Depression as a risk factor for cognitive impairment in later life: the Health In Men cohort study

Almeida, Osvaldo P., Hankey, Graeme J., Yeap, Bu B., Golledge, Jonathan, and Flicker, Leon (2016) Depression as a risk factor for cognitive impairment in later life: the Health In Men cohort study. International Journal of Geriatric Psychiatry, 31 (4). pp. 416-424.

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Background: Depression is an established risk factor for dementia in later life, but it is unclear if this relationship is causal. This study aimed to determine if clinically significant depressive symptoms are likely to be causally related to cognitive impairment in later life.

Methods: Observational cohort study of 4568 men aged 70-89years living in Perth, Western Australia, who were free of cognitive impairment at the beginning of follow-up. Current clinically significant depressive symptoms were defined by a score of 7 or more on the Geriatric Depression Scale 15 items. Past depression was ascertained via electronic medical records, by self-report or use of antidepressants. A score of 27 or less on the Telephone Interview for Cognitive Status modified or a recorded diagnosis of dementia in electronic medical records established the presence of cognitive impairment.

Results: During the 5-year follow-up, 534 men developed cognitive impairment, 811 died and 1455 were lost. The presence of clinically significant depressive symptoms at study entry was associated with increased risk rate (RR) of cognitive impairment (RR=2.59, 95% confidence interval: 95%CI=1.57-4.27), death (RR=5.07, 95%CI=3.32-7.75) and loss to follow-up (RR=2.03, 95%CI=1.32-3.13). These associations remained statistically significant after adjustment for age, country of birth, education, smoking history, and prevalence hypertension, diabetes, coronary heart disease and stroke. History of past clinically significant depressive symptoms was not associated with incident cognitive impairment (RR=1.09, 95%CI=0.78-1.52).

Conclusions: The lack of association between past depression and cognitive impairment suggests that the link between depression and cognitive impairment is not causal and that the presence of clinically significant depressive symptoms in later life may herald the onset of cognitive impairment in at least some people.

Item ID: 44053
Item Type: Article (Research - C1)
ISSN: 1099-1166
Keywords: depression, cognitive impairment, dementia, epidemiology, risk factors
Funders: National Health and Medical Research Council of Australia (NHMRC)
Projects and Grants: NHMRC 279408, 379600, 403963, 513823, 540403, 540504, 540405, 634492, 1021416, 1045710 & 1060557
Date Deposited: 20 Apr 2016 07:49
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320101 Cardiology (incl. cardiovascular diseases) @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100%
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