This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (81)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Alzheimer Disease  • Cognitive Disorders  • Dementias  • Psychiatry  • Depression  • Alert me on articles by topic  Social Bookmarking   What's this?

A Prospective Cohort Study

Pedro J. Modrego, MD; Jaime Ferrández, MD

Arch Neurol. 2004;61:1290-1293.

Background  Mild cognitive impairment has been regarded as a precursor to dementia of Alzheimer type, but not all patients with mild cognitive impairment develop dementia.

Objective  To determine whether depression may increase the risk of developing dementia.

Setting  The outpatient clinics of a community general hospital.

Design  Prospective cohort study.

Methods  A cohort of 114 patients with amnestic mild cognitive impairment was followed up for a mean period of 3 years. At baseline, the patients underwent memory tests, the Spanish version of the Mini-Mental State Examination, a verbal fluency test, the Geriatric Depression Scale, and the Clinical Dementia Rating Scale for staging purposes. Psychiatric examination for depression was based on structured interview and Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition criteria. We also carried out either computed tomography or magnetic resonance imaging of the brain.

Main Outcome Measures  We carried out periodic evaluations based on the Mini-Mental State Examination, verbal fluency test, Geriatric Depression Scale, Blessed Dementia Rating Scale, and Clinical Dementia Rating Scale. The end point was the development of probable Alzheimer disease according to the criteria of the National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer’s Disease and Related Disorders Association.

Results  Depression was observed in 41 patients (36%) at baseline. After a mean period of 3 years, 59 patients (51.7%) developed dementia of Alzheimer type, and 6 died. Of the depressed patients, 35 (85%) developed dementia in comparison with 24 (32%) of the nondepressed patients (relative risk, 2.6; 95% confidence interval, 1.8-3.6). The survival analysis also showed that depressed patients developed dementia earlier than the nondepressed. Most patients with depression at baseline exhibited a poor response to antidepressants.

Conclusions  We conclude that patients with mild cognitive impairment and depression are at more than twice the risk of developing dementia of Alzheimer type as those without depression. Patients with a poor response to antidepressants are at an especially increased risk of developing dementia.

Author Affiliations: Neurology Unit (Dr Modrego) and Psychiatry Unit (Dr Ferrández), Hospital de Alcañiz, Alcañiz, Spain.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Does Anxiety Affect Risk of Dementia? Findings From the Caerphilly Prospective Study
Gallacher et al.
Psychosom. Med. 2009;71:659-666.
ABSTRACT | FULL TEXT  

Donepezil delays progression to AD in MCI subjects with depressive symptoms
Lu et al.
Neurology 2009;72:2115-2121.
ABSTRACT | FULL TEXT  

Depression in the Prodromal Phase of Alzheimer Disease and the Reverse Causal Hypothesis
Modrego
Arch Gen Psychiatry 2009;66:107-107.
FULL TEXT  

A 60-Year-Old Woman With Mild Memory Impairment: Review of Mild Cognitive Impairment
Ellison
JAMA 2008;300:1566-1574.
ABSTRACT | FULL TEXT  

Low plasma eicosapentaenoic acid and depressive symptomatology are independent predictors of dementia risk
Samieri et al.
Am. J. Clin. Nutr. 2008;88:714-721.
ABSTRACT | FULL TEXT  

Change in Depressive Symptoms During the Prodromal Phase of Alzheimer Disease
Wilson et al.
Arch Gen Psychiatry 2008;65:439-445.
ABSTRACT | FULL TEXT  

Neuropsychological Correlates of Self-Reported Depression and Self-Reported Cognition Among Patients With Mild Cognitive Impairment
Bruce et al.
J Geriatr Psychiatry Neurol 2008;21:34-40.
ABSTRACT  

PREDICTORS OF PROGRESSION FROM MILD COGNITIVE IMPAIRMENT TO ALZHEIMER DISEASE
Rozzini et al.
Neurology 2008;70:735-736.
FULL TEXT  

Distinguishing Between Depression and Dementia in Older Persons: Neuropsychological and Neuropathological Correlates
Wright and Persad
J Geriatr Psychiatry Neurol 2007;20:189-198.
ABSTRACT  

Neurocognitive Impairment and Dementia in Mood Disorders
Pfennig et al.
J. Neuropsychiatry Clin. Neurosi. 2007;19:373-382.
ABSTRACT | FULL TEXT  

Depressed Mood in Informal Caregivers of Individuals With Mild Cognitive Impairment
Lu et al.
AM J ALZHEIMERS DIS OTHER DEMEN 2007;22:273-285.
ABSTRACT  

Depressive Symptoms and Cognitive Change in Older Mexican Americans
Raji et al.
J Geriatr Psychiatry Neurol 2007;20:145-152.
ABSTRACT  

Predictors of progression from mild cognitive impairment to Alzheimer disease
Palmer et al.
Neurology 2007;68:1596-1602.
ABSTRACT | FULL TEXT  

Depressive Symptoms Associated With Hereditary Alzheimer's Disease: A Case Description
Contreras et al.
AM J ALZHEIMERS DIS OTHER DEMEN 2007;21:411-415.
ABSTRACT  

Correlates and outcomes of dementia among dialysis patients: the Dialysis Outcomes and Practice Patterns Study
Kurella et al.
Nephrol Dial Transplant 2006;21:2543-2548.
ABSTRACT | FULL TEXT  

Depression, apolipoprotein e genotype, and the incidence of mild cognitive impairment: a prospective cohort study.
Geda et al.
Arch Neurol 2006;63:435-440.
ABSTRACT | FULL TEXT  

Depressive Symptoms and Cognitive Decline in Late Life: A Prospective Epidemiological Study
Ganguli et al.
Arch Gen Psychiatry 2006;63:153-160.
ABSTRACT | FULL TEXT  

Prognosis of Depression in Old Age Compared to Middle Age: A Systematic Review of Comparative Studies
Mitchell and Subramaniam
Am. J. Psychiatry 2005;162:1588-1601.
ABSTRACT | FULL TEXT  

Diagnosis and treatment of Alzheimer's disease
Desai and Grossberg
Neurology 2005;64:S34-S39.
ABSTRACT | FULL TEXT  

Depression Is Unrelated to Conversion to Dementia in Patients With Mild Cognitive Impairment
Rozzini et al.
Arch Neurol 2005;62:505-505.
FULL TEXT  

Depression Is Unrelated to Conversion to Dementia in Patients With Mild Cognitive Impairment--Reply
Modrego
Arch Neurol 2005;62:505-506.
FULL TEXT