Exploring the excess mortality due to depressive symptoms in a community-based sample: The role of Alzheimer's Disease

JOURNAL OF AFFECTIVE DISORDERS

卷:202

Article

Lara, Elvira^1,2,3  Maria Haro, Josep^1,2,3  Tang, Ming-Xin^4,5,6,7  Manly, Jennifer^4,5,6,7  Stern, Yaakov^4,5,6,7,8 

[1] Parc Sanitari St Joan de Deu, Dr Antoni Pujadas 42, Barcelona 08830, Spain

[2] CIBERSAM, Inst Salud Carlos III, Ctr Invest Biomed Red Salud Mental, Madrid, Spain

[3] Univ Barcelona, Fac Med, Barcelona, Spain

[4] Columbia Univ Coll Phys & Surg, Dept Neurol, Cognit Neurosci Div, New York, NY 10032 USA

[5] Columbia Univ Coll Phys & Surg, Taub Inst Res Alzheimers Dis & Aging Brain, 630 W 168th St, New York, NY 10032 USA

[6] Columbia Univ, Coll Phys & Surg, Dept Neurol, New York, NY USA

[7] Columbia Univ, Div Epidemiol, Joseph P Mailman Sch Publ Hlth, New York, NY USA

[8] Columbia Univ, Gertrude H Sergievsky Ctr, Coll Phys & Surg, New York, NY 10027 USA

关键词: Depressive symptoms;    Mortality;    Alzheimer's Disease;    Community-based study;   

DOI  :  10.1016/j.jad.2016.05.057

来源: Elsevier

【 摘 要 】

Background: Depression has been associated with increased risk of death. However, there is lack of studies exploring such relationship in the context of dementia. Given the high prevalence of both depression and Alzheimer's Disease (AD), investigating their temporal association with mortality is of public health relevance. Methods: Longitudinal data from the WHICAP study were analyzed (1958 individuals aged >= 65 years). Depressive symptoms were assessed with the 10-item Center for Epidemiologic Studies Depression Scale (CES-D). Respondents were identified as having AD if they satisfied the criteria of the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Cox regressions analyses were performed to determine the association between depressive symptoms and risk of all-cause mortality using the overall sample, and by AD status. Results: Depressive symptoms were significantly associated with higher mortality risk after adjusting for all potential covariates in the overall sample (HR =1.22; 95% CI=1.02, 1.46) and in individuals with incident AD (HR =1.88; 95% CI=1.12, 3.18). Limitations: The CES-D does not measure clinical depression but depressive symptomatology. Since those who were exposed to known risk factors for mortality are likely to die prematurely, our results may have been skewed to the individuals with longer survival. Conclusions: Strategies focusing on prevention and early treatment of depression in the elderly may have a beneficial effect not only on patient quality of life and disability, but may also increase survival in the context of AD. (C) 2016 Elsevier B.V. All rights reserved.

【 授权许可】

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