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Is the relationship between syndromes of depression and dementia temporal? The MRC-ALPHA and Hefei-China studies

Published online by Cambridge University Press:  23 June 2008

R. Chen ,
Z. Hu ,
L. Wei ,
X. Qin  and
J. R. Copeland
R. Chen*
Affiliation:
School of Health Administration, Anhui Medical University, Hefei, Anhui, China Department of Epidemiology and Public Health, Royal Free and University College Medical School, London, UK
Z. Hu
Affiliation:
School of Health Administration, Anhui Medical University, Hefei, Anhui, China
L. Wei
Affiliation:
Medicines Monitoring Unit, Ninewells Hospital and Medical School, University of Dundee, UK
X. Qin
Affiliation:
School of Health Administration, Anhui Medical University, Hefei, Anhui, China
J. R. Copeland
Affiliation:
Department of Psychiatry, University of Liverpool, UK
*
*Address for correspondence: Dr R. Chen, M.D., Ph.D., Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK. (Email: ruoling.chen@ucl.ac.uk)
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Abstract

Background

Recent studies have shown a temporal association between depressive symptoms and cognitive decline. However, the relationship between syndromes of depression and dementia is unknown.

Method

A total of 1736 people aged ⩾65 years in China and 5222 older people in the UK were interviewed using the Geriatric Mental State Examination (GMS) and reinterviewed at follow-up. Five levels of syndromes of depression and dementia were diagnosed using the Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT).

Results

Although there were fewer depressive syndromes in Chinese than British participants, both populations showed a similarly high level of syndromes of dementia (organic disorder) (20% for women, 14% for men). There was a significant cross-sectional correlation between syndrome levels of depression and dementia (correlation coefficients: 0.141–0.248 for Chinese, 0.168–0.248 for British). This was maintained for different age, gender and people with and without cardiovascular disease (CVD). The relationship between syndromes of baseline depression and follow-up dementia was less substantial: the correlation coefficient was 0.075 [95% confidence interval (CI) 0.021–0.128] for the Chinese sample at the 1-year follow-up, and 0.093 (95% CI 0.061–0.125) for the British at the 2-year follow-up and 0.093 (95% CI 0.049–0.130) at the 4-year follow-up. This relationship disappeared in participants without baseline organic syndromes. In a multiple adjusted logistic regression analysis, an increased risk of organic syndromes seemed to be associated with baseline, mainly in the highest level of, depressive syndromes.

Conclusions

The relationship between syndromes of depression and dementia might be temporal. The lack of an obvious dose–response relationship between baseline depressive syndromes and follow-up dementia syndromes suggests that the causal relationship between depression and dementia needs further investigation.

Keywords

Dementiadepressionelderlyrelationshipsyndromes
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 3 , March 2009 , pp. 425 - 430
Copyright
Copyright © 2008 Cambridge University Press

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