Psychological distress associated with increased risk for dementia

Psychological distress symptoms were significantly associated with increased risk for all-cause dementia, researchers reported in JAMA Network Open.

“Symptoms of psychological distress have shown association with subsequent dementia, but the nature of association remains unclear,” Sonja Sulkava, MD, PhD, of the Finnish Institute for Health and Welfare in Helsinki, Finland, and colleagues wrote.

Sulkava and colleagues sought to examine the association between psychological distress and etiological risk for dementia and incidence of dementia.

The experts conducted a cohort study that consisted of population-based cross-sectional national surveys collected in Finland every 5 years from 1972 to 2007. The cohort was linked to Finnish Health Register data for dementia and mortality for each participant until the end of 2017.

Participants self-reported symptoms of psychological distress, such as stress, depressive mood, exhaustion and nervousness. Incident all-cause dementia was collected through national health registers.

Among 67,688 participants (mean age, 45.4 years; 51.7% women), 7,935 received a diagnosis of dementia over a mean follow-up period of 25.4 years. Psychological distress was significantly associated with all-cause dementia, with incidence rate ratios ranging from 1.17 (95% CI, 1.08-1.26) for exhaustion to 1.24 (95% CI, 1.11-1.38) for stress.

“We suggest that symptoms of psychological distress are etiological risk factors for dementia but only weakly increase the incidence of dementia in the presence of competing risk of death,” Sulkava and colleagues wrote.

In an editorial comment from Yoram Barak, MD, MHA, of the University of Otago in New Zealand, he argues that because depression was based on self-reported responses, the possibility of understanding the role of stress as a causative agent in the development of dementia is negated, as no information on lifelong neurotic-like traits and clinical diagnoses of anxiety and depression are included.

“These findings suggest that to solve the conundrum surrounding the association of depression and anxiety with risk of dementia we need to look into enduring patterns of perceiving the internal and external environment over long periods and through phases of our lifecycle,” Barak wrote.

Reference:

Barak Y. JAMA Netw Open. 2022;doi:10.1001/jamanetworkopen.2022.47124.