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Longitudinal Relationship of Cognitive Functioning with Depressive Symptoms in Older Adults

Longitudinal Relationship of Cognitive Functioning with Depressive Symptoms in Older Adults. Archana Jajodia, Ph.D. University of Southern California. Collaborators. Archana Jajodia (first author) Andrew Revell John J. McArdle Lesley A. Ross Milton Strauss Vonetta Dotson. Aims.

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Longitudinal Relationship of Cognitive Functioning with Depressive Symptoms in Older Adults

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  1. Longitudinal Relationship of Cognitive Functioning with Depressive Symptoms in Older Adults Archana Jajodia, Ph.D. University of Southern California

  2. Collaborators • Archana Jajodia (first author) • Andrew Revell • John J. McArdle • Lesley A. Ross • Milton Strauss • Vonetta Dotson

  3. Aims • Examine rates of change of symptoms of depression in older adults over time • Examine rates of change of cognitive decline in executive functioning and memory • Examine longitudinal relationship of symptoms of depression with cognitive decline in executive functioning and memory

  4. Background • Depression is related to cognitive decline in older adults • Executive functioning and memory • Longitudinal evidence is less conclusive • Direction of effects is not well-established • Cognitive decline preceding depression has not been explored • Delineating temporal relationships between cognitive functioning and depression may be key to identify mechanisms

  5. Hypotheses • Executive functioning and memory will decline with age and depression will increase • Greater depression will be associated with • lower memory and executive functioning • greater decline in memory and executive functioning with age • Lower executive functioning will predict subsequent increase in depression • Higher depression will predict subsequent decline in memory

  6. Measures • Data from 15 time points • Executive functioning • Fluency: animals, vegetables, fruits • Digit span backwards • Alphabet span • Number comparisons • Memory • East Boston story: immediate, delayed recall • Word list learning: immediate, delayed, recognition • Depressive Symptoms • CES-D (10 items)

  7. Analytic Plan • Univariate latent change models for • Depressive symptoms • Memory • Executive functioning • Bivariate dynamic change models for • Memory and depressive symptoms • Executive functioning and depressive symptoms

  8. Building the Dynamic Latent Difference Score Model (McArdle et al., 2001) • Step1. Modeling Latent Change Dx1 Dx14 x1 x2 x15 X1 X2 X15 … ex ex ex eX1 eX2 eX15

  9. Step 2. Adding Slope and Intercept (Constant Change over Time Model) 1 mx1 ax xslope ax Dx1 Dx14 sx1 mx0 xslope* x1 x2 x15 rx0,x1 xinter X1 X2 X15 sx0 … xinter* ex ex ex eX1 eX2 eX15

  10. Step 3. Adding Proportional Change and Covariates (Dual Change over Time Model) 1 mx1 ax xslope ax Dx1 Dx14 sx1 bx bx bx mx0 xslope* x1 x2 x15 rx0,x1 xinter X1 X2 X15 sx0 … xinter* ex ex ex eX1 eX2 eX15 Covariates

  11. Covariates Repeat for other Variable eY1 eY2 eY15 ey ey ey yinter* sy0 Y1 Y2 Y15 … yinter ry0,y1 y1 y2 y15 my0 yslope* by by by sy1 Dy1 Dy14 ay yslope ay my1 1

  12. Covariates Bivariate Model eY1 eY2 eY15 ey ey ey yinter* sy0 Y1 Y2 Y15 … yinter ry0,y1 ry0,x1 y1 y2 y15 my0 yslope* by by by sy1 Dy1 Dy14 ay rx1,y1 yslope ay my1 1 rx0,y0 rx,y mx1 ax xslope ax Dx1 Dx14 sx1 bx bx bx mx0 xslope* x1 x2 x15 rx0,y1 rx0,x1 xinter X1 X2 X15 sx0 … xinter* ex ex ex eX1 eX2 eX15 Covariates

  13. Covariates eY1 eY2] eY4 ey ey ey yinter* sy0 Y1 Y2 Y5 … yinter ry0,y1 ry0,x1 y1 y2 y5 my0 yslope* by by by sy1 Dy1 Dy4 ay rx1,y1 yslope ay gxy gxy gxy my1 1 rx0,y0 rx,y mx1 gyx gyx gyx ax xslope ax Dx1 Dx4 sx1 bx bx bx mx0 xslope* x1 x2 x5 rx0,y1 rx0,x1 xinter X1 X2 X5 sx0 … xinter* ex ex ex Adding Cross loadings eX1 eX2 eX5 Covariates

  14. Results with Memory and Depressive Symptoms • Proportional change (βs): • Memoryt ΔMemoryt+1 = 0 • CESDt ΔCESDt+1 = 0.11 symptoms (11% increase, p-value = 0.001) • Cross-loadings (γs): • Memoryt ΔCESDt+1 = 0.013 symptoms/unit score • p-value = 0.007 • CESDt ΔMemoryt+1 = -1.5 units/ symptom • p-value = 0.00007 • Model Fit: • χ2 (552) = 1,215 • RMSEA = 0.033

  15. Results with Memory and Depressive Symptoms

  16. Results with Memory and Depressive Symptoms: Covariates

  17. Results with Executive Functioning and Depressive Symptoms • Proportional change (βs): • ExecFnt ΔExecFnt+1 = 0.07 (7% increase, p-value = 0.0000007) • CESDt ΔCESDt+1 = -0.12 symptoms (12% decrease, p-value = 0.004) • Cross-loadings: • ExecFnt ΔCESDt+1 = -0.10 symptoms/unit score • p-value = 0.0000006 • CESDt ΔExecFnt+1 = ns • Model Fit: • χ2 (552) = 1,227 • RMSEA = 0.033

  18. Results with Executive Functioning and Depressive Symptoms

  19. Results with Executive Functioning and Depressive Symptoms: Covariates

  20. Summary of Results • More depressive symptoms associated with poorer memory and executive functioning • Not with decline in cognition • Executive functioning leads to changes in depressive symptoms over time • Depressive symptoms lead to changes in memory over time

  21. Questions & Further Work • Cognitive measures – ok to use composites? • Distinguishing late onset and early onset depression? • Integrate history of major depression in models

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