Exploring sex differences in the relationship between depressive symptoms and dementia incidence: prospective results from the PAQUID Study.
Level 3 - non-randomized controlled study
Prospective population-based cohort study with 8-year follow-up
PubMed 12890066 · doi:10.1046/j.1532-5415.2003.51352.x
What was done
The PAQUID study followed 3,777 noninstitutionalized adults aged 65 and older from urban and rural communities in southwest France across four interview waves over an 8-year period. Depressive symptomatology was assessed using the Center for Epidemiologic Studies-Depression (CES-D) scale. Dementia incidence was evaluated via the Mini-Mental State Examination, cognitive batteries, standardized DSM-III-R criteria questionnaires, neurological examinations, and Hachinski scores to determine etiology (Alzheimer's disease, vascular dementia, and other types). Statistical analyses were weighted for non-mortality attrition to compare risk between men and women.
What was found
Over 8 years, 97 men (incidence rate: 14.4 per 1,000) and 183 women (incidence rate: 19.0 per 1,000) developed dementia. Baseline depressive symptomatology was present in 12.9% of men and 14.7% of women. Depressive symptoms significantly increased dementia risk at the subsequent interview wave in men (OR = 3.5, 95% CI: 1.9–6.5) but not in women (OR = 1.2, 95% CI: 0.7–2.0; P-value for sex difference = 0.03). Men with hypertension who were depressed had a 50% higher risk than normotensive depressed men; hypertension did not modify the absence of association in women. Distant depression did not increase dementia risk.
Why it matters
These results highlight notable sex differences in cognitive aging, suggesting that late-life depressive symptoms in men may specifically reflect a vascular depression prodrome or marker of accelerated neurovascular decline.
Limits
As an observational cohort, the study cannot establish whether proximal depression is a causal contributor or a prodromal manifestation of dementia. The abstract does not report specific medication use or detailed biological markers, and findings from this regional French population may not generalize to other demographic settings.
Cited by
- partial Untreated depression doubles the risk of Alzheimer's disease in women and quadruples the risk in men.