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Depression and risk of cognitive decline and Alzheimer's disease: Results of two prospective community-based studies in the Netherlands

  • M. I. Geerlings (a1), L. M. Bouter (a1), R. A. Schoevers (a2), A. T. F. Beekman (a2), C. Jonker (a2), D. J. H. Deeg (a2), W. Van Tilburg (a2), H. J. Adèr (a3) and B. Schmand (a4)...
Abstract
Background

Depression may be associated with cognitive decline in elderly people with impaired cognition.

Aims

To investigate whether depressed elderly people with normal cognition are at increased risk of cognitive decline and Alzheimer's disease.

Methods

Two independent samples of older people with normal cognition were selected from the community-based Amsterdam Study of the Elderly (AMSTEL) and the Longitudinal Aging Study Amsterdam (LASA). In AMSTEL, depression was assessed by means of the Geriatric Mental State Schedule. Clinical diagnoses of incident Alzheimer's disease were made using a two-step procedure. In LASA, depression was assessed with the Center for Epidemiologic Studies Depression Scale. Cognitive decline was defined as a drop of ⩾ 3 on the Mini-Mental State Examination at follow-up.

Results

Both in the AMSTEL and the LASA sample, depression was associated with an increased risk of Alzheimer's disease and cognitive decline, respectively, but only in subjects with higher levels of education.

Conclusions

In a subgroup of more highly educated elderly people, depression may be an early manifestation of Alzheimer's disease before cognitive symptoms become apparent.

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Copyright
Corresponding author
M. I. Geerlings, Department of Epidemiology & Biostatistics, Erasmus Medical Center Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands. Tel: +31 10 408 7478; Fax: +31 10 408 9382; e-mail: geerlings@epib.fgg.eur.nl
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Declaration of interest

Grants detailed in Acknowledgements. No conflict of interest.

Footnotes
References
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Depression and risk of cognitive decline and Alzheimer's disease: Results of two prospective community-based studies in the Netherlands

  • M. I. Geerlings (a1), L. M. Bouter (a1), R. A. Schoevers (a2), A. T. F. Beekman (a2), C. Jonker (a2), D. J. H. Deeg (a2), W. Van Tilburg (a2), H. J. Adèr (a3) and B. Schmand (a4)...
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