Depression as a risk factor for cognitive impairment in later life: the Health In Men cohort study

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    Abstract

    Background Depression is an established risk factor for dementia in later life, but it is unclear if this relationship is causal. This study aimed to determine if clinically significant depressive symptoms are likely to be causally related to cognitive impairment in later life. Methods Observational cohort study of 4568 men aged 70–89 years living in Perth, Western Australia, who were free of cognitive impairment at the beginning of follow-up. Current clinically significant depressive symptoms were defined by a score of 7 or more on the Geriatric Depression Scale 15 items. Past depression was ascertained via electronic medical records, by self-report or use of antidepressants. A score of 27 or less on the Telephone Interview for Cognitive Status modified or a recorded diagnosis of dementia in electronic medical records established the presence of cognitive impairment. Results During the 5-year follow-up, 534 men developed cognitive impairment, 811 died and 1455 were lost. The presence of clinically significant depressive symptoms at study entry was associated with increased risk rate (RR) of cognitive impairment (RR = 2.59, 95% confidence interval: 95%CI = 1.57–4.27), death (RR = 5.07, 95%CI = 3.32–7.75) and loss to follow-up (RR = 2.03, 95%CI = 1.32–3.13). These associations remained statistically significant after adjustment for age, country of birth, education, smoking history, and prevalence hypertension, diabetes, coronary heart disease and stroke. History of past clinically significant depressive symptoms was not associated with incident cognitive impairment (RR = 1.09, 95%CI = 0.78–1.52). Conclusions The lack of association between past depression and cognitive impairment suggests that the link between depression and cognitive impairment is not causal and that the presence of clinically significant depressive symptoms in later life may herald the onset of cognitive impairment in at least some people. Copyright © 2015 John Wiley & Sons, Ltd.
    Original languageEnglish
    Pages (from-to)416-424
    Number of pages9
    JournalInternational Journal of Geriatric Psychiatry
    Volume31
    Issue number4
    Early online date17 Aug 2015
    DOIs
    Publication statusPublished - 2 Mar 2016

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    Men's Health
    Cohort Studies
    Depression
    Electronic Health Records
    Dementia
    Cognitive Dysfunction
    Western Australia
    Nuclear Family
    Geriatrics
    Self Report
    Antidepressive Agents
    Coronary Disease
    Smoking
    History
    Stroke
    Parturition
    Confidence Intervals
    Interviews
    Hypertension
    Education

    Cite this

    @article{e6f4ed31b3dd42aa9236c73437cdc7ac,
    title = "Depression as a risk factor for cognitive impairment in later life: the Health In Men cohort study",
    abstract = "Background Depression is an established risk factor for dementia in later life, but it is unclear if this relationship is causal. This study aimed to determine if clinically significant depressive symptoms are likely to be causally related to cognitive impairment in later life. Methods Observational cohort study of 4568 men aged 70–89 years living in Perth, Western Australia, who were free of cognitive impairment at the beginning of follow-up. Current clinically significant depressive symptoms were defined by a score of 7 or more on the Geriatric Depression Scale 15 items. Past depression was ascertained via electronic medical records, by self-report or use of antidepressants. A score of 27 or less on the Telephone Interview for Cognitive Status modified or a recorded diagnosis of dementia in electronic medical records established the presence of cognitive impairment. Results During the 5-year follow-up, 534 men developed cognitive impairment, 811 died and 1455 were lost. The presence of clinically significant depressive symptoms at study entry was associated with increased risk rate (RR) of cognitive impairment (RR = 2.59, 95{\%} confidence interval: 95{\%}CI = 1.57–4.27), death (RR = 5.07, 95{\%}CI = 3.32–7.75) and loss to follow-up (RR = 2.03, 95{\%}CI = 1.32–3.13). These associations remained statistically significant after adjustment for age, country of birth, education, smoking history, and prevalence hypertension, diabetes, coronary heart disease and stroke. History of past clinically significant depressive symptoms was not associated with incident cognitive impairment (RR = 1.09, 95{\%}CI = 0.78–1.52). Conclusions The lack of association between past depression and cognitive impairment suggests that the link between depression and cognitive impairment is not causal and that the presence of clinically significant depressive symptoms in later life may herald the onset of cognitive impairment in at least some people. Copyright {\circledC} 2015 John Wiley & Sons, Ltd.",
    author = "Osvaldo Almeida and Graeme Hankey and Bu Yeap and J. Golledge and Leon Flicker",
    year = "2016",
    month = "3",
    day = "2",
    doi = "10.1002/gps.4347",
    language = "English",
    volume = "31",
    pages = "416--424",
    journal = "International Journal of Geriatric Psychiatry",
    issn = "0885-6230",
    publisher = "John Wiley & Sons",
    number = "4",

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    TY - JOUR

    T1 - Depression as a risk factor for cognitive impairment in later life: the Health In Men cohort study

    AU - Almeida, Osvaldo

    AU - Hankey, Graeme

    AU - Yeap, Bu

    AU - Golledge, J.

