Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-10T10:59:12.446Z Has data issue: false hasContentIssue false
  • English
  • Français

Hospital-treated mental and behavioral disorders and risk of Alzheimer's disease: A nationwide nested case-control study

Published online by Cambridge University Press:  23 March 2020

V. Tapiainen ,
S. Hartikainen ,
H. Taipale ,
J. Tiihonen  and
A.-M. Tolppanen
V. Tapiainen*
Affiliation:
School of Pharmacy, University of Eastern Finland, Kuopio, Finland Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland
S. Hartikainen
Affiliation:
School of Pharmacy, University of Eastern Finland, Kuopio, Finland Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland
H. Taipale
Affiliation:
School of Pharmacy, University of Eastern Finland, Kuopio, Finland Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland
J. Tiihonen
Affiliation:
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden National Institute for Health and Welfare, Helsinki, Finland Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
A.-M. Tolppanen
Affiliation:
School of Pharmacy, University of Eastern Finland, Kuopio, Finland Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland
*
*Corresponding author. School of Pharmacy, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland. Tel.: +358509121140. E-mail address:vesa.tapiainen@gmail.com (V. Tapiainen).
Get access

Abstract

Background:

Studies investigating psychiatric disorders as Alzheimer's disease (AD) risk factors have yielded heterogeneous findings. Differences in time windows between the exposure and outcome could be one explanation. We examined whether (1) mental and behavioral disorders in general or (2) specific mental and behavioral disorder categories increase the risk of AD and (3) how the width of the time window between the exposure and outcome affects the results.

Methods:

A nationwide nested case-control study of all Finnish clinically verified AD cases, alive in 2005 and their age, sex and region of residence matched controls (n of case-control pairs 27,948). History of hospital-treated mental and behavioral disorders was available since 1972.

Results:

Altogether 6.9% (n = 1932) of the AD cases and 6.4% (n = 1784) of controls had a history of any mental and behavioral disorder. Having any mental and behavioral disorder (adjusted OR = 1.07, 95% CI = 1.00–1.16) or depression/other mood disorder (adjusted OR = 1.17, 95% CI = 1.05–1.30) were associated with higher risk of AD with 5-year time window but not with 10-year time window (adjusted OR, 95% CI 0.99, 0.91–1.08 for any disorder and 1.08, 0.96–1.23 for depression).

Conclusions:

The associations between mental and behavioral disorders and AD were modest and dependent on the time window. Therefore, some of the disorders may represent misdiagnosed prodromal symptoms of AD, which underlines the importance of proper differential diagnostics among older persons. These findings also highlight the importance of appropriate time window in psychiatric and neuroepidemiology research.

