Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-22T09:57:31.009Z Has data issue: false hasContentIssue false

Cognitive function and risk for depression in old age: a meta-analysis of published literature

Published online by Cambridge University Press:  12 October 2010

Chang-Quan Huang
Affiliation:
Key Laboratory of Chronobiology of Health Ministry, Basic and Forensic School, Sichuan University, Chengdu, China Department of Geriatrics, Third Hospital of Mianyang, Mianyang, Sichuan, China
Zheng-Rong Wang*
Affiliation:
Key Laboratory of Chronobiology of Health Ministry, Basic and Forensic School, Sichuan University, Chengdu, China
Yong-Hong Li
Affiliation:
Key Laboratory of Chronobiology of Health Ministry, Basic and Forensic School, Sichuan University, Chengdu, China
Yi-Zhou Xie
Affiliation:
Key Laboratory of Chronobiology of Health Ministry, Basic and Forensic School, Sichuan University, Chengdu, China
Qing-Xiu Liu
Affiliation:
Department of Geriatrics, Third Hospital of Mianyang, Mianyang, Sichuan, China
*
Correspondence should be addressed to: Wang Zheng-Rong, Key Laboratory of Chronobiology of Health Ministry, Basic and Forensic School, Sichuan University, Chengdu, China610041. Phone: +86 1370 909 8387. Email: [email protected].
Get access

Abstract

Background: We assessed the relationship between cognitive impairment (including mild cognitive impairment with no signs of dementia, and dementia) and risk for depression in old age (60 years and older).

Methods: MEDLINE, EMBASE and the Cochrane Library database were used to identify potential studies. All of the clinical studies that produced data on the association between cognitive function and risk of depression among individuals aged 55 years or older were identified and included in this review. The studies were classified into cross-sectional and longitudinal subsets. The quantitative meta-analysis of cross-sectional and longitudinal studies were performed. For prevalence and incidence rates of depression, odds risk (OR) and relative risk (RR) were calculated, respectively.

Results: Since all but two studies found in the search were for individuals aged 60 years or over, we assessed and reported on results for this larger group only. In this review we included 13 cross-sectional and four prospective longitudinal studies. The quantitative meta-analysis showed that, in old age, individuals with non-dementia cognitive impairment had neither significant higher prevalence nor incidence rates of depression than those without (odds risk (OR): 1.48, 95% confidence intervals (95% CI): 0.87–2.52; relative risk (RR): 1.12, 95% CI: 0.62–2.01). In old age, individuals with dementia had both significant higher prevalence and incidence rates of depression than those without (OR: 1.82, 95% CI: 1.15–2.89; RR: 3.92, 95% CI: 1.93–7.99).

Conclusions: Despite the methodological limitations of this meta-analysis, we found that in old age, there was no association between depression and cognitive impairment with no dementia; however, there was a definite association between depression and dementia and thus dementia might be a risk for depression.

