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Title: Trajectories of depressive and anxiety symptoms in older adults: a 6-year prospective cohort study
Austin Authors: Holmes, Sophie E;Esterlis, Irina;Mazure, Carolyn M;Lim, Yen Ying;Ames, David;Rainey-Smith, Stephanie R;Fowler, Chris;Ellis, Kathryn;Martins, Ralph N;Salvado, Olivier;Doré, Vincent ;Villemagne, Victor L ;Rowe, Christopher C ;Laws, Simon M;Masters, Colin L ;Pietrzak, Robert H;Maruff, Paul;Australian Imaging, Biomarkers and Lifestyle (AIBL) Research Group
Affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
The Florey Institute, The University of Melbourne, Parkville, Victoria, Australia
Academic Unit for Psychiatry of Old Age, St. Vincent's Health, Department of Psychiatry, The University of Melbourne, Kew, Victoria, Australia
National Ageing Research Institute, Parkville, Victoria, Australia
Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Hospital, Perth, Western Australia, Australia
The Commonwealth Scientific and Industrial Research Organization, Canberra, Australia
Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Victoria, Australia
Cooperative Research Centre for Mental Health, Carlton, Victoria, Australia
School of Biomedical Sciences, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
Cogstate Ltd., Melbourne, Victoria, Australia
Issue Date: 24-Jul-2017 2017-07-24
Publication information: International Journal of Geriatric Pharmacy 2018; 33(2): 405-413
Abstract: OBJECTIVE: Depressive and anxiety symptoms are common in older adults, significantly affect quality of life, and are risk factors for Alzheimer's disease. We sought to identify the determinants of predominant trajectories of depressive and anxiety symptoms in cognitively normal older adults. METHOD: Four hundred twenty-three older adults recruited from the general community underwent Aβ positron emission tomography imaging, apolipoprotein and brain-derived neurotrophic factor genotyping, and cognitive testing at baseline and had follow-up assessments. All participants were cognitively normal and free of clinical depression at baseline. Latent growth mixture modeling was used to identify predominant trajectories of subthreshold depressive and anxiety symptoms over 6 years. Binary logistic regression analysis was used to identify baseline predictors of symptomatic depressive and anxiety trajectories. RESULTS: Latent growth mixture modeling revealed two predominant trajectories of depressive and anxiety symptoms: a chronically elevated trajectory and a low, stable symptom trajectory, with almost one in five participants falling into the elevated trajectory groups. Male sex (relative risk ratio (RRR) = 3.23), lower attentional function (RRR = 1.90), and carriage of the brain-derived neurotrophic factor Val66Met allele in women (RRR = 2.70) were associated with increased risk for chronically elevated depressive symptom trajectory. Carriage of the apolipoprotein epsilon 4 allele (RRR = 1.92) and lower executive function in women (RRR = 1.74) were associated with chronically elevated anxiety symptom trajectory. CONCLUSION: Our results indicate distinct and sex-specific risk factors linked to depressive and anxiety trajectories, which may help inform risk stratification and management of these symptoms in older adults at risk for Alzheimer's disease.
DOI: 10.1002/gps.4761
ORCID: 0000-0002-4929-1932
PubMed URL: 28736899
Type: Journal Article
Appears in Collections:Journal articles

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