Keywords

Addiction, consumption/abuse/dependenceAffective disordersAnxiety disordersSchizophrenia and psychosisAlzheimer diseaseEpidemiology
Type
Original article
Information
European Psychiatry , Volume 43 , June 2017 , pp. 92 - 98
Copyright
Copyright © European Psychiatric Association 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alzheimer's Disease International. World Alzheimer report 2015. Available from: https://www.alz.co.uk/research/WorldAlzheimerReport2015.pdf [Accessed: October 10, 2016].Google Scholar
Alzheimer's Association, 2014 Alzheimer's disease facts and figures. Alzheimers Dement 2014;10(2):e47–e92.CrossRefGoogle Scholar
da Silva, JGoncalves-Pereira, MXavier, MMukaetova-Ladinska, EBAffective disorders and risk of developing dementia: systematic review. Br J Psychiatry 2013;202(3):177–186.CrossRefGoogle ScholarPubMed
Agbayewa, MOEarlier psychiatric morbidity in patients with Alzheimer's disease. J Am Geriatr Soc 1986;34(8):561–564.CrossRefGoogle ScholarPubMed
Wetherell, JLGatz, MJohansson, BPedersen, NLHistory of depression and other psychiatric illness as risk factors for Alzheimer disease in a twin sample. Alzheimer Dis Assoc Disord 1999;13(1):47–52.CrossRefGoogle Scholar
Byers, ALYaffe, KDepression and risk of developing dementia. Nat Rev Neurol 2011;7(6):323–331.CrossRefGoogle ScholarPubMed
Ownby, RLCrocco, EAcevedo, AJohn, VLoewenstein, DDepression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression analysis. Arch Gen Psychiatry 2006;63(5):530–538.CrossRefGoogle ScholarPubMed
Brommelhoff, JAGatz, MJohansson, BMcArdle, JJFratiglioni, LPedersen, NLDepression as a risk factor or prodromal feature for dementia? Findings in a population-based sample of Swedish twins. Psychol Aging 2009;24(2):373–384.CrossRefGoogle ScholarPubMed
Steffens, DCPlassman, BLHelms, MJWelsh-Bohmer, KASaunders, AMBreitner, JCA twin study of late-onset depression and apolipoprotein E epsilon 4 as risk factors for Alzheimer's disease. Biol Psychiatry 1997;41(8):851–856.CrossRefGoogle ScholarPubMed
Speck, CEKukull, WABrenner, DEBowen, JDMcCormick, WCTeri, Let al.History of depression as a risk factor for Alzheimer's disease. Epidemiology 1995;6(4):366–369.CrossRefGoogle ScholarPubMed
Palsson, SAevarsson, OSkoog, IDepression, cerebral atrophy, cognitive performance and incidence of dementia. Population study of 85-year-olds. Br J Psychiatry 1999;174: 249–253.CrossRefGoogle ScholarPubMed
Geerlings, MIden Heijer, TKoudstaal, PJHofman, ABreteler, MMHistory of depression, depressive symptoms, and medial temporal lobe atrophy and the risk of Alzheimer disease. Neurology 2008;70(15):1258–1264.CrossRefGoogle ScholarPubMed
Green, RCCupples, LAKurz, AAuerbach, SGo, RSadovnick, Det al.Depression as a risk factor for Alzheimer disease: the MIRAGE study. Arch Neurol 2003;60(5):753–759.CrossRefGoogle ScholarPubMed
Kessing, LVOlsen, EWMortensen, PBAndersen, PKDementia in affective disorder: a case-register study. Acta Psychiatr Scand 1999;100(3):176–185.CrossRefGoogle ScholarPubMed
Kessing, LVNilsson, FMIncreased risk of developing dementia in patients with major affective disorders compared to patients with other medical illnesses. J Affect Disord 2003;73(3):261–269.CrossRefGoogle ScholarPubMed
Kessing, LVAndersen, PKDoes the risk of developing dementia increase with the number of episodes in patients with depressive disorder and in patients with bipolar disorder?. J Neurol Neurosurg Psychiatry 2004;75(12):1662–1666.CrossRefGoogle ScholarPubMed
Cooper, BHolmes, CPrevious psychiatric history as a risk factor for late-life dementia: a population-based case-control study. Age Ageing 1998;27(2):181–188.CrossRefGoogle ScholarPubMed
Ribe, ARLaursen, TMCharles, MKaton, WFenger-Gron, MDavydow, Det al.Long-term risk of dementia in persons with schizophrenia: a Danish population-based cohort study. JAMA Psychiatry 2015;72(11):1095–1101.CrossRefGoogle ScholarPubMed
Korner, ALopez, AGLauritzen, LAndersen, PKKessing, LVLate and very-late first-contact schizophrenia and the risk of dementia – a nationwide register based study. Int J Geriatr Psychiatry 2009;24(1):61–67.CrossRefGoogle ScholarPubMed
Brodaty, HSachdev, PKoschera, AMonk, DCullen, BLong-term outcome of late-onset schizophrenia: 5-year follow-up study. Br J Psychiatry 2003;183: 213–219.CrossRefGoogle ScholarPubMed
Rabins, PVLavrisha, MLong-term follow-up and phenomenologic differences distinguish among late-onset schizophrenia, late-life depression, and progressive dementia. Am J Geriatr Psychiatry 2003;11(6):589–594.CrossRefGoogle ScholarPubMed
Cankurtaran, MYavuz, BBCankurtaran, ESHalil, MUlger, ZAriogul, SRisk factors and type of dementia: vascular or Alzheimer?. Arch Gerontol Geriatr 2008;47(1):25–34.CrossRefGoogle ScholarPubMed
Zalsman, GAizenberg, DSigler, MNahshony, EKarp, LWeizman, AIncreased risk for dementia in elderly psychiatric inpatients with late-onset major depression. J Nerv Ment Dis 2000;188(4):242–243.CrossRefGoogle ScholarPubMed
