Just six common symptoms of depression were responsible for the link between depression in middle-age and future dementia, according to a 23-year prospective study issued by the Lancet Psychiatry.Why It’s Relevant
Treating depression as a unitary construct might hinder the identification of patient subgroups who are most at risk of developing dementia. A more nuanced understanding of symptom-specific associations might help clinicians pinpoint which middle-aged patients are most at risk.
What Was Done
Researchers examined responses from 5,811 middle-aged civil service workers (72% men, 92% White, average age 56) who took the 30-item General Health Questionnaire (GHQ-30) as part of this longitudinal study.
At baseline, 1,248 participants (22%) had elevated depressive symptoms (GHQ-30 score ≥5). Over the 23-year follow-up, 586 individuals (10%) developed dementia.
By the Numbers
Overall, having an elevated GHQ-30 score at baseline was associated with a 27% increased risk of dementia. In analyses adjusted for age, sex, and ethnicity, six of the 30 symptoms were associated with long-term dementia risk in individuals under 60:
- “Losing confidence in myself”: 51% greater risk of dementia
- “Not able to face up to problems”: 49%
- “Not feeling warmth and affection for others”: 44%
- “Nervous and strung-up all the time”: 34%
- “Not satisfied with the way tasks are carried out”: 33%
- “Difficulties concentrating”: 29%
What’s More
Among individuals who were older than 60 at baseline, these six symptoms accounted for about half of one’s dementia risk.
The Other Side
The study was based on observational data, so researchers were unable to infer causation. Furthermore, the depression measure was based on self-report and limited to 30 items, which might not fully capture the breadth and severity of depressive symptoms.
Takeaway Message
“Our findings, if replicated, could help clinicians distinguish between middle-aged patients whose depression reflects an elevated dementia risk and those whose symptoms are more likely due to other causes, supporting clinical evaluation and more tailored treatments,” the researchers wrote.
Related Information
Source
Philipp Frank, et al. Specific midlife depressive symptoms and long-term dementia risk: a 23-year UK prospective cohort study. Lancet Psychiatry. Published December 15, 2025. doi: doi.org/10.1016/S2215-0366(25)00331-1
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