Cancer
Duration of depressive symptoms prior to a cancer diagnosis and post-cancer memory function and decline Ashly C. Westrick* Ashly Westrick Henry Ford Health System
Background. Depressive symptoms are associated with increased risk for cognitive decline in the general population, but less is known about how depressive symptoms might influence cognitive aging after a cancer diagnosis in mid-to-later life. We aimed to determine if the duration of depressive symptoms before a cancer diagnosis was associated with post-cancer diagnosis memory function and decline.
Methods: Data were from 425 adults aged ≥50 with an incident cancer diagnosis (2004-2020) and three waves of depression data prior to their diagnosis (1998-2020) in the US Health and Retirement Study. Depressive symptoms were measured biennially using the Center for Epidemiologic Studies Depression Scale (CES-D; range 0 to 8); a score of ≥3 was considered clinically relevant depressive symptoms. Duration of clinically relevant depressive symptoms was categorized as never, 1 time point, or ≥2 time points. Episodic memory was assessed from the time of cancer diagnosis as a composite of immediate and delayed recall. Multivariable adjusted linear mixed-effects models estimated the association between pre-diagnosis depression duration and post-diagnosis memory function.
Results: The mean age was 68.9 years (SD: 8.55) and 52.7% were male. In the three waves (~9 years) prior to diagnosis, 23.3% of participants (99/425) had depressive symptoms at ≥2 time points, 20.0% (85/425) had depressive symptoms at 1 time point, and 56.7 (241/425) had no depressive symptoms. The mean follow-up time after cancer diagnosis was 8 years (SD=5.03). A longer duration of depression was associated with worse memory at the time of diagnosis (-0.45 SD units, 95% CI: -0.72, -0.18) and a faster rate of memory decline post-diagnosis (-0.17 SD units/year, 95% CI: -0.68, 0.34), although imprecisely estimated.
Discussion: Increased duration of depressive symptoms was associated with worse memory function at the time of cancer diagnosis and may be associated with faster memory decline.