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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).
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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

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