Skip to main content
×
×
Home

Diagnosed depression and sociodemographic factors as predictors of mortality in patients with dementia

  • Gemma Lewis (a1), Nomi Werbeloff (a1), Joseph F. Hayes (a2), Robert Howard (a2) and David P. J. Osborn (a2)...
Abstract
Background

Potentially modifiable risk factors for developing dementia have been identified. However, risk factors for increased mortality in patients with diagnosed dementia are not well understood. Identifying factors that influence prognosis would help clinicians plan care and address unmet needs.

Aims

To investigate diagnosed depression and sociodemographic factors as predictors of mortality in patients with dementia in UK secondary clinical care services.

Method

We conducted a cohort study of patients with a dementia diagnosis in an electronic health records database in a UK National Health Service mental health trust.

Results

In 3374 patients with 10 856 person-years of follow-up, comorbid depression was not associated with mortality (adjusted hazard ratio 0.94; 95% CI 0.71–1.24). Single patients had higher mortality than those who were married (adjusted hazard ratio 1.25; 95% CI 1.03–1.50). Patients of Asian ethnicity had lower mortality rates than White British patients (adjusted hazard ratio 0.50; 95% CI 0.34–0.73).

Conclusions

Clinically diagnosed depression does not increase mortality in patients with dementia. Patients who are single are a potential high-mortality risk group. Lower mortality rates in Asian patients with dementia that have been reported in the USA also apply in the UK.

