In Reply We agree with Dr Howland that depression is a comorbidity of primary importance in both cardiovascular diseases and dementia. Depressive symptoms are prevalent in older persons (eg, 12.6% of our study participants had high depressive symptomatology based on validated cutoffs on the Center for Epidemiologic Studies–Depression Scale, and 6.4% consumed antidepressant medications at baseline1), and depression may represent both a risk factor and a prodrome of dementia.2
Samieri C, Empana J. Cardiovascular Health and Cognitive Decline—Reply. JAMA. 2018;320(23):2483–2484. doi:10.1001/jama.2018.17566
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