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Late-life depression and risk of vascular dementia and Alzheimer's disease: systematic review and meta-analysis of community-based cohort studies

  • Breno S. Diniz (a1), Meryl A. Butters (a2), Steven M. Albert (a3), Mary Amanda Dew (a2) and Charles F. Reynolds (a2)...
Abstract
Background

Late-life depression may increase the risk of incident dementia, in particular of Alzheimer's disease and vascular dementia.

 Aims

To conduct a systematic review and meta-analysis to evaluate the risk of incident all-cause dementia, Alzheimer's disease and vascular dementia in individuals with late-life depression in population-based prospective studies.

 Method

A total of 23 studies were included in the meta-analysis. We used the generic inverse variance method with a random-effects model to calculate the pooled risk of dementia, Alzheimer's disease and vascular dementia in older adults with late-life depression.

 Results

Late-life depression was associated with a significant risk of all-cause dementia (1.85, 95% CI 1.67-2.04, P< 0.001), Alzheimer's disease (1.65, 95% CI 1.42-1.92, P<0.001) and vascular dementia (2.52, 95% CI 1.77-3.59, P<0.001). Subgroup analysis, based on five studies, showed that the risk of vascular dementia was significantly higher than for Alzheimer's disease (P=0.03).

 Conclusions

Late-life depression is associated with an increased risk for all-cause dementia, vascular dementia and Alzheimer's disease. The present results suggest that it will be valuable to design clinical trials to investigate the effect of late-life depression prevention on risk of dementia, in particular vascular dementia and Alzheimer's disease.
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Copyright
COPYRIGHT: © Royal College of Psychiatrists, 2013 
Corresponding author
Meryl A. Butters, PhD, Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. Email: ButtersMA@upmc.edu
Footnotes
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Declaration of interest

In the past 3 years B.S.D. has received payment for lectures from Novartis and had travel/meeting expenses covered by Pfizer. M.A.B. received remuneration for neuropsychological assessment services on a fee-for-service basis, for clinical trials conducted by Northstar Neuroscience and Medtronic and from Fox Learning Systems for developing computerised neuropsychological tasks for an NIH-funded study. The following pharmaceutical companies provide pharmaceutical supplies for C.F.R.'s NIH-sponsored work: Bristol-Myers Squibb, Forrest Laboratories, Lilly and Pfizer.

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References
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  • Cited by 254
  • Cited by
    Crossref Citations
    Crossref logo
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Lin, Kuan-Ho Chiu, Chih-Hao Kuo, Wei-Wen Ju, Da-Tong Shen, Chia-Yao Chen, Ray-Jade Lin, Chien-Chung Viswanadha, Vijaya Padma Liu, Jian-Sheng Huang, Rwei-Fen S. and Huang, Chih-Yang 2018. The preventive effects of edible folic acid on cardiomyocyte apoptosis and survival in early onset triple-transgenic Alzheimer's disease model mice. Environmental Toxicology, Vol. 33, Issue. 1, p. 83.

    Stahl, Sarah T. and Albert, Steven M. 2018. Walking Tests: Are They Sensitive Enough to Detect Cognitive Decline in Older Adults?. The American Journal of Geriatric Psychiatry, Vol. 26, Issue. 4, p. 449.

    Vicario, A. Cerezo, G.H. del Sueldo, M. Zilberman, J. Pawluk, S.M. Lódolo, N. De Cerchio, A.E. Ruffa, R.M. Plunkett, R. Giuliano, M.E. Forcada, P. Hauad, S. and Flores, R. 2018. Neurocognitive disorder in hypertensive patients. Heart–Brain Study. Hipertensión y Riesgo Vascular,

    Ishijima, Satoko Baba, Hajime Maeshima, Hitoshi Shimano, Takahisa Inoue, Megumi Suzuki, Toshihito and Arai, Heii 2018. Glucocorticoid may influence amyloid β metabolism in patients with depression. Psychiatry Research, Vol. 259, p. 191.

    Tampi, Rajesh R. Tampi, Deena J. Walters, M. Ingre Manikkara, Geetha Alag, Poorvanshi and Garg, Garima 2018. Psychiatric Disorders Late in Life. p. 167.

    Poole, Lydia and Jackowska, Marta 2018. The Epidemiology of Depressive Symptoms and Poor Sleep: Findings from the English Longitudinal Study of Ageing (ELSA). International Journal of Behavioral Medicine, Vol. 25, Issue. 2, p. 151.

