Is the relationship between syndromes of depression and dementia temporal? The MRC-ALPHA and Hefei-China studies
Is the relationship between syndromes of depression and dementia temporal? The MRC-ALPHA and Hefei-China studies
复制标题
DOI：
10.1017/s0033291708003735
复制
发表时间：
2009-03-01
影响因子：
6.9
通讯作者：
Copeland, J. R.
中科院分区：
文献类型：
--
作者：
Chen, R.;Hu, Z.;Copeland, J. R.
背景。最近的研究表明，抑郁症状和认知能力下降之间存在时间上的关联。然而，抑郁症状与痴呆之间的关系尚不清楚。使用老年精神状态检查（GMS）对中国1736名65岁的人和英国5222名老年人进行了访谈，并在随访时进行了再次访谈。使用计算机辅助分类自动老年医学检查（AGECAT）诊断抑郁和痴呆综合征的五个级别。尽管中国人的抑郁症状比英国人少，但两国人群的痴呆症状（器质性紊乱）水平相似（女性为20%，男性为14%）。抑郁症和痴呆的综合征水平之间存在显著的横断面相关性（相关系数：中国人0.141-0.248，英国人0.168-0.248）。在不同年龄、性别和有无心血管疾病（CVD）的人群中，这一结果都得到了维持。基线抑郁症状与随访痴呆之间的关系不太明显：1年随访时，中国样本的相关系数为0.075[95%可信区间（CI） 0.021-0.128]， 2年随访时，英国样本的相关系数为0.093 (95% CI 1.061-0.125)， 4年随访时，相关系数为0.093 （95% CI 0.049-0.130）。这种关系在没有基线器质性综合征的参与者中消失。在一项多因素调整logistic回归分析中，器质性综合征的风险增加似乎与基线有关，主要是在抑郁综合征的最高水平。抑郁症和痴呆症状之间的关系可能是暂时的。基线抑郁综合征与继发性痴呆之间缺乏明显的剂量-反应关系，提示抑郁与痴呆之间的因果关系有待进一步研究。
Background. Recent studies have shown a temporal association between depressive symptoms and cognitive decline. However, the relationship between syndromes of depression and dementia is unknown.Method. A total of 1736 people aged >= 65 years in China and 5222 older people in the UK were interviewed using the Geriatric Mental State Examination (GMS) and reinterviewed at follow-up. Five levels of syndromes of depression and dementia were diagnosed using the Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT).Results. Although there were fewer depressive syndromes in Chinese than British participants, both populations showed a similarly high level of syndromes of dementia (organic disorder) (20% for women, 14% for men). There was a significant cross-sectional correlation between syndrome levels of depression and dementia (correlation coefficients: 0.141-0.248 for Chinese, 0.168-0.248 for British). This was maintained for different age, gender and people with and without cardiovascular disease (CVD). The relationship between syndromes of baseline depression and follow-up dementia was less Substantial: the correlation coefficient was 0.075 [95% confidence interval (CI) 0.021-0.128] for the Chinese sample at the 1-year follow-up, and 0.093 (95% CI 1.061-0.125) for the British at the 2-year follow-up and 0.093 (95% CI 0.049-0.130) at the 4-year follow-up. This relationship disappeared in participants without baseline organic syndromes. In a multiple adjusted logistic regression analysis, an increased risk of organic syndromes seemed to be associated with baseline, mainly in the highest level of, depressive syndromes.Conclusions. The relationship between syndromes of depression and dementia might be temporal. The lack of an obvious dose-response relationship between baseline depressive syndromes and follow-Lip dementia suggests that the causal relationship between depression and dementia needs further investigation.