Depression and risk of developing dementia.
Depression and risk of developing dementia.
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DOI：
10.1038/nrneurol.2011.60
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发表时间：
2011-05-03
影响因子：
38.1
通讯作者：
Yaffe, Kristine
中科院分区：
文献类型：
--
作者：
Byers, Amy L.;Yaffe, Kristine
抑郁症在整个生命过程中非常常见，痴呆症在晚年很常见。文献表明抑郁症和痴呆症之间存在关联，越来越多的证据表明，抑郁症的发生时间对于确定这种关联的性质可能很重要。特别是，早期抑郁症或抑郁症状一直被证明与痴呆症风险增加2倍或更多相关。相比之下，对晚年抑郁症的研究更加相互矛盾，但大多数人支持一种关联;然而，这种关联的性质尚不清楚（例如，如果抑郁症是痴呆症的前驱症状或后果或风险因素）。将抑郁症与痴呆联系起来的可能生物学机制包括血管疾病、糖皮质激素类固醇的改变和海马萎缩、β-淀粉样蛋白斑块沉积增加、炎症变化和神经生长因子缺乏。抑郁症的治疗策略可能会干预这些途径，从而改变痴呆症的风险。考虑到未来几十年痴呆症的预计增加，我们了解单独治疗抑郁症或与其他治疗方案相结合是否能改善认知至关重要。本文就老年抑郁症和老年抑郁症与痴呆症的关系进行综述，探讨老年抑郁症与痴呆症的相关机制及其治疗意义。
Depression is highly common throughout the life course and dementia is common in late life. The literature suggests an association between depression and dementia, and growing evidence implies that timing of depression may be important to defining the nature of the association. In particular, earlier-life depression or depressive symptoms consistently have been shown to be associated with a 2-fold or greater increase in risk of dementia. In contrast, studies of late-life depression have been more conflicting but the majority support an association; yet, the nature of this association is unclear (e.g., if depression is a prodrome or consequence or risk factor for dementia). The likely biological mechanisms linking depression to dementia include vascular disease, alterations in glucocorticoid steroids and hippocampal atrophy, increased deposition of β-amyloid plaques, inflammatory changes, and deficits of nerve growth factors. Treatment strategies for depression might intervene on these pathways and in turn may alter risk for dementia. Given the projected increase of dementia in the coming decades, it is critically important that we understand whether treatment for depression alone or combined with other regimens improves cognition. In this review, we summarize and analyze current evidence for late-life and earlier-life depression and their relationship to dementia, discuss the primary underlying mechanisms and implications for treatment.
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