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Neurology. 2016 Sep 13;87(11):1102-9. doi: 10.1212/WNL.0000000000003089. Epub 2016 Aug 12.

Late-onset depressive symptoms increase the risk of dementia in small vessel disease.

Author information

1
From the Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Departments of Neurology (I.W.M.v.U., H.M.v.d.H., E.M.C.v.L., A.M.T., E.J.v.D., E.R., F.-E.d.L.), Geriatrics (J.A.H.R.C.), Medical Psychology (R.P.C.K.), and Psychiatry (I.T.), Nijmegen; Department of Neurology (A.G.W.v.N.), Amphia Ziekenhuis Breda; and Department of Neurology (K.F.d.L.), HagaZiekenhuis The Hague, the Netherlands.
2
From the Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Departments of Neurology (I.W.M.v.U., H.M.v.d.H., E.M.C.v.L., A.M.T., E.J.v.D., E.R., F.-E.d.L.), Geriatrics (J.A.H.R.C.), Medical Psychology (R.P.C.K.), and Psychiatry (I.T.), Nijmegen; Department of Neurology (A.G.W.v.N.), Amphia Ziekenhuis Breda; and Department of Neurology (K.F.d.L.), HagaZiekenhuis The Hague, the Netherlands. frankerik.deleeuw@radboudumc.nl.

Abstract

OBJECTIVE:

We prospectively investigated the role of depressive symptoms (DS) on all-cause dementia in a population with small vessel disease (SVD), considering onset age of DS and cognitive performance.

METHODS:

The RUN DMC study (Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort) is a prospective cohort study among 503 older adults with SVD on MRI without dementia at baseline (2006), with a follow-up of 5 years (2012). Kaplan-Meier curves stratified for DS and dementia risk were compared using log-rank test. We calculated hazard ratios using Cox regression analyses.

RESULTS:

Follow-up was available for 496 participants (mean baseline age 65.6 years [SD 8.8]; mean follow-up time 5.2 years). All-cause dementia developed in 41 participants. The 5.5-year dementia risk was higher in those with DS (hazard ratio 2.7, 95% confidence interval 1.4-5.2), independent of confounders. This was driven by those with late-onset DS. Five-year cumulative risk difference for dementia was higher in participants with depressive symptoms who had high baseline cognitive performance (no DS 0.0% vs DS 6.9%, log-rank p < 0.001) compared with those who had low cognitive performance at baseline.

CONCLUSIONS:

Late-onset DS increases dementia risk, independent of SVD. Especially in those with relatively high cognitive performance, DS indicate a higher risk. In contrast to current practice, clinicians should monitor those with DS who also show relatively good cognitive test scores.

PMID:
27521430
DOI:
10.1212/WNL.0000000000003089
[Indexed for MEDLINE]

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