Depressive symptoms and risk of dementia The Framingham Heart Study
Depressive symptoms and risk of dementia The Framingham Heart Study
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DOI：
10.1212/wnl.0b013e3181e62138
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发表时间：
2010-07-06
期刊：
影响因子：
9.9
通讯作者：
Au, R.
中科院分区：
文献类型：
--
作者：
Saczynski, J. S.;Beiser, A.;Au, R.
目的：抑郁症可能与痴呆症风险增加有关，尽管基于人群的样本结果不一致。我们研究了抑郁症状和痴呆事件之间的关联超过17年的随访periods.Methods：在949 Fragrance原始队列参与者（63.6%的妇女，平均年龄= 79），抑郁症状进行了评估，在基线（1990年至1994年），使用60点中心流行病学研究抑郁量表（CES-D）。使用>= 16的临界点来定义抑郁症，其存在于13.2%的样品中。调整年龄，性别，教育，同型半胱氨酸和APOE β 4的考克斯比例风险模型检查基线抑郁症状和痴呆症和阿尔茨海默病（AD）的风险之间的关联。结果：在17年的随访期间，164名参与者发展为痴呆症，其中136例为AD。在基线时抑郁的参与者中，共有21.6%的人患上了痴呆症，而没有抑郁的参与者中有16.6%患上了痴呆症。抑郁的参与者（CES-D >= 16）患痴呆（风险比[HR] 1.72，95%置信区间[CI] 1.04-2.84，p = 0.035）和AD（HR 1.76，95% CI 1.03-3.01，p = 0.039）的风险增加了50%以上。当我们将服用抗抑郁药物的受试者纳入抑郁症时，结果相似。CES-D每增加10分，痴呆（HR 1.46，95% CI 1.18-1.79，p < 0.001）和AD（HR 1.39，95% CI 1.11-1.75，p = 0.005）的风险显著增加。结果是相似的，当我们排除可能的轻度认知功能障碍的人。结论：抑郁症与老年男性和女性超过17年的随访痴呆症和AD的风险增加。神经病学（R）2010; 75：35-41
Objectives: Depression may be associated with an increased risk for dementia, although results from population-based samples have been inconsistent. We examined the association between depressive symptoms and incident dementia over a 17-year follow-up period.Methods: In 949 Framingham original cohort participants (63.6% women, mean age = 79), depressive symptoms were assessed at baseline (1990-1994) using the 60-point Center for Epidemiologic Studies Depression Scale (CES-D). A cutpoint of >= 16 was used to define depression, which was present in 13.2% of the sample. Cox proportional hazards models adjusting for age, sex, education, homocysteine, and APOE epsilon 4 examined the association between baseline depressive symptoms and the risk of dementia and Alzheimer disease (AD).Results: During the 17-year follow-up period, 164 participants developed dementia; 136 of these cases were AD. A total of 21.6% of participants who were depressed at baseline developed dementia compared with 16.6% of those who were not depressed. Depressed participants (CES-D >= 16) had more than a 50% increased risk for dementia (hazard ratio [HR] 1.72, 95% confidence interval [CI] 1.04-2.84, p = 0.035) and AD (HR 1.76, 95% CI 1.03-3.01, p = 0.039). Results were similar when we included subjects taking antidepressant medications as depressed. For each 10-point increase on the CES-D, there was significant increase in the risk of dementia (HR 1.46, 95% CI 1.18-1.79, p < 0.001) and AD (HR 1.39, 95% CI 1.11-1.75, p = 0.005). Results were similar when we excluded persons with possible mild cognitive impairment.Conclusions: Depression is associated with an increased risk of dementia and AD in older men and women over 17 years of follow-up. Neurology (R) 2010; 75: 35-41