    Heward, Jessica Stone, Lydia Paddick, Stella-Maria Mkenda, Sarah Gray, William K. Dotchin, Catherine L. Kissima, John Collingwood, Cecilia Swai, Bernadetha and Walker, Richard W. 2018. A longitudinal study of cognitive decline in rural Tanzania: rates and potentially modifiable risk factors. International Psychogeriatrics, p. 1.

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    Edwards, Beatrice J. Zhang, Xiaotao Sun, Ming Holmes, Holly M. Ketonen, Leena Guha, Nandita Khalil, Peter Song, Juhee Kesler, Shelli Shah, Jay B. Tripathy, Debasish Valero, Vicente and Champlin, Richard E. 2018. Neurocognitive deficits in older patients with cancer. Journal of Geriatric Oncology,

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    Foong, Hui Foh Hamid, Tengku Aizan Ibrahim, Rahimah Haron, Sharifah Azizah and Shahar, Suzana 2018. Predicting cognitive function of the Malaysian elderly: a structural equation modelling approach. Aging & Mental Health, Vol. 22, Issue. 1, p. 109.

    Sun, Meng Lanctot, Krista Herrmann, Nathan and Gallagher, Damien 2018. Exercise for Cognitive Symptoms in Depression: A Systematic Review of Interventional Studies. The Canadian Journal of Psychiatry, Vol. 63, Issue. 2, p. 115.

    Sherzai, Ayesha Ovbiagele, Bruce and Sherzai, Dean 2018. Time Trends and Characteristics of Prevalent Dementia among Patients Hospitalized for Stroke in the United States. Journal of Stroke and Cerebrovascular Diseases,

    Foong, Hui Foh Hamid, Tengku Aizan Ibrahim, Rahimah and Haron, Sharifah Azizah 2018. Moderating effect of intrinsic religiosity on the relationship between depression and cognitive function among community-dwelling older adults. Aging & Mental Health, Vol. 22, Issue. 4, p. 483.

    Chen, Rong-Hua Liu, Nan Zhou, Yi-Chan and Xiao, Ying-Chun 2018. Investigation and Analysis of Sleep Status in Patients with Vascular Depression. International Journal of Gerontology,

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    Gunathilake, Roshan and Nair, Balakrishnan Kichu R. 2018. Geriatric Medicine. p. 137.
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Late-life depression and risk of vascular dementia and Alzheimer's disease: systematic review and meta-analysis of community-based cohort studies

  • Breno S. Diniz (a1), Meryl A. Butters (a2), Steven M. Albert (a3), Mary Amanda Dew (a2) and Charles F. Reynolds (a2)...
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Late-life depression and risk of vascular dementia and Alzheimer's disease

Manjeet S. Bhatia
01 July 2013

This is an excellent meta analysis of 23 studies by Breno S.Diniz andhis team indicating depression as a risk factor for vascular dementia and Alzheimer's disease.The risk may be contributed directly or indirectly. Direct linkage could be that Late- life depression is a precursor for dementia (more commonly for vascular dementia)The severity of depression needs to be analysed as increase in severity of depression carries a higher risk for dementia (Chen et al, 2007). The linkage may indirect i.e.depression predisposing or leading to cardiovascular diseases (e.g.hypertension, coronary artery disease), medical disorders (e.g. diabetes mellitus, dyslipidemia)and other comorbid psychiatric disorder (alcohol dependence)(Saunderset al 1991), which may increase the risk for dementia. The contribution of drugs used in treating depression or medicaldisorders also need to be understood.It is equally true that mood disorder(usually depression) is the commonest presentation in dementia especially Alzheimer's disease. Therefore,it becomes equally important to conduct follow up studies to analyse how many patients with late-life depression at time of presentation have co morbid dementia or they develop it in the course of illness (Ownby et al, 2006).There is need to develop biological markers to differentiate pseudo-dementia (due to depression) from true dementia. These markers can also help in detecting at risk patients for dementia, especially Alzheimer's disease.This meta analysis has opened the door for studies to determine depression as a riskfactor for dementia. References:1. Chen Z, Wei L,Qin X,McCracken C, Copeland JR. Severity of depression and risk for subsequent dementia: cohort studies in China and the UK.Br J Psychiatry 2008;193:373-377.2.Saunders PA, Copeland JR, Dewey ME, Davidson IA, McWilliam C, Sharma V, Sullivan CI. Heavy drinking as a risk factor for depression and dementia in elderly men. Findings from the Liverpool longitudinal community study. Br J Psychiatry 1991; 159: 213-6.3. Ownby RL, Crocco E, Acevedo A, John V, Loewenstein D. Depression and risk for Alzheimer disease: systematic review, meta-analysis, and meta regression analysis. Arch Gen Psychiatry 2006 ; 63: 530 -8.

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