title: Hospital-treated mental and behavioral disorders and risk of Alzheimer's disease: A nationwide nested case-control study.
abstract: Studies investigating psychiatric disorders as Alzheimer's disease (AD) risk factors have yielded heterogeneous findings. Differences in time windows between the exposure and outcome could be one explanation. We examined whether (1) mental and behavioral disorders in general or (2) specific mental and behavioral disorder categories increase the risk of AD and (3) how the width of the time window between the exposure and outcome affects the results.
  
  
  
  A nationwide nested case-control study of all Finnish clinically verified AD cases, alive in 2005 and their age, sex and region of residence matched controls (n of case-control pairs 27,948). History of hospital-treated mental and behavioral disorders was available since 1972.
  
  
  
  Altogether 6.9% (n=1932) of the AD cases and 6.4% (n=1784) of controls had a history of any mental and behavioral disorder. Having any mental and behavioral disorder (adjusted OR=1.07, 95% CI=1.00-1.16) or depression/other mood disorder (adjusted OR=1.17, 95% CI=1.05-1.30) were associated with higher risk of AD with 5-year time window but not with 10-year time window (adjusted OR, 95% CI 0.99, 0.91-1.08 for any disorder and 1.08, 0.96-1.23 for depression).
  
  
  
  The associations between mental and behavioral disorders and AD were modest and dependent on the time window. Therefore, some of the disorders may represent misdiagnosed prodromal symptoms of AD, which underlines the importance of proper differential diagnostics among older persons. These findings also highlight the importance of appropriate time window in psychiatric and neuroepidemiology research.
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland. Electronic address: vesa.tapiainen@gmail.com.
authors.forename: V
authors.initials: V
authors.lastname: Tapiainen
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland; Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Hartikainen
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Taipale
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; National Institute for Health and Welfare, Helsinki, Finland; Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Tiihonen
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland.
authors.forename: A-M
authors.initials: AM
authors.lastname: Tolppanen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000209:etiology* / Q000523:psychology; D016022:Case-Control Studies; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000523:psychology; D008875:Middle Aged; D013997:Time Factors
keywords: Addiction; Affective disorders; Alzheimer disease; Anxiety disorders; Epidemiology; Schizophrenia and psychosis; consumption/abuse/dependence