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Population based longitudinal cohort study.
Follow up period:
Four US communities in North Carolina, Maryland, California, and Pennsylvania; enrolment 1989–90 and 1992–93.
2220 community dwelling adults aged over 65 years. Exclusions: dementia (increasing or stable deficit in at least two cognitive domains, which affected activities of daily living (ADLs), in people with previously normal function) at baseline or final follow up; mild cognitive impairment (Modified Mini-Mental State Examination (3MS) score <90) at 1992–93 testing; receiving any major medical treatment or care, or wheelchair bound.
Depressive symptoms (Center for Epidemiological Studies Depression Scale; maximum score = 30; no depressive symptoms = 0–2; …
For correspondence: Deborah E Barnes, PhD, MPH, Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA;
Sources of funding: National Heart, Lung, and Blood Institute, USA; National Institute for Aging; national Alliance for Research on Schizophrenia and Depression.