INTRODUCTIONThe course of depressive symptoms and dementia risk is unclear, as are potential structural neuropathological common causes.METHODSUtilizing joint latent class mixture models, we identified longitudinal trajectories of annually assessed depressive symptoms and dementia risk over 21 years in 957 older women (baseline age 72.7 years old) from the Women's Health Initiative Memory Study. In a subsample of 569 women who underwent structural magnetic resonance imaging, we examined whether estimates of cerebrovascular disease and Alzheimer's disease (AD)‐related neurodegeneration were associated with identified trajectories.RESULTSFive trajectories of depressive symptoms and dementia risk were identified. Compared to women with minimal symptoms, women who reported mild and stable and emerging depressive symptoms were at the highest risk of developing dementia and had more cerebrovascular disease and AD‐related neurodegeneration.DISCUSSIONThere are heterogeneous profiles of depressive symptoms and dementia risk. Common neuropathological factors may contribute to both depression and dementia.Highlights The progression of depressive symptoms and concurrent dementia risk is heterogeneous. Emerging depressive symptoms may be a prodromal symptom of dementia. Cerebrovascular disease and AD are potentially shared neuropathological factors.

中文翻译：

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老年女性 20 年抑郁症状、痴呆和结构神经病理学

简介 抑郁症状和痴呆风险的病程尚不清楚，潜在的结构性神经病理学常见原因也不清楚。方法利用联合潜在类别混合模型，我们确定了 957 名老年女性（基线年龄 72.7 岁）21 年来每年评估的抑郁症状和痴呆风险的纵向轨迹旧）来自女性健康倡议记忆研究。在接受结构磁共振成像的 569 名女性子样本中，我们检查了脑血管疾病和阿尔茨海默病 (AD) 相关神经变性的估计是否与已确定的轨迹相关。结果确定了五个抑郁症状和痴呆风险的轨迹。与症状轻微的女性相比，报告轻度、稳定和新出现抑郁症状的女性患痴呆症的风险最高，并且患有更多脑血管疾病和 AD 相关神经变性。讨论 抑郁症状和痴呆风险存在异质性。常见的神经病理因素可能导致抑郁症和痴呆症。亮点 抑郁症状的进展和并发痴呆风险是异质的。 新出现的抑郁症状可能是痴呆症的前驱症状。 脑血管疾病和 AD 是潜在的共同神经病理因素。