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Cited by 21Dementia and Cognitive Impairment ResearchTreatment of Major DepressionMental Health Treatment and Access

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Clinical factors associated with progression to dementia in people with late-life depression: a cohort study of patients in secondary care

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Peakman, Georgia, Karunatilake, Nishshanka, Seynaeve, Mathieu, Perera, Gayan, Aarsland, Dag, Stewart, Robert, Mueller, Christoph·2020·BMJ Open
DOI 10.1136/bmjopen-2019-035147PMC PMC7252968
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Abstract

Objectives: Depression can be a prodromal feature or a risk factor for dementia. We aimed to investigate which clinical factors in patients with late-life depression are associated with a higher risk of developing dementia and a more rapid conversion. Design: Retrospective cohort study. Setting: South London and Maudsley NHS Foundation Trust (SLaM) secondary mental healthcare services. Participants: The SLaM Clinical Record Interactive Search was used to retrieve anonymised data on 3659 patients aged 65 years or older who had received a diagnosis of depression in mental health services and had been followed up for at least 3 months. Outcome measures: Predictors of development of incident dementia were investigated, including demographic factors, health status rated on the Health of the National Outcome scale for older people (HoNOS65+), depression recurrence and treatments including psychotropic drugs and cognitive behavioural therapy (CBT). Results: In total, 806 (22.0%) patients developed dementia over a mean follow-up time of 2.7 years. Significant predictors of receiving a dementia diagnosis in fully adjusted models and after accounting for multiple comparisons were older age (adjusted HR=1.04, 95% CI 1.03 to 1.06 per year difference from sample mean) and the HoNOS65+ subscale measuring cognitive problems (HR=4.72, 95% CI 3.67 to 6.06 for scores in the problematic range). Recurrent depressive disorder or past depression (HR=0.65, 95% CI 0.55 to 0.77) and the receipt of CBT (HR=0.73 95% CI 0.61 to 0.87) were associated with a lower dementia risk. Over time, hazards related to age increased and hazards related to cognitive problems decreased. Conclusions: In older adults with depression, a higher risk of being subsequently diagnosed with dementia was predicted by higher age, new onset depression, severity of cognitive symptoms and not receiving CBT. Further exploration is needed to determine whether the latter risk factors are responsive to interventions.

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  • Peakman et al. observed an increased dementia risk after 2.5 years of antidepressant use in older individuals with depression.

    “Peakman et al. [39] observed an increased dementia risk after 2.5 years of antidepressant use in older individuals with depression.”

    From Long-Term Antidepressant Use and Dementia Risk: A Propensity Score-Matched Study of Swiss Older Adults, with an Anticholinergic-Specific Analysis (2026) · cites this paper as [39]

    The Results report a higher dementia hazard among patients prescribed any antidepressant after depression diagnosis, but the Discussion says this association was not significant after correction for multiple comparisons. The paper reports a mean follow-up of 2.7 years, not an increased risk specifically after 2.5 years of antidepressant use; it also says the analysis could not establish whether antidepressants influenced dementia risk. The cited passages have section labels but no page numbers. (LLM, conf=0.88)

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  • Peakman et al. (2020) and Goveas et al. (2012) found that antidepressant use was associated with dementia risk (adjusted HR 1.32 [95% CI 1.01-1.74] and 1.69 [95% CI 1.21-2.35], respectively), but no association was found for SSRIs (adjusted HR 1.07 [95% CI 0.91-1.25] and 1.50 [95% CI 0.89-2.53], respectively).

    “Nonetheless, Peakman et al., 2020 [33] and Goveas et al., 2012 [34] pointed out that even though antidepressant use was found to be associated with the risk of dementia (adjusted hazard ratio [HR]: 1.32 [95% CI: 1.01–1.74] and 1.69 [95% CI: 1.21–2.35], respectively), an association was not found for SSRIs (adjusted HR: 1.07 [95% CI: 0.91–1.25] and 1.50 [95% CI: 0.89–2.53], respectively).”

    From Association between first-line antidepressant use and risk of dementia in older adults: a retrospective cohort study (2023) · cites this paper as [33]

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Research works printed but not linked: 38

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Metadata

Authors
Peakman, G., Karunatilake, N., Seynaeve, M., Perera, G., Aarsland, D., Stewart, R., & Mueller, C.
Affiliations
  • King's College London (GB)
  • South London and Maudsley NHS Foundation Trust (GB)
Corresponding author
Peakman, Georgia
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2020-05
Volume
10
Issue
5
Pages
e035147
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2019-035147
PMC
PMC7252968
OpenAlex
W3027738263
Cited by
21
References
11
Citations by year
2026: 4 · 2025: 6 · 2024: 1 · 2023: 5 · 2022: 2 · 2021: 2 · 2020: 1
FWCI
1.67
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • UCL Discovery (University College London) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
Wellcome Trust
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords
geriatric depression, dementia risk, conversion to dementia, older adults, cognitive impairment, depression recurrence, cognitive behavioral therapy, psychotropic drugs, risk factors
MeSH terms
Aged, Aged, 80 and over, Antidepressive Agents, Dementia, Depression, Female, Health Status, Humans, London, Male, Mental Health Services, Retrospective Studies, Risk Factors, Cognitive Behavioral Therapy

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