    AU - Flicker, Leon

    PY - 2016/3/2

    Y1 - 2016/3/2

    N2 - Background Depression is an established risk factor for dementia in later life, but it is unclear if this relationship is causal. This study aimed to determine if clinically significant depressive symptoms are likely to be causally related to cognitive impairment in later life. Methods Observational cohort study of 4568 men aged 70–89 years living in Perth, Western Australia, who were free of cognitive impairment at the beginning of follow-up. Current clinically significant depressive symptoms were defined by a score of 7 or more on the Geriatric Depression Scale 15 items. Past depression was ascertained via electronic medical records, by self-report or use of antidepressants. A score of 27 or less on the Telephone Interview for Cognitive Status modified or a recorded diagnosis of dementia in electronic medical records established the presence of cognitive impairment. Results During the 5-year follow-up, 534 men developed cognitive impairment, 811 died and 1455 were lost. The presence of clinically significant depressive symptoms at study entry was associated with increased risk rate (RR) of cognitive impairment (RR = 2.59, 95% confidence interval: 95%CI = 1.57–4.27), death (RR = 5.07, 95%CI = 3.32–7.75) and loss to follow-up (RR = 2.03, 95%CI = 1.32–3.13). These associations remained statistically significant after adjustment for age, country of birth, education, smoking history, and prevalence hypertension, diabetes, coronary heart disease and stroke. History of past clinically significant depressive symptoms was not associated with incident cognitive impairment (RR = 1.09, 95%CI = 0.78–1.52). Conclusions The lack of association between past depression and cognitive impairment suggests that the link between depression and cognitive impairment is not causal and that the presence of clinically significant depressive symptoms in later life may herald the onset of cognitive impairment in at least some people. Copyright © 2015 John Wiley & Sons, Ltd.

    AB - Background Depression is an established risk factor for dementia in later life, but it is unclear if this relationship is causal. This study aimed to determine if clinically significant depressive symptoms are likely to be causally related to cognitive impairment in later life. Methods Observational cohort study of 4568 men aged 70–89 years living in Perth, Western Australia, who were free of cognitive impairment at the beginning of follow-up. Current clinically significant depressive symptoms were defined by a score of 7 or more on the Geriatric Depression Scale 15 items. Past depression was ascertained via electronic medical records, by self-report or use of antidepressants. A score of 27 or less on the Telephone Interview for Cognitive Status modified or a recorded diagnosis of dementia in electronic medical records established the presence of cognitive impairment. Results During the 5-year follow-up, 534 men developed cognitive impairment, 811 died and 1455 were lost. The presence of clinically significant depressive symptoms at study entry was associated with increased risk rate (RR) of cognitive impairment (RR = 2.59, 95% confidence interval: 95%CI = 1.57–4.27), death (RR = 5.07, 95%CI = 3.32–7.75) and loss to follow-up (RR = 2.03, 95%CI = 1.32–3.13). These associations remained statistically significant after adjustment for age, country of birth, education, smoking history, and prevalence hypertension, diabetes, coronary heart disease and stroke. History of past clinically significant depressive symptoms was not associated with incident cognitive impairment (RR = 1.09, 95%CI = 0.78–1.52). Conclusions The lack of association between past depression and cognitive impairment suggests that the link between depression and cognitive impairment is not causal and that the presence of clinically significant depressive symptoms in later life may herald the onset of cognitive impairment in at least some people. Copyright © 2015 John Wiley & Sons, Ltd.

    U2 - 10.1002/gps.4347

    DO - 10.1002/gps.4347

    M3 - Article

    VL - 31

    SP - 416

    EP - 424

    JO - International Journal of Geriatric Psychiatry

    JF - International Journal of Geriatric Psychiatry

    SN - 0885-6230

    IS - 4

    ER -