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. 2011 Sep;68(9):970-7.
doi: 10.1001/archgenpsychiatry.2011.86.

Temporal relationship between depression and dementia: findings from a large community-based 15-year follow-up study

Ge Li  1 , Lucy Y Wang, Jane B Shofer, Mary Lou Thompson, Elaine R Peskind, Wayne McCormick, James D Bowen, Paul K Crane, Eric B Larson
Affiliations

Temporal relationship between depression and dementia: findings from a large community-based 15-year follow-up study

Ge Li et al. Arch Gen Psychiatry. 2011 Sep.

Abstract

Context: Late-life depression is associated with increased risk of dementia, but the temporal relationship between depression and development of dementia remains unclear.

Objectives: To examine the association between risk of dementia and baseline depressive symptoms; history of depression, particularly early-life (<50 years) vs late-life depression (≥50 years); and individual domains of the Center for Epidemiologic Studies Depression Scale.

Design: A large cohort with initially nondemented participants was followed up biennially for up to 15 years. Baseline depressive symptoms were assessed using the 11-item version of the Center for Epidemiologic Studies Depression Scale; presence of significant depressive symptoms was defined as a score of 11 or greater. Self-reported history of depression was collected at the baseline interview. Cox proportional hazards regression was used to assess the association between depression and dementia risk.

Setting: Population-based cohort drawn from members of the Group Health Cooperative in Seattle, Washington.

Participants: A cohort of 3410 participants without dementia aged at least 65 years.

Results: During a mean of 7.1 years of follow-up, 658 participants (19.3%) developed dementia. At baseline, 9.4% of participants had presence of significant depressive symptoms, and 21.2% reported a history of depression. The adjusted hazard ratio for dementia associated with baseline depressive symptoms was 1.71 (95% confidence interval, 1.37-2.13), after adjusting for age at entry, sex, educational level, and wave of enrollment. Compared with participants without depression history, those with late-life depression were at increased dementia risk (adjusted hazard ratio, 1.46; 95% confidence interval, 1.16-1.84), but early-life depression had no association with dementia risk (1.10 [0.83-1.47]). Depressed mood (adjusted hazard ratio, 1.48; 95% confidence interval, 1.25-1.76) and perceived performance difficulty (1.39 [1.15-1.67]) were independently associated with dementia.

Conclusion: This study confirmed that late-life depression is associated with increased risk of dementia and supplied evidence that late-life depression may be an early manifestation of dementia rather than increasing risk for dementia.

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Conflict of interest statement

We have no conflicts of interest or financial disclosures to report.

Figures

Figure 1
Figure 1
Kaplan-Meier cumulative risk curves for dementia by baseline depressive symptoms status based on CESD-11 assessment
Figure 2
Figure 2
Kaplan-Meier cumulative risk curves for each type of dementia by baseline depressive symptoms status based on CESD-11 assessment
See this image and copyright information in PMC

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