Depressive Symptoms in Mild Cognitive Impairment and the Risk of Dementia: A Systematic Review and Comparative Meta-Analysis of Clinical and Community-Based Studies

Autor: Eva Y L Tan, Sebastian Köhler, Inez H.G.B. Ramakers, Frans R.J. Verhey, Renske E.G. Hamel, Juan Luis Muñoz-Sánchez
Rok vydání: 2019
Předmět:
0301 basic medicine
IMPACT
Population
LATE-LIFE DEPRESSION
Prodromal Symptoms
PROGRESSION
03 medical and health sciences
0302 clinical medicine
depressive symptoms
mild cognitive impairment
systematic review
Risk Factors
mental disorders
Medicine
Dementia
Humans
Cognitive Dysfunction
Risk factor
education
Prospective cohort study
PREDICTORS
Depression (differential diagnoses)
POPULATION
NEUROPSYCHIATRIC SYMPTOMS
education.field_of_study
business.industry
Depression
General Neuroscience
INCIDENT DEMENTIA
General Medicine
Late life depression
medicine.disease
meta-analysis
ALZHEIMERS-DISEASE
Psychiatry and Mental health
Clinical Psychology
030104 developmental biology
Meta-analysis
Relative risk
INSTRUMENTAL ACTIVITIES
Disease Progression
Geriatrics and Gerontology
business
FOLLOW-UP
030217 neurology & neurosurgery
Clinical psychology
Zdroj: Journal of Alzheimer's disease : JAD. 67(4)
ISSN: 1875-8908
Popis: Background Affective symptoms are considered a risk factor or prodromal symptom for dementia. Recent reviews indicate that depressive symptoms predict progression from mild cognitive impairment (MCI) to dementia, but results need to be further explored. Objective To investigate the effect of depressive symptoms on the development of dementia in people with MCI, and explore potential sources of between-study variability, including study setting by a systematic review and meta-analysis. Methods Databases were searched for prospective studies defining people with MCI at baseline, investigating dementia at follow-up and giving information about depressive symptoms. Two authors independently extracted data from the studies and rated the methodological quality. Meta-analyses were conducted using random-effect models to yield pooled risk ratios (RR). Meta-regression analyses tested differences between clinical and community-based studies and other sources of heterogeneity. Results Thirty-five studies, representing 14,158 individuals with MCI, were included in the meta-analysis. Depressive symptoms in MCI predicted dementia in 15 community-based studies (RR = 1.69, 95% CI 1.49-1.93, I2 = 0.0%), but not in 20 clinical studies (RR = 1.02, 95% CI 0.92-1.14, I2 = 73.0%). Further investigation of this effect showed that the mean age of community-based studies was significantly higher than of clinical studies but neither this nor other study characteristics explained variability in study outcomes. Conclusions Depressive symptoms are associated with an increased risk of conversion from MCI to dementia in community-based studies. In contrast, evidence in clinical populations was insufficient with high heterogeneity.
Databáze: OpenAIRE
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