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February 2006

Perspectives on Depression, Mild Cognitive Impairment, and Cognitive Decline

Author Affiliations

Author Affiliations: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC (Drs Steffens, Krishnan and Welsh-Bohmer); Division of AIDS and Health and Behavior Research, National Institute of Mental Health, National Institutes of Health, Bethesda (Dr Otey), and Department of Psychiatry, The Johns Hopkins University School of Medicine, Baltimore (Dr Lyketsos), Md; Department of Psychiatry, Weill Medical College of Cornell University, Ithaca, NY (Dr Alexopoulos); Departments of Psychiatry (Drs Butters, Ganguli, and Reynolds) and Neurology and Neuroscience (Dr Reynolds), Western Psychiatric Institute and Clinic, and Department of Neurology, University of Pittsburgh School of Medicine (Dr Lopez), Pittsburgh, Pa; Department of Psychology, University of Minnesota, Minneapolis (Dr Cuthbert), and Department of Neurology, Mayo Clinic Rochester, Rochester (Drs Geda and Petersen), Minn; Department of Psychiatry, Indiana University, Bloomington (Dr Hendrie); Neuropsychiatric Institute, University of California, Los Angeles (Dr Kumar), Department of Neurosciences, University of California, San Diego (Dr Peavy), and Department of Psychiatry, Stanford University School of Medicine, Stanford (Dr Yesavage), Calif; Department of Psychological and Brain Sciences, University of Louisville, Ky (Dr Mast); Department of Neurology, Washington University School of Medicine, St Louis, Mo (Dr Morris); Department of Psychology, Utah State University, Logan (Dr Norton); and Department of Clinical Neurosciences, Brown Medical School, Providence, RI (Dr Salloway).

Arch Gen Psychiatry. 2006;63(2):130-138. doi:10.1001/archpsyc.63.2.130

Context  The public health implications of depression and cognitive impairment in late life are enormous. Cognitive impairment and late-life depression are associated with increased risk for subsequent dementia; however, investigations of these phenomena appear to be proceeding along separate tracks.

Objectives and Data Source  The National Institute of Mental Health organized the conference “Perspectives on Depression, Mild Cognitive Impairment, and Cognitive Decline” to consider how the varied perspectives might be better integrated to examine the associations among depression, mild cognitive impairment, and cognitive decline and to illuminate the common or distinct mechanisms involved in these associations.

Data Synthesis  The following 2 broad questions were addressed: (1) What gaps in our knowledge have the greatest public health significance? (2) Can we more efficiently use our research dollars and participant resources to fill these gaps? Meeting participants included grantees from the National Institute of Mental Health and the National Institute on Aging and program staff from the National Institute of Mental Health, the National Institute on Aging, and the National Institute of Neurological Disorders and Stroke.

Conclusions  One of the most important recommendations to emerge from the meeting discussions is for increased collaboration among clinical and epidemiological investigators whose work focuses in the area of depression with those working primarily in the area of memory disorders. Directions for future research were identified.

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