Psychiatry Investig.  2019 Aug;16(8):575-580. 10.30773/pi.2019.06.07.

Anhedonia and Dysphoria Are Differentially Associated with the Risk of Dementia in the Cognitively Normal Elderly Individuals: A Prospective Cohort Study

Affiliations
  • 1Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. kwkimmd@snu.ac.kr
  • 2Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
  • 3Department of Neuropsychiatry, National Medical Center, Seoul, Republic of Korea.
  • 4Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • 5Department of Psychiatry, Mediplex Sejong Hospital, Incheon, Republic of Korea.
  • 6Department of Psychiatry, Bongseng Memorial Hospital, Busan, Republic of Korea.
  • 7Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Republic of Korea.
  • 8Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Republic of Korea.
  • 9Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
  • 10Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Republic of Korea.
  • 11Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Republic of Korea.
  • 12Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea.
  • 13Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Republic of Korea.
  • 14Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Republic of Korea.
  • 15Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea.
  • 16Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Republic of Korea.
  • 17Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
  • 18Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea.
  • 19Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.
  • 20Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.
  • 21National Institute of Dementia, Seongnam, Republic of Korea.

Abstract


OBJECTIVE
We investigated the impact of depressed mood (dysphoria) and loss of interest or pleasure (anhedonia)on the risk of dementia in cognitively-normal elderly individuals.
METHODS
This study included 2,685 cognitively-normal elderly individuals who completed the baseline and 4-year follow-up assessments of the Korean Longitudinal Study on Cognitive Aging and Dementia. We ascertained the presence of dysphoria and anhedonia using the Mini International Neuropsychiatric Inventory. We defined subjective cognitive decline as the presence of subjective cognitive complaints without objective cognitive impairments. We analyzed the association of dysphoria and anhedonia with the risk of cognitive disorders using multinomial logistic regression analysis adjusted for age, sex, education, Cumulative Illness Rating Scale score, Apolipoprotein E genotype, and neuropsychological test performance.
RESULTS
During the 4-year follow-up period, anhedonia was associated with an approximately twofold higher risk of mild cognitive impairment (OR=2.09, 95% CI=1.20-3.64, p=0.008) and fivefold higher risk of dementia (OR=5.07, 95% CI=1.44-17.92, p=0.012) but was not associated with the risk of subjective cognitive decline. In contrast, dysphoria was associated with an approximately twofold higher risk of subjective cognitive decline (OR=2.06, 95% CI=1.33-3.19, p=0.001) and 1.7-fold higher risk of mild cognitive impairment (OR=1.75, 95% CI=1.00-3.05, p=0.048) but was not associated with the risk of dementia.
CONCLUSION
Anhedonia, but not dysphoria, is a risk factor of dementia in cognitively-normal elderly individuals.

Keyword

Anhedonia; Dysphoria; Depression; Dementia

MeSH Terms

Aged*
Anhedonia*
Apolipoproteins
Cognition Disorders
Cognitive Aging
Cohort Studies*
Dementia*
Depression
Education
Follow-Up Studies
Genotype
Humans
Logistic Models
Longitudinal Studies
Mild Cognitive Impairment
Neuropsychological Tests
Pleasure
Prospective Studies*
Risk Factors
Apolipoproteins
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