A Dynamic View of Depressive Symptoms and Neurocognitive Change Among Patients With Coronary Artery Disease | Cardiology | JAMA Psychiatry | JAMA Network
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1.
Connerney I, Sloan RP, Shapiro PA, Bagiella E, Seckman C. Depression is associated with increased mortality 10 years after coronary artery bypass surgery.  Psychosom Med. 2010;72(9):874-88120841558PubMedGoogle ScholarCrossref
2.
Carney RM, Freedland KE. Depression in patients with coronary heart disease.  Am J Med. 2008;121(11):(suppl 2)  S20-S2718954589PubMedGoogle ScholarCrossref
3.
Timberlake N, Klinger L, Smith P, Venn G, Treasure T, Harrison M, Newman SP. Incidence and patterns of depression following coronary artery bypass graft surgery.  J Psychosom Res. 1997;43(2):197-2079278908PubMedGoogle ScholarCrossref
4.
Blumenthal JA, Lett HS, Babyak MA, White W, Smith PK, Mark DB, Jones R, Mathew JP, Newman MF.NORG Investigators.  Depression as a risk factor for mortality after coronary artery bypass surgery.  Lancet. 2003;362(9384):604-60912944059PubMedGoogle ScholarCrossref
5.
van Melle JP, de Jonge P, Spijkerman TA, Tijssen JGP, Ormel J, van Veldhuisen DJ, van den Brink RHS, van den Berg MP. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis.  Psychosom Med. 2004;66(6):814-82215564344PubMedGoogle ScholarCrossref
6.
Warsch JRL, Wright CB. The aging mind: vascular health in normal cognitive aging.  J Am Geriatr Soc. 2010;58:(suppl 2)  S319-S32421029061PubMedGoogle ScholarCrossref
7.
Selnes OA, Grega MA, Bailey MM, Pham LD, Zeger SL, Baumgartner WA, McKhann GM. Cognition 6 years after surgical or medical therapy for coronary artery disease.  Ann Neurol. 2008;63(5):581-59018481292PubMedGoogle ScholarCrossref
8.
Wilson RS, Mendes De Leon CF, Bennett DA, Bienias JL, Evans DA. Depressive symptoms and cognitive decline in a community population of older persons.  J Neurol Neurosurg Psychiatry. 2004;75(1):126-12914707321PubMedGoogle Scholar
9.
Barnes DE, Alexopoulos GS, Lopez OL, Williamson JD, Yaffe K. Depressive symptoms, vascular disease, and mild cognitive impairment: findings from the Cardiovascular Health Study.  Arch Gen Psychiatry. 2006;63(3):273-27916520432PubMedGoogle ScholarCrossref
10.
Raji MA, Reyes-Ortiz CA, Kuo Y-F, Markides KS, Ottenbacher KJ. Depressive symptoms and cognitive change in older Mexican Americans.  J Geriatr Psychiatry Neurol. 2007;20(3):145-15217712097PubMedGoogle ScholarCrossref
11.
Chodosh J, Kado DM, Seeman TE, Karlamangla AS. Depressive symptoms as a predictor of cognitive decline: MacArthur Studies of Successful Aging.  Am J Geriatr Psychiatry. 2007;15(5):406-41517353297PubMedGoogle ScholarCrossref
12.
Han L, McCusker J, Cole M, Abrahamowicz M, Čapek R. 12-Month cognitive outcomes of major and minor depression in older medical patients.  Am J Geriatr Psychiatry. 2008;16(9):742-75118757768PubMedGoogle ScholarCrossref
13.
Ownby RL, Crocco E, Acevedo A, John V, Loewenstein D. Depression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression analysis.  Arch Gen Psychiatry. 2006;63(5):530-53816651510PubMedGoogle ScholarCrossref
14.
Geerlings MI, den Heijer T, Koudstaal PJ, Hofman A, Breteler MMB. History of depression, depressive symptoms, and medial temporal lobe atrophy and the risk of Alzheimer disease.  Neurology. 2008;70(15):1258-126418391157PubMedGoogle ScholarCrossref
15.
Goveas JS, Espeland MA, Woods NF, Wassertheil-Smoller S, Kotchen JM. Depressive symptoms and incidence of mild cognitive impairment and probable dementia in elderly women: the Women's Health Initiative Memory Study.  J Am Geriatr Soc. 2011;59(1):57-6621226676PubMedGoogle ScholarCrossref
16.
Köhler S, van Boxtel MPJ, van Os J, Thomas AJ, O’Brien JT, Jolles J, Verhey FRJ, Allardyce J. Depressive symptoms and cognitive decline in community-dwelling older adults.  J Am Geriatr Soc. 2010;58(5):873-87920374396PubMedGoogle ScholarCrossref
17.
Singh-Manoux A, Akbaraly TN, Marmot M, Melchior M, Ankri J, Sabia S, Ferrie JE. Persistent depressive symptoms and cognitive function in late midlife: the Whitehall II Study.  J Clin Psychiatry. 2010;71(10):1379-138520584520PubMedGoogle ScholarCrossref
18.
Vinkers DJ, Gussekloo J, Stek ML, Westendorp RGJ, van der Mast RC. Temporal relation between depression and cognitive impairment in old age: prospective population based study.  BMJ. 2004;329(7471):88115345599PubMedGoogle ScholarCrossref
