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Symptoms of depression could represent a prodromal stage of AD. Very early mood alterations may help to stratify those at highest risk of late\u2010life AD. We aim to investigate associations between baseline\/longitudinal scores for depression, presence of cognitive impairment and\/or AD pathology at death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods\/Design<\/jats:title><jats:p>Between 1991 and 2015, participants from The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age underwent 10 waves of assessment using the Geriatric Depression Scale (GDS). AD pathology at death was evaluated in 106 eligible cases. Analyses aimed to examine associations between GDS scores, cognitive status and AD pathology (as measured by Braak stage, Thal phase and CERAD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline GDS scores were significantly higher for those cognitively impaired at death than those cognitively normal. Significantly higher baseline GDS scores were found for those with greater Consortium to Establish a Registry for Alzheimer\u2019s Disease (CERAD) scores than those with lower CERAD scores. Similarly, significantly higher baseline GDS scores were found for those with a greater Braak stage than those with lower tau burden. These correlations remained after controlling for age at death, education and <jats:italic>APOE<\/jats:italic> \u03b54, but were less robust. Mean longitudinal GDS scores associated with cognition but not pathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>GDS scores collected approximately 20 years before death were associated with cognitive status and AD pathology at death. We postulate that early AD\u2010related pathological change produces raised GDS scores due to an overlapping neural basis with depression, and that this may be considered as an early diagnostic marker for AD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/gps.5470","type":"journal-article","created":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T19:30:37Z","timestamp":1605123037000},"page":"713-721","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Mid to late\u2010life scores of depression in the cognitively healthy are associated with cognitive status and Alzheimer's disease pathology at death"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2208-7728","authenticated-orcid":false,"given":"Andrew C.","family":"Robinson","sequence":"first","affiliation":[{"name":"Division of Neuroscience &amp; Experimental Psychology Faculty of Biology, Medicine and Health School of Biological Sciences The University of Manchester Salford Royal Hospital  Salford UK"},{"name":"Geoffrey Jefferson Brain Research Centre Manchester Academic Health Science Centre (MAHSC)  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Roncaroli","sequence":"additional","affiliation":[{"name":"Division of Neuroscience &amp; Experimental Psychology Faculty of Biology, Medicine and Health School of Biological Sciences The University of Manchester Salford Royal Hospital  Salford UK"},{"name":"Geoffrey Jefferson Brain Research Centre Manchester Academic Health Science Centre (MAHSC)  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne S.","family":"Davidson","sequence":"additional","affiliation":[{"name":"Division of Neuroscience &amp; Experimental Psychology Faculty of Biology, Medicine and Health School of Biological Sciences The University of Manchester Salford Royal Hospital  Salford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Minshull","sequence":"additional","affiliation":[{"name":"Division of Neuroscience &amp; Experimental Psychology Faculty of Biology, Medicine and Health School of Biological Sciences The University of Manchester Salford Royal Hospital  Salford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Calvin","family":"Heal","sequence":"additional","affiliation":[{"name":"Centre for Biostatistics Faculty of Biology, Medicine and Health School of Health Sciences The University of Manchester  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Montaldi","sequence":"additional","affiliation":[{"name":"Division of Neuroscience &amp; 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