Severe psychiatric disorders are associated with increased risk of dementia.
Humans
Dementia
/ epidemiology
Female
Male
Middle Aged
Aged
Adult
Mental Disorders
/ epidemiology
Wales
/ epidemiology
Electronic Health Records
/ statistics & numerical data
Bipolar Disorder
/ epidemiology
United Kingdom
/ epidemiology
Schizophrenia
/ epidemiology
Risk Factors
Aged, 80 and over
Incidence
Adult psychiatry
Data Interpretation, Statistical
Depression & mood disorders
Schizophrenia & psychotic disorders
Journal
BMJ mental health
ISSN: 2755-9734
Titre abrégé: BMJ Ment Health
Pays: England
ID NLM: 9918521385306676
Informations de publication
Date de publication:
17 Jun 2024
17 Jun 2024
Historique:
received:
28
03
2024
accepted:
31
05
2024
medline:
18
6
2024
pubmed:
18
6
2024
entrez:
17
6
2024
Statut:
epublish
Résumé
Individuals with psychiatric disorders have an increased risk of developing dementia. Most cross-sectional studies suffer from selection bias, underdiagnosis and poor population representation, while there is only limited evidence from longitudinal studies on the role of anxiety, bipolar and psychotic disorders. Electronic health records (EHRs) permit large cohorts to be followed across the lifespan and include a wide range of diagnostic information. To assess the association between four groups of psychiatric disorders (schizophrenia, bipolar disorder/mania, depression and anxiety) with dementia in two large population-based samples with EHR. Using EHR on nearly 1 million adult individuals in Wales, and from 228 937 UK Biobank participants, we studied the relationships between schizophrenia, mania/bipolar disorder, depression, anxiety and subsequent risk of dementia. In Secure Anonymised Information Linkage, there was a steep increase in the incidence of a first diagnosis of psychiatric disorder in the years prior to the diagnosis of dementia, reaching a peak in the year prior to dementia diagnosis for all psychiatric diagnoses. Psychiatric disorders, except anxiety, were highly significantly associated with a subsequent diagnosis of dementia: HRs=2.87, 2.80, 1.63 for schizophrenia, mania/bipolar disorder and depression, respectively. A similar pattern was found in the UK Biobank (HRs=4.46, 3.65, 2.39, respectively) and anxiety was also associated with dementia (HR=1.34). Increased risk of dementia was observed for all ages at onset of psychiatric diagnoses when these were divided into 10-year bins. Psychiatric disorders are associated with an increased risk of subsequent dementia, with a greater risk of more severe disorders. A late onset of psychiatric disorders should alert clinicians of possible incipient dementia.
Sections du résumé
BACKGROUND
BACKGROUND
Individuals with psychiatric disorders have an increased risk of developing dementia. Most cross-sectional studies suffer from selection bias, underdiagnosis and poor population representation, while there is only limited evidence from longitudinal studies on the role of anxiety, bipolar and psychotic disorders. Electronic health records (EHRs) permit large cohorts to be followed across the lifespan and include a wide range of diagnostic information.
OBJECTIVE
OBJECTIVE
To assess the association between four groups of psychiatric disorders (schizophrenia, bipolar disorder/mania, depression and anxiety) with dementia in two large population-based samples with EHR.
METHODS
METHODS
Using EHR on nearly 1 million adult individuals in Wales, and from 228 937 UK Biobank participants, we studied the relationships between schizophrenia, mania/bipolar disorder, depression, anxiety and subsequent risk of dementia.
FINDINGS
RESULTS
In Secure Anonymised Information Linkage, there was a steep increase in the incidence of a first diagnosis of psychiatric disorder in the years prior to the diagnosis of dementia, reaching a peak in the year prior to dementia diagnosis for all psychiatric diagnoses. Psychiatric disorders, except anxiety, were highly significantly associated with a subsequent diagnosis of dementia: HRs=2.87, 2.80, 1.63 for schizophrenia, mania/bipolar disorder and depression, respectively. A similar pattern was found in the UK Biobank (HRs=4.46, 3.65, 2.39, respectively) and anxiety was also associated with dementia (HR=1.34). Increased risk of dementia was observed for all ages at onset of psychiatric diagnoses when these were divided into 10-year bins.
CONCLUSIONS
CONCLUSIONS
Psychiatric disorders are associated with an increased risk of subsequent dementia, with a greater risk of more severe disorders.
CLINICAL IMPLICATIONS
CONCLUSIONS
A late onset of psychiatric disorders should alert clinicians of possible incipient dementia.
Identifiants
pubmed: 38886095
pii: bmjment-2024-301097
doi: 10.1136/bmjment-2024-301097
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
J Geriatr Psychiatry Neurol. 2013 Sep;26(3):131-7
pubmed: 23733854
J Neurol Neurosurg Psychiatry. 2002 Jul;73(1):40-4
pubmed: 12082043
Int J Popul Data Sci. 2020 Feb 25;5(1):1121
pubmed: 32935048
Br J Psychiatry Suppl. 1994 Apr;(23):29-38
pubmed: 8037899
J Affect Disord. 2022 Jun 15;307:301-309
pubmed: 35283178
Nat Hum Behav. 2023 Jul;7(7):1216-1227
pubmed: 37106081
Schizophr Res. 2020 Sep;223:220-226
pubmed: 32807646
Int Psychogeriatr. 2018 Feb;30(2):209-219
pubmed: 28560931
J Geriatr Psychiatry Neurol. 2022 Jul;35(4):527-534
pubmed: 34114509
BMC Psychiatry. 2010 Sep 30;10:77
pubmed: 20920287
Nature. 2018 Oct;562(7726):203-209
pubmed: 30305743
JAMA Psychiatry. 2021 Jun 1;78(6):632-641
pubmed: 33688938
Int J Geriatr Psychiatry. 2022 Apr 11;37(5):
pubmed: 35460299
Psychol Med. 1999 May;29(3):697-701
pubmed: 10405091
Int J Geriatr Psychiatry. 2007 Jun;22(6):563-7
pubmed: 17136705
Schizophr Bull. 2008 Nov;34(6):1024-32
pubmed: 18156637
Am J Geriatr Psychiatry. 2017 Apr;25(4):357-362
pubmed: 28161155
JAMA Psychiatry. 2015 Nov;72(11):1095-101
pubmed: 26444987
Nat Rev Neurol. 2011 May 03;7(6):323-31
pubmed: 21537355
Lancet Neurol. 2016 May;15(6):546-8
pubmed: 27302120
Br J Psychiatry. 2013 May;202(5):329-35
pubmed: 23637108
Br J Psychiatry. 1999 Dec;175:544-8
pubmed: 10789351
Int J Geriatr Psychiatry. 2021 Apr;36(4):573-582
pubmed: 33113255
Neurology. 2015 Sep 8;85(10):898-904
pubmed: 26109713
Am J Geriatr Psychiatry. 2016 Oct;24(10):823-42
pubmed: 27591161