19.
Ganguli M, Du Y, Dodge HH, Ratcliff GG, Chang CC. Depressive symptoms and cognitive decline in late life: a prospective epidemiological study.  Arch Gen Psychiatry. 2006;63(2):153-16016461857PubMedGoogle ScholarCrossref
20.
Jorm AF. History of depression as a risk factor for dementia: an updated review.  Aust N Z J Psychiatry. 2001;35(6):776-78111990888PubMedGoogle ScholarCrossref
21.
Butters MA, Young JB, Lopez O, Aizenstein HJ, Mulsant BH, Reynolds CF III, DeKosky ST, Becker JT. Pathways linking late-life depression to persistent cognitive impairment and dementia.  Dialogues Clin Neurosci. 2008;10(3):345-35718979948PubMedGoogle Scholar
22.
Geda YE, Knopman DS, Mrazek DA, Jicha GA, Smith GE, Negash S, Boeve BF, Ivnik RJ, Petersen RC, Pankratz VS, Rocca WA. Depression, apolipoprotein E genotype, and the incidence of mild cognitive impairment: a prospective cohort study.  Arch Neurol. 2006;63(3):435-44016533972PubMedGoogle ScholarCrossref
23.
Corsentino EA, Sawyer K, Sachs-Ericsson N, Blazer DG. Depressive symptoms moderate the influence of the apolipoproteinEε4 allele on cognitive decline in a sample of community dwelling older adults.  Am J Geriatr Psychiatry. 2009;17(2):155-16519155747PubMedGoogle ScholarCrossref
24.
Niti M, Yap KB, Kua EH, Ng TP. APOE-ε4, depressive symptoms, and cognitive decline in Chinese older adults: Singapore Longitudinal Aging Studies.  J Gerontol A Biol Sci Med Sci. 2009;64(2):306-31119181718PubMedGoogle ScholarCrossref
25.
Rudolph JL, Schreiber KA, Culley DJ, McGlinchey RE, Crosby G, Levitsky S, Marcantonio ER. Measurement of post-operative cognitive dysfunction after cardiac surgery: a systematic review.  Acta Anaesthesiol Scand. 2010;54(6):663-67720397979PubMedGoogle ScholarCrossref
26.
McKhann GM, Borowicz LM, Goldsborough MA, Enger C, Selnes OA. Depression and cognitive decline after coronary artery bypass grafting.  Lancet. 1997;349(9061):1282-12849142062PubMedGoogle ScholarCrossref
27.
Andrew MJ, Baker RA, Kneebone AC, Knight JL. Mood state as a predictor of neuropsychological deficits following cardiac surgery.  J Psychosom Res. 2000;48(6):537-54611033372PubMedGoogle ScholarCrossref
28.
Tsushima WT, Johnson DB, Lee JD, Matsukawa JM, Fast KMS. Depression, anxiety and neuropsychological test scores of candidates for coronary artery bypass graft surgery.  Arch Clin Neuropsychol. 2005;20(5):667-67315885979PubMedGoogle ScholarCrossref
29.
Phillips-Bute B, Mathew JP, Blumenthal JA, Grocott HP, Laskowitz DT, Jones RH, Mark DB, Newman MF. Association of neurocognitive function and quality of life 1 year after coronary artery bypass graft (CABG) surgery.  Psychosom Med. 2006;68(3):369-37516738066PubMedGoogle ScholarCrossref
30.
Stroobant N, Vingerhoets G. Depression, anxiety, and neuropsychological performance in coronary artery bypass graft patients: a follow-up study.  Psychosomatics. 2008;49(4):326-33118621938PubMedGoogle ScholarCrossref
31.
Tully PJ, Baker RA, Knight JL, Turnbull DA, Winefield HR. Neuropsychological function 5 years after cardiac surgery and the effect of psychological distress.  Arch Clin Neuropsychol. 2009;24(8):741-75119875394PubMedGoogle ScholarCrossref
32.
Carney RM, Freedland KE, Steinmeyer B, Blumenthal JA, de Jonge P, Davidson KW, Czajkowski SM, Jaffe AS. History of depression and survival after acute myocardial infarction.  Psychosom Med. 2009;71(3):253-25919251868PubMedGoogle ScholarCrossref
33.
de Jonge P, Honig A, van Melle JP, Schene AH, Kuyper AMG, Tulner D, Schins A, Ormel J.MIND-IT Investigators.  Nonresponse to treatment for depression following myocardial infarction: association with subsequent cardiac events.  Am J Psychiatry. 2007;164(9):1371-137817728422PubMedGoogle ScholarCrossref
34.
Lespérance F, Frasure-Smith N, Talajic M, Bourassa MG. Five-year risk of cardiac mortality in relation to initial severity and one-year changes in depression symptoms after myocardial infarction.  Circulation. 2002;105(9):1049-105311877353PubMedGoogle ScholarCrossref
35.
Roth M, Huppert FA, Mountjoy CQ, Tym E. The Cambridge Examination for Mental Disorders of the Elderly–Revised (CAMDEX-R Schedule). Cambridge, England: Cambridge University Press; 1998
36.
