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Psychiatric disorders and risk of subsequent dementia: Systematic review and meta‐analysis of longitudinal studies

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Stafford, Jean, Chung, Wing Tung, Sommerlad, Andrew, Kirkbride, James B., Howard, Robert·2022·International Journal of Geriatric Psychiatry
DOI 10.1002/gps.5711PMC PMC9325434
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Abstract

Objectives: Although psychiatric disorders have been found to be associated with increased risk of dementia, previous findings are mixed, and the nature of these relationships remains poorly understood. We examined longitudinal associations between depression, anxiety, post‐traumatic stress disorders (PTSD), bipolar disorder (BPD), psychotic disorders and subsequent dementia. Methods: We searched three databases for longitudinal, population‐based studies investigating associations between psychiatric disorders and dementia (PROSPERO registration: CRD42020209638). We conducted narrative synthesis, and random‐effects meta‐analyses to obtain pooled estimates. We used meta‐regression and stratified analyses to examine variation by sex, age‐at‐onset and follow‐up time. Results: Fifty‐seven citations met eligibility criteria. Most studies focussed on depression ( n = 33), which was associated with subsequent all‐cause dementia (pooled relative risk [RR]: 1.96, 95% confidence interval [CI]: 1.59–2.43; I 2 = 96.5%), Alzheimer's Disease (pooled RR: 1.9, 95% CI: 1.52–2.38; I 2 = 85.5%), and Vascular Dementia (pooled RR: 2.71, 95% CI: 2.48–2.97; I 2 = 0). Associations were stronger in studies with shorter follow‐up periods and for severe and late‐onset depression. Findings regarding anxiety were mixed, and we did not find evidence of an overall association (pooled RR: 1.18, 95% CI: 0.96–1.45; I 2 = 52.2%, n = 5). Despite sparse evidence, psychotic disorders (pooled RR: 2.19, 95% CI: 1.44–3.31; I 2 = 99%), PTSD and BPD were associated with subsequent dementia. Conclusions: People with psychiatric disorders represent high‐risk groups for dementia, highlighting the importance of ongoing symptom monitoring in these groups. Findings regarding temporality and age‐at‐onset indicate that depression symptoms could reflect prodromal dementia for some individuals. Further longitudinal research is required to determine whether psychiatric disorders represent causal risk factors or early markers of dementia neuropathology.

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  • Depression is associated with an increased risk of dementia (RR 2.25, 1.69-2.98, I2=82.8%).

    “we performed a random effects meta-analysis using the seven studies with a 10 to 14-year follow-up (104-111) and found an increased risk of dementia (RR 2.25, 1.69 -2.98 I 2 = 82.8% )”

    From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [104]

    The Results (Subgroup analyses; page unavailable) report an association between depression and all-cause dementia, but the pooled estimate is RR 1.96 (95% CI 1.59–2.43; I² 96.5%), not the quoted figures. For 9–14 years of follow-up, the paper reports RR 1.98 (95% CI 1.36–2.89; I² 95.5%) across 10 estimates, rather than the claimed seven-study result. (LLM, conf=0.90)

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1 retracted

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2 of the 80 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. [75]Madsen IEH, Nyberg ST, Magnusson Hanson LL, et al. Job strain as a risk factor for clinical depression: systematic review and meta‐analysis with additional individual participant data. Psychol Med. 2017; 47(8): 1342‐ 1356. 28122650 PMC5471831
  2. [78]Wang TY, Wei HT, Liou YJ, et al. Risk for developing dementia among patients with posttraumatic stress disorder: a nationwide longitudinal study. J Affect Disord. 2016; 205(May 2013): 306‐ 310. 27552595

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Authors
Stafford, J., Chung, W. T., Sommerlad, A., Kirkbride, J. B., & Howard, R.
Affiliations
  • MRC Unit for Lifelong Health and Ageing (GB)
  • University College London (GB)
Corresponding author
Stafford, Jean
ORCID
Venue
International Journal of Geriatric Psychiatry
Publisher
Wiley
Published
2022-04-23
Volume
37
Issue
5
ISSN
  • 0885-6230 (ISSN-L)
  • 1099-1166
DOI
10.1002/gps.5711
PMC
PMC9325434
OpenAlex
W4223420355
Cited by
126
References
80
Citations by year
2026: 31 · 2025: 38 · 2024: 32 · 2023: 20 · 2022: 5
FWCI
4.09
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Geriatric Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
Funders
  • Wellcome Trust (101272/Z/13/Z, 204841/Z/16/Z)
  • Medical Research Council (MC_UU_00019/3)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Keywords
dementia risk, mental illness, depression, anxiety, post-traumatic stress disorder, bipolar disorder, psychosis, Alzheimer's disease, vascular dementia, prodromal dementia, age at onset of depression, follow-up duration

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