Type
Review Article
Copyright
Copyright © International Psychogeriatric Association 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allen, H., Jolley, D., Comish, J. and Burns, A. (1997). Depression in dementia: a study of mood in a community sample and referrals to a community service. International Journal of Geriatric Psychiatry, 12, 513518.3.0.CO;2-A>CrossRefGoogle Scholar
Bergdahl, E. et al. (2005). Depression among the oldest old: the Umeå 85+ study. International Psychogeriatrics, 17, 557575.CrossRefGoogle ScholarPubMed
Borkowska, A., Drozdz, W. and Jurkowski, P. (2007). The Wisconsin Card Sorting Test and the N-back test in mild cognitive impairment and elderly depression. World Journal of Biological Psychiatry, 12, 17.Google Scholar
Brodaty, H., Luscombe, G. and Anstey, K. J. (2003). Neuropsychological performance and dementia in depressed patients after 25-year follow-up: a controlled study. Psychological Medicine, 33, 12631275.CrossRefGoogle ScholarPubMed
Brown, P. J., Woods, C. M. and Storandt, M. (2007). Model stability of the 15-item Geriatric Depression Scale across cognitive impairment and severe depression. Psychology and Aging, 22, 372379.CrossRefGoogle ScholarPubMed
Bruce, M. L. et al. (2002). Major depression in elderly home health care patients. American Journal of Psychiatry, 159, 13671374.CrossRefGoogle ScholarPubMed
Cervilla, J. A., Prince, M. and Joels, S. (2000). Does depression predict cognitive outcome 9 to 12 years later? Evidence from a prospective study of elderly hypertensives. Psychological Medicine, 30, 10171023.CrossRefGoogle ScholarPubMed
Cole, M. G. and Dendukuri, N. (2003). Risk factors for depression among elderly community subjects: a systematic review and meta-analysis. American Journal of Psychiatry, 160, 11471156.CrossRefGoogle ScholarPubMed
Cole, M. G., Bellavance, F. and Mansour, A. (1999). Prognosis of depression in elderly community and primary care populations: a systematic review and meta-analysis. American Journal of Psychiatry, 156, 11821189CrossRefGoogle ScholarPubMed
Devanand, D. P., Sano, M. and Tang, M. X. (1996). Depressed mood and the incidence of Alzheimer's disease in the elderly living in the community. Archives of General Psychiatry, 53, 175182.CrossRefGoogle ScholarPubMed
Dufouil, C., Fuhrer, R. and Dartigues, J. F. (1996). Longitudinal analysis of the association between depressive symptomatology and cognitive deterioration. American Journal of Epidemiology, 144, 634641.CrossRefGoogle ScholarPubMed
Forsell, Y. (2000). Predictors for depression, anxiety and psychotic symptoms in a very elderly population: data from a 3-year follow-up study. Social Psychiatry and Psychiatric Epidemiology, 35, 259263.CrossRefGoogle Scholar
Ganguli, M., Du, Y., Dodge, H. H., Ratcliff, G. G. and Chang, C. C. (2006). Depressive symptoms and cognitive decline in late life: a prospective epidemiological study. Archives of General Psychiatry, 63, 153160.CrossRefGoogle ScholarPubMed
Goodwin, R. D. et al. (2003). Association between physical activity and mental disorder among adults in the United States. Preventive Medicine, 36, 698–370.CrossRefGoogle ScholarPubMed
Gostynski, M., Ajdacic-Gross, V., Gutzwiller, F., Michel, J. P. and Herrmann, F. (2002). Depression among the elderly in Switzerland. Nervenarzt, 73, 851860.CrossRefGoogle ScholarPubMed
Green, R. C., Cupples, L. A. and Kurz, A. (2003). Depression as a risk factor for Alzheimer disease. Archives of Neurology, 60, 753759.CrossRefGoogle ScholarPubMed
Gurland, B. J., Wilkder, D. E. and Berkman, C. (1988). Depression and disability in the elderly: reciprocal relations and changes with age. International Journal of Geriatric Psychiatry, 3, 163179CrossRefGoogle Scholar
Harpole, L. H., Williams, J. W. and Olsen, M. K. (2005). Improving depression outcomes in older adults with comorbid medical illness. General Hospital Psychiatry, 27, 412.CrossRefGoogle ScholarPubMed
Henderson, A. S., Korten, A. E. and Jacomb, P. A. (1997). The course of depression in the elderly: a longitudinal community-based study in Australia. Psychological Medicine, 27, 119129.CrossRefGoogle ScholarPubMed
Huang, C. Q., Dong, B. R., Pu, Y. S., Zhang, Y. and Liu, Q. X. (2009a). Collaborative care interventions for depression in the elderly: a systematic review of randomized controlled trials. Journal of Investigative Medicine, 57, 446455.Google Scholar
Huang, C. Q., Dong, B. R., Lu, Z. C., Yue, J. R. and Liu, Q. X. (2010a). Chronic diseases and risk for depression in old age: a meta-analysis of published literature. Ageing Research Reviews, 9, 131141. doi:10.1016/j.arr.2009.05.005.CrossRefGoogle ScholarPubMed
Huang, C. Q., Zhang, X. M., Dong, B. R., Lu, Z. C., Yue, J. R. and Liu, Q. X. (2010b). Health status and risk for depression among the elderly: a meta-analysis of published literature. Age and Aging, 39, 2330.Google Scholar
Hudon, C., Belleville, S. and Gauthier, S. (2008). The association between depressive and cognitive symptoms in amnestic mild cognitive impairment. International Psychogeriatrics, 20, 710723.CrossRefGoogle ScholarPubMed
Jorm, A. F. (2001). History of depression as a risk factor for dementia: an updated review. Australian and New Zealand Journal of Psychiatry, 35, 776781.CrossRefGoogle ScholarPubMed
Katon, W., von Korff, M., Lin, E., Bush, T. and Ormel, J. (1992). Adequacy and duration of antidepressant treatment in primary care. Medical Care, 30, 6776.CrossRefGoogle ScholarPubMed
Katon, W. J., Lin, E., Russo, J. and Unutzer, J. (2003). Increased medical costs of a population-based sample of depressed elderly patients. Archives of General Psychiatry, 60, 897903.CrossRefGoogle ScholarPubMed
Kulaksizoglu, I. B. et al. (2005). Unrecognized depression in community-dwelling elderly persons in Istanbul. International Psychogeriatrics, 17, 303312.CrossRefGoogle ScholarPubMed
Leon, F. G., Ashton, A. K., Mello, D. A. and Dantz, B. (2003). Depression and comorbid medical illness: therapeutic and diagnostic challenges. Journal of Family Practice (Suppl.), S19–S23.Google Scholar
Macdonald, A. J. D. (1997). Mental health in old age. BMJ, 315, 413417.CrossRefGoogle ScholarPubMed
Madianos, M. G., Gournas, G. and Stefanis, C. N. (1992). Depressive symptoms and depression among elderly people in Athens. Acta Psychiatrica Scandinavica, 8, 320326.CrossRefGoogle Scholar
McCabe, M. P., Davison, T. and Mellor, D. (2006). Depression among older people with cognitive impairment: prevalence and detection. International Journal of Geriatric Psychiatry, 21, 633644.CrossRefGoogle ScholarPubMed
McCall, N. T., Parks, P., Smith, K., Pope, G. and Griggs, M. (2002). The prevalence of major depression or dysthymia among aged Medicare Fee-for-Service beneficiaries. International Journal of Geriatric Psychiatry, 17, 557565.CrossRefGoogle ScholarPubMed
Migliorelli, R., Teson, A., Sabe, L. and Petracchi, M. (1995). Prevalence and correlates of dysthymia and major depression among patients with Alzheimer's disease. American Journal of Psychiatry, 152, 3744.Google ScholarPubMed
Naarding, P. et al. (2003). Depression in vascular dementia. International Journal of Geriatric Psychiatry, 18, 325330.CrossRefGoogle ScholarPubMed
Paterniti, S., Verider-Taillerfer, M. H. and Dufouil, C. (2002). Depressive symptoms and cognitive decline in elderly people. British Journal of Psychiatry, 181, 406410.CrossRefGoogle ScholarPubMed
Prince, M. J., Harwood, R. H., Thomas, A. and Mann, A. H. (1998). A prospective population-based cohort study of the effects of disablement and social milieu on the onset and maintenance of late-life depression: the Gospel Oak Project VII. Psychological Medicine, 28, 337350.CrossRefGoogle ScholarPubMed
Schoevers, R. A., Beekman, A. T., Deeg, D. J., Geerlings, M. I., Jonker, C. and Tilburg, W. (2000). Risk factors for depression in later life; results of a prospective community based study (AMSTEL). Journal of Affective Disorders, 59, 127137.CrossRefGoogle ScholarPubMed
Sewitch, M. J., McCusker, J., Dendukuri, N. and Yaffe, M. J. (2004). Depression in frail elders: impact on family caregivers. International Journal of Geriatric Psychiatry, 19, 655665.CrossRefGoogle ScholarPubMed
Shah, A. (2009). The relationship between elderly suicide rates and the human development index: a cross-national study of secondary data from the World Health Organization and the United Nations. International Psychogeriatrics, 21, 6977.CrossRefGoogle ScholarPubMed
Snowdon, J. and Lane, F. (1995). The Botany survey: a longitudinal study of depression and cognitive impairment in an elderly population. International Journal of Geriatric Psychiatry, 10, 349358.CrossRefGoogle Scholar
Sonnenberg, C. M., Beekman, A. T., Deeg, D. J. and Tilburg, W. (2000). Sex differences in late-life depression. Acta Psychiatrica Scandinavica, 101, 286292.Google ScholarPubMed
Steffens, D. C. and Potter, G. G. (2008). Geriatric depression and cognitive impairment. Psychological Medicine, 38, 163175.CrossRefGoogle ScholarPubMed
Stek, M. L., Vinkers, D. J., Gussekloo, J., Mast, R. C., Beekman, A. T. and Westendorp, R. G. (2006). Natural history of depression in the oldest old: population-based prospective study. British Journal of Psychiatry, 188, 6569.CrossRefGoogle ScholarPubMed
Steunenberg, B., Beekman, A. T., Deeg, D. J. and Kerkhof, A. J. (2006). Personality and the onset of depression in late life. Journal of Affective Disorders, 92, 243–51.CrossRefGoogle ScholarPubMed
Stroup, D. F., Berlin, J. A., Morton, S. C., Olkin, I., Williamson, G. D. and Rennie, D. (2000). Meta-analysis of Observational Studies in Epidemiology (MOOSE): a proposal for reporting. JAMA, 283, 20082012.CrossRefGoogle Scholar
Sutcliffe, C., Burns, A. and Challis, D. (2007). Depressed mood, cognitive impairment, and survival in older people admitted to care homes in England. American Journal of Geriatric Psychiatry, 15, 708715.CrossRefGoogle ScholarPubMed
Unützer, J. et al. (1997). Depressive symptoms and the cost of health services in HMO patients aged 65 and over: a 4-year prospective study. JAMA, 277, 16181623.CrossRefGoogle ScholarPubMed
Walters, K., Breeze, E., Wilkinson, P., Price, G. M., Bulpitt, C. J. and Fletcher, A. (2004). Local area deprivation and urban-rural differences in anxiety and depression among people older than 75 years in Britain. American Journal of Public Health, 94, 17681774.CrossRefGoogle ScholarPubMed
Wells, K. B. and Burman, M. A. (1991). Caring for depression in America: lessons learned from early findings of the Medical Outcomes Study. Psychiatric Medicine, 9, 503519Google ScholarPubMed
Wilson, R. S., Mendes, D., Leon, C. F. and Bennett, D. A. (2004). Depressive symptoms and cognitive decline in a community population of older persons. Journal of Neurology, Neurosurgery and Psychiatry, 75, 126129.Google Scholar
von Korff, M., Ormel, J., Katon, W. and Lin, E. H. (1992). Disability and depression among high utilizers of health care: a longitudinal analysis. Archives of General Psychiatry, 49, 91100CrossRefGoogle ScholarPubMed
Yaffe, K., Blackwell, T. and Gore, R. (1999). Depressive symptoms and cognitive decline in nondemented elderly women. Archives of General Psychiatry, 56, 425430.CrossRefGoogle ScholarPubMed
Yasuda, M., Horie, S., Albert, S. M. and Simone, B. (2007). The prevalence of depressive symptoms and other variables among frail aging men in New York City's Personal Care services program. Journal of Men's Health and Gender, 4, 165170.CrossRefGoogle Scholar
Zubenko, G. S., Zubenko, W. N., and McPherson, S. (2003). A collaborative study of the emergence and clinical features of the major depressive syndrome of Alzheimer's disease. American Journal of Psychiatry, 160, 857866.CrossRefGoogle ScholarPubMed