The British Journal of Psychiatry (2008) 193: 373-377. doi: 10.1192/bjp.bp.107.044974
© 2008 The Royal College of Psychiatrists
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Severity of depression and risk for subsequent dementia: cohort studies in China and the UK*

Ruoling Chen, MD, PhD

Department of Epidemiology and Public Health, Royal Free and University College Medical School, London, UK

Zhi Hu, MD, PhD

School of Health Administration, Anhui Medical University, China

Li Wei, MD, PhD

Medicines Monitoring Unit, Ninewells Hospital and Medical School, University of Dundee, UK

Xia Qin, BSc

School of Health Administration, Anhui Medical University, China

Cherie McCracken, PhD and John R. Copeland, MD, ScD, FRCP

Division of Psychiatry, University of Liverpool, UK

Correspondence: Ruoling Chen, Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK. Email: ruoling.chen{at}ucl.ac.uk

Declaration of interest

None. Funding detailed in Acknowledgements.

* An abstract of this study was presented at the 135th Annual Meeting of the American Public Health Association, Washington DC, USA, 3–6 November 2007.

Background

Depression and dementia often exist concurrently. The associations of depressive syndromes and severity of depression with incident dementia have been little studied.

Aims

To determine the effects of depressive syndromes and cases of depression on the risk of incident dementia.

Method

Participants in China and the UK aged >=65 years without dementia were interviewed using the Geriatric Mental State interview and re-interviewed 1 year later in 1254 Chinese, and 2 and 4 years later in 3341 and 2157 British participants respectively (Ageing in Liverpool Project Health Aspects: part of the Medical Research Council – Cognitive Function and Ageing study).

Results

Incident dementia was associated with only the most severe depressive syndromes in both Chinese and British participants. The risk of dementia increased, not in the less severe cases of depression but in the most severe cases. The multiple adjusted hazard ratio (HR)=5.44 (95% CI 1.67–17.8) for Chinese participants at 1-year follow-up, and HR=2.47 (95% CI 1.25–4.89) and HR=2.62 (95% CI 1.18–5.80) for British participants at 2- and 4-year follow-up respectively. The effect was greater in younger participants.

Conclusions

Only the most severe syndromes and cases of depression are a risk factor for dementia.




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The British Journal of Psychiatry, March 1, 2009; 194(3): 287 - 287.
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