Ghali WA, Knudtson ML.APPROACH Investigators.  Overview of the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease.  Can J Cardiol. 2000;16(10):1225-123011064296PubMedGoogle Scholar
37.
Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS): recent evidence and development of a shorter version.  Clin Gerontol. 1986;5(1/2):165-173Google Scholar
38.
Almeida OP, Almeida SA. Short versions of the Geriatric Depression Scale: a study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV Int J Geriatr Psychiatry. 1999;14(10):858-86510521885PubMedGoogle ScholarCrossref
39.
Benedict RHB. Brief Visuospatial Memory Test–Revised: Professional Manual. Lutz, FL: Psychological Assessment Resources, Inc; 1997
40.
Welsh KA, Butters N, Mohs RC, Beekly D, Edland S, Fillenbaum G, Heyman A. The Consortium to Establish a Registry for Alzheimer's Disease (CERAD), V: a normative study of the neuropsychological battery.  Neurology. 1994;44(4):609-6148164812PubMedGoogle ScholarCrossref
41.
Strauss E, Sherman EMS, Spreen O. Verbal fluency, Trail Making Test (TMT). In: Strauss E, Sherman EMS, Spreen O, eds. A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. 3rd ed. New York, NY: Oxford University Press; 2006:499-526, 655-677
42.
Heaton RK, Grant I, Matthews CG. Comprehensive Norms for an Expanded Halstead-Reitan Battery: Demographic Corrections, Research Findings, and Clinical Applications. Odessa, FL: Psychological Assessment Resources; 1991
43.
Folstein MF, Folstein SE, McHugh PR. “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician.  J Psychiatr Res. 1975;12(3):189-1981202204PubMedGoogle ScholarCrossref
44.
Jones WJ, Williams LS, Meschia JF. Validating the Questionnaire for Verifying Stroke-Free Status (QVSFS) by neurological history and examination.  Stroke. 2001;32(10):2232-223611588306PubMedGoogle ScholarCrossref
45.
Spielberger C, Gorsuch R, Lushene R. State-Trait Anxiety Inventory (STAI) Manual. Palo Alto, CA: Consulting Psychologists Press; 1970
46.
Koch W, Ehrenhaft A, Griesser K, Pfeufer A, Müller J, Schömig A, Kastrati A. TaqMan systems for genotyping of disease-related polymorphisms present in the gene encoding apolipoprotein E.  Clin Chem Lab Med. 2002;40(11):1123-113112521230PubMedGoogle ScholarCrossref
47.
Schafer JL. Analysis of Incomplete Multivariate Data. New York, NY: Chapman& Hall; 1997
48.
Lenze EJ, Schulz R, Martire LM, Zdaniuk B, Glass T, Kop WJ, Jackson SA, Reynolds CF III. The course of functional decline in older people with persistently elevated depressive symptoms: longitudinal findings from the Cardiovascular Health Study.  J Am Geriatr Soc. 2005;53(4):569-57515817000PubMedGoogle ScholarCrossref
49.
Royall DR, Palmer R, Chiodo LK, Polk MJ. Depressive symptoms predict longitudinal change in executive control but not memory.  Int J Geriatr Psychiatry. 2012;27(1):89-9621351296PubMedGoogle ScholarCrossref
50.
Yen Y-C, Rebok GW, Gallo JJ, Jones RN, Tennstedt SL. Depressive symptoms impair everyday problem-solving ability through cognitive abilities in late life.  Am J Geriatr Psychiatry. 2011;19(2):142-15020808123PubMedGoogle ScholarCrossref
51.
Sneed JR, Culang ME, Keilp JG, Rutherford BR, Devanand DP, Roose SP. Antidepressant medication and executive dysfunction: a deleterious interaction in late-life depression.  Am J Geriatr Psychiatry. 2010;18(2):128-13520104069PubMedGoogle ScholarCrossref
52.
Wilson RS, Hoganson GM, Rajan KB, Barnes LL, Mendes de Leon CF, Evans DA. Temporal course of depressive symptoms during the development of Alzheimer disease.  Neurology. 2010;75(1):21-2620603481PubMedGoogle ScholarCrossref
53.
Alexopoulos GS, Meyers BS, Young RC, Campbell S, Silbersweig D, Charlson M. “Vascular depression” hypothesis.  Arch Gen Psychiatry. 1997;54(10):915-9229337771PubMedGoogle ScholarCrossref
54.
Rollman BL, Belnap BH, LeMenager MS, Mazumdar S, Houck PR, Counihan PJ, Kapoor WN, Schulberg HC, Reynolds CF III. Telephone-delivered collaborative care for treating post-CABG depression: a randomized controlled trial.  JAMA. 2009;302(19):2095-210319918088PubMedGoogle ScholarCrossref
55.
Freedland KE, Skala JA, Carney RM, Rubin EH, Lustman PJ, Dávila-Román VG, Steinmeyer BC, Hogue CW Jr. Treatment of depression after coronary artery bypass surgery: a randomized controlled trial.  Arch Gen Psychiatry. 2009;66(4):387-39619349308PubMedGoogle ScholarCrossref
Original Article
Mar 2012

