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. 2024 Nov 28;16(4):e70036.
doi: 10.1002/dad2.70036. eCollection 2024 Oct-Dec.

Associations between depression and anxiety in midlife and dementia more than 30 years later: The HUNT Study

Ragnhild Holmberg Aunsmo  1   2   3 , Bjørn Heine Strand  2   4   5 , Kaarin J Anstey  6   7 , Sverre Bergh  2   8 , Mika Kivimäki  9   10 , Sebastian Köhler  11   12 , Steinar Krokstad  13   14   15 , Gill Livingston  16 , Fiona E Matthews  17 , Geir Selbæk  1   2   4
Affiliations

Associations between depression and anxiety in midlife and dementia more than 30 years later: The HUNT Study

Ragnhild Holmberg Aunsmo et al. Alzheimers Dement (Amst). .

Abstract

Introduction: It is unclear how midlife depression and anxiety affect dementia risk. We examined this in a Norwegian cohort followed for 30 years.

Methods: Dementia status at age 70+ in the fourth wave of the Trøndelag Health Study (HUNT4, 2017-2019, N = 9745) was linked with anxiety and depression from HUNT1 (1984-1985), HUNT2 (1995-1997), HUNT3 (2006-2008), and HUNT4. Longitudinal anxiety and depression score, and prevalence trajectories during 1984-2019 by dementia status at HUNT4 were fitted using mixed effects regression adjusting for age, sex, education, and lifestyle and health factors.

Results: Dementia at HUNT4 was associated with higher case prevalence at all waves, from 1.9 percentage points (pp) (95% CI: 0.1-3.7) higher at HUNT1 to 7.6 pp (95% CI: 5.7-9.6) higher at HUNT4.

Discussion: Our findings show that depression and anxiety was more common more than 30 years before dementia onset in those who later developed dementia.

Highlights: Older individuals with dementia had a higher prevalence of mixed anxiety- and depressive symptoms (A + D), both concurrently with and more than three decades prior to their dementia diagnosis.Older individuals with dementia had higher levels of anxiety, both concurrently and up to two decades prior to their dementia diagnosis.Depressive symptoms increased by time among those who developed dementia, but not among others.Results were similar for all cause dementia, Alzheimer's disease, and other types of dementia; however, for vascular dementia, the difference was not significant until dementia was present.

Keywords: Alzheimer's disease; anxiety; association between anxiety and dementia; association between depression and dementia; dementia; depression; depressive symptoms; mental distress; midlife anxiety; midlife anxiety and depression; midlife depression; risk factor for dementia; trajectories.

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Conflict of interest statement

The authors declare no conflict of interest. Author disclosures are available in the supporting information.

Figures

FIGURE 1
FIGURE 1
Mean HADS total score and sub‐scores, and prevalence of  cases with clinical significant sum of anxiety‐ and depressive symptoms (A+D), by dementia status at HUNT4 over time (1984 = HUNT1, 1995 = HUNT2, 2006 = HUNT3, 2017 = HUNT4), fully adjusted. HADS, Hospital Anxiety and Depression Scale; HUNT, Trøndelag Health study.
FIGURE 2
FIGURE 2
Mean HADS‐total (HADS‐T) score by types of dementia over time, fully adjusted, vertical plots indicating confidence intervals. HADS, Hospital Anxiety and Depression Scale.
See this image and copyright information in PMC

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