Association between dementia and depression: a retrospective study using the Korean National Health Insurance Service-National Sample Cohort database

OBJECTIVES: Dementia is common in people over the age of 65 years, with 80% of people with dementia older than 75 years. Previous studies have linked dementia to late-life depression, but the association between dementia and mid-life depression is poorly understood. Depression is a preventable and treatable medical condition, which means it is a modifiable factor that can potentially prevent or delay dementia. This study aimed to identify the association between dementia and depression within the life course. DESIGN: A nationwide, retrospective propensity score matched cohort study associating dementia with depression. Depression diagnosed between the ages of 45 and 64 years was classified as ‘mid-life’ and ‘late-life’ if diagnosed at 65 years or older. Patients were considered to have depression when one or more International Statistical Classification of Diseases and Related Health Problems, 10th revision codes for depression were recorded as primary or secondary diagnosis. SETTING: National Health Insurance Service-National Sample Cohort database of the National Health Insurance Service in South Korea, containing patient data from 2002 to 2013. PARTICIPANTS: The study included 1824 and 374 852 patients in the case and control groups, respectively. A logistic regression analysis with complex sampling design was performed after adjusting for covariates, using the propensity score matching method without callipers, with a 1:1 nearest neighbour matching algorithm. PRIMARY AND SECONDARY OUTCOME MEASURES: The association of mid-onset and late-onset depression with dementia in terms of sociodemographic characteristics, such as sex and age, within the Korean population. RESULTS: Dementia was significantly associated with the presence of depression (OR=2.20, 95% CI=1.53–3.14); in particular, female patients with depression and patients aged 45–64 years with depression had increased odds of dementia (OR=2.65, 95% CI=1.78–3.93 and OR=2.72, 95% CI=1.41–5.24, respectively) CONCLUSION: Depression is an associated factor for dementia, especially among people aged 45–64 years (mid-life).