title: Depression risk in patients with late-onset rheumatoid arthritis in Germany.
abstract: The goal of this study was to determine the prevalence of depression and its risk factors in patients with late-onset rheumatoid arthritis (RA) treated in German primary care practices.
  
  
  
  Longitudinal data from general practices (n=1072) throughout Germany were analyzed. Individuals initially diagnosed with RA (2009-2013) were identified, and 7301 patients were included and matched (1:1) to 7301 controls. The primary outcome measure was the initial diagnosis of depression within 5 years after the index date in patients with and without RA. Cox proportional hazards models were used to adjust for confounders.
  
  
  
  The mean age was 72.2 years (SD: 7.6 years). A total of 34.9 % of patients were men. Depression diagnoses were present in 22.0 % of the RA group and 14.3 % of the control group after a 5-year follow-up period (p < 0.001). In the multivariate regression model, RA was a strong risk factor for the development of depression (HR: 1.55, p < 0.001). There was significant interaction of RA and diagnosed inflammatory polyarthropathies (IP) (RA*IP interaction: p < 0.001). Furthermore, dementia, cancer, osteoporosis, hypertension, and diabetes were associated with a higher risk of developing depression (p values <0.001).
  
  
  
  The risk of depression is significantly higher in patients with late-onset RA than in patients without RA for subjects treated in primary care practices in Germany. RA patients should be screened routinely for depression in order to ensure improved treatment and management.
authors: Fresenius University of Applied Sciences, Idstein, Germany.
authors: Julia
authors: J
authors: Drosselmeyer
authors: Department of Biology, École Normale Supérieure de Lyon, Lyon, France.
authors: Louis
authors: L
authors: Jacob
authors: German Diabetes Center, Institute for Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.
authors: Wolfgang
authors: W
authors: Rathmann
authors: Department of Social and Preventive Medicine, University of Potsdam, Potsdam, Germany.
authors: Michael A
authors: MA
authors: Rapp
authors: Department of Epidemiology, IMS Health, Darmstädter Landstraße 1089, 60598, Frankfurt am Main, Germany. kkostev@de.imshealth.com.
authors: Karel
authors: K
authors: Kostev
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D005858:Germany; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D018434:Sickness Impact Profile
keywords: Depression; Germany; Late-onset rheumatoid arthritis; Primary care; Risk factors