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Randomized Controlled Trial
. 2018 Sep 5;13(9):e0203343.
doi: 10.1371/journal.pone.0203343. eCollection 2018.

The relationship between depression and cognitive function in adults with cardiovascular risk: Evidence from a randomised attention-controlled trial

Haley M LaMonica  1   2   3 , Daniel J Biddle  1 , Sharon L Naismith  1   2 , Ian B Hickie  1   3 , Paul Maruff  4 , Nicholas Glozier  1   3
Affiliations
Randomized Controlled Trial

The relationship between depression and cognitive function in adults with cardiovascular risk: Evidence from a randomised attention-controlled trial

Haley M LaMonica et al. PLoS One. .

Abstract

Background and aim: This study assessed the association between depressive symptom severity and cognition in middle-to-older aged adults with mild-to-moderate depression and cardiovascular risk factors using an online test battery (CogState) and whether changes in depressive symptoms over 3 months were associated with changes in cognition.

Methods: Participants (mean age = 57.8) with cardiovascular risk and mild-to-moderate depressive symptoms completed measures of psychomotor speed, learning, and executive function prior to (n = 445)_and after (n = 334) online depression or attention control interventions. The symptom severity-cognition relationship was examined both cross-sectionally and prospectively.

Results: Participants exhibited significantly reduced psychomotor speed and variable impairments on measures of learning and executive functioning relative to normative data. However, there was no association of depression severity with cognition at baseline or of change in depressive symptoms with change in cognitive performance.

Limitations: Participants were well-educated, which may have protected against cognitive decline. Attrition may limit generalisability, though is unlikely to explain the lack of association between depression symptoms and cognition.

Conclusions: Adults with comorbid mild-to-moderate depressive symptoms and cardiovascular risks performed less well than age-matched normative data on three online cognitive tests; however, we were unable to show any symptom-cognition association cross-sectionally or longitudinally, despite significant improvements in depressive symptoms. This challenges the generalisability of such associations found in more severely unwell clinical samples to those with a broader depressive symptom profile, or suggests that underlying cardiovascular disease may account for the association seen in some clinical studies. This has implications for scaling up selective prevention of cognitive decline.

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Conflict of interest statement

Professors Naismith, Hickie, and Glozier received a grant from beyondblue to support the conduct of the study. Professor Hickie served as the Commissioner of the National Mental Health Commission and was a member of the Medibank Clinical Reference Group and the Bupa Australia Medical Advisory Board during this study. Professor Paul Maruff is a full time employee of Cogstate. All other authors declare that they have no conflicts of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

References

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