Back to Search Start Over

Severe psychiatric disorders are associated with increased risk of dementia

Authors :
Valentina Escott-Price
Michael J Owen
George Kirov
Jun Han
Joshua Stevenson-Hoare
Sophie E Legge
Emily Simmonds
Michael O’Donovan
Source :
BMJ Mental Health, Vol 27, Iss 1 (2024)
Publication Year :
2024
Publisher :
BMJ Publishing Group, 2024.

Abstract

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 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 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 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 Psychiatric disorders are associated with an increased risk of subsequent dementia, with a greater risk of more severe disorders.Clinical implications A late onset of psychiatric disorders should alert clinicians of possible incipient dementia.

Subjects

Subjects :
Psychiatry
RC435-571

Details

Language :
English
ISSN :
27559734
Volume :
27
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMJ Mental Health
Publication Type :
Academic Journal
Accession number :
edsdoj.2ccddd154d294e579bb786009c2e76c5
Document Type :
article
Full Text :
https://doi.org/10.1136/bmjment-2024-301097