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Pathways linking late-life depression to persistent cognitive impairment and dementia
Butters MA, Young JB, Lopez O, Aizenstein HJ, Mulsant BH, Reynolds CF, DeKosky ST, Becker JT.. Dialogues in clinical neuroscience, 2008-01-01
Topic: Risk, prevention and care in population studies
There is a strong association between late-life depression, cognitive impairment, cerebrovascular disease, and poor cognitive outcomes, including progressive dementia, especially Alzheimer's disease. While neuroimaging evidence suggests that cerebrovascular disease plays a prominent role, it seems that depression alone may also confer substantial risk for developing Alzheimer's disease. The relationships between the prominent cerebrovascular changes, other structural abnormalities, specific forms of cognitive dysfunction, and increased risk for developing Alzheimer's disease among those with late-life depression have been difficult to reconcile. The varied findings suggest that there are likely multiple pathways to poor cognitive outcomes. We present a framework outlining multiple, non-mutually exclusive etiologic links between depression, cognitive impairment, and progressive decline, including dementia. Importantly, the model is both testable and falsifiable. Going forward, using models such as this to inform research should accelerate knowledge acquisition on the depression/dementia relationship that may be useful for dementia prevention, monitoring the impact of depression treatment on clinical status and course of illness.
Key findings
- While neuroimaging evidence suggests that cerebrovascular disease plays a prominent role, it seems that depression alone may also confer substantial risk for developing Alzheimer's disease.
- The relationships between the prominent cerebrovascular changes, other structural abnormalities, specific forms of cognitive dysfunction, and increased risk for developing Alzheimer's disease among those with late-life depression have been difficult to reconcile.
- The varied findings suggest that there are likely multiple pathways to poor cognitive outcomes.
Why it matters
This paper presents a framework suggesting that late-life depression may be linked to cognitive impairment and a higher risk of Alzheimer's disease through multiple possible pathways, including cerebrovascular disease. It is a proposed model for research, not a tested treatment or prevention.
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Study details
- Evidence strengthLow
How this study scored 53/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Dialogues in clinical neuroscience) |
| Journal's citation record | 2 / 4 | Dialogues in Clinical Neuroscience: journal h-index 154 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2008 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 536 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 26.8 citations a year over 20 year(s) since 2008 |
| Impact for its field and year | 4 / 6 | Cited 9.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 20 other studies in this library |
| Still being cited | 3 / 4 | Cited 99 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author James T. Becker: h-index 104 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Toronto: institution h-index 1,923 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 18979948) |
| Free to read | 2 / 2 | Free to read |
| Total | 53 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.31887/dcns.2008.10.3/mabutters
- PubMed: 18979948
- Original source →
- Free full text: Dialogues in Clinical Neuroscience →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Butters, M. A., Young, J. B., Lopez, O., Aizenstein, H. J., Mulsant, B. H., Reynolds, C. F., et al. (2008). Pathways linking late-life depression to persistent cognitive impairment and dementia. Dialogues in clinical neuroscience. https://doi.org/10.31887/dcns.2008.10.3/mabutters
Vancouver
Butters MA, Young JB, Lopez O, Aizenstein HJ, Mulsant BH, Reynolds CF, et al. Pathways linking late-life depression to persistent cognitive impairment and dementia. Dialogues in clinical neuroscience. 2008. doi:10.31887/dcns.2008.10.3/mabutters. PMID: 18979948.
BibTeX
@article{butters2008-18979948,
author = {Butters, M. A. and Young, J. B. and Lopez, O. and Aizenstein, H. J. and Mulsant, B. H. and Reynolds, C. F. and DeKosky, S. T. and Becker, J. T.},
title = {{Pathways linking late-life depression to persistent cognitive impairment and dementia}},
journal = {Dialogues in clinical neuroscience},
year = {2008},
doi = {10.31887/dcns.2008.10.3/mabutters},
pmid = {18979948},
url = {https://doi.org/10.31887/dcns.2008.10.3/mabutters}
}
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