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Risk of major depression in partners of people with Alzheimer's disease : A national cohort study

Crump, Casey LU ; Wei, Jingkai ; Vickrey, Barbara G. ; Edwards, Alexis C. LU ; Schulz, Paul E. ; Sieh, Weiva ; Sundquist, Jan LU and Sundquist, Kristina LU (2025) In Age and Ageing 54(10).
Abstract

Background Alzheimer's disease (AD) may cause significant psychosocial distress not only in the patient but also their partner. However, long-term risks of major depression in partners of AD patients are largely unknown. Methods A national cohort study was conducted of all 145 289 partners of people diagnosed with all-cause dementia, including 57 113 partners of people diagnosed with AD, in Sweden during 1998-2017, and 1 300 561 population-based controls. Cox regression was used to compute hazard ratios (HRs) for subsequent risk of major depression identified from nationwide outpatient and inpatient diagnoses through 2018, adjusting for sociodemographic factors and prior mental disorders. Results The 10-year cumulative incidence of... (More)

Background Alzheimer's disease (AD) may cause significant psychosocial distress not only in the patient but also their partner. However, long-term risks of major depression in partners of AD patients are largely unknown. Methods A national cohort study was conducted of all 145 289 partners of people diagnosed with all-cause dementia, including 57 113 partners of people diagnosed with AD, in Sweden during 1998-2017, and 1 300 561 population-based controls. Cox regression was used to compute hazard ratios (HRs) for subsequent risk of major depression identified from nationwide outpatient and inpatient diagnoses through 2018, adjusting for sociodemographic factors and prior mental disorders. Results The 10-year cumulative incidence of major depression was 5.4% in partners of people with AD, 5.6% in partners of people with all-cause dementia, and 3.9% in controls. The adjusted relative rate of major depression was increased ~1.5-fold in partners of people with AD (HR, 1.53; 95% CI, 1.35-1.72) or all-cause dementia (1.45; 1.34-1.57), compared with controls. These risks were elevated among both women (AD: HR, 1.41; 95% CI, 1.22-1.64; all-cause dementia: 1.36; 1.24-1.50) and men (AD: 1.81; 1.46-2.25; all-cause dementia: 1.73; 1.48-2.01). Risks remained significantly elevated ≥3 years later in both women (1.3- to 1.5-fold) and men (1.5-fold). Risks were generally highest in partners aged ≥85 years. Conclusions In this large national cohort, partners of people diagnosed with AD or all-cause dementia had ~1.5-fold risks of major depression, which remained elevated several years later. Partners of people with dementia need psychosocial support and long-term follow-up for timely detection and treatment of depression.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Alzheimer disease, dementia, depression, mental health, older people, spouses
in
Age and Ageing
volume
54
issue
10
article number
afaf283
publisher
Oxford University Press
external identifiers
  • scopus:105017942782
  • pmid:41056473
ISSN
0002-0729
DOI
10.1093/ageing/afaf283
language
English
LU publication?
yes
id
30d8996e-323e-449b-8a6b-88568b43c49b
date added to LUP
2025-11-25 12:04:02
date last changed
2025-11-25 12:05:05
@article{30d8996e-323e-449b-8a6b-88568b43c49b,
  abstract     = {{<p>Background Alzheimer's disease (AD) may cause significant psychosocial distress not only in the patient but also their partner. However, long-term risks of major depression in partners of AD patients are largely unknown. Methods A national cohort study was conducted of all 145 289 partners of people diagnosed with all-cause dementia, including 57 113 partners of people diagnosed with AD, in Sweden during 1998-2017, and 1 300 561 population-based controls. Cox regression was used to compute hazard ratios (HRs) for subsequent risk of major depression identified from nationwide outpatient and inpatient diagnoses through 2018, adjusting for sociodemographic factors and prior mental disorders. Results The 10-year cumulative incidence of major depression was 5.4% in partners of people with AD, 5.6% in partners of people with all-cause dementia, and 3.9% in controls. The adjusted relative rate of major depression was increased ~1.5-fold in partners of people with AD (HR, 1.53; 95% CI, 1.35-1.72) or all-cause dementia (1.45; 1.34-1.57), compared with controls. These risks were elevated among both women (AD: HR, 1.41; 95% CI, 1.22-1.64; all-cause dementia: 1.36; 1.24-1.50) and men (AD: 1.81; 1.46-2.25; all-cause dementia: 1.73; 1.48-2.01). Risks remained significantly elevated ≥3 years later in both women (1.3- to 1.5-fold) and men (1.5-fold). Risks were generally highest in partners aged ≥85 years. Conclusions In this large national cohort, partners of people diagnosed with AD or all-cause dementia had ~1.5-fold risks of major depression, which remained elevated several years later. Partners of people with dementia need psychosocial support and long-term follow-up for timely detection and treatment of depression.</p>}},
  author       = {{Crump, Casey and Wei, Jingkai and Vickrey, Barbara G. and Edwards, Alexis C. and Schulz, Paul E. and Sieh, Weiva and Sundquist, Jan and Sundquist, Kristina}},
  issn         = {{0002-0729}},
  keywords     = {{Alzheimer disease; dementia; depression; mental health; older people; spouses}},
  language     = {{eng}},
  number       = {{10}},
  publisher    = {{Oxford University Press}},
  series       = {{Age and Ageing}},
  title        = {{Risk of major depression in partners of people with Alzheimer's disease : A national cohort study}},
  url          = {{http://dx.doi.org/10.1093/ageing/afaf283}},
  doi          = {{10.1093/ageing/afaf283}},
  volume       = {{54}},
  year         = {{2025}},
}