Depressed Mood is Not a Risk Factor for Incident Dementia in a Community-Based Cohort
Depressed Mood is Not a Risk Factor for Incident Dementia in a Community-Based Cohort
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DOI：
10.1097/jgp.0b013e3181aad1fe
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发表时间：
2009-08-01
影响因子：
7.2
通讯作者：
Reynolds, Charles F.
中科院分区：
文献类型：
--
作者：
Becker, James T.;Chang, Yue-Fang;Reynolds, Charles F.
目的：探讨认知功能正常个体抑郁情绪与阿尔茨海默病发展的关系。设计：纵向观察。设置：基于社区的队列研究。参与者：心血管健康研究-认知研究中共有288名参与者（平均年龄：77.52岁，SD = 3.65，范围：70-89岁）。所有参与者在1998/1999年被判定为认知正常，并且在1998/1999年之前至少有三次认知和情绪状态的测量。1998-1999年至2007年的平均随访时间为7.1年（范围：1-9年，中位数= 9年）。测量值：1998/1999年以前的受试者采用流行病学中心抑郁量表（CESD）作为情绪状态指标，采用改良简易精神状态检查量表（3 MSE）作为认知功能指标。这些措施被认为是在两个方面：参与者被分类根据：1）他们是否表现出高度负相关的CESD和3 MSE分数（即，表明更大的抑郁与更差的认知有关）和2）他们是否表现出持续升高的CESD评分。研究结果，痴呆的发展（N = 48），是基于共识分类，这是基于详细的神经心理学和神经系统检查。结果如下：作者没有发现情绪状态（无论是单独的还是与认知状态有关的）与随后的痴呆症发展之间存在一致的关系。那些认知功能与情绪状态高度相关的人并不比其他参与者更容易患痴呆症。那些有持续抑郁情绪的人也不比那些没有持续抑郁情绪的人更容易患痴呆症。结论：在这项前瞻性的、以社区为基础的老年人研究范围内，作者找不到强有力的证据来支持情绪障碍与痴呆症的发展有关的假设。（Am J Geriatr Psychiatry 2009; 17：653-663）
Objectives: To determine the relationship between depressed mood and the development of Alzheimer disease in cognitively normal individuals. Design: Longitudinal and observational. Setting: Community-based cohort study. Participants: A total of 288 participants in the Cardiovascular Health Study-Cognition Study (mean age: 77.52, SD = 3.65, range: 70-89). All of the participants were adjudicated as cognitively normal in 1998/1999, and all had at least three visits before 1998/1999 with measures of cognition and mood state. The mean length of follow-up from 1998-1999 to 2007 was 7.1 years (range: 1-9 years, median = 9 years). Measurements: The Center for Epidemiological Studies-Depression Scale (CESD) was used to index mood state, and the Modified Mini-Mental State Examination (3MSE) was the index of cognitive function among participants before 1998/1999. These measures were considered in two ways: participants were classified according to: 1) whether they showed a high-negative correlation between their CESD and 3MSE scores (i.e., indicating that greater depression was linked to poorer cognition) and 2) whether they showed persistently elevated CESD scores. The study outcome, development of dementia (N = 48), was based on consensus classifications, which was based on detailed neuropsychological and neurological exams. Results: The authors could find no consistent relationship between mood state, either alone or in relation to cognitive status, and the subsequent development of dementia. Those individuals whose cognitive functions were highly correlated with their mood state were no more likely to develop dementia than other participants. Those who had persistently depressed mood were also no more likely to develop dementia than those without persistently depressed mood. Conclusion: Within the confines of this prospective, community-based study of elderly adults, the authors could not find strong evidence to support the hypothesis that mood disturbance was linked with the development of dementia. ( Am J Geriatr Psychiatry 2009; 17: 653-663)