A Dynamic View of Depressive Symptoms and Neurocognitive Change Among Patients With Coronary Artery Disease

Author Affiliations

Author Affiliations: Departments of Community Health Sciences (Ms Freiheit and Drs Hogan, Eliasziw, Patten, Faris, Ghali, and Maxwell), Medicine (Drs Hogan, Patten, Anderson, Ghali, Knudtson, and Maxwell and Ms Galbraith), Clinical Neurosciences (Drs Hogan, Eliasziw, and Demchuk), Radiology (Dr Demchuk), Cardiac Sciences (Drs Anderson and Knudtson and Ms Galbraith), and Medical Genetics (Dr Parboosingh), Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.

Arch Gen Psychiatry. 2012;69(3):244-255. doi:10.1001/archgenpsychiatry.2011.1361
Abstract

Context Older patients with coronary artery disease often experience depressive symptoms and are vulnerable to developing cognitive impairment. Whether depressive symptoms increase their risk of cognitive decline is unknown.

Objectives To examine the association between the stability of depressive symptoms and cognitive decline for 30 months among patients undergoing coronary angiography and to explore whether any observed associations were modified by the presence of the apolipoprotein E (APOE)ε4 allele.

Design Cohort study.

Setting Urban tertiary care hospital serving southern Alberta.

Participants Three hundred fifty patients 60 years or older (73.7% male) undergoing nonemergent catheterization (October 27, 2003, through February 28, 2007) without prior revascularization. We compared a baseline measure of depressive symptoms (Geriatric Depression Scale score≥5) with a dynamic measure capturing change from baseline to 12 months.

Main Outcome Measures Mean change in domain (z scores for attention/executive function, learning/memory, and verbal fluency) and global (raw Mini-Mental State Examination) cognitive scores from baseline to 6, 12, and 30 months and from 12 to 30 months.

Results In adjusted models, participants with persistent depressive symptoms (at baseline and≥1follow-up visit) showed significantly greater declines at 30 months in attention/executive function (mean z score change,−0.22), learning/memory (−0.19), verbal fluency (−0.18), and global cognition (mean Mini-Mental State Examination [MMSE] score change,−0.99) compared with participants with no or baseline-only depressive symptoms. Persistent depressive symptoms were associated with significantly greater declines in all cognitive measures from 12 to 30 months after adjusting for sociodemographic and clinical factors. For global cognition, a significantly greater decline was evident for patients with persistent depressive symptoms and the APOEε4 allele (mean MMSE score change,−2.93 [95% CI,−4.40 to−1.45]).

Conclusions Depressive symptoms persist in some patients with coronary artery disease, placing them at a greater risk for cognitive decline. Whether this decline is additionally modified by the presence of APOEε4 requires further investigation.

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