Posted on May 11, 2013 by
- Review article
Late-life depression and risk of vascular dementia and Alzheimer?s disease: systematic review and meta-analysis of community-based cohort studies
+ Author Affiliations
Breno S. Diniz, MD, PhD, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA, and Department of Mental Health, School of Medicine, Federal University of Minas Gerais, Brazil; Meryl A. Butters, PhD, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA; Steven M. Albert, PhD, Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, USA; Mary Amanda Dew, PhD, Charles F. Reynolds 3rd, MD, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA
- Correspondence: Meryl A. Butters, PhD, Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O?Hara Street, Pittsburgh, PA 15213, USA. Email: ButtersMA@upmc.edu
Declaration of interest
In the past 3 years B.S.D. has received payment for lectures from Novartis and had travel/meeting expenses covered by Pfizer. M.A.B. received remuneration for neuropsychological assessment services on a fee-for-service basis, for clinical trials conducted by Northstar Neuroscience and Medtronic and from Fox Learning Systems for developing computerised neuropsychological tasks for an NIH-funded study. The following pharmaceutical companies provide pharmaceutical supplies for C.F.R.?s NIH-sponsored work: Bristol-Myers Squibb, Forrest Laboratories, Lilly and Pfizer.
Late-life depression may increase the risk of incident dementia, in particular of Alzheimer?s disease and vascular dementia.
To conduct a systematic review and meta-analysis to evaluate the risk of incident all-cause dementia, Alzheimer?s disease and vascular dementia in individuals with late-life depression in population-based prospective studies.
A total of 23 studies were included in the meta-analysis. We used the generic inverse variance method with a random-effects model to calculate the pooled risk of dementia, Alzheimer?s disease and vascular dementia in older adults with late-life depression.
Late-life depression was associated with a significant risk of all-cause dementia (1.85, 95% CI 1.67-2.04, P<0.001), Alzheimer?s disease (1.65, 95% CI 1.42-1.92, P<0.001) and vascular dementia (2.52, 95% CI 1.77-3.59, P<0.001). Subgroup analysis, based on five studies, showed that the risk of vascular dementia was significantly higher than for Alzheimer?s disease (P = 0.03).
Late-life depression is associated with an increased risk for all-cause dementia, vascular dementia and Alzheimer?s disease. The present results suggest that it will be valuable to design clinical trials to investigate the effect of late-life depression prevention on risk of dementia, in particular vascular dementia and Alzheimer?s disease.