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Is the relationship between syndromes of depression and dementia temporal? The MRC-ALPHA and Hefei-China studies

Published online by Cambridge University Press:  23 June 2008

R. Chen ,
Z. Hu ,
L. Wei ,
X. Qin  and
J. R. Copeland
R. Chen*
Affiliation:
School of Health Administration, Anhui Medical University, Hefei, Anhui, China Department of Epidemiology and Public Health, Royal Free and University College Medical School, London, UK
Z. Hu
Affiliation:
School of Health Administration, Anhui Medical University, Hefei, Anhui, China
L. Wei
Affiliation:
Medicines Monitoring Unit, Ninewells Hospital and Medical School, University of Dundee, UK
X. Qin
Affiliation:
School of Health Administration, Anhui Medical University, Hefei, Anhui, China
J. R. Copeland
Affiliation:
Department of Psychiatry, University of Liverpool, UK
*
*Address for correspondence: Dr R. Chen, M.D., Ph.D., Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK. (Email: [email protected])
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Abstract

Background

Recent studies have shown a temporal association between depressive symptoms and cognitive decline. However, the relationship between syndromes of depression and dementia is unknown.

Method

A total of 1736 people aged ⩾65 years in China and 5222 older people in the UK were interviewed using the Geriatric Mental State Examination (GMS) and reinterviewed at follow-up. Five levels of syndromes of depression and dementia were diagnosed using the Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT).

Results

Although there were fewer depressive syndromes in Chinese than British participants, both populations showed a similarly high level of syndromes of dementia (organic disorder) (20% for women, 14% for men). There was a significant cross-sectional correlation between syndrome levels of depression and dementia (correlation coefficients: 0.141–0.248 for Chinese, 0.168–0.248 for British). This was maintained for different age, gender and people with and without cardiovascular disease (CVD). The relationship between syndromes of baseline depression and follow-up dementia was less substantial: the correlation coefficient was 0.075 [95% confidence interval (CI) 0.021–0.128] for the Chinese sample at the 1-year follow-up, and 0.093 (95% CI 0.061–0.125) for the British at the 2-year follow-up and 0.093 (95% CI 0.049–0.130) at the 4-year follow-up. This relationship disappeared in participants without baseline organic syndromes. In a multiple adjusted logistic regression analysis, an increased risk of organic syndromes seemed to be associated with baseline, mainly in the highest level of, depressive syndromes.

Conclusions

The relationship between syndromes of depression and dementia might be temporal. The lack of an obvious dose–response relationship between baseline depressive syndromes and follow-up dementia syndromes suggests that the causal relationship between depression and dementia needs further investigation.

Keywords

Dementiadepressionelderlyrelationshipsyndromes
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 3 , March 2009 , pp. 425 - 430
Copyright
Copyright © 2008 Cambridge University Press

