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The temporal association between incident late‐life depression and incident dementia
Author(s) -
Heser K.,
Fink A.,
Reinke C.,
Wagner M.,
Doblhammer G.
Publication year - 2020
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.13220
Subject(s) - dementia , depression (economics) , rate ratio , medicine , demography , confidence interval , incidence (geometry) , late life depression , relative risk , longitudinal study , gerontology , psychiatry , disease , cognition , physics , pathology , sociology , optics , economics , macroeconomics
Objective There is an established association between depression and subsequent dementia. The present study examined temporal associations between incident late‐life depression and subsequent dementia, also considering age and sex. Methods We used longitudinal health claims data from the largest German health insurance provider (‘Allgemeine Ortskrankenkasse’) considering up to 9 follow‐up years in piecewise exponential models. ICD‐10 codes were used to define incident depression and dementia in individuals ≥65 years ( n = 97 110). Results Incident depression was associated with a higher risk of subsequent dementia (incidence rate ratios (IRR) adjusted for age and sex: IRR = 1.58, 95% CI = 1.51–1.64). The strongest association was found for the shortest interval of 1 quarter (IRR = 2.04, 95% CI = 1.88–2.21), with significant associations up to an interval of roughly 3 years. The association was more pronounced and lasted for more quarters in the younger portion of this study group (ages from 65–74: IRR = 2.00, 95% CI = 1.83–2.18; 75–84: IRR = 1.64, 95% CI = 1.55–1.73; ≥85: IRR = 1.19, 95% CI = 1.08–1.31). It was stronger among men than women (men: IRR = 1.98, 95% CI = 1.84–2.14; women: IRR = 1.44, 95% CI = 1.37–1.51) with no sex‐specific temporal association. Conclusion This large claims data study confirmed that incident late‐life depression is associated with a higher risk of dementia within the 3 years following diagnosis. Hence, incident late‐life depression should prompt further cognitive examinations and referrals to specialists. This might apply especially to younger seniors and men.