Depression risk in patients with late-onset rheumatoid arthritis in Germany

• Published in: Quality of life research Vol. 26; no. 2; pp. 437 - 443
• Main Authors: Drosselmeyer, Julia, Jacob, Louis, Rathmann, Wolfgang, Rapp, Michael A., Kostev, Karel
• Format: Journal Article
• Language: English
• Published: Cham Springer 01.02.2017; Springer International Publishing; Springer Nature B.V
• Subjects: Age; Aged; Aged, 80 and over; Analysis; Antidepressants; Arthritis, Rheumatoid - psychology; Cardiovascular disease; Chronic illnesses; CLINICAL AND POLICY APPLICATIONS; Dementia; Depression - psychology; Diabetes; Epidemiology; Female; Germany; Heart failure; Humans; Longitudinal Studies; Male; Medical practices; Medicine; Medicine & Public Health; Mental depression; Middle Aged; Osteoarthritis; Osteoporosis; Patients; Prescriptions; Primary care; Proportional Hazards Models; Public Health; Quality of life; Quality of Life Research; Rheumatoid arthritis; Risk Factors; Sickness Impact Profile; Sociology; Studies; Germany; Depression; Late-onset rheumatoid arthritis; Primary care; Risk factors; Germany
• ISSN: 0962-9343; 1573-2649
• DOI: 10.1007/s11136-016-1387-2

Goal The goal of this study was to determine the prevalence of depression and its risk factors in patients with lateonset rheumatoid arthritis (RA) treated in German primary care practices. Methods Longitudinal data from general practices (n=1072) throughout Germany were analyzed. Individuals initially diagnosed with RA (2009-2013) were identified, and 7301 patients were included and matched (1:1) to 7301 controls. The primary outcome measure was the initial diagnosis of depression within 5 years after the index date in patients with and without RA. Cox proportional hazards models were used to adjust for confounders. Results The mean age was 72.2 years (SD: 7.6 years). A total of 34.9 % of patients were men. Depression diagnoses were present in 22.0 % of the RA group and 14.3 % of the control group after a 5-year follow-up period (p < 0.001). In the multivariate regression model, RA was a strong risk factor for the development of depression (HR: 1.55, p < 0.001). There was significant interaction of RA and diagnosed inflammatory polyarthropathies (IP) (RA*IP interaction: p < 0.001). Furthermore, dementia, cancer, osteoporosis, hypertension, and diabetes were associated with a higher risk of developing depression (p values <0.001). Conclusion The risk of depression is significantly higher in patients with late-onset RA than in patients without RA for subjects treated in primary care practices in Germany. RA patients should be screened routinely for depression in order to ensure improved treatment and management.