Depression and incident alzheimer disease

The impact of disease severity

Patricia Gracia-García, Concepción De-La-Cámara, Javier Santabárbara, Raúl Lopez-Anton, Miguel Angel Quintanilla, Tirso Ventura, Guillermo Marcos, Antonio Campayo, Pedro Saz, Constantine G Lyketsos, Antonio Lobo

Research output: Contribution to journalArticle

Abstract

Objectives To test the hypothesis that clinically significant depression (particularly severe depression) increases the risk of Alzheimer's disease (AD). Methods A longitudinal, three-wave epidemiologic study was implemented in a sample of individuals aged 55 years and older (n = 4,803) followed up at 2.5 years and 4.5 years. This was a population-based cohort drawn from the Zaragoza Dementia and Depression (ZARADEMP) Project, in Zaragoza, Spain. Participants included individuals cognitively intact at baseline (n = 3,864). The main outcome measures were depression as assessed by using the diagnostic interview Geriatric Mental State- Automated Geriatric Examination for Computer Assisted Taxonomy package; and AD diagnosed by a panel of research psychiatrists according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. The 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%); of these, 16.4% had severe depression. Seventy incident cases of AD were found at follow-up. Compared with nondepressed individuals, the incidence rate of AD was significantly higher in the severely depressed subjects (incidence rate ratio: 3.59 [95% confidence interval: 1.30-9.94]). A consistent, significant association was observed between severe depression at baseline and incident AD in the multivariate model (hazard ratio: 4.30 [95% CI: 1.39-13.33]). Untreated depression was associated with incident AD in the unadjusted model; however, in the final model, this association was attenuated and nonsignificant. Conclusions Severe depression increases the risk of AD, even after controlling for the competing risk of death.

Original languageEnglish (US)
Pages (from-to)119-129
Number of pages11
JournalAmerican Journal of Geriatric Psychiatry
Volume23
Issue number2
DOIs
StatePublished - Feb 1 2015

Fingerprint

Alzheimer Disease
Depression
Geriatrics
Incidence
Proportional Hazards Models
Diagnostic and Statistical Manual of Mental Disorders
Spain
Psychiatry
Dementia
Epidemiologic Studies
Outcome Assessment (Health Care)
Confidence Intervals
Interviews
Mortality
Research
Population

Keywords

  • Alzheimer's disease
  • depression
  • incidence
  • Risk factor

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology

Cite this

Gracia-García, P., De-La-Cámara, C., Santabárbara, J., Lopez-Anton, R., Quintanilla, M. A., Ventura, T., ... Lobo, A. (2015). Depression and incident alzheimer disease: The impact of disease severity. American Journal of Geriatric Psychiatry, 23(2), 119-129. https://doi.org/10.1016/j.jagp.2013.02.011

Depression and incident alzheimer disease : The impact of disease severity. / Gracia-García, Patricia; De-La-Cámara, Concepción; Santabárbara, Javier; Lopez-Anton, Raúl; Quintanilla, Miguel Angel; Ventura, Tirso; Marcos, Guillermo; Campayo, Antonio; Saz, Pedro; Lyketsos, Constantine G; Lobo, Antonio.

In: American Journal of Geriatric Psychiatry, Vol. 23, No. 2, 01.02.2015, p. 119-129.

Research output: Contribution to journalArticle

Gracia-García, P, De-La-Cámara, C, Santabárbara, J, Lopez-Anton, R, Quintanilla, MA, Ventura, T, Marcos, G, Campayo, A, Saz, P, Lyketsos, CG & Lobo, A 2015, 'Depression and incident alzheimer disease: The impact of disease severity', American Journal of Geriatric Psychiatry, vol. 23, no. 2, pp. 119-129. https://doi.org/10.1016/j.jagp.2013.02.011
Gracia-García P, De-La-Cámara C, Santabárbara J, Lopez-Anton R, Quintanilla MA, Ventura T et al. Depression and incident alzheimer disease: The impact of disease severity. American Journal of Geriatric Psychiatry. 2015 Feb 1;23(2):119-129. https://doi.org/10.1016/j.jagp.2013.02.011
Gracia-García, Patricia ; De-La-Cámara, Concepción ; Santabárbara, Javier ; Lopez-Anton, Raúl ; Quintanilla, Miguel Angel ; Ventura, Tirso ; Marcos, Guillermo ; Campayo, Antonio ; Saz, Pedro ; Lyketsos, Constantine G ; Lobo, Antonio. / Depression and incident alzheimer disease : The impact of disease severity. In: American Journal of Geriatric Psychiatry. 2015 ; Vol. 23, No. 2. pp. 119-129.
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abstract = "Objectives To test the hypothesis that clinically significant depression (particularly severe depression) increases the risk of Alzheimer's disease (AD). Methods A longitudinal, three-wave epidemiologic study was implemented in a sample of individuals aged 55 years and older (n = 4,803) followed up at 2.5 years and 4.5 years. This was a population-based cohort drawn from the Zaragoza Dementia and Depression (ZARADEMP) Project, in Zaragoza, Spain. Participants included individuals cognitively intact at baseline (n = 3,864). The main outcome measures were depression as assessed by using the diagnostic interview Geriatric Mental State- Automated Geriatric Examination for Computer Assisted Taxonomy package; and AD diagnosed by a panel of research psychiatrists according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. The 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{\%}); of these, 16.4{\%} had severe depression. Seventy incident cases of AD were found at follow-up. Compared with nondepressed individuals, the incidence rate of AD was significantly higher in the severely depressed subjects (incidence rate ratio: 3.59 [95{\%} confidence interval: 1.30-9.94]). A consistent, significant association was observed between severe depression at baseline and incident AD in the multivariate model (hazard ratio: 4.30 [95{\%} CI: 1.39-13.33]). Untreated depression was associated with incident AD in the unadjusted model; however, in the final model, this association was attenuated and nonsignificant. Conclusions Severe depression increases the risk of AD, even after controlling for the competing risk of death.",
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