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References

Alexopoulos, GS, Meyers, BS, Young, RC, Mattis, S, Kakuma, T (1993). The course of geriatric depression with ‘reversible dementia’: a controlled study. American Journal of Psychiatry 150, 1693–1699.Google ScholarPubMed
Almeida, OP, Flicker, L, Norman, P, Hankey, GJ, Vasikaran, S, van Bockxmeer, FM, Jamrozik, K (2007). Association of cardiovascular risk factors and disease with depression in later life. American Journal of Geriatric Psychiatry 15, 506–513.CrossRefGoogle ScholarPubMed
Andersen, K, Lolk, A, Kragh-Sorensen, P, Petersen, NE, Green, A (2005). Depression and the risk of Alzheimer disease. Epidemiology 16, 233–238.CrossRefGoogle ScholarPubMed
Cervilla, JA, Prince, M, Joels, S, Mann, A (2000). Does depression predict cognitive outcome 9 to 12 years later? Evidence from a prospective study of elderly hypertensives. Psychological Medicine 30, 1017–1023.CrossRefGoogle ScholarPubMed
Chen, R, Hu, Z, Qin, X, Xu, X, Copeland, JR (2004). A community-based study of depression in older people in Hefei, China – the GMS-AGECAT prevalence, case validation and socio-economic correlates. International Journal of Geriatric Psychiatry 19, 407–413.CrossRefGoogle ScholarPubMed
Chen, R, Hu, Z, Wei, L, Qin, X, McCracken, C, Copeland, JR (in press). Associations of the severity of depressive syndromes and cases with dementia in later life – two cohort studies in China and UK. British Journal of Psychiatry.Google Scholar
Chen, R, Tunstall-Pedoe, H (2005). Socioeconomic deprivation and waist circumference in men and women: the Scottish MONICA surveys 1989–1995. European Journal of Epidemiology 20, 141–147.CrossRefGoogle ScholarPubMed
Chen, R, Wei, L, Hu, Z, Qin, X, Copeland, JR, Hemingway, H (2005). Depression in older people in rural China. Archives of Internal Medicine 165, 2019–2025.CrossRefGoogle ScholarPubMed
Chen, Z, Peto, R, Collins, R, MacMahon, S, Lu, J, Li, W (1991). Serum cholesterol concentration and coronary heart disease in population with low cholesterol concentrations. British Medical Journal 303, 276–282.CrossRefGoogle ScholarPubMed
Copeland, JR, Beekman, AT, Dewey, ME, Hooijer, C, Jordan, A, Lawlor, BA, Lobo, A, Magnusson, H, Mann, AH, Meller, I, Prince, MJ, Reischies, F, Turrina, C, deVries, MW, Wilson, KC (1999). Depression in Europe. Geographical distribution among older people. British Journal of Psychiatry 174, 312–321.CrossRefGoogle ScholarPubMed
Copeland, JR, Dewey, ME, Griffiths-Jones, HM (1986). A computerized psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychological Medicine 16, 89–99.CrossRefGoogle ScholarPubMed
Copeland, JR, Prince, M, Wilson, KC, Dewey, ME, Payne, J, Gurland, B (2002). The Geriatric Mental State Examination in the 21st century. International Journal of Geriatric Psychiatry 17, 729–732.CrossRefGoogle Scholar
Emery, VO, Oxman, TE (1992). Update on the dementia spectrum of depression. American Journal of Psychiatry 149, 305–317.Google ScholarPubMed
Ganguli, M, Du, Y, Dodge, HH, Ratcliff, GG, Chang, CC (2006). Depressive symptoms and cognitive decline in late life: a prospective epidemiological study. Archives of General Psychiatry 63, 153–160.CrossRefGoogle ScholarPubMed
Geerlings, MI, Schoevers, RA, Beekman, AT, Jonker, C, Deeg, DJ, Schmand, B, Ader, HJ, Bouter, LM, Van, TW (2000). Depression and risk of cognitive decline and Alzheimer's disease. Results of two prospective community-based studies in The Netherlands. British Journal of Psychiatry 176, 568–575.CrossRefGoogle ScholarPubMed
Hu, FB, Wang, B, Chen, C, Jin, Y, Yang, J, Stampfer, MJ, Xu, X (2000). Body mass index and cardiovascular risk factors in a rural Chinese population. American Journal of Epidemiology 151, 88–97.CrossRefGoogle Scholar
Jorm, AF (2000). Is depression a risk factor for dementia or cognitive decline? A review. Gerontology 46, 219–227.CrossRefGoogle ScholarPubMed
Jorm, AF (2001). History of depression as a risk factor for dementia: an updated review. Australian and New Zealand Journal of Psychiatry 35, 776–781.CrossRefGoogle ScholarPubMed
Liu, J, Li, S, Zhang, WX, Chen, CH (2001). Assessment of computerized diagnostic system of Geriatric Mental State schedule shortened community version (GMS-AGECAT). China Psychology Health Journal 15, 220–222.Google Scholar
Rovner, BW, Broadhead, J, Spencer, M, Carson, K, Folstein, MF (1989). Depression and Alzheimer's disease. American Journal of Psychiatry 146, 350–353.Google ScholarPubMed
Saunders, PA, Copeland, JR, Dewey, ME, Gilmore, C, Larkin, BA, Phaterpekar, H, Scott, A (1993). The prevalence of dementia, depression and neurosis in later life: the Liverpool MRC-ALPHA study. International Journal of Epidemiology 22, 838–847.CrossRefGoogle ScholarPubMed
Vinkers, DJ, Gussekloo, J, Stek, ML, Westendorp, RG, van der Mast, RC (2004). Temporal relation between depression and cognitive impairment in old age: prospective population-based study. British Medical Journal 329, 881–888.CrossRefGoogle ScholarPubMed
Wilson, KC, Chen, R, Taylor, S, McCracken, CF, Copeland, JR (1999). Socio-economic deprivation and the prevalence and prediction of depression in older community residents. The MRC-ALPHA study. British Journal of Psychiatry 175, 549–553.CrossRefGoogle ScholarPubMed
Wilson, RS, Krueger, KR, Arnold, SE, Schneider, JA, Kelly, JF, Barnes, LL, Tang, Y, Bennett, DA (2007). Loneliness and risk of Alzheimer disease. Archives of General Psychiatry 64, 234–240.CrossRefGoogle ScholarPubMed