Trajectories of Concurrent Depressive Symptoms and Cognitive Function on Health Outcomes and Mortality – Findings from a Minority Aging Population

Nai-Wei Chen , Beaumont Health System
Miriam Mutambudzi, MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow
Kyriakos S. Markides, University of Texas at Galveston

Background: Older Mexican Americans have high prevalence of depressive symptoms and increased risk of subsequent cognitive decline when clinically relevant depressive symptomatology is present. This analysis identified the distinctive concurrent trajectory classes of depressive symptoms (DS) and cognitive function (CF) and investigated whether these trajectories were associated with an increased risk of functional limitations, health service utilization, and mortality in Mexican Americans aged =75 over a nine year follow-up period. Methods: Data came from participants of the Hispanic Established Populations for Epidemiologic Study of the Elderly (H-EPESE) collected during four waves from 2004-5 to 2013. Latent growth curve analysis was used to identify distinctive concurrent trajectories of DS and CF. Generalized linear mixed models were employed to examine if the concurrent trajectories were associated with health outcomes. Cox regression model was used to examine the risk of mortality as a function of the concurrent trajectories. Results: 1,302 participants were successfully classified into 6 distinct concurrent trajectory classes of DS (low-increasing, high) and CF (high, high-declining, medium-declining). Compared to the co-occurrence of low-increasing DS and high CF trajectories, those with the high DS and declining CF trajectories were at significantly greater risk of ADL and IADL functional limitations (1.6?2.9 fold), more medical visits (1.2?1.4 fold), hospitalization (1.6?1.9 fold), and mortality (1.7?2.6 fold). Conclusions: Differences in adverse health outcomes across concurrent trajectory classes of DS and CF suggest that differences in underlying co-occurrence and progression have important implications for public health interventions as well as development of aging social and health policies.

See extended abstract

 Presented in Session P2. Poster Session Ageing, Health and Mortality