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Depression and Incident Alzheimer Disease: The Impact of Disease Severity

2013; Elsevier BV; Volume: 23; Issue: 2 Linguagem: Inglês

10.1016/j.jagp.2013.02.011

1545-7214

Patricia Gracia‐García, Concepción De‐la‐Cámara, Javier Santabárbara, Raúl López‐Antón, Miguel Quintanilla, Tirso Ventura, Guillermo Marcos, Antonio Campayo, Pedro Saz, Constantine G. Lyketsos, António Lobo,

Stroke Rehabilitation and Recovery

Objective-We test the hypothesis that clinically significant depression, severe depression in particular, increases the risk of Alzheimer's Disease (AD).Design-A longitudinal, three-wave epidemiological enquiry was implemented in a sample of individuals aged ≥55 years (n = 4,803) followed-up at 2.5 years and 4.5 years. Setting-Population-based cohort drawn from the ZARADEMP Project, in Zaragoza, Spain.Participants-Cognitively intact individuals at baseline (n = 3,864).Main outcome measures-Depression was assessed by a standardized diagnostic interview (Geriatric Mental State, GMS-AGECAT).A panel of research psychiatrist diagnosed AD according to DSM-IV criteria.Fine and Gray multivariate regression model was used in the analysis, accounting for mortality.Results-At baseline, clinically significant depression was diagnosed in 452 participants (11.7%).Among the depressed, 16.4% had severe depression.Seventy incident cases of AD were found at follow-up.Compared with non-depressed individuals, the incidence rate of AD was significantly higher in the depressed (incidence rate ratio, IRR = 1.91 (95%CI: 1.04-3.51)and particularly in the severely depressed (IRR = 3.59 (95%CI: 1.30-9.94).A consistent, significant association was observed between severe depression at baseline and incident AD in the multivariate model (hazard ratio,.Untreated depression was associated with incident AD in the unadjusted model, although in the final model this association was attenuated and non-significant.Conclusions-Severe depression increases the risk of AD, even after controlling for the competing risk of death.This finding may stimulate studies about the effect of treating depression in relation to the risk of AD.