Cognition, depressive symptoms and vascular factors among southwest tribal elders

Abstract

Objectives: Few data exist on cognitive and depressive symptoms and vascular factors in American Indian (AI) elders. Since vascular risk factors increase risk for cognitive impairments, depression and dementia, and since AI elders are at high vascular risk, it is timely to assess the interplay of these factors in comprehensive studies of aging in this population. To begin, pilot studies must be conducted to show these types of data can be collected successfully. Design: A cross-sectional pilot study, the Southwest Heart Mind Study (SHMS). Setting: Tribal community in the Southwest United States. Participants: AI elders, aged ≥55 years. Main Outcome Measures: Cross-cultural demographic, social network and risk factor surveys; tests of cognition, depression and anxiety; physical measurements; blood biochemistries; and APOE genotyping. Results: SHMS elders were comparable to other rural elder populations on cognitive and depressive symptom scores. The average CogScore was 28.8 (out of 32), the average Geriatric Depression Scale (GDS) was 6.7 (of 30), and the average Hamilton Anxiety Scale was 1.2 (of 4). 32% possessed at least one APOEe4 allele. High vascular risk was evident: 76% were overweight or obese; 54% self-reported history of hypertension; 24% heart trouble; 32% type 2 diabetes; 35% depression; and 24% a family history of serious memory loss. More than 70% reported prescription medication use. 54% cared for someone besides self. Conclusions: A better understanding of the burden of vascular risk in relation to cognition and depression among Southwest Tribes is needed.