Association of depression and dementia @ יואל קסלר
Association of depression and dementia @ יואל קסלר

במאמר זה ב יואל קסלר .קום אנו מציגים נתונים ממחקר חדש שמראה כי אבחנה של דיכאון אפילו בשלב מוקדם בחיים קשורה להופעה גבוהה יותר של דמנציה בהמשך. מחקר זה מצביע על כך שדיכאון עשוי להוות גורם סיכון לדמנציה.

In this post, "Association of depression and dementia @ יואל קסלר " we present new data just published in JAMA Neurology demonstrating a connection between depression and dementia regardless of whether the depression was diagnosed early in life ( many years prior to the onset of dementia) or later in life. These findings suggest the possibility that depression may be a risk factor for dementia regardless of the age of diagnosis. The full publication can be found here.

Association of Early-, Middle-, and Late-Life Depression With Incident Dementia in a Danish Cohort

Holly Elser, MD, PhD1,2Erzsébet Horváth-Puhó, PhD1Jaimie L. Gradus, DMSc, DSc

Key Points

Question  Does the association between depression and dementia persist whether depression is diagnosed in early, middle, or late life?

Findings  In this population cohort study of more than 1.4 million adult Danish citizens followed up from 1977 to 2018, the risk of dementia more than doubled for both men and women with diagnosed depression and was higher for men than women; the risk of dementia persisted whether depression was diagnosed in early, middle, or late life.

Meaning  Dementia risk associated with depression diagnosis was higher for men than women; the persistent association between dementia and depression diagnosed in early and middle life suggests that depression may increase dementia risk.

Abstract

Importance  Late-life depressive symptoms are associated with subsequent dementia diagnosis and may be an early symptom or response to preclinical disease. Evaluating associations with early- and middle-life depression will help clarify whether depression influences dementia risk.

Objective  To examine associations of early-, middle-, and late-life depression with incident dementia.

Design, Setting, and Participants  This was a nationwide, population-based, cohort study conducted from April 2020 to March 2023. Participants included Danish citizens from the general population with depression diagnoses who were matched by sex and birth year to individuals with no depression diagnosis. Participants were followed up from 1977 to 2018. Excluded from analyses were individuals followed for less than 1 year, those younger than 18 years, or those with baseline dementia.

Exposure  Depression was defined using diagnostic codes from the International Classification of Diseases (ICD) within the Danish National Patient Registry (DNPR) and Danish Psychiatric Central Research Register (DPCRR).

Main Outcomes and Measure  Incident dementia was defined using ICD diagnostic codes within the DPCRR and DNPR. Cox proportional hazards regression was used to examine associations between depression and dementia adjusting for education, income, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, anxiety disorders, stress disorders, substance use disorders, and bipolar disorder. Analyses were stratified by age at depression diagnosis, years since index date, and sex.

Results  There were 246 499 individuals (median [IQR] age, 50.8 [34.7-70.7] years; 159 421 women [64.7%]) with diagnosed depression and 1 190 302 individuals (median [IQR] age, 50.4 [34.6-70.0] years; 768 876 women [64.6%]) without depression. Approximately two-thirds of those diagnosed with depression were diagnosed before the age of 60 years (684 974 [67.7%]). The hazard of dementia among those diagnosed with depression was 2.41 times that of the comparison cohort (95% CI, 2.35-2.47). This association persisted when the time elapsed from the index date was longer than 20 to 39 years (hazard ratio [HR], 1.79; 95% CI, 1.58-2.04) and among those diagnosed with depression in early, middle, or late life (18-44 years: HR, 3.08; 95% CI, 2.64-3.58; 45-59 years: HR, 2.95; 95% CI, 2.75-3.17; ≥60 years: HR, 2.31; 95% CI, 2.25-2.38). The overall HR was greater for men (HR, 2.98; 95% CI, 2.84-3.12) than for women (HR, 2.21; 95% CI, 2.15-2.27).

Conclusions and Relevance  Results suggest that the risk of dementia was more than doubled for both men and women with diagnosed depression. The persistent association between dementia and depression diagnosed in early and middle life suggests that depression may increase dementia risk.

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יואל קסלר

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