Association between physiological serum concentration of estrogen and the mental health of community-dwelling postmenopausal women age 70 years and over
Association between physiological serum concentration of estrogen and the mental health of community-dwelling postmenopausal women age 70 years and over
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DOI：
10.1176/appi.ajgp.13.2.142
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发表时间：
2005-02-01
影响因子：
7.2
通讯作者：
Flicker, L
中科院分区：
文献类型：
--
作者：
Almeida, OP;Lautenschlager, N;Flicker, L
目的：探讨绝经后老年妇女雌激素生理水平与情绪/认知功能的关系。方法：采用横断面研究方法，对265名绝经后妇女(平均年龄74.6岁)进行半结构精神病学访谈(CAMDEX-R)，并采用Beck抑郁和焦虑问卷(BDI)和SF-36健康调查问卷对她们的健康状况进行自我评估。认知能力评定采用CAMDEX认知部分(CAMCOG)、韦氏记忆量表的单词表分测验、韦氏成人智力量表的积木设计分测验和言语流利性分测验。雌二醇和雌酮敏感的免疫分析法检测血清雌二醇和雌酮。结果：血清雌二醇水平最低的50个百分位数的女性比血清雌二醇水平最高的50个百分位数的女性更有可能有提示临床显著或严重抑郁的BDI评分。血清雌酮水平最低的50个百分位数的女性BAI得分较高。血清雌二醇/雌酮与认知功能之间没有明显的关联。结论：在老年绝经后妇女中，生理血清雌二醇和雌酮浓度与抑郁和焦虑评分呈负相关。血清雌二醇和抑郁分级之间的关系不是线性的，似乎受到阈值效应的影响。
Objective: The authors investigated the association between physiological levels of estrogen and mood/cognitive functioning among older postmenopausal women. Methods: This was a cross-sectional study of 265 postmenopausal women (mean age: 74.6 years), who were given a semistructured psychiatric interview (CAMDEX-R) and self-rated their health with the Beck Depression and Anxiety Inventories (BDI and BAI) and the SF-36 Health Survey. Cognitive abilities were assessed with the cognitive subsection of the CAMDEX (CAMCOG), the Word Lists subtest of the Wechsler Memory Scale, and the Block Design and Verbal Fluency subtests of the Wechsler Adult Intelligence Scale. Estradiol- and estrone-sensitive immunoassays were used to measure serum estradiol and estrone. Results: Women in the lowest 50th percentile of serum estradiol were more likely than women in the highest 50th percentile to have BDI scores suggestive of clinically significant or severe depression. Women in the lowest 50th percentile of serum estrone had higher BAI scores. There was no significant association between serum estradiol/estrone and cognitive functioning. Conclusions: Physiological serum concentrations of estradiol and estrone are inversely associated with depression and anxiety scores in older postmenopausal women. The association between serum estradiol and depression ratings is not linear and seems to be subject to a threshold effect.