Skip to main content
×
×
Home

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.

  • 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.

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

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

      Late-life depression and risk of vascular dementia and Alzheimer's disease: systematic review and meta-analysis of community-based cohort studies
      Available formats
      ×
Copyright
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
Hide All

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.

Footnotes
References
Hide All
1 Byers, AL, Yaffe, K, Covinsky, KE, Friedman, MB, Bruce, ML. High occurrence of mood and anxiety disorders among older adults: the National Comorbidity Survey Replication. Arch Gen Psychiatry 2010; 67: 489–96.
2 Butters, MA, Becker, JT, Nebes, RD, Zmuda, MD, Mulsant, BH, Pollock, BG, et al Changes in cognitive functioning following treatment of late-life depression. Am J Psychiatry 2000; 157: 1949–54.
3 Butters, MA, Young, JB, Lopez, O, Aizenstein, HJ, Mulsant, BH, Reynolds, CF 3rd, et al Pathways linking late-life depression to persistent cognitive impairment and dementia. Dialogues Clin Neurosci 2008; 10: 345–57.
4 Ownby, RL, Crocco, E, Acevedo, A, John, V, Loewenstein, D. Depression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression analysis. Arch Gen Psychiatry 2006; 63: 530–8.
5 Lenoir, H, Dufouil, C, Auriacombe, S, Lacombe, JM, Dartigues, JF, Ritchie, K, et al Depression history, depressive symptoms, and incident dementia: the 3C Study. J Alzheimers Dis 2011; 26: 2738.
6 Barnes, DE, Yaffe, K. The projected effect of risk factor reduction on Alzheimer's disease prevalence. Lancet Neurol 2011; 10: 819–28.
7 Wells, GA, Shea, B, O'Connell, D, Peterson, J, Welch, V, Losos, M, et al The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. Ottawa Hospital Research Institute, 2011 (http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp).
8 Dal Forno, G, Palermo, MT, Donohue, JE, Karagiozis, H, Zonderman, A, Kawas, CH. Depressive symptoms, sex, and risk for Alzheimer's disease. Ann Neurol 2005; 57: 381–7.
9 Chen, R, Hu, 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: 373–7.
10 Bassuk, SS, Berkman, LF, Wypij, D. Depressive symptomatology and incident cognitive decline in an elderly community sample. Arch Gen Psychiatry 1998; 55: 1073–81.
11 Becker, JT, Chang, YF, Lopez, OL, Yaffe, K, Young, J, Kuller, L, et al Depressed mood is not a risk factor for incident dementia in a community-based cohort. Am J Geriatr Psychiatry 2009; 17: 653–63.
12 Chen, P, Ganguli, M, Mulsant, BH, DeKosky, ST. The temporal relationship between depressive symptoms and dementia: a community-based prospective study. Arch Gen Psychiatry 1999; 56: 261–6.
13 Devanand, DP, Sano, M, Tang, MX, Tang, MX, Taylor, S, Gurland, BJ, et al Depressed mood and the incidence of Alzheimer's disease in the elderly living in the community. Arch Gen Psychiatry 1996; 53: 175–82.
14 Fuhrer, R, Dufouil, C, Dartigues, JF. Exploring sex differences in the relationship between depressive symptoms and dementia incidence: prospective results from the PAQUID Study. J Am Geriatr Soc 2003; 51: 1055–63.
15 Gatz, JL, Tyas, SL, St John, P, Montgomery, P. Do depressive symptoms predict Alzheimer's disease and dementia? J Gerontol A Biol Sci Med Sci 2005; 60: 744–7.
16 Geerlings, MI, Schoevers, RA, Beekman, ATF, Jonker, C, Deeg, DJH, Schmand, B, et al Depression and risk of cognitive decline and Alzheimer's disease. Results of two prospective community-based studies in The Netherlands. Br J Psychiatry 2000; 176: 568–75.
17 Geerlings, MI, den Heijer, T, Koudstaal, PJ, Hofman, A, Breteler, MM. History of depression, depressive symptoms, and medial temporal lobe atrophy and the risk of Alzheimer disease. Neurology 2008; 70: 1258–64.
18 Goveas, JS, Espeland, MA, Woods, NF, Wassertheil-Smoller, S, Kotchen, JM. Depressive symptoms and incidence of mild cognitive impairment and probable dementia in elderly women: the Women's Health Initiative Memory Study. J Am Geriatr Soc 2011; 59: 5766.
19 Irie, F, Masaki, KH, Petrovitch, H, Abbott, RD, Ross, GW, Taaffe, DR, et al Apolipoprotein E epsilon4 allele genotype and the effect of depressive symptoms on the risk of dementia in men: the Honolulu-Asia Aging Study. Arch Gen Psychiatry 2008; 65: 906–12.
