Late-life depression and risk of vascular dementia and Alzheimer’s disease: systematic review and meta-analysis of community-based cohort studies

Breno S. Diniz , Meryl A. Butters , Steven M. Albert , Mary Amanda Dew , Charles F. Reynolds
  • 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.

Abstract

Background

Late-life depression may increase the risk of incident dementia, in particular of Alzheimer’s disease and vascular dementia.

Aims

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.

Method

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.

Results

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).

Conclusions

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.

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