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Depression, Vascular Factors, and Risk of Dementia in Primary Care: A Retrospective Cohort Study
Author(s) -
Köhler Sebastian,
Buntinx Frank,
Palmer Katie,
Akker Marjan
Publication year - 2015
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.13357
Subject(s) - medicine , dementia , hazard ratio , depression (economics) , vascular dementia , stroke (engine) , proportional hazards model , retrospective cohort study , cohort study , diabetes mellitus , cohort , confidence interval , psychiatry , disease , endocrinology , mechanical engineering , engineering , economics , macroeconomics
Objectives To study the interaction between and timing effects of depression and vascular disorders on dementia risk. Design Retrospective cohort study. Setting Primary care practices in the south of the Netherlands. Participants Individuals in primary care aged 50 to 100 followed for 13 years (N = 35,791). Measurements Medical diagnoses of incident depression, hypertension, obesity, type 2 diabetes mellitus, stroke, and dementia were extracted from a research database. Cox proportional hazards regression was used to test whether incident depression predicted dementia and its putative interactions with vascular factors. Results In total, 1,680 participants developed dementia. Individuals with depression (n = 978) had a higher risk of dementia (adjusted hazard ratio ( HR ) = 2.03, 95% confidence interval ( CI ) = 1.56–2.64). Depression exerted most effect in participants with incident stroke ( HR = 5.29, 95% CI = 2.52–11.14) or newly diagnosed hypertension ( HR = 3.09, 95% CI = 1.54–6.20). Conclusion Depression in later life increases the risk of dementia. The effect is particularly high in individuals with depression and vascular disorders. Targeting late‐onset depression in individuals with vascular disorders might lower dementia risk by preventing cerebrovascular changes.