Is Late-Onset Depression a Prodrome to Major Neurocognitive Disorder?

Late-onset depression (LOD) was not associated with the risk for major neurocognitive disorder (MNCD) in older adults, according study findings published in the journal Clinical Epidemiology and Global Health.

The most common psychiatric morbidities among older adults are depression and MNCD. To evaluate a potential link between the 2 conditions, this hospital-based, case-control study was conducted using data sourced from the Government Medical College in India. Patients (N=342) aged 60 years and older were assessed for MNCD using the Malayalam adaptation of Addenbrooke’s Cognitive Examination and LOD using the Structured Clinical Interview for Diagnostic and Statistician Manual for Mental Disorders-Fourth Edition between 2015 and 2019.

Patients with MNCD (n=170) and control individuals (n=172) were aged mean 70.8 (SD, 8.02) and 69.2 (SD, 6.17) years (P =.03), 50.0% and 40.1% were women, 12.9% and 12.8% were illiterate, and 39.4% and 45.3% earned less than 5000 Indian rupees per month, respectively.

In the univariate analysis, MNCD risk was associated with age, monthly income, family history of MNCD, hypertension, hyperlipidemia, movement disorders, normal pressure hydrocephalus, and a history of treatment for depression.

In a multivariate analysis, MNCD was associated with treatment for depression (adjusted odds ratio [aOR], 4.91; 95% CI, 1.64-14.74; P =.005), movement disorders (aOR, 4.35; 95% CI, 2.39-7.91; P =.0001), age 80 years and older (aOR, 3.97; 95% CI, 1.71-9.22; P =.001), family history of MNCD (aOR, 2.65; 95% CI, 1.38-5.07; P =.003), female gender (aOR, 2.38; 95% CI, 1.40-4.03; P =.001), and hyperlipidemia (aOR, 2.24; 95% CI, 1.27-3.93; P =.005).

Risk for MNCD was not associated with LOD (aOR, 0.62; 95% CI, 0.32-1.20; P =.16).

This study was limited by power due to low prevalence of depression among this study cohort.

The researchers concluded, “Increasing age, female sex, a positive family history of MNCD and medical comorbidities like hyperlipidaemia and movement disorders were significant risk factors along with a history of treatment for depression.”

Reference

Indu PV, M SB, Kumar KA, Vidhukumar K, Sarma PS. Late-onset depression: A risk factor for major neurocognitive disorder? Clin Epidemiol Global Health. 2022;15:101041. doi:10.1016/j.cegh.2022.101041