Table 1.
(Category A1): Studies suggesting that depression is a significant risk factor for dementia.
| Study | Cohort | N | Mean age (SD) | % Female | FU | Depression assessment | Diagnostic criteria of cognitive decline | Incidence of dementia | Risk? | Risk adjustments |
|---|---|---|---|---|---|---|---|---|---|---|
| (Brodaty et al., 2012) | Community of English speaking Australians | 799 (480 NC, 319 MCI). 169 drop-outs | 78 (4.7) | 67.8% | 2 years | NPI | Petersen MCI, DSM-IV Dementia | 11 from MCI, 3 from NCI, too small for subtyping | OR 3.67 [1.1–12.5] | No difference (age, sex, education, NPI score) |
| (Burke et al., 2016) | Prospective UDS NACC: 80% White, 13% African, 6% Hispanic | 11453 start, 8762 more than 1 visit | 71 (10.89) | 65.2% | Mean 3 years (1-10) | 1) Recent 2) Earlier 3) Current episode (DSM-IV) | AD NINCDS/ADRDA | 330 AD. Subgroups not clearly reported | 1) HR 2.35 [1.88–2.94] 2) HR 1.35 [1.06–1.73] 3) HR 2.82 [2.21–3.59] | Stronger after correction 1) HR 5.75 [3.28–10.07] 2) 3.20 [1.78–5.73] 3) HR 5.50 [3.09–9.64] |
| (Devanand et al., 1996) | Community in Manhattan 30% White, 41% Latino 27% African | 852 NC at baseline, 478 one or more FU sessions | 73 (7.1) | 69.4% | 1-5, mean 2.54 years (1.12 SD) | HAM-D >10 and ‘mood’ item | DSM-III-R | 61 cases, (21% depressed vs 9% non), mostly AD (2 other, 1 PSP) | RR 2.94 [1.7-4.9] | Still significant (RR 2.05) after age, education, Moderate CI |
| (Ezzati et al., 2019) | Einstein Aging study: Bronx community, 65% white | 1219 | 78 (5.4) 70+ | 62% | Yearly visits for 4.5 years (3.5 SD) up to 17 years | GDS-15 | DSM-IV | 132 cases, 111 AD | Per point HR 1.11 [1.03-1.19], not significant before 3 years | Age, sex, race, education, comorbidity and baseline cognition (BIMC) |
| (Irie et al., 2008) | USA Japanese in Hawaii | 1932 | 76 (3.6) | 0% | 6.1 years mean | CES-D > 9 | DSM-III-R, NINCDS/ADRDA | 6.3% (e4), 9.3% (dep) 13.7% (both) 4.2%(neither) | Dementia HR 2.2 [1.3–3.7] AD 2.9 [1.4–5.9] | Classic risk factors and self-reported memory |
| (Saczynski et al., 2010) | Framingham study: prospective community cohort | 949 | 79 (5) | 63.6% | Mean 8, up to 17 years | CES-D > 16 | DSM-IV, CDR >1, NINCDS/ADRDA | 164 cases (136 AD) | Dementia HR 1.72 [1.04–2.84] AD 1.76 [1.03–3.01] | Age, education, homocysteine, APOE, MCI |
| (Spira et al., 2012) | Oldest old white (SOF WISE) | 302 | 87 (2) > 85 | 100% | 5 years after baseline | GDS-15 > 6 | Petersen MCI, DSM-IV-TR dementia | 84 cases 65% of GDS ≥6 & 37% < 6 | MOR 3.15, [1.03-9.65] | Risk factors, alcohol, benzodiazepines |
Values in square brackets are 95% confidence intervals. p-values are under 0.05 unless otherwise specified. UDS-NACC, Uniform Data Set - National Alzheimer’s Coordinating Centre; NC, Normal cognition; MCI, Mild Cognitive Impairment; SD, Standard Deviation; GDS, Geriatric Depression Scale; HAM-D, Hamilton Depression Rating Scale; NPI, Neuropsychiatric Inventory; DSM, Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association); FU, follow-up, NINCDS; National Institute of Neurological and Communication Disorders and Stroke; ADRDA, Alzheimer’s Disease and Related Disorders Association criteria; CES-D, Centre for Epidemiological Studies Depression scale; BIMC, Blessed Information Memory Concentration; CDR, Clinical Dementia Rating Scale; SOF-WISE, Study of Osteoporotic Fractures - Women; Cognitive Impairment Study of Exceptional Aging.