High risk for psychiatric disorders seen before dementia diagnosis

Patients with dementia have markedly increased risks for psychiatric disorders before dementia diagnosis, according to a study published online Oct. 17 in JAMA Network Open.

Minjia Mo, Ph.D., from the Karolinska Institutet in Stockholm, and colleagues examined temporal risk patterns of psychiatric disorders among patients with dementia before, at the time of, and after diagnosis. The analysis included 796,505 individuals, including 209,245 with dementia (2000 to 2017).

The researchers found that the relative risk for psychiatric disorders was consistently higher among patients with dementia versus control participants. The risk for psychiatric disorders began to increase from three years before diagnosis (hazard ratio, 1.72) and peaked the week after diagnosis (hazard ratio, 4.74), subsequently decreasing rapidly afterwards. Results were consistent for Alzheimer disease, mixed dementia, vascular dementia, and unspecified dementia.

In the year leading up to the dementia diagnosis, there was a marked increased use of psychiatric medications, which peaked six months after diagnosis. Antidepressant use was consistently higher among patients with dementia versus controls, and the difference increased from two years before dementia diagnosis (15.9 versus 7.9 percent).

“These results suggest that managing psychiatric comorbidities is crucial for individuals with dementia across various disease stages,” the authors write.

One author disclosed ties to the biotechnology industry.

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