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Age of major depression onset, depressive symptoms, and risk for subsequent dementia: results of the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe)

Published online by Cambridge University Press:  09 November 2012

K. Heser ,
F. Tebarth ,
B. Wiese ,
M. Eisele ,
H. Bickel ,
M. Köhler ,
E. Mösch ,
S. Weyerer ,
J. Werle  and
H.-H. König
...Show all authors
K. Heser*
Affiliation:
Department of Psychiatry, University of Bonn, Germany
F. Tebarth
Affiliation:
Department of Psychiatry, University of Bonn, Germany
B. Wiese
Affiliation:
Institute for Biometrics, Hannover Medical School, Germany
M. Eisele
Affiliation:
Department of Primary Medical Care, University Medical Centre, Hamburg-Eppendorf, Germany
H. Bickel
Affiliation:
Department of Psychiatry, Technical University, Munich, Germany
M. Köhler
Affiliation:
Department of Primary Medical Care, University Medical Centre, Hamburg-Eppendorf, Germany
E. Mösch
Affiliation:
Department of Psychiatry, Technical University, Munich, Germany
S. Weyerer
Affiliation:
Central Institute for Mental Health, Mannheim, Germany
J. Werle
Affiliation:
Central Institute for Mental Health, Mannheim, Germany
H.-H. König
Affiliation:
Department of Medical Sociology and Health Economics, University Medical Centre, Hamburg-Eppendorf, Germany
H. Leicht
Affiliation:
Department of Medical Sociology and Health Economics, University Medical Centre, Hamburg-Eppendorf, Germany
M. Pentzek
Affiliation:
Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Germany
A. Fuchs
Affiliation:
Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Germany
S. G. Riedel-Heller
Affiliation:
Department of Psychiatry, University of Leipzig, Germany
M. Luppa
Affiliation:
Department of Psychiatry, University of Leipzig, Germany
J. Prokein
Affiliation:
Institute for Biometrics, Hannover Medical School, Germany
M. Scherer
Affiliation:
Department of Primary Medical Care, University Medical Centre, Hamburg-Eppendorf, Germany
W. Maier
Affiliation:
Department of Psychiatry, University of Bonn, Germany DZNE, Center for Neurodegenerative Diseases, Bonn, Germany
M. Wagner
Affiliation:
Department of Psychiatry, University of Bonn, Germany DZNE, Center for Neurodegenerative Diseases, Bonn, Germany
*
*Address for correspondence: Ms. K. Heser, Department of Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany. (Email: [email protected])
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Abstract

Background

Whether late-onset depression is a risk factor for or a prodrome of dementia remains unclear. We investigated the impact of depressive symptoms and early- v. late-onset depression on subsequent dementia in a cohort of elderly general-practitioner patients (n = 2663, mean age = 81.2 years).

Method

Risk for subsequent dementia was estimated over three follow-ups (each 18 months apart) depending on history of depression, particularly age of depression onset, and current depressive symptoms using proportional hazard models. We also examined the additive prediction of incident dementia by depression beyond cognitive impairment.

Results

An increase of dementia risk for higher age cut-offs of late-onset depression was found. In analyses controlling for age, sex, education, and apolipoprotein E4 genotype, we found that very late-onset depression (aged ⩾70 years) and current depressive symptoms separately predicted all-cause dementia. Combined very late-onset depression with current depressive symptoms was specifically predictive for later Alzheimer's disease (AD; adjusted hazard ratio 5.48, 95% confidence interval 2.41–12.46, p < 0.001). This association was still significant after controlling for cognitive measures, but further analyses suggested that it was mediated by subjective memory impairment with worries.

Conclusions

Depression might be a prodrome of AD but not of dementia of other aetiology as very late-onset depression in combination with current depressive symptoms, possibly emerging as a consequence of subjectively perceived worrisome cognitive deterioration, was most predictive. As depression parameters and subjective memory impairment predicted AD independently of objective cognition, clinicians should take this into account.

Keywords

Alzheimer's diseasedepressive symptomsmajor depressionrisk for dementia
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 8 , August 2013 , pp. 1597 - 1610
Copyright
Copyright © Cambridge University Press 2012 

