期刊
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY
卷 26, 期 8, 页码 819-827出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jagp.2018.05.002
关键词
Depression; Alzheimer dementia; mild cognitive impairment; cognition
资金
- Academic Scholars Award from Department of Psychiatry, University of Toronto
- NIA/NIH [U01 AG016976]
- NIA [P30 AG019610, P30 AG013846, P50 AG008702, P50 AG025688, P50 AG047266, P30 AG010133, P50 AG005146, P50 AG005134, P50 AG005133, P50 AG005142, P30 AG012300, P30 AG049638, P50 AG005136, P50 AG033514, P50 AG005681, P50 AG047270]
- The NIA [P50 AG016574, P50 AG005138, P30 AG008051, P30 AG013854, P30 AG008017, P30 AG010161, P50 AG047366, P30 AG010129, P50 AG016573, P50 AG005131, P50 AG023501, P30 AG035982, P30 AG028383, P30 AG053760, P30 AG010124]
- NATIONAL INSTITUTE ON AGING [P50AG005138, P50AG016574, P50AG005133, P30AG028383, P50AG005136, U01AG016976, P30AG049638, P50AG005142, P50AG005131, P50AG033514, P50AG047366, P30AG008017, P50AG005146, P50AG047270, P30AG010129, P30AG013854, P30AG010133, P50AG047266, P30AG010124, P30AG012300, P30AG010161, P50AG023501, P30AG008051, P50AG005681, P50AG005134, P50AG008702, P30AG019610, P30AG035982, P50AG016573, P50AG025688, P30AG053760, P30AG013846] Funding Source: NIH RePORTER
Objective: Older adults with depression are at increased risk of Alzheimer dementia, but predictors of increased risk remain incompletely understood. We aim to identify characteristics of older adults with depression most at risk of progressing to Alzheimer dementia. Identification of high-risk subgroups could facilitate future interventional strategies to reduce risk of Alzheimer dementia in older adults with depression. Methods: Using data from the National Alzheimer's Coordinating Center, 1,965 participants with clinically defined depression and mild cognitive impairment at baseline were followed until development of Alzheimer dementia or loss to follow-up. Results: Seven hundred and eighty (39.7%) developed Alzheimer dementia over a median follow-up duration of 27 months. In survival analyses, age (hazard ratio [HR] 1.04, 95% 1.03-1.05), baseline Mini-Mental State Exam (HR 0.85, 95% confidence interval 0.83-0.87), amnestic subtype of mild cognitive impairment (HR 1.66, 95% 1.30-2.12), presence of APOE4 allele (HR 1.99, 1.69-2.36), and presence of active depression within the last two years (HR 1.44, 95% confidence interval 1.16-1.79) were all independently associated with increased risk of Alzheimer dementia. Six hundred and fifty-six (41.7%) participants with mild cognitive impairment and active depression within the last two years developed Alzheimer dementia compared to 120 (31.6%) of those with a more remote history of depression. Conclusion: Older adults with depression and mild cognitive impairment demonstrated a high rate of progression to Alzheimer dementia over a relatively short duration of follow-up. Individuals with a combination of mild cognitive impairment and recently active depression are a particularly high-risk subgroup.
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