Depressive symptoms, cognitive decline, and risk of AD in older persons
Depressive symptoms, cognitive decline, and risk of AD in older persons
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DOI：
10.1212/wnl.59.3.364
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发表时间：
2002-08-13
期刊：
影响因子：
9.9
通讯作者：
Bennett, DA
中科院分区：
文献类型：
--
作者：
Wilson, RS;Barnes, LL;Bennett, DA
背景资料：横断面和回顾性病例对照研究表明抑郁症状与认知障碍和AD相关，但很少有前瞻性研究，其结果不一致。方法：参与者是天主教神职人员，年龄：65岁，没有AD的临床证据。在7年的时间里，他们接受了年度临床评价，包括AD的临床分类和详细的认知功能测试，从这些测试中获得了整体和特定的认知指标。抑郁症状的数量在基线时采用改良的10项流行病学研究中心抑郁量表（CES-D）进行评估。使用比例风险模型，研究了CES-D评分与AD事件的相关性，使用随机效应模型，研究了认知功能下降的相关性。结果：在基线时，参与者在CES-D量表（范围，0至8）上报告平均约一种抑郁症状。在7年的随访中，108人发展为AD。在控制选定的人口统计学和临床变量（包括认知功能基线水平）的分析中，CES-D评分与AD风险和认知功能下降率相关。对于每一种抑郁症状，患AD的风险平均增加19%，全球认知指标的年下降平均增加24%。结论：研究结果提高了老年人抑郁症状可能与AD发病风险相关的可能性。
Background: Cross-sectional and retrospective case-control studies suggest an association of depression symptoms with cognitive impairment and AD, but there have been few prospective studies and their results have been inconsistent. Methods: Participants are Catholic clergy members who were aged :65 years and who did not have clinical evidence of AD. During a 7-year period, they underwent annual clinical evaluations that included clinical classification of AD and detailed cognitive function testing from which global and specific measures of cognition were derived. Number of depressive symptoms was assessed at baseline with a modified, 10-item Center for Epidemiologic Studies Depression Scale (CES-D). The association of CES-D score with incident AD, using proportional hazards models, and cognitive decline, using random effects models, was examined. Results: At baseline, participants reported an average of about one depressive symptom on the CES-D scale (range, 0 to 8). During the 7 years of follow-up, 108 persons developed AD. In analyses that controlled for selected demographic and clinical variables including baseline level of cognitive function, CES-D score was associated with both risk of AD and rate of cognitive decline. For each depressive symptom, risk of developing AD increased by an average of 19%, and annual decline on a global cognitive measure increased by an average of 24%. Conclusions: The results raise the possibility that depressive symptoms in older persons may be associated with risk of developing AD.