Racial and Ethnic Differences in the Association between Depressive Symptoms and Cognitive Outcomes in Older Adults: Findings from KHANDLE and STAR

ABSTRACT INTRODUCTION Depressive symptoms are associated with higher risk of dementia but how they impact cognition in diverse populations is unclear. METHODS Asian, Black, LatinX, or White participants (n=2,227) in the Kaiser Healthy Aging and Diverse Life Experiences (age 65+) and the Study of Healthy Aging in African Americans (age 50+) underwent up to three waves of cognitive assessments over four years. Multilevel models stratified by race/ethnicity were used to examine whether depressive symptoms were associated with cognition or cognitive decline and whether associations differed by race/ethnicity. RESULTS Higher depressive symptoms were associated with lower baseline verbal episodic memory scores (−0.06, 95%CI:-0.12,-0.01; −0.15, 95%CI:-0.25,-0.04), and faster decline annually in semantic memory (−0.04, 95%CI:-0.07,-0.01; −0.10, 95%CI:-0.15,-0.05) for Black and LatinX participants. Depressive symptoms were associated with lower baseline but not decline in executive function. DISCUSSION Depressive symptoms were associated with worse cognitive domains, with some evidence of heterogeneity across racial/ethnic groups. Highlights We examined whether baseline depressive symptoms were differentially associated with domain-specific cognition or cognitive decline by race/ethnicity. Depressive symptoms were associated with worse cognitive scores for all racial/ethnic groups across different domains examined. Higher depressive symptoms were associated with faster cognitive decline for semantic memory for Black and LatinX participants. The results suggest a particularly harmful association between depressive symptoms and cognition in certain racial/ethnic groups.