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References

Amieva, H, Le Goff, M, Millet, X, Orgogozo, JM, Pérès, K, Barberger-Gateau, P, Jacqmin-Gadda, H, Dartigues, JF (2008). Prodromal Alzheimer's disease: successive emergence of the clinical symptoms. Annals of Neurology 64, 492–498.CrossRefGoogle ScholarPubMed
Andrade, L, Caraveo-Anduaga, JJ, Berglund, P, Bijl, RV, de Graaf, R, Vollebergh, W, Dragomirecá, E, Kohn, R, Keller, M, Kessler, RC, Kawakami, N, Kilic, C, Offord, D, Üstün, TB, Wittchen, HU (2003). The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) surveys. International Journal of Methods in Psychiatric Research 12, 3–21.CrossRefGoogle Scholar
APA (1994). DSM-IV: Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychological Association: Washington, DC.Google Scholar
Arthur, A, Jagger, C, Lindesay, J, Graham, C, Clarke, M (1999). Using an annual over-75 health check to screen for depression: validation of the short Geriatric Depression Scale (GDS15) within general practice. International Journal of Geriatric Psychiatry 14, 431–438.3.0.CO;2-I>CrossRefGoogle ScholarPubMed
Barnes, DE, Yaffe, K, McCormick, M, Schaefer, C, Quesenberry, Jr. CP, Byers, AL, Whitmer, RA (2010). Mid-life depression and risk of dementia: differential effects for vascular dementia and Alzheimer's disease [Abstract]. Alzheimer's and Dementia 6 (Suppl. 1), S109.CrossRefGoogle Scholar
Blazer, DG (2003). Depression in late life: review and commentary. Journal of Gerontology 58A, 249–265.Google Scholar
Brommelhoff, JA, Gatz, M, Johansson, B, McArdle, JJ, Fratiglioni, L, Pedersen, NL (2009). Depression as a risk factor or prodromal feature for dementia? Findings in a population-based sample of Swedish twins. Psychology and Aging 24, 373–384.CrossRefGoogle ScholarPubMed
Byers, AL, Yaffe, K (2011). Depression and risk of developing dementia. Nature Reviews Neurology 7, 323–331.CrossRefGoogle ScholarPubMed
Dotson, VM, Beydoun, MA, Zonderman, AB (2010). Recurrent depressive symptoms and the incidence of dementia and mild cognitive impairment. Neurology 75, 27–34.CrossRefGoogle ScholarPubMed
Folstein, MF, Folstein, SE, McHugh, PR (1975). ‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189–198.CrossRefGoogle Scholar
Gatz, JL, Tyas, SL, St. John, P, Montgomery, P (2005). Do depressive symptoms predict Alzheimer's disease and dementia? Journal of Gerontology 60, 744–747.Google ScholarPubMed
Geerlings, MI, den Heijer, T, Koudstaal, PJ, Hofman, A, Breteler, MMB (2008). History of depression, depressive symptoms, and medial temporal lobe atrophy and the risk of Alzheimer disease. Neurology 70, 1258–1264.CrossRefGoogle ScholarPubMed
Geerlings, MI, Jonker, C, Bouter, LM, Adèr, HJ, Schmand, (1999). Association between memory complaints and incident Alzheimer 's disease in elderly people with normal baseline cognition. American Journal of Psychiatry 156, 531–537.CrossRefGoogle ScholarPubMed
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
Jorm, AF, Butterworth, P, Anstey, KJ, Christensen, H, Easteal, S, Maller, J, Mather, KA, Turakulov, RI, Wen, W, Sachdev, P (2004). Memory complaints in a community sample aged 60–64 years: associations with cognitive functioning, psychiatric symptoms, medical conditions, APOE genotype, hippocampus and amygdala volumes, and white-matter hyperintensities. Psychological Medicine 34, 1495–1506.CrossRefGoogle Scholar
Kessler, RC, Berglund, P, Demler, O, Jin, R, Koretz, D, Merikangas, KR, Rush, AJ, Walters, EE, Wang, PS (2003). The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association 289, 3095–3105.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593–602.CrossRefGoogle ScholarPubMed
Köhler, S, Van Boxtel, M, Jolles, J, Verhey, F (2011). Depressive symptoms and risk for dementia: a 9-year follow-up of the Maastricht Aging Study. American Journal of Geriatric Psychiatry 19, 902–905.CrossRefGoogle ScholarPubMed
König, W, Lüttinger, P, Müller, W (1988). A comparative analysis of the development and structure of educational systems: methodological foundations and the construction of a comparative education scale. CASMIN Working Paper 12. University Mannheim: Mannheim, Germany.Google Scholar
Korczyn, AD, Halperin, I (2009). Depression and dementia. Journal of the Neurological Sciences 283, 139–142.CrossRefGoogle ScholarPubMed
