Patricia Gracia-García1, Concepción de-la-Cámara2, Javier Santabárbara3, Raúl Lopez-Anton4, Miguel Angel Quintanilla5, Tirso Ventura6, Guillermo Marcos7, Antonio Campayo2, Pedro Saz8, Constantine Lyketsos9, Antonio Lobo10. 1. Psychiatry Service, Hospital Clínico Universitario, Zaragoza, Spain. 2. Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain; Instituto Aragonés de Ciencias de la Salud (I+CS), Zaragoza, Spain; Department of Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain. 3. Instituto Aragonés de Ciencias de la Salud (I+CS), Zaragoza, Spain; Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain. 4. Instituto Aragonés de Ciencias de la Salud (I+CS), Zaragoza, Spain; Psychiatry Service, Hospital Universitario Miguel Servet, Zaragoza, Spain. 5. Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain. 6. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain; Medical Records Service, Hospital Clínico Universitario, Zaragoza, Spain. 7. Instituto Aragonés de Ciencias de la Salud (I+CS), Zaragoza, Spain; Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain; Johns Hopkins University, Johns Hopkins Bayview Medical Center, Baltimore, Maryland. 8. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain; Instituto Aragonés de Ciencias de la Salud (I+CS), Zaragoza, Spain. 9. Johns Hopkins University, Johns Hopkins Bayview Medical Center, Baltimore, Maryland. 10. Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain; Instituto Aragonés de Ciencias de la Salud (I+CS), Zaragoza, Spain; Department of Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain. Electronic address: alobo@unizar.es.
Abstract
OBJECTIVES: To test the hypothesis that clinically significant depression (particularly severe depression) increases the risk of Alzheimer's disease (AD). METHODS: A longitudinal, three-wave epidemiologic study was implemented in a sample of individuals aged 55 years and older (n = 4,803) followed up at 2.5 years and 4.5 years. This was a population-based cohort drawn from the Zaragoza Dementia and Depression (ZARADEMP) Project, in Zaragoza, Spain. Participants included individuals cognitively intact at baseline (n = 3,864). The main outcome measures were depression as assessed by using the diagnostic interview Geriatric Mental State- Automated Geriatric Examination for Computer Assisted Taxonomy package; and AD diagnosed by a panel of research psychiatrists according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. The Fine and Gray multivariate regression model was used in the analysis, accounting for mortality. RESULTS: At baseline, clinically significant depression was diagnosed in 452 participants (11.7%); of these, 16.4% had severe depression. Seventy incident cases of AD were found at follow-up. Compared with nondepressed individuals, the incidence rate of AD was significantly higher in the severely depressed subjects (incidence rate ratio: 3.59 [95% confidence interval: 1.30-9.94]). A consistent, significant association was observed between severe depression at baseline and incident AD in the multivariate model (hazard ratio: 4.30 [95% CI: 1.39-13.33]). Untreated depression was associated with incident AD in the unadjusted model; however, in the final model, this association was attenuated and nonsignificant. CONCLUSIONS: Severe depression increases the risk of AD, even after controlling for the competing risk of death.
OBJECTIVES: To test the hypothesis that clinically significant depression (particularly severe depression) increases the risk of Alzheimer's disease (AD). METHODS: A longitudinal, three-wave epidemiologic study was implemented in a sample of individuals aged 55 years and older (n = 4,803) followed up at 2.5 years and 4.5 years. This was a population-based cohort drawn from the Zaragoza Dementia and Depression (ZARADEMP) Project, in Zaragoza, Spain. Participants included individuals cognitively intact at baseline (n = 3,864). The main outcome measures were depression as assessed by using the diagnostic interview Geriatric Mental State- Automated Geriatric Examination for Computer Assisted Taxonomy package; and AD diagnosed by a panel of research psychiatrists according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. The Fine and Gray multivariate regression model was used in the analysis, accounting for mortality. RESULTS: At baseline, clinically significant depression was diagnosed in 452 participants (11.7%); of these, 16.4% had severe depression. Seventy incident cases of AD were found at follow-up. Compared with nondepressed individuals, the incidence rate of AD was significantly higher in the severely depressed subjects (incidence rate ratio: 3.59 [95% confidence interval: 1.30-9.94]). A consistent, significant association was observed between severe depression at baseline and incident AD in the multivariate model (hazard ratio: 4.30 [95% CI: 1.39-13.33]). Untreated depression was associated with incident AD in the unadjusted model; however, in the final model, this association was attenuated and nonsignificant. CONCLUSIONS: Severe depression increases the risk of AD, even after controlling for the competing risk of death.
Authors: L A Farrer; L A Cupples; J L Haines; B Hyman; W A Kukull; R Mayeux; R H Myers; M A Pericak-Vance; N Risch; C M van Duijn Journal: JAMA Date: 1997 Oct 22-29 Impact factor: 56.272
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Authors: Jennifer Monereo-Sánchez; Miranda T Schram; Oleksandr Frei; Kevin O'Connell; Alexey A Shadrin; Olav B Smeland; Lars T Westlye; Ole A Andreassen; Tobias Kaufmann; David E J Linden; Dennis van der Meer Journal: Front Neurosci Date: 2021-07-05 Impact factor: 4.677