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Depression subtypes and 5-year risk of dementia and Alzheimer disease in patients aged 70 years.

Abstract

OBJECTIVE

The objective of this study was to estimate several subtypes of depressive disorders as risk factors for dementia and Alzheimer disease (AD) specifically.

METHODS

This is a population-based cohort study using a sample of 451 non-demented older people. Adjusted Cox proportional hazard models were calculated to determine the association of depression with dementia or AD development after 5 years. Baseline evaluation included the Cambridge Mental Disorders of the Elderly Examination (CAMDEX). Depressive disorders (major episode [MD] and minor depressive disorders [MDDIS]) were assessed following DSM-IV criteria and further classified according to the age at onset (early versus late onset). In turn, all late-onset depressions were grouped as with or without depression-executive dysfunction syndrome (DEDS). Dementia (and dementia subtypes) diagnoses were made using the CAMDEX. When the patients were deceased, the Retrospective Collateral Dementia Interview was used.

RESULTS

Late-onset depressions (both MD and MDDIS) were associated with increased dementia (hazard ratio [HR] = 2.635; 95% CI = 1.153-6.023; and HR = 2.517; 95% CI = 1.200-5.280, respectively), and AD (HR = 6.262; 95% CI = 2.017-19.446; and HR = 4.208; 95% CI = 1.828-9.685, respectively) after adjustment by age, gender, marital status, education, cognitive impairment, executive function and stroke history. A second model revealed that only late-onset depressions with DEDS increased the risk for both dementia (late-onset MD with DEDS: HR = 6.262; 95% CI = 2.017-19.446; late-onset MDDIS with DEDS: HR = 4.208; 95% CI = 1.828-9.685) and AD (late-onset MD with DEDS: HR = 7.807; 95% CI = 1.567-38.894; late-onset MDDIS with DEDS: HR = 6.099; 95% CI = 2.123-17.524).

CONCLUSIONS

Late-onset depressive episodes with DEDS are risk factors for dementia and AD development, regardless of the severity of the depression.

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  • Authors+Show Affiliations

    ,

    Research Unit, Institut d'Assistència Sanitària, Salt, Girona, Spain.

    , , , ,

    Source

    MeSH

    Age of Onset
    Aged
    Aged, 80 and over
    Alzheimer Disease
    Cohort Studies
    Dementia
    Depressive Disorder
    Female
    Humans
    Kaplan-Meier Estimate
    Male
    Prevalence
    Proportional Hazards Models
    Risk Factors
    Severity of Illness Index
    Spain

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22588687

    Citation

    Vilalta-Franch, Joan, et al. "Depression Subtypes and 5-year Risk of Dementia and Alzheimer Disease in Patients Aged 70 Years." International Journal of Geriatric Psychiatry, vol. 28, no. 4, 2013, pp. 341-50.
    Vilalta-Franch J, López-Pousa S, Llinàs-Reglà J, et al. Depression subtypes and 5-year risk of dementia and Alzheimer disease in patients aged 70 years. Int J Geriatr Psychiatry. 2013;28(4):341-50.
    Vilalta-Franch, J., López-Pousa, S., Llinàs-Reglà, J., Calvó-Perxas, L., Merino-Aguado, J., & Garre-Olmo, J. (2013). Depression subtypes and 5-year risk of dementia and Alzheimer disease in patients aged 70 years. International Journal of Geriatric Psychiatry, 28(4), pp. 341-50. doi:10.1002/gps.3826.
    Vilalta-Franch J, et al. Depression Subtypes and 5-year Risk of Dementia and Alzheimer Disease in Patients Aged 70 Years. Int J Geriatr Psychiatry. 2013;28(4):341-50. PubMed PMID: 22588687.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Depression subtypes and 5-year risk of dementia and Alzheimer disease in patients aged 70 years. AU - Vilalta-Franch,Joan, AU - López-Pousa,Secundino, AU - Llinàs-Reglà,Jordi, AU - Calvó-Perxas,Laia, AU - Merino-Aguado,Javier, AU - Garre-Olmo,Josep, Y1 - 2012/05/16/ PY - 2011/12/22/received PY - 2012/04/11/accepted PY - 2012/5/17/entrez PY - 2012/5/17/pubmed PY - 2013/9/12/medline SP - 341 EP - 50 JF - International journal of geriatric psychiatry JO - Int J Geriatr Psychiatry VL - 28 IS - 4 N2 - OBJECTIVE: The objective of this study was to estimate several subtypes of depressive disorders as risk factors for dementia and Alzheimer disease (AD) specifically. METHODS: This is a population-based cohort study using a sample of 451 non-demented older people. Adjusted Cox proportional hazard models were calculated to determine the association of depression with dementia or AD development after 5 years. Baseline evaluation included the Cambridge Mental Disorders of the Elderly Examination (CAMDEX). Depressive disorders (major episode [MD] and minor depressive disorders [MDDIS]) were assessed following DSM-IV criteria and further classified according to the age at onset (early versus late onset). In turn, all late-onset depressions were grouped as with or without depression-executive dysfunction syndrome (DEDS). Dementia (and dementia subtypes) diagnoses were made using the CAMDEX. When the patients were deceased, the Retrospective Collateral Dementia Interview was used. RESULTS: Late-onset depressions (both MD and MDDIS) were associated with increased dementia (hazard ratio [HR] = 2.635; 95% CI = 1.153-6.023; and HR = 2.517; 95% CI = 1.200-5.280, respectively), and AD (HR = 6.262; 95% CI = 2.017-19.446; and HR = 4.208; 95% CI = 1.828-9.685, respectively) after adjustment by age, gender, marital status, education, cognitive impairment, executive function and stroke history. A second model revealed that only late-onset depressions with DEDS increased the risk for both dementia (late-onset MD with DEDS: HR = 6.262; 95% CI = 2.017-19.446; late-onset MDDIS with DEDS: HR = 4.208; 95% CI = 1.828-9.685) and AD (late-onset MD with DEDS: HR = 7.807; 95% CI = 1.567-38.894; late-onset MDDIS with DEDS: HR = 6.099; 95% CI = 2.123-17.524). CONCLUSIONS: Late-onset depressive episodes with DEDS are risk factors for dementia and AD development, regardless of the severity of the depression. SN - 1099-1166 UR - https://www.unboundmedicine.com/medline/citation/22588687/Depression_subtypes_and_5_year_risk_of_dementia_and_Alzheimer_disease_in_patients_aged_70_years_ L2 - https://doi.org/10.1002/gps.3826 DB - PRIME DP - Unbound Medicine ER -