Lenoir, H, Dufouil, C, Auriacombe, S, Lacombe, JM, Dartigues, JF, Ritchie, K, Tzourio, C (2011). Depression history, depressive symptoms, and incident dementia: the 3C study. Journal of Alzheimer's Disease 23, 1–12.Google Scholar
Li, G, Wang, LY, Shofer, JB, Thompson, ML, Peskind, ER, McCormick, W, Bowen, JD, Crane, PK, Larson, EB (2011). Temporal relationship between depression and dementia: findings from a large community-based 15-year follow-up study. Archives of General Psychiatry 68, 970–977.CrossRefGoogle ScholarPubMed
Montorio, I, Izal, M (1996). The Geriatric Depression Scale: a review of its development and utility. International Psychogeriatrics 8, 103–112.CrossRefGoogle Scholar
O'Connor, DW, Pollitt, PA, Roth, M, Brook, PB, Reiss, BB (1990). Memory complaints and impairment in normal, depressed, and demented elderly persons identified in a community survey. Archives of General Psychiatry 47, 224–227.CrossRefGoogle Scholar
Ownby, RL, Crocco, E, Acevedo, A, John, V, Loewenstein, D (2006). Depression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression-analysis. Archives of General Psychiatry 63, 530–538.CrossRefGoogle ScholarPubMed
Panza, F, Frisardi, V, Capurso, C, D`Introno, A, Colacicco, AM, Imbimbo, BP, Santamato, A, Vendemiale, G, Seripa, D, Pilotto, A, Capurso, A, Solfrizzi, V (2010). Late-life depression, mild cognitive impairment, and dementia: possible continuum? American Journal of Geriatric Psychiatry 18, 98–116.CrossRefGoogle ScholarPubMed
Reisberg, B, Prichep, L, Mosconi, L, John, ER, Glodzik-Sobanska, L, Boksay, I, Monteiro, I, Torossian, C, Vedvyas, A, Ashraf, N, Jamil, IA, de Leon, MJ (2008). The pre-mild cognitive impairment, subjective cognitive impairment stage of Alzheimer's disease. Alzheimer's and Dementia 4 (Suppl. 1), S98–S108.CrossRefGoogle ScholarPubMed
Riedel-Heller, SG, Matschinger, H, Schork, A, Angermeyer, MC (1999). Do memory complaints indicate the presence of cognitve impairment? Results of a field study. European Archives of Psychiatry and Clinical Neuroscience 249, 197–204.CrossRefGoogle Scholar
Roman, RC, Tatechimi, TK, Erkinjuntii, T, Cummings, JL, Masdeu, JC, Garcia, JH, Amaducci, L, Orgogozo, JM, Brun, A, Hofman, A, et al. (1993). Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 43, 250–260.CrossRefGoogle ScholarPubMed
Saczynski, JS, Beiser, A, Seshadri, S, Auerbach, S, Wolf, PA, Au, R (2010). Depressive symptoms and risk of dementia: the Framingham Heart Study. Neurology 75, 35–41.CrossRefGoogle ScholarPubMed
Sheikh, JI, Yesavage, JA (1986). Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. In: Clinical Gerontology: A Guide to Assessment and Intervention (ed. Brink, T. L.), pp. 165–173. Haworth: New York.Google Scholar
Steffens, DC, Plassman, BL, Helms, MJ, Welsh-Bohmer, KA, Saunders, AM, Breitner, JCS (1997). A twin study of late-onset depression and apolipoprotein E e4 as risk factors for Alzheimer's disease. Biological Psychiatry 41, 851–856.CrossRefGoogle ScholarPubMed
Van Reekum, R, Simard, M, Clarke, D, Binns, MA, Conn, D (1999). Late-life depression as a possible predictor of dementia. American Journal of Geriatric Psychiatry 7, 151–159.Google ScholarPubMed
Wancata, J, Alexandrowicz, R, Marquart, B, Weiss, M, Friedrich, F (2006). The criterion validity of the Geriatric Depression Scale: a systematic review. Acta Psychiatrica Scandinavica 114, 398–410.CrossRefGoogle ScholarPubMed
Wilson, RS, Barnes, LL, Mendes de Leon, CF, Aggarwal, NT, Schneider, JS, Bach, J, Pilat, J, Beckett, LA, Arnold, SE, Evans, DA, Bennett, DA (2002). Depressive symptoms, cognitive decline, and risk of AD in older persons. Neurology 59, 364–370.CrossRefGoogle ScholarPubMed
Wittchen, HU, Pfister, H (1997). DIA-X-Interviews [German version]. Swets & Zeitlinger: Frankfurt/Main.Google Scholar
Yesavage, JA, Brink, TL, Rose, TL, Lum, O, Huang, V, Adey, MB, Leirer, VO (1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research 17, 37–49.CrossRefGoogle Scholar
Zalsman, G, Aizenberg, D, Sigler, M, Nashony, E, Karp, L, Weizman, A (2000). Increased risk for dementia in elderly psychiatric inpatients with late-onset major depression. Journal of Nervous and Mental Disease 188, 242–243.CrossRefGoogle ScholarPubMed
Zaudig, M, Hiller, W (1996). SIDAM Handbook. Structured Interview for Diagnosis of Dementia of Alzheimer type, Multi-infarct Dementia and Dementia of other Aetiology according to DSM-III-R, DSM-IV, and ICD-10 [German version]. Huber: Bern.Google Scholar