Dae Jong Oh1,2, Ji Won Han3, Jong Bin Bae3, Tae Hui Kim4, Kyung Phil Kwak5, Bong Jo Kim6, Shin Gyeom Kim7, Jeong Lan Kim8, Seok Woo Moon9, Joon Hyuk Park10, Seung-Ho Ryu11, Jong Chul Youn12, Dong Young Lee1,13, Dong Woo Lee14, Seok Bum Lee15, Jung Jae Lee15, Jin Hyeong Jhoo16, Ki Woong Kim1,3,17. 1. Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea. 2. Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea. 3. Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, South Korea. 4. Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea. 5. Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea. 6. Department of Psychiatry, School of Medicine, Gyeongsang National University, Jinju, South Korea. 7. Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea. 8. Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea. 9. Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, South Korea. 10. Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea. 11. Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, South Korea. 12. Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, South Korea. 13. Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea. 14. Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea. 15. Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea. 16. Department of Psychiatry, School of Medicine, Kangwon National University, Chuncheon, South Korea. 17. Department of Brain and Cognitive Science, College of Natural Sciences, Seoul National University, Seoul, South Korea.
Abstract
OBJECTIVES: Subsyndromal depression is prevalent and associated with poor outcomes in late life, but its effect on the risk of dementia has barely been investigated. This study is aimed to investigate the effect of subsyndromal depression on dementia risk in cognitively normal older adults and patients with mild cognitive impairment. METHODS: Data were collected from a nationwide, population-based, prospective cohort study on a randomly sampled Korean elderly population aged 60 years or older, which has been followed every 2 years. Using 6-year follow-up data of 4456 non-demented elderly, the authors examined the risk of dementia associated with late-onset subsyndromal depression using multivariate Cox proportional hazard models. After standardized diagnostic interviews, subsyndromal depression and dementia were diagnosed by the operational diagnostic criteria and Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria, respectively. RESULTS: Subsyndromal depression tripled the risk of dementia in non-demented elderly individuals (hazard ratio = 3.02, 95% confidence interval = [1.56, 5.85], p < 0.001). In subgroup analyses, subsyndromal depression was associated with the risk of dementia in cognitively normal participants only (hazard ratio = 4.59, 95% confidence interval = [1.20, 17.54], p = 0.026); chronic/recurrent subsyndromal depression with increasing severity during the follow-up period was associated with the risk of dementia (hazard ratio = 15.34, 95% confidence interval = [4.19, 56.18], p < 0.001). CONCLUSION: Late-onset subsyndromal depression is a potential predictor of incident dementia when it is chronic or recurrent with increasing severity in cognitively normal older adults.
OBJECTIVES:Subsyndromal depression is prevalent and associated with poor outcomes in late life, but its effect on the risk of dementia has barely been investigated. This study is aimed to investigate the effect of subsyndromal depression on dementia risk in cognitively normal older adults and patients with mild cognitive impairment. METHODS: Data were collected from a nationwide, population-based, prospective cohort study on a randomly sampled Korean elderly population aged 60 years or older, which has been followed every 2 years. Using 6-year follow-up data of 4456 non-demented elderly, the authors examined the risk of dementia associated with late-onset subsyndromal depression using multivariate Cox proportional hazard models. After standardized diagnostic interviews, subsyndromal depression and dementia were diagnosed by the operational diagnostic criteria and Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria, respectively. RESULTS:Subsyndromal depression tripled the risk of dementia in non-demented elderly individuals (hazard ratio = 3.02, 95% confidence interval = [1.56, 5.85], p < 0.001). In subgroup analyses, subsyndromal depression was associated with the risk of dementia in cognitively normal participants only (hazard ratio = 4.59, 95% confidence interval = [1.20, 17.54], p = 0.026); chronic/recurrent subsyndromal depression with increasing severity during the follow-up period was associated with the risk of dementia (hazard ratio = 15.34, 95% confidence interval = [4.19, 56.18], p < 0.001). CONCLUSION: Late-onset subsyndromal depression is a potential predictor of incident dementia when it is chronic or recurrent with increasing severity in cognitively normal older adults.
Entities:
Keywords:
Subsyndromal depression; dementia; geriatric psychiatry; population-based study
Authors: Hee Won Yang; Jong Bin Bae; Dae Jong Oh; Dong Gyu Moon; Eunji Lim; Jin Shin; Bong Jo Kim; Dong Woo Lee; Jeong Lan Kim; Jin Hyeong Jhoo; Joon Hyuk Park; Jung Jae Lee; Kyung Phil Kwak; Seok Bum Lee; Seok Woo Moon; Seung-Ho Ryu; Shin Gyeom Kim; Ji Won Han; Ki Woong Kim Journal: JAMA Netw Open Date: 2021-12-01
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