Association between depression and the risk of Alzheimer\u2019s disease using the Korean National Health Insurance Service-Elderly Cohort

Hyunkyu Kim,Junhyun Kwon,Wonjeong Jeong,Youseok Kim,Eun-Cheol Park,Sung-In Jang

doi:10.1038/s41598-021-02201-6

Abstract

In this cohort study, we assessed the association between depression and the risk of Alzheimer’s disease from data obtained from the 2002 to 2013 Korean National Health Insurance Service-Elderly Cohort Database, which accounts for 10% of the South Korean population aged > 60 years. A total 518,466 patients were included in the analysis and followed up, unless they were excluded due to death or migration. Patients who sought treatment for depression or dementia within 1 year of the washout period and who were diagnosed with dementia within the 1-year period of the diagnosis of depression were excluded from the study. The risk of dementia was analysed using Cox proportional hazards models. Patients with a history of depression during the follow-up period were at a higher risk of Alzheimer’s disease than those without a history of depression (HR 3.35, CI 3.27–3.42). The severe-depression group exhibited the highest risk of Alzheimer’s disease (HR 4.41, CI 4.04–4.81), while the mild-depression group exhibited a relatively lower risk of Alzheimer’s disease (HR 3.31, CI 3.16–3.47). The risk of Alzheimer’s disease was associated with depression history and an increased severity of depression increased the risk of Alzheimer’s disease.

Highlights

In this cohort study, we assessed the association between depression and the risk of Alzheimer’s disease from data obtained from the 2002 to 2013 Korean National Health Insurance Service-Elderly Cohort Database, which accounts for 10% of the South Korean population aged > 60 years
Cognitive impairment caused by dementia places a major socio-economic burden over patients and their families owing to the poor quality of life, hospitalisation, increased mortality, and p overty[3,4,5,6,7,8]
A total of 518,466 patients were included in the analysis: 10.3% of patients were diagnosed with dementia during the follow-up period, while 14.9% of patients were diagnosed with depression

Summary

Introduction

We assessed the association between depression and the risk of Alzheimer’s disease from data obtained from the 2002 to 2013 Korean National Health Insurance Service-Elderly Cohort Database, which accounts for 10% of the South Korean population aged > 60 years. Patients with a history of depression during the follow-up period were at a higher risk of Alzheimer’s disease than those without a history of depression (HR 3.35, CI 3.27–3.42). One meta-analysis suggested that dementia was attributed to depression in 7.9% of the worldwide depression population and 11.1% of that in the USA20 These results suggest that managing depression may limit the occurrence of dementia, which can curtail the socio-economic cost of treating patients with dementia. The confirmation of the association between depression and the risk of dementia in nationally representative cohort data would provide a strong cornerstone for the prophylaxis of dementia through the modulation and management of depression in the elderly population. We wished to exclude any external causes of dementia, including trauma

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