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P3‐045: Obesity and dementia: Protection or risk?
Author(s) -
Rosin Elisa,
Costa Amanda L.,
Varela Juliana S.,
Restelatto Luciane M.F.,
Bombardelli Karine,
Silva Rodolfo S.,
Palmero Alan,
Abrahim Pedro,
Chaves Marcia L.
Publication year - 2010
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2010.05.1538
Subject(s) - medicine , dementia , overweight , dyslipidemia , obesity , depression (economics) , body mass index , geriatric depression scale , stroke (engine) , cognition , physical therapy , psychiatry , gerontology , depressive symptoms , disease , economics , macroeconomics , mechanical engineering , engineering
Background: Late-life depression has been associated with increased dementia risk, but it is unclear whether this association is consistent across all types of dementia. To address this question, we examined associations between depression symptoms and development of clinical Alzheimer’s disease (AD), vascular, mixed (due to multiple etiologies), and other (non-AD, non-vascular) dementias in participants of the Adult Changes in Thought study, a community-based prospective study. Methods: A combined cohort of 3, 410 cognitively normal participants aged 65 years (60% female, mean age-at-entry 74.9 years [range 65 101]) underwent biennial assessments for dementia using DSM-IV criteria for dementia of the Alzheimer’s, vascular, mixed, and other types. Depression was assessed using the 11-item version of the Center for Epidemiologic Studies Depression Scale (CESD11, total score: 0 33). The primary exposure of interest for this study was depression at baseline, with significant depression symptoms designated as CESD-11 score > 10. Self-reported history and age at onset of depression episodes were also collected at baseline interview. Cox proportional hazards regression with delayed entry and age as the time axis was used to assess the association between baseline CESD-11 > 10 and hazard of each dementia subtype. Results: Mean follow-up was 7.1 years. During follow-up, 386 participants were diagnosed with AD, 89 vascular, 109 mixed, and 73 with other dementia. CESD-11 score > 10 at baseline was present in 14% of participants who developed dementia. Compared with participants with a baseline CESD-11 score of 0-10, the hazard ratio of depression symptoms at baseline for AD was 1.43 (95% CI 1.05, 1.94), vascular dementia 1.78 (95% CI 0.98, 3.22), mixed dementia 2.30 (95% CI 1.39, 3.79), and other dementia 2.42 (1.32, 4.43) after adjusting for ageat-entry categories, gender, education, and cohort. Self reported past history of depression at baseline was only associated with the ‘‘other dementia’’ subtype (adjusted hazard ratio 1.95 [1.17, 3.26]) but not with AD, vascular, or mixed dementia. Conclusions: These data suggest that depression symptoms in late life may be associated with increased dementia risk across all dementia subtypes, but possibly particularly with subtypes other than AD and vascular dementia.