20 Kim, JM, Kim, SY, Bae, KY, Kim, SW, Shin, IS, Yang, SJ, et al Apolipoprotein e4 genotype and depressive symptoms as risk factors for dementia in an older Korean population. Psychiatry Investig 2010; 7: 135–40.
21 Köhler, S, van Boxtel, M, Jolles, J, Verhey, F. Depressive symptoms and risk for dementia: a 9-year follow-up of the maastricht aging study. Am J Geriatr Psychiatry 2011; 19: 902–5.
22 Hébert, R, Lindsay, J, Verreault, R, Rockwood, K, Hill, G, Dubois, MF. Vascular dementia: incidence and risk factors in the Canadian study of health and aging. Stroke 2000; 31: 1487–93.
23 Li, G, Wang, LY, Shofer, JB, Thompson, ML, Peskind, ER, McCormick, W, et al Temporal relationship between depression and dementia: findings from a large community-based 15-year follow-up study. Arch Gen Psychiatry 2011; 68: 970–7.
24 Lindsay, J, Laurin, D, Verreault, R, Hébert, R, Helliwell, B, Hill, GB, et al Risk factors for Alzheimer's disease: a prospective analysis from the Canadian Study of Health and Aging. Am J Epidemiol 2002; 156: 445–53.
25 Palmer, K, Berger, AK, Monastero, R, Winblad, B, Backman, L, Fratiglioni, L. Predictors of progression from mild cognitive impairment to Alzheimer disease. Neurology 2007; 68: 1596–602.
26 Pálsson, S, Aevarsson, O, Skoog, I. Depression, cerebral atrophy, cognitive performance and incidence of dementia. Population study of 85-year-olds. Br J Psychiatry 1999; 174: 249–53.
27 Saczynski, JS, Beiser, A, Seshadri, S, Auerbach, S, Wolf, PA, Au, R. Depressive symptoms and risk of dementia: the Framingham Heart Study. Neurology 2010; 75: 3541.
28 Spira, AP, Rebok, GW, Stone, KL, Kramer, JH, Yaffe, K. Depressive symptoms in oldest-old women: risk of mild cognitive impairment and dementia. Am J Geriatr Psychiatry 2012; 20: 1006–15.
29 Yaffe, K, Blackwell, T, Gore, R, Sands, L, Reus, V, Browner, WS. Depressive symptoms and cognitive decline in nondemented elderly women: a prospective study. Arch Gen Psychiatry 1999; 56: 425–30.
30 Barnes, DE, Yaffe, K, Byers, AL, McCormick, M, Schaefer, C, Whitmer, RA. Midlife vs. late-life depressive symptoms and risk of dementia: differential effects for Alzheimer disease and vascular dementia. Arch Gen Psychiatry 2012; 69: 493–8.
31 Charlson, M, Peterson, JC. Medical comorbidity and late life depression: what is known and what are the unmet needs? Biol Psychiatry 2002; 5: 226–35.
32 Sheline, YI, Pieper, CF, Barch, DM, Welsh-Bohmer, K, McKinstry, RC, MacFall, JR, et al Support for the vascular depression hypothesis in late-life depression: results of a 2-site, prospective, antidepressant treatment trial. Arch Gen Psychiatry 2010; 67: 277–85.
33 Laukka, EJ, Fratiglioni, L, Backman, L. The influence of vascular disease on cognitive performance in the preclinical and early phases of Alzheimer's disease. Dement Geriatr Cogn Disord 2010; 29: 498503.
34 Gold, G, Giannakopoulos, P, Herrmann, FR, Bouras, C, Kovari, E. Identification of Alzheimer and vascular lesion thresholds for mixed dementia. Brain 2007; 130: 2830–6.
35 Cuijpers, P, Beekman, AT, Reynolds, CF 3rd. Preventing depression: a global priority. JAMA 2012; 307: 1033–4.
36 Reynolds, CF 3rd, Cuijpers, P, Patel, V, Cohen, A, Dias, A, Chowdhary, N, et al Early intervention to reduce the global health and economic burden of major depression in older adults. Annu Rev Public Health 2012; 33: 123–35.
37 Dotson, VM, Beydoun, MA, Zonderman, AB. Recurrent depressive symptoms and the incidence of dementia and mild cognitive impairment. Neurology 2010; 75: 2734.
38 Kessing, LV, Andersen, PK. Does the risk of developing dementia increase with the number of episodes in patients with depressive disorder and in patients with bipolar disorder? J Neurol Neurosurg Psychiatry 2004; 75: 1662–6.
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
PDF
Supplementary materials

Diniz et al. supplementary material
Supplementary Table S2

 PDF (39 KB)
39 KB
PDF
Supplementary materials

Diniz et al. supplementary material
Supplementary Material

 PDF (277 KB)
277 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

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)...
Submit a response

eLetters

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.

... More

Conflict of interest: None declared

Write a reply

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *