The Separate and Interactive Associations of Trauma and Depression on Cognition in Urban Dwelling Adults

The current study investigated the separate and interactive associations of trauma and depression on cognition in a sample of ethnically diverse urban dwelling adults aged 30-89. Participants were divided into groups based on a diagnosis of depression (D+/-) as measured by the Structured Clinical Interview for the DSM-IV (SCID) and the Hamilton Depression Rating Scale, and a history of trauma (T+/-) as measured by the SCID. Thus, our study included the following four groups: T+D+, T-D+, T+D-, and T-D-. Participants completed a comprehensive neuropsychological protocol. A principal components analysis resulted in a 3-factor solution representing verbally-mediated learning/memory /recognition (VERBAL), visually-mediated learning/memory/recognition (VISUAL), and speeded attention/cognitive flexibility (SA/CF). Composite scores created from PCA results were each subjected to multivariable regression analyses with T+/- and D+/- controlling for age. We found a main effect for trauma, such that trauma, regardless of depression, was associated with worse VERBAL performance. This main effect was primarily driven by performance on immediate and long delayed recall, but not recognition on the CVLT and LM tests indicating worse retrieval. Depression was not associated with VERBAL performance. Trauma and depression were not separately or interactively associated with VISUAL or SA/CF composites. Multivariable regressions revealed that the association between trauma and VERBAL performance was only significant in older adults. While our study did not reveal interactive associations of trauma and depression on cognition, it did suggest that trauma is associated with worse learning and memory performance regardless of depression. Thus, trauma should be assessed in patients with depression as well as patients with memory complaints.