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Depression as a risk factor for cognitive impairment in later life: the Health In Men cohort study
Author(s) -
Almeida Osvaldo P.,
Hankey Graeme J.,
Yeap Bu B.,
Golledge Jonathan,
Flicker Leon
Publication year - 2016
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4347
Subject(s) - dementia , depression (economics) , medicine , risk factor , relative risk , cohort , cohort study , geriatric depression scale , late life depression , telephone interview , history of depression , cognitive disorder , medical record , confidence interval , psychiatry , pediatrics , cognition , disease , depressive symptoms , social science , sociology , economics , macroeconomics
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.