life

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Cognitive Functioning and Late-Life Depression

Journal of the International Neuropsychological Society ◽

10.1017/s1355617714000198 ◽

2014 ◽

Vol 20 (5) ◽

pp. 461-467 ◽

Cited By ~ 47

Author(s):

Aaron M. Koenig ◽

Rishi K. Bhalla ◽

Meryl A. Butters

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Cognitive Functioning ◽

Neuropsychological Assessment ◽

Cognitive Deficits ◽

Late Life ◽

Cognitive Outcomes ◽

Review Of The Literature ◽

Late Life Depression ◽

The Relationship

AbstractThis brief report provides an introduction to the topic of cognitive functioning in late-life depression (LLD). In addition to providing a review of the literature, we present a framework for understanding the heterogeneity of cognitive outcomes in this highly prevalent disorder. In addition, we discuss the relationship between LLD and dementia, and highlight the importance of regularly assessing cognitive functioning in older adults who present with depressive symptoms. If cognitive deficits are discovered during a neuropsychological assessment, we recommend referral to a geriatric psychiatrist or cognitive neurologist, for evaluation and treatment of the patient’s symptoms. (JINS, 2014, 20, 1–7)

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