Ingeborg W M van Uden1, Helena M van der Holst1, Esther M C van Leijsen1, Anil M Tuladhar1, Anouk G W van Norden1, Karlijn F de Laat1, Jurgen A H R Claassen1, Ewoud J van Dijk1, Roy P C Kessels1, Edo Richard1, Indira Tendolkar1, Frank-Erik de Leeuw2. 1. From the Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Departments of Neurology (I.W.M.v.U., H.M.v.d.H., E.M.C.v.L., A.M.T., E.J.v.D., E.R., F.-E.d.L.), Geriatrics (J.A.H.R.C.), Medical Psychology (R.P.C.K.), and Psychiatry (I.T.), Nijmegen; Department of Neurology (A.G.W.v.N.), Amphia Ziekenhuis Breda; and Department of Neurology (K.F.d.L.), HagaZiekenhuis The Hague, the Netherlands. 2. From the Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Departments of Neurology (I.W.M.v.U., H.M.v.d.H., E.M.C.v.L., A.M.T., E.J.v.D., E.R., F.-E.d.L.), Geriatrics (J.A.H.R.C.), Medical Psychology (R.P.C.K.), and Psychiatry (I.T.), Nijmegen; Department of Neurology (A.G.W.v.N.), Amphia Ziekenhuis Breda; and Department of Neurology (K.F.d.L.), HagaZiekenhuis The Hague, the Netherlands. frankerik.deleeuw@radboudumc.nl.
Abstract
OBJECTIVE: We prospectively investigated the role of depressive symptoms (DS) on all-cause dementia in a population with small vessel disease (SVD), considering onset age of DS and cognitive performance. METHODS: The RUN DMC study (Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort) is a prospective cohort study among 503 older adults with SVD on MRI without dementia at baseline (2006), with a follow-up of 5 years (2012). Kaplan-Meier curves stratified for DS and dementia risk were compared using log-rank test. We calculated hazard ratios using Cox regression analyses. RESULTS: Follow-up was available for 496 participants (mean baseline age 65.6 years [SD 8.8]; mean follow-up time 5.2 years). All-cause dementia developed in 41 participants. The 5.5-year dementia risk was higher in those with DS (hazard ratio 2.7, 95% confidence interval 1.4-5.2), independent of confounders. This was driven by those with late-onset DS. Five-year cumulative risk difference for dementia was higher in participants with depressive symptoms who had high baseline cognitive performance (no DS 0.0% vs DS 6.9%, log-rank p < 0.001) compared with those who had low cognitive performance at baseline. CONCLUSIONS: Late-onset DS increases dementia risk, independent of SVD. Especially in those with relatively high cognitive performance, DS indicate a higher risk. In contrast to current practice, clinicians should monitor those with DS who also show relatively good cognitive test scores.
OBJECTIVE: We prospectively investigated the role of depressive symptoms (DS) on all-cause dementia in a population with small vessel disease (SVD), considering onset age of DS and cognitive performance. METHODS: The RUN DMC study (Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort) is a prospective cohort study among 503 older adults with SVD on MRI without dementia at baseline (2006), with a follow-up of 5 years (2012). Kaplan-Meier curves stratified for DS and dementia risk were compared using log-rank test. We calculated hazard ratios using Cox regression analyses. RESULTS: Follow-up was available for 496 participants (mean baseline age 65.6 years [SD 8.8]; mean follow-up time 5.2 years). All-cause dementia developed in 41 participants. The 5.5-year dementia risk was higher in those with DS (hazard ratio 2.7, 95% confidence interval 1.4-5.2), independent of confounders. This was driven by those with late-onset DS. Five-year cumulative risk difference for dementia was higher in participants with depressive symptoms who had high baseline cognitive performance (no DS 0.0% vs DS 6.9%, log-rank p < 0.001) compared with those who had low cognitive performance at baseline. CONCLUSIONS: Late-onset DS increases dementia risk, independent of SVD. Especially in those with relatively high cognitive performance, DS indicate a higher risk. In contrast to current practice, clinicians should monitor those with DS who also show relatively good cognitive test scores.
Authors: M Ly; H T Karim; J T Becker; O L Lopez; S J Anderson; H J Aizenstein; C F Reynolds; M D Zmuda; M A Butters Journal: Transl Psychiatry Date: 2021-03-02 Impact factor: 6.222
Authors: Luis Agüera-Ortiz; Rocío García-Ramos; Francisco J Grandas Pérez; Jorge López-Álvarez; José Manuel Montes Rodríguez; F Javier Olazarán Rodríguez; Javier Olivera Pueyo; Carmelo Pelegrin Valero; Jesús Porta-Etessam Journal: Front Psychiatry Date: 2021-02-26 Impact factor: 4.157