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Cumulative and variable depression symptom exposure and incident dementia: Panel data analysis of four longitudinal cohort studies
Zhiyong Hou, Ming Yu, Keqiang Lu, Yiming Ma, Ran Jia, Guichuan Lai, Yuqi Bai, Weijun Huang. Alzheimer s & Dementia, 2025-11-01
Topic: Risk, prevention and care in population studies
Each 1-unit increase in cumulative score was associated with a 3%-8% higher dementia hazard across cohorts. Highest versus lowest cumulative quartiles showed markedly elevated risk. Sustained high exposure for 4 years conferred ≈2.7-3.9× greater risk. Higher variability and worsening trajectories were also linked to higher incidence. Associations were robust across subgroups. Persistent and unstable depression symptoms independently predict higher dementia risk, supporting longitudinal mood monitoring and sustained management. HIGHLIGHTS: Multi-cohort study of 23,305 adults (ELSA, HRS, SHARE, CHARLS). Cumulative depression burden shows a dose-response with dementia risk. Highest versus lowest quartile: dementia hazard up to 18× (HRS). Sustained high symptoms (4 years) linked to ≈2.7-3.9× greater risk. Visit-to-visit variability independently associates with higher dementia risk.
Key findings
- Each 1-unit increase in cumulative score was associated with a 3%-8% higher dementia hazard across cohorts.
- Highest versus lowest cumulative quartiles showed markedly elevated risk.
- Sustained high exposure for 4 years conferred ≈2.7-3.9× greater risk.
- Higher variability and worsening trajectories were also linked to higher incidence.
- Associations were robust across subgroups.
Why it matters
This multi-cohort study found that cumulative and variable depression symptom exposure independently predicted higher dementia risk, with sustained high exposure for 4 years conferring approximately 2.7-3.9× greater risk. It supports longitudinal mood monitoring and sustained management.
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Study details
- Study designcohort study
- Participants23,305
- Evidence strengthModerate
How this study scored 56/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 4 / 4 | 23,305 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 11 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 3.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 7.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 11 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Weijun Huang: h-index 15 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Manchester: institution h-index 1,304 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41313677) |
| Free to read | 2 / 2 | Free to read |
| Total | 56 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Hou, Z., Yu, M., Lu, K., Ma, Y., Jia, R., Lai, G., et al. (2025). Cumulative and variable depression symptom exposure and incident dementia: Panel data analysis of four longitudinal cohort studies. Alzheimer s & Dementia. https://doi.org/10.1002/alz.70950
Vancouver
Hou Z, Yu M, Lu K, Ma Y, Jia R, Lai G, et al. Cumulative and variable depression symptom exposure and incident dementia: Panel data analysis of four longitudinal cohort studies. Alzheimer s & Dementia. 2025. doi:10.1002/alz.70950. PMID: 41313677.
BibTeX
@article{hou2025-41313677,
author = {Hou, Zhiyong and Yu, Ming and Lu, Keqiang and Ma, Yiming and Jia, Ran and Lai, Guichuan and Bai, Yuqi and Huang, Weijun},
title = {{Cumulative and variable depression symptom exposure and incident dementia: Panel data analysis of four longitudinal cohort studies}},
journal = {Alzheimer s \& Dementia},
year = {2025},
doi = {10.1002/alz.70950},
pmid = {41313677},
url = {https://doi.org/10.1002/alz.70950}
}
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