Longitudinal Associations Between Cognitive Functioning and Depressive Symptoms Among Older Adult Spouses in the Cardiovascular Health Study

Objective: To examine the bidirectional associations between older adult spouses' cognitive functioning and depressive symptoms over time. Design: Longitudinal, dyadic path analysis with the actor-partner interdependence model. Setting: Data were from visit 5 (1992/1993), visit 8 (1995/1996), and visit 11 (1998/1999) of the Cardiovascular Health Study, a multisite, longitudinal, observational study of risk factors for cardiovascular disease in adults 65 years or older. Demographic information was from the 1989/1990 original and 1992/1993 African American cohort baseline visits. Participants: Husbands and wives from 1,028 community-dwelling married couples (N = 2,065). Measurements: Cognitive functioning was measured with the Modified Mini-Mental State Exam. Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale. Age, education, and disability (activities of daily living and instrumental activities of daily living) were included as covariates. Results: Cross-partner associations (partner effects) revealed that one spouse's greater depressive symptoms predicted the other spouse's lower cognitive functioning, but a spouse's lower cognitive functioning did not predict the other spouse's greater depressive symptoms over time. Within-individual associations (actor effects) revealed that an individual's lower cognitive functioning predicted the individual's greater depressive symptoms over time, but greater depressive symptoms did not predict lower cognitive functioning over time. Effects did not differ for husbands and wives. Conclusion: Having a spouse who is depressed may increase one's risk of cognitive decline as well as one's risk of depression. Interventions for preventing cognitive decline and depression among older adults may be enhanced by considering the marital context.