ObjectivesDepression can be a prodromal feature or a risk factor for dementia. We aimed to investigate which clinical factors in patients with late-life depression are associated with a higher risk of developing dementia and a more rapid conversion.DesignRetrospective cohort study.SettingSouth London and Maudsley NHS Foundation Trust (SLaM) secondary mental healthcare services.ParticipantsThe SLaM Clinical Record Interactive Search was used to retrieve anonymised data on 3659 patients aged 65 years or older who had received a diagnosis of depression in mental health services and had been followed up for at least 3 months.Outcome measuresPredictors of development of incident dementia were investigated, including demographic factors, health status rated on the Health of the National Outcome scale for older people (HoNOS65+), depression recurrence and treatments including psychotropic drugs and cognitive behavioural therapy (CBT).ResultsIn total, 806 (22.0%) patients developed dementia over a mean follow-up time of 2.7 years. Significant predictors of receiving a dementia diagnosis in fully adjusted models and after accounting for multiple comparisons were older age (adjusted HR=1.04, 95% CI 1.03 to 1.06 per year difference from sample mean) and the HoNOS65+ subscale measuring cognitive problems (HR=4.72, 95% CI 3.67 to 6.06 for scores in the problematic range). Recurrent depressive disorder or past depression (HR=0.65, 95% CI 0.55 to 0.77) and the receipt of CBT (HR=0.73 95% CI 0.61 to 0.87) were associated with a lower dementia risk. Over time, hazards related to age increased and hazards related to cognitive problems decreased.ConclusionsIn older adults with depression, a higher risk of being subsequently diagnosed with dementia was predicted by higher age, new onset depression, severity of cognitive symptoms and not receiving CBT. Further exploration is needed to determine whether the latter risk factors are responsive to interventions.
Background Depression in later life is increasingly being recognised as a prodrome for the development of dementia. We aimed to investigate which clinical factors are associated with more rapid conversion from depression to dementia. Method The South London and Maudsley NHS Foundation Trust (SLaM) Clinical Record Interactive Search (CRIS) was used to retrieve anonymised data on patients who were aged 65 years or older and received a diagnosis of depression in mental health services, followed by a diagnosis of dementia >3 months later. Predictors of accelerated dementia development were investigated including demographic factors, health status rated on the Health of the National Outcome scale for older people (HoNOS65+), depression recurrence, and treatments including psychotropic drugs and cognitive behavioural therapy (CBT). Result In 806 patients with late‐life depression who later received a diagnosis of dementia, significant predictors of shorter time to dementia diagnosis in fully adjusted models were older age, male gender, higher deprivation, and HoNOS65+ subscales measuring depressed mood and cognitive problems. A diagnosis of recurrent depressive disorder was independently associated with a longer time to dementia diagnosis. Antipsychotic drugs and CBT were significantly associated with longer times to dementia diagnosis when adjusted for demographic factors and severity of mood and cognitive difficulties, but not in fully adjusted models. Conclusion In older adults with depression and subsequent dementia diagnosed by mental health services, faster progression to a diagnosis of dementia was predicted by age and gender, new onset depression, and severity of depressive and cognitive symptoms.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.