Change in depressive symptoms during the prodromal phase of Alzheimer disease
Change in depressive symptoms during the prodromal phase of Alzheimer disease
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DOI：
10.1001/archpsyc.65.4.439
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发表时间：
2008-04-01
影响因子：
--
通讯作者：
Bennett, David A.
中科院分区：
文献类型：
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作者：
Wilson, Robert S.;Arnold, Steven E.;Bennett, David A.
背景：前瞻性研究已经建立了抑郁症状与痴呆风险之间的联系，但抑郁症状在痴呆演变过程中如何变化还不确定。目的：检验抑郁症状在阿尔茨海默病(AD)的前驱阶段增加的假设。设计：前瞻性队列研究。参与者和背景：在长达13年的时间里，917名研究开始时没有痴呆的年长天主教修女、牧师和僧侣完成了年度临床评估，其中包括执行10个条目的流行病学研究中心抑郁量表以及轻度认知障碍和AD的临床分类。主要结果衡量：流行病学抑郁症研究中心报告的抑郁症状的变化。结果：在基线，917名年长的天主教修女、牧师和僧侣完成了年度临床评估，包括执行10个条目的轻度认知障碍和AD的临床分类。主要结果：流行病学抑郁症研究中心报告的抑郁症状的变化。结果：在基线，917名年长的天主教修女、牧师和僧侣在研究开始时完成了年度临床评估，包括执行10个条目的轻度认知障碍和AD的临床分类。主要结果：流行病学抑郁研究中心报告的抑郁症状的变化参与者报告的平均抑郁症状(SD)为1.0(1.5)。患有AD的患者(n=190)在诊断前抑郁症状没有增加，这一发现不受年龄、性别、教育程度、记忆障碍、血管负担或个性的影响。在诊断为阿尔茨海默病后，抑郁症状没有系统性的变化，尽管与男性相比，女性的症状往往会减少，那些病前开放程度较高、病前随和程度较低的人的症状往往会减少。在基线没有认知损害的人中，随后发展为轻度认知损害的人抑郁症状没有增加。结论：我们没有发现在AD的前驱阶段抑郁症状增加的证据。
Context: Prospective studies have established an association between depressive symptoms and risk of dementia, but how depressive symptoms change during the evolution of dementia is uncertain.Objective: To test the hypothesis that depressive symptoms increase during the prodromal phase of Alzheimer disease (AD).Design: Prospective cohort study.Participants and Setting: For up to 13 years, 917 older Catholic nuns, priests, and monks without dementia at study onset completed annual clinical evaluations that included administration of the 10-item Center for Epidemiologic Studies Depression Scale and clinical classification of mild cognitive impairment and AD.Main Outcome Measure: Change in depressive symptoms reported on the Center for Epidemiologic Studies Depression Scale.Results: At baseline, participants reported a mean (SD) of 1.0 (1.5) depressive symptoms. Those who developed AD (n = 190) showed no increase in depressive symptoms before the diagnosis was made, and this finding was not modified by age, sex, education, memory complaints, vascular burden, or personality. There was no systematic change in depressive symptoms after the AD diagnosis, although symptoms tended to decrease in women relative to men and in those with a higher pre-morbid level of openness and a lower premorbid level of agreeableness. Among those without cognitive impairment at baseline, depressive symptoms did not increase in those who subsequently developed mild cognitive impairment.Conclusion: We found no evidence of an increase in depressive symptoms during the prodromal phase of AD.