Tolppanen, AMTaipale, HKoponen, MLavikainen, PTanskanen, ATiihonen, Jet al.Use of existing data sources in clinical epidemiology: Finnish health care registers in Alzheimer's disease research – the medication use among persons with Alzheimer's disease (MEDALZ-2005) study. Clin Epidemiol 2013;5: 277–285.CrossRefGoogle ScholarPubMed
Personal identity code - population register centre. http://vrk.fi/en/personal-identity-code1 [Accessed: October 17, 2016].Google Scholar
Sund, RQuality of the Finnish Hospital Discharge Register: a systematic review. Scand J Public Health 2012;40(6):505–515.CrossRefGoogle ScholarPubMed
McKhann, GDrachman, DFolstein, MKatzman, RPrice, DStadlan, EMClinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force on Alzheimer's disease. Neurology 1984;34(7):939–944.CrossRefGoogle ScholarPubMed
American Psychiatric Association Task Force on DSM-IV. Diagnostic and statistical manual of mental disorders: DSM-IV, 4th ed., Washington, DC: American Psychiatric Association; 1994.Google Scholar
Memory disorders. Current care guideline. Working group set up by the Finnish medical society Duodecim, societas gerontologica fennica, the Finnish neurological society, Finnish psychogeriatric association and the Finnish association for general practice. Helsinki: The Finnish medical society Duodecim, 2010. Available at: http://www.kaypahoito.fi [in Finnish with English summary].Google Scholar
Karjalainen, KLintonen, TJoukamaa, MLillsunde, PMental disorders associated with driving under the influence of alcohol and/or drugs: a register-based study. Eur Addict Res 2013;19(3):113–120.CrossRefGoogle ScholarPubMed
Charlson, MEPompei, PAles, KLMacKenzie, CRA new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40(5):373–383.CrossRefGoogle ScholarPubMed
Howard, RRabins, PVSeeman, MVJeste, DVLate-onset schizophrenia and very-late-onset schizophrenia-like psychosis: an international consensus. The international late-onset schizophrenia group. Am J Psychiatry 2000;157(2):172–178.CrossRefGoogle ScholarPubMed
Amieva, HLe Goff, MMillet, XOrgogozo, JMPeres, KBarberger-Gateau, Pet al.Prodromal Alzheimer's disease: successive emergence of the clinical symptoms. Ann Neurol 2008;64(5):492–498.CrossRefGoogle ScholarPubMed
AHFS drug information 2003, McEvoy, GKLithium salts Bethesda, MD: American society of health-system pharmacists; 2003. p. 2405–2414.Google Scholar
Nunes, PVForlenza, OVGattaz, WFLithium and risk for Alzheimer's disease in elderly patients with bipolar disorder. Br J Psychiatry 2007;190: 359–360.CrossRefGoogle ScholarPubMed
Kessing, LVSondergard, LForman, JLAndersen, PKLithium treatment and risk of dementia. Arch Gen Psychiatry 2008;65(11):1331–1335.CrossRefGoogle ScholarPubMed
Kessing, LVForman, JLAndersen, PKDoes lithium protect against dementia?. Bipolar Disord 2010;12(1):87–94.CrossRefGoogle ScholarPubMed
Forlenza, OVDiniz, BSRadanovic, MSantos, FSTalib, LLGattaz, WFDisease-modifying properties of long-term lithium treatment for amnestic mild cognitive impairment: randomised controlled trial. Br J Psychiatry 2011;198(5):351–356.CrossRefGoogle ScholarPubMed
Katon, WPedersen, HSRibe, ARFenger-Gron, MDavydow, DWaldorff, FBet al.Effect of depression and diabetes mellitus on the risk for dementia: a national population-based cohort study. JAMA Psychiatry 2015;72(6):612–619.CrossRefGoogle ScholarPubMed
Andersen, KLolk, AKragh-Sorensen, PPetersen, NEGreen, ADepression and the risk of Alzheimer disease. Epidemiology 2005;16(2):233–238.CrossRefGoogle ScholarPubMed
Solomon, ANgandu, TSoininen, HHallikainen, MMKivipelto, MLaatikainen, TValidity of dementia and Alzheimer's disease diagnoses in Finnish national registers. Alzheimers Dement 2014;10(3):303–309.CrossRefGoogle ScholarPubMed
Nordentoft, MWahlbeck, KHallgren, JWestman, JOsby, UAlinaghizadeh, Het al.Excess mortality, causes of death and life expectancy in 270,770 patients with recent onset of mental disorders in Denmark, Finland and Sweden. PLoS One 2013;8(1):e55176.CrossRefGoogle ScholarPubMed
Wahlbeck, KWestman, JNordentoft, MGissler, MLaursen, TMOutcomes of Nordic mental health systems: life expectancy of patients with mental disorders. Br J Psychiatry 2011;199(6):453–458.CrossRefGoogle ScholarPubMed
Isohanni, MMakikyro, TMoring, JRasanen, PHakko, HPartanen, Uet al.A comparison of clinical and research DSM-III-R diagnoses of schizophrenia in a Finnish national birth cohort. Clinical and research diagnoses of schizophrenia. Soc Psychiatry Psychiatr Epidemiol 1997;32(5):303–308.CrossRefGoogle Scholar
Makikyro, TIsohanni, MMoring, JHakko, HHovatta, ILonnqvist, JAccuracy of register-based schizophrenia diagnoses in a genetic study. Eur Psychiatry 1998;13(2):57–62.CrossRefGoogle Scholar
Supplementary material: Image

Tapiainen et al. supplementary material

Figure S1

Download Tapiainen et al. supplementary material(Image)
Image 185.7 KB
Supplementary material: Image

Tapiainen et al. supplementary material

Figure S2

Download Tapiainen et al. supplementary material(Image)
Image 726.3 KB
Supplementary material: PDF

Tapiainen et al. supplementary material

Table S1

Download Tapiainen et al. supplementary material(PDF)
PDF 296.9 KB
Submit a response

Comments

No Comments have been published for this article.