Depression and Increased Risk of Alzheimer's Dementia: Longitudinal Analyses of Modifiable Risk and Sex-Related Factors |
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| Institution: | 1. Neuropsychopharmacology Research Group (DK, RW, KLL, NH, DG), Sunnybrook Research Institute, Toronto, Ontario, Canada;2. Department of Pharmacology and Toxicology (DK, RW, KLL), University of Toronto, Toronto, Ontario, Canada;3. ICES (AK, SEB), Toronto, Ontario, Canada;4. Institute of Health Policy, Management, and Evaluation (AK, SEB), Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada;5. Department of Psychiatry (KLL, NH, DG), University of Toronto, Toronto, Ontario, Canada;1. Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing (FVL, KC, KM, AJ), University of Rochester Medical Center, Rochester, NY;2. Department of Psychiatry, School of Medicine and Dentistry (FVL, AP, BPC), University of Rochester Medical Center, Rochester, NY;3. Department of Brain and Cognitive Sciences (FVL), University of Rochester;4. Department of Neuroscience, School of Medicine and Dentistry (FVL), University of Rochester Medical Center, Rochester, NY;5. Department of Neurology, School of Medicine and Dentistry (FVL, AP), University of Rochester Medical Center, Rochester, NY;6. Division of Geriatrics & Aging, Department of Medicine, School of Medicine and Dentistry (DN), University of Rochester Medical Center, Rochester, NY;7. Department of Public Health, School of Medicine and Dentistry (BPC), University of Rochester Medical Center, Rochester, NY;1. RAND Corporation (LF), Arlington, VA;2. Alzheimer''s Association (ES), Chicago, IL;3. Persons Living with Dementia Stakeholder Group, Care of E Shubeck, Alzheimer''s Association (MS, TW, CHH, EKK, BL, MM, BN, GO, LP, BVB), Chicago, IL;4. The Gerontological Society of America (KM), Washington, DC;5. Drexel University College of Nursing and Health Professions (LG), Philadelphia, PA;6. Alpert Medical School of Brown University, Brown University School of Public Health, and Butler Hospital, Providence, RI;1. University of Pittsburgh, Pittsburgh, PA;2. Section of Geriatrics, UPMC Western Psychiatric Institute and Clinic, Pittsburgh, PA;1. Department of Neurology (RBS, IHR), University of Rochester, Rochester, NY;2. Center for Health?+?Technology (RBS), University of Rochester, Rochester, NY |
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| Abstract: | ObjectiveOur understanding of why older adults with depression are at increased risk of Alzheimer's disease (AD) remains incomplete. Most adults living with AD are women, and women have a near twofold lifetime risk of depression. We examined the risk of depression upon incident AD, and how sex influences this risk.MethodsUsing the National Alzheimer's Coordinating Center database, older adults (age 50+) with normal cognition, who visited memory clinics across the United States between September 2005 and December 2019, were followed until first diagnosis of AD or loss to follow up. Multivariable survival analyses were performed to determine if recent and/or remote depression were independent risk factors for AD, if this depression-related risk exists for each sex or was moderated by sex.ResultsSix hundred and fifty-two of 10,739 enrolled participants developed AD over a median follow-up of 55.3 months. Recent depression (active within the last 2 years) was independently associated with increased risk of AD (hazard ratio HR] = 2.0; 95%CI, 1.5–2.6) while a remote history of depression was not (HR = 1.0; 95%CI, 0.7–1.5). After stratification by sex, recent depression was an independent predictor in females (HR = 2.3; 95%CI, 1.7–3.1) but not in males (HR = 1.4; 95%CI, 0.8–2.6). No interaction between recent depression and sex was observed.ConclusionOnly a recent history of depression was associated with higher risk of AD. This association was significant among women only, but was not moderated by sex. Future analyses should determine if these findings extend to other populations and may be explained by variable distribution of neurobiological or other modifiable risk factors between the sexes. |
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