Psychiatric disorders and cognitive dysfunction among older, postmenopausal women: Results from the women's health initiative memory study

Christopher C. Colenda, Claudine Legault, Stephen R. Rapp, Margaret W. Debon, Patricia Hogan, Robert Wallace, Linda Hershey, Judith Ockene, Rachel Whitmer, Lawrence S. Phillips, Gloria E. Sarto

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: To estimate the frequency of depressive symptoms and selected psychiatric disorders in the Women's Health Initiative Memory Study (WHIMS) cohort and related them to cognitive syndromes. Design: WHIMS was a randomized, double-blinded, placebo-controlled prevention clinical trial examining whether opposed and unopposed hormone therapy reduced the risk of dementia in healthy postmenopausal women. Participants scoring below a designated cutpoint on a cognitive screener received a comprehensive neuropsychiatric workup and adjudicated outcome of no cognitive impairment, mild cognitive impairment, or probable dementia. Participants: Seven thousand four hundred seventy-nine WHIMS participants between age 65 and 79 years and free of dementia at the time of enrollment in WHIMS. Five hundred twenty-one unique participants contributed complete data required for these analyses. Measures: Depressive symptoms were measured with the 15-item Geriatric Depression Scale and the presence of selected psychiatric disorders (major depression, generalized anxiety, and panic and alcohol abuse) was made using the PRIME-MD. Results: The 18% of women had at least one psychiatric disorder with depression being the most common (16%) followed by general anxiety or panic (6%) and alcohol abuse (1%). Depression and the presence of a psychiatric disorder were associated with impaired cognitive status. Participants having a psychiatric disorder were more than twice as likely to be diagnosed with cognitive impairment as those with no psychiatric disorder (odds ratio = 2.06, 95% confidence interval = 1.17-3.60). Older age, white race, and diabetes were also associated with cognitive impairment. Conclusion:The frequency of a psychiatric disorder is associated with poorer cognitive functioning among older women enrolled in WHIMS. That approximately one in five women had a probable psychiatric disorder, most typically depression, highlights the need for greater detection and treatment efforts in this population.

Original languageEnglish (US)
Pages (from-to)177-186
Number of pages10
JournalAmerican Journal of Geriatric Psychiatry
Volume18
Issue number2
DOIs
StatePublished - Jan 1 2010
Externally publishedYes

Fingerprint

Women's Health
Psychiatry
Depression
Dementia
Panic
Alcoholism
Anxiety
Cognitive Dysfunction
Controlled Clinical Trials
Geriatrics
Cohort Studies
Odds Ratio
Placebos
Hormones
Confidence Intervals
Therapeutics
Population

Keywords

  • Cognition
  • Comorbidity
  • MCI
  • Psychiatric disorders
  • Risk of dementia

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Psychiatric disorders and cognitive dysfunction among older, postmenopausal women : Results from the women's health initiative memory study. / Colenda, Christopher C.; Legault, Claudine; Rapp, Stephen R.; Debon, Margaret W.; Hogan, Patricia; Wallace, Robert; Hershey, Linda; Ockene, Judith; Whitmer, Rachel; Phillips, Lawrence S.; Sarto, Gloria E.

In: American Journal of Geriatric Psychiatry, Vol. 18, No. 2, 01.01.2010, p. 177-186.

Research output: Contribution to journalArticle

Colenda, CC, Legault, C, Rapp, SR, Debon, MW, Hogan, P, Wallace, R, Hershey, L, Ockene, J, Whitmer, R, Phillips, LS & Sarto, GE 2010, 'Psychiatric disorders and cognitive dysfunction among older, postmenopausal women: Results from the women's health initiative memory study', American Journal of Geriatric Psychiatry, vol. 18, no. 2, pp. 177-186. https://doi.org/10.1097/JGP.0b013e3181c65864
Colenda, Christopher C. ; Legault, Claudine ; Rapp, Stephen R. ; Debon, Margaret W. ; Hogan, Patricia ; Wallace, Robert ; Hershey, Linda ; Ockene, Judith ; Whitmer, Rachel ; Phillips, Lawrence S. ; Sarto, Gloria E. / Psychiatric disorders and cognitive dysfunction among older, postmenopausal women : Results from the women's health initiative memory study. In: American Journal of Geriatric Psychiatry. 2010 ; Vol. 18, No. 2. pp. 177-186.
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