Declaration of interest

None.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Diagnosed depression and sociodemographic factors as predictors of mortality in patients with dementia
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Diagnosed depression and sociodemographic factors as predictors of mortality in patients with dementia
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Diagnosed depression and sociodemographic factors as predictors of mortality in patients with dementia
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence: Gemma Lewis, Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, UK. Email: gemma.lewis@ucl.ac.uk
References
Hide All
1Ahmadi-Abhari, S, Guzman-Castillo, M, Bandosz, P, Shipley, MJ, Muniz-Terrera, G, Singh-Manoux, A, et al. Temporal trend in dementia incidence since 2002 and projections for prevalence in England and Wales to 2040: modelling study. BMJ 2017; 358: j2856.
2Livingston, G, Sommerlad, A, Orgeta, V, Costafreda, SG, Huntley, J, Ames, D, et al. The Lancet Commissions dementia prevention, intervention, and care. Lancet 2017; 390: 2673–734.
3Sjöberg, L, Karlsson, B, Atti, A-R, Skoog, I, Fratiglioni, L, Wang, H-X. Prevalence of depression: comparisons of different depression definitions in population-based samples of older adults. J Affect Disord 2017; 221: 123–31.
4Cuijpers, P, Smit, F. Excess mortality in depression: a meta-analysis of community studies. J Affect Disord 2002; 72: 227–36.
5Petersen, JD, Waldorff, FB, Siersma, VD, Phung, TKT, Bebe, ACKM, Waldemar, G. Major depressive symptoms increase 3-year mortality rate in patients with mild dementia. Int J Alzheimers Dis 2017; 2017: 18.
6Bellelli, G, Frisoni, GB, Turco, R, Trabucchi, M. Depressive symptoms combined with dementia affect 12-months survival in elderly patients after rehabilitation post-hip fracture surgery. Int J Geriatr Psychiatry 2008; 23: 1073–7.
7Burns, A, Lewis, G, Jacoby, R, Levy, R. Factors affecting survival in Alzheimer's disease. Psychol Med 1991; 21: 363–70.
8Pimouguet, C, Delva, F, Le Goff, M, Stern, Y, Pasquier, F, Berr, C, et al. Survival and early recourse to care for dementia: a population based study. Alzheimer’s Dement 2015; 11: 385–93.
9Gambassi, G, Landi, F, Lapane, KL, Sgadari, A, Mor, V, Bernabei, R. Predictors of mortality in patients with Alzheimer's disease living in nursing homes. J Neurol Neurosurg Psychiatry 1999; 67: 5965.
10Andersen, K, Lolk, A, Martinussen, T, Kragh-Sørensen, P. Very mild to severe dementia and mortality: a 14-year follow-up – the Odense study. Dement Geriatr Cogn Disord 2010; 29: 61–7.
11Roehr, S, Luck, T, Bickel, H, Brettschneider, C, Ernst, A, Fuchs, A, et al. Mortality in incident dementia - results from the German Study on Aging, Cognition, and Dementia in Primary Care Patients. Acta Psychiatr Scand 2015; 132: 257–69.
12Lara, E, Haro, JM, Tang, M-X, Manly, J, Stern, Y, Sant, PS, et al. Exploring the excess mortality due to depressive symptoms in a community-based sample: the role of Alzheimer's disease. 2016; 202: 163–70.
13Mueller, C, Huntley, J, Stubbs, B, Sommerlad, A, Carvalho, AF, Perera, G, et al. Associations of neuropsychiatric symptoms and antidepressant prescription with survival in Alzheimer's disease. J Am Med Dir Assoc 2017;18: 1076–81.
14Mehta, KM, Yaffe, K, Perez-Stable, EJ, Stewart, A, Barnes, D, Kurland, BF, et al. Race/ethnic differences in AD survival in US Alzheimer's Disease Centers. Neurology 2008; 70: 1163–70.
15Reuser, M, Willekens, FJ, Bonneux, L. Higher education delays and shortens cognitive impairment: a multistate life table analysis of the US Health and Retirement Study. Eur J Epidemiol 2011; 26: 395403.
16Mayeda, ER, Glymour, MM, Quesenberry, CP, Johnson, JK, Pérez-Stable, EJ, Whitmer, RA. Survival after dementia diagnosis in five racial/ethnic groups. Alzheimer’s Dement 2017; 13: 761–9.
17Werbeloff, N, Chang, C-K, Broadbent, M, Hayes, JF, Stewart, R, Osborn, DPJ. Admission to acute mental health services after contact with crisis resolution and home treatment teams: an investigation in two large mental health-care providers. Lancet Psychiatry 2017; 4: 4956.
18Solomon, DA, Keller, MB, Leon, AC, Mueller, TI, Shea, MT, Warshaw, M, et al. Recovery from major depression. A 10-year prospective follow-up across multiple episodes. Arch Gen Psychiatry 1997; 54: 1001–6.
19Perera, G, Broadbent, M, Callard, F, Chang, C-K, Downs, J, Dutta, R, et al. Cohort profile of the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Case Register: current status and recent enhancement of an Electronic Mental Health Record-derived data resource. BMJ Open 2016; 6: e008721.
20Department for Communities and Local Government. English Indices of Deprivation 2010. TSO, 2011 (https://www.gov.uk/government/statistics/english-indices-of-deprivation-2010).
21Folstein, MF, Folstein, SE, McHugh, PR. ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.
22Sterne, JAC, White, IR, Carlin, JB, Spratt, M, Royston, P, Kenward, MG, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ 2009; 338: b2393.
23Livingston, G, Sommerlad, A, Orgeta, V, Costafreda, SG, Huntley, J, Ames, D, et al. Dementia prevention, intervention, and care. Lancet 2017; 390: 2673–734.
24Knopman, DS, Roberts, RO, Pankratz, VS, Cha, RH, Rocca, WA, Mielke, MM, et al. Incidence of dementia among participants and nonparticipants in a longitudinal study of cognitive aging. Am J Epidemiol 2014; 180: 414–23.
25Wong, J, Motulsky, A, Eguale, T, Buckeridge, DL, Abrahamowicz, M, Tamblyn, R. Treatment indications for antidepressants prescribed in primary care in Quebec, Canada, 2006–2015. JAMA 2016; 315: 2230.
26Sautter, JM, Thomas, PA, Dupre, ME, George, LK. Socioeconomic status and the Black-White mortality crossover. Am J Public Health 2012; 102: 1566–71.
27Aizer, AA, Chen, M-H, McCarthy, EP, Mendu, ML, Koo, S, Wilhite, TJ, et al. Marital status and survival in patients with cancer. J Clin Oncol 2013; 31: 3869–76.
28Murphy, M, Grundy, E, Kalogirou, S. The increase in marital status differences in mortality up to the oldest age in seven European countries, 1990–99. Popul Stud (NY) 2007; 61: 287–98.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×
Type Description Title
WORD
Supplementary materials

Lewis et al. supplementary material
Table S1

 Word (17 KB)
17 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Diagnosed depression and sociodemographic factors as predictors of mortality in patients with dementia

  • Gemma Lewis (a1), Nomi Werbeloff (a1), Joseph F. Hayes (a2), Robert Howard (a2) and David P. J. Osborn (a2)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *