title: Longitudinal Association of Dementia and Depression.
abstract: OBJECTIVE
  Depression is an important precursor to dementia, but less is known about the role dementia plays in altering the course of depression. We examined whether depression prevalence, incidence, and severity are higher in those with dementia versus those with mild cognitive impairment (MCI), or normal cognition.
  
  
  METHODS
  Prospective cohort study using the longitudinal Uniform Data Set of the National Alzheimer's Coordinating Center (2005-2013).
  
  
  METHODS
  34 Alzheimer Disease research centers.
  
  
  METHODS
  27,776 subjects with dementia, MCI, or normal cognition.
  
  
  METHODS
  Depression status was determined by a clinical diagnosis of depression within the prior 2 years and by a Geriatric Depression Scale-Short Form score >5.
  
  
  RESULTS
  Rates of depression were significantly higher in subjects with MCI and dementia compared with those with normal cognition at index visit. Controlling for demographics and common chronic conditions, logistic regression analysis revealed elevated depression in those with MCI (OR: 2.40 [95% CI: 2.25, 2.56]) or dementia (OR: 2.64 [95% CI: 2.43, 2.86]) relative to those with normal cognition. In the subjects without depression at the index visit (N = 18,842), those with MCI and dementia had higher probabilities of depression diagnosis 2 years post index visit than those with normal cognition: MCI = 21.7%, dementia = 24.7%, normal cognition = 10.5%.
  
  
  CONCLUSIONS
  MCI and dementia were associated with significantly higher rates of depression in concurrent as well as prospective analyses. These findings suggest that efforts to effectively engage and treat older adults with dementia will need also to address co-occurring depression.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA. Electronic address: snowden@uw.edu.
authors.forename: Mark B
authors.initials: MB
authors.lastname: Snowden
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA.
authors.forename: David C
authors.initials: DC
authors.lastname: Atkins
authors.affiliation: Health Promotion Research Center, University of Washington School of Medicine, Seattle, WA.
authors.forename: Lesley E
authors.initials: LE
authors.lastname: Steinman
authors.affiliation: Betty Irene Moore School of Nursing, University of California, Davis, CA.
authors.forename: Janice F
authors.initials: JF
authors.lastname: Bell
authors.affiliation: Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO.
authors.forename: Lucinda L
authors.initials: LL
authors.lastname: Bryant
authors.affiliation: Health Promotion Research Center, University of Washington School of Medicine, Seattle, WA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Copeland
authors.affiliation: Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA.
authors.forename: Annette L
authors.initials: AL
authors.lastname: Fitzpatrick
mesh_terms: D000368:Aged; D060825:Cognitive Dysfunction / Q000150:complications / Q000453:epidemiology*; D016208:Databases, Factual; D003704:Dementia / Q000150:complications / Q000453:epidemiology*; D003863:Depression / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: Alzheimer disease; Dementia; depression