Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Aug;26(8):819-827.
doi: 10.1016/j.jagp.2018.05.002. Epub 2018 May 9.

Depression and Risk of Alzheimer Dementia: A Longitudinal Analysis to Determine Predictors of Increased Risk among Older Adults with Depression

Damien Gallagher  1 , Alex Kiss  2 , Krista Lanctot  3 , Nathan Herrmann  4
Affiliations

Depression and Risk of Alzheimer Dementia: A Longitudinal Analysis to Determine Predictors of Increased Risk among Older Adults with Depression

Damien Gallagher et al. Am J Geriatr Psychiatry. 2018 Aug.

Abstract

Objective: Older adults with depression are at increased risk of Alzheimer dementia, but predictors of increased risk remain incompletely understood. We aim to identify characteristics of older adults with depression most at risk of progressing to Alzheimer dementia. Identification of high-risk subgroups could facilitate future interventional strategies to reduce risk of Alzheimer dementia in older adults with depression.

Methods: Using data from the National Alzheimer's Coordinating Center, 1,965 participants with clinically defined depression and mild cognitive impairment at baseline were followed until development of Alzheimer dementia or loss to follow-up.

Results: Seven hundred and eighty (39.7%) developed Alzheimer dementia over a median follow-up duration of 27 months. In survival analyses, age (hazard ratio [HR] 1.04, 95% 1.03-1.05), baseline Mini-Mental State Exam (HR 0.85, 95% confidence interval 0.83-0.87), amnestic subtype of mild cognitive impairment (HR 1.66, 95% 1.30-2.12), presence of APOE4 allele (HR 1.99, 1.69-2.36), and presence of active depression within the last two years (HR 1.44, 95% confidence interval 1.16-1.79) were all independently associated with increased risk of Alzheimer dementia. Six hundred and fifty-six (41.7%) participants with mild cognitive impairment and active depression within the last two years developed Alzheimer dementia compared to 120 (31.6%) of those with a more remote history of depression.

Conclusion: Older adults with depression and mild cognitive impairment demonstrated a high rate of progression to Alzheimer dementia over a relatively short duration of follow-up. Individuals with a combination of mild cognitive impairment and recently active depression are a particularly high-risk subgroup.

Keywords: Alzheimer dementia; Depression; cognition; mild cognitive impairment.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: NH has received consultation fees from Pfizer, Lilly, Merck & Astellas. KL has received grant support from AbbVie, Axovant & advisory board fees from Lundbeck, Otsuka & Novartis. DG and AK have no conflicts to declare.

Figures

Figure 1:
Figure 1:
Survival to development of AD according to presence or absence of active depression within the last two years.
See this image and copyright information in PMC

Comment in

References

    1. Diniz BS, Butters MA, Albert SM, et al.: Late-life depression and risk of vascular dementia and Alzheimer’s disease: systematic review and meta-analysis of community-based cohort studies. Br J Psychiatry 2013; 202:329–335 - PMC - PubMed
    1. McKinnon MC, Yucel K, Nazarov A, et al.: A meta-analysis examining clinical predictors of hippocampal volume in patients with major depressive disorder. Journal of psychiatry & neuroscience : JPN 2009; 34:41–54 - PMC - PubMed
    1. Gallagher D, Kiss A, Lanctot K, et al.: Depressive symptoms and cognitive decline: A longitudinal analysis of potentially modifiable risk factors in community dwelling older adults. J Affect Disord 2016; 190:235–240 - PubMed
    1. Maes M, Galecki P, Chang YS, et al.: A review on the oxidative and nitrosative stress (O&NS) pathways in major depression and their possible contribution to the (neuro)degenerative processes in that illness. Prog Neuropsychopharmacol Biol Psychiatry 2011;35:676–692 - PubMed
    1. Taylor WD, Aizenstein HJ,Alexopoulos GS: The vascular depression hypothesis: mechanisms linking vascular disease with depression. Mol Psychiatry 2013; 18:963–974 - PMC - PubMed

Publication types