Increased Risk of Dementia with Mid-, Late-Life Depressive SymptomsIndividuals who display depressive symptoms in mid- or late life have an increased risk of dementia, according to a report in the May issue of Archives of General Psychiatry.

More than five million people in the United States suffer from Alzheimer’s disease (AD), at a health care cost (in 2010 dollars) of approximately $172 billion.

“Prevalence and costs of AD and other dementias are projected to rise dramatically during the next 40 years unless a prevention or a cure can be found. Therefore, it is critical to gain a greater understanding of the key risk factors and etiologic underpinnings of dementia from a population-based perspective,” the authors write.

Deborah E. Barnes, Ph.D., M.P.H., of the University of California, San Francisco and colleagues evaluated data from 13,535 long-term Kaiser Permanente members.

The team examined depressive symptoms assessed in midlife and in late life and risks of developing dementia, Alzheimer disease and vascular dementia. Vascular dementia, or VaD, results from brain damage caused by impaired blood flow to the brain.

Depressive symptoms were present in 14.1 percent of study participants in midlife only, 9.2 percent in late life only and 4.2 percent in both.

During six years of followup, 22.5 percent of patients were diagnosed with dementia; 5.5 percent with Alzheimer disease and 2.3 percent with VaD.

When examining AD and VaD separately, patients with late-life depressive symptoms had a two-fold increase in AD risk, and patients with midlife and late-life symptoms had more than a three-fold increase in VaD risk.

“Our findings suggest that chronic depression during the life course may be etiologically associated with an increased risk of dementia, particularly VaD, whereas depression that occurs for the first time in late life is likely to reflect a prodromal stage of dementia, in particular AD,” the authors conclude.

Source: Arch Gen Psychiatry 2012;69[5]:493-498.