title: Association of psychological distress late in life and dementia-related mortality.
abstract: OBJECTIVE
  It is not fully understood how subjective feelings of psychological distress prognosticate dementia. Our aim was to investigate the association between self-reported psychological distress and risk of dementia-related mortality.
  
  
  METHODS
  We included 31,043 eligible individuals between the ages of 60 and 80 years, at time of examination, from the CONOR (Cohort of Norway) database. They were followed for a period of 17.4 years (mean 11.5 years). The CONOR Mental Health Index, a seven-item self-report scale was used. A cut-off score equal to or above 2.15 on the scale denoted psychological distress. Cox regression was used to assess the association between psychological distress and risk of dementia-related mortality.
  
  
  RESULTS
  Total number of registered deaths was 11,762 and 1118 (9.5%) were classified as cases of dementia-related mortality. We found that 2501 individuals (8.1%) had psychological distress, of these, 119 (10.6%) had concomitant dementia-related mortality. Individuals with psychological distress had an increased risk of dementia-related mortality HR = 1.52 (95% confidence interval (CI) 1.25-1.85) after adjusting for age, gender and education. The association remained significant although attenuated when implemented in a full adjusted model, including general health status, smoking, obesity, hypertension, diabetes and history of cardiovascular disease; hazard ratio, HR = 1.30 (95% CI 1.06-1.59).
  
  
  CONCLUSIONS
  Our results indicate that psychological distress in elderly individuals is associated with increased risk of dementia-related mortality. Individuals at increased risk of dementia may benefit from treatments or interventions that lessen psychological distress, but this needs to be confirmed in future clinical studies.
authors: a Institute of Health and Society , University of Oslo , Oslo , Norway.
authors: Tor Atle
authors: TA
authors: Rosness
authors: a Institute of Health and Society , University of Oslo , Oslo , Norway.|b Norwegian Institute of Public Health , Oslo , Norway.|c Norwegian National Advisory Unit on Ageing and Health, Vestfold Health Trust , Tønsberg , Norway.
authors: Bjørn Heine
authors: BH
authors: Strand
authors: d Department of Geriatric Psychiatry , Akershus University Hospital , Oslo , Norway.
authors: Astrid Liv Mina
authors: AL
authors: Bergem
authors: a Institute of Health and Society , University of Oslo , Oslo , Norway.
authors: Per
authors: P
authors: Nafstad
authors: c Norwegian National Advisory Unit on Ageing and Health, Vestfold Health Trust , Tønsberg , Norway.
authors: Ellen Melbye
authors: EM
authors: Langballe
authors: c Norwegian National Advisory Unit on Ageing and Health, Vestfold Health Trust , Tønsberg , Norway.
authors: Knut
authors: K
authors: Engedal
authors: b Norwegian Institute of Public Health , Oslo , Norway.
authors: Kristian
authors: K
authors: Tambs
authors: a Institute of Health and Society , University of Oslo , Oslo , Norway.
authors: Espen
authors: E
authors: Bjertness
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003704:Dementia / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology / Q000401:mortality*
keywords: dementia; distress; geriatric medicine; longitudinal studies; mental health