Specific depression dimensions are associated with a faster rate of cognitive decline in older adults

INTRODUCTION: Understanding the relationship between different depression presentations and cognitive outcome may elucidate high‐risk sub‐groups for cognitive decline. METHODS: In this study we utilized longitudinal data from the National Alzheimer's Coordinating Center (NACC) on 16,743 initially not demented older adults followed every 12 months for an average of 5 years. Depression dimensions were defined based on the 15‐item Geriatric Depression Scale (GDS‐15), that is, dysphoric mood, Withdrawal‐Apathy‐Vigor (WAV), anxiety, hopelessness, and subjective memory complaint (SMC). RESULTS: After adjustment for sociodemographic and clinical covariates, SMC and hopelessness were associated with faster decline in global cognition and all cognitive domains and WAV with decline executive function. Dysphoric mood and anxiety were not associated with a faster cognitive decline in any of the cognitive domains. DISCUSSION: Different depression dimensions had different associations with the rate of cognitive decline, suggesting distinct pathophysiology and the need for more targeted interventions.