Trajectories of Depressive Symptoms in Older Adults and Risk of Dementia.
Trajectories of Depressive Symptoms in Older Adults and Risk of Dementia.
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DOI：
10.1001/jamapsychiatry.2016.0004
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发表时间：
2016-05-01
期刊：
影响因子：
25.8
通讯作者：
Yaffe, Kristine
中科院分区：
文献类型：
--
作者：
Kaup, Allison R.;Byers, Amy L.;Falvey, Cherie;Simonsick, Eleanor M.;Satterfield, Suzanne;Ayonayon, Hilsa N.;Smagula, Stephen F.;Rubin, Susan M.;Yaffe, Kristine
抑郁症已被确定为痴呆症的一个危险因素。然而，大多数研究只测量了一个时间点的抑郁症状，随着时间的推移，老年人可能表现出不同的抑郁症状模式。研究老年人抑郁症状轨迹与痴呆风险之间的关系。这是一个前瞻性队列调查黑人和白人社区居住的老年人健康，老龄化和身体组成研究。参与者于1997年5月至1998年6月登记，并在2001年至2002年期间进行随访。该分析的日期为2014年9月至2015年12月。实验地点是田纳西州孟菲斯和宾夕法尼亚州匹兹堡的社区研究中心。从基线到第5年评估抑郁症状的轨迹。使用流行病学研究中心抑郁量表短表测量症状，并使用潜在类别增长曲线分析计算轨迹。11年的痴呆发生率，由痴呆药物使用、医院记录或显著的认知能力下降（修正迷你精神状态检查≥1.5 SD的种族特异性下降）确定。我们使用Cox比例风险回归模型检验了抑郁症状轨迹与痴呆发病率之间的关系，该模型调整了人口统计学、各组之间存在差异的健康因素以及抑郁症状评估期间（基线至第5年）的认知。分析队列包括2488名黑人和白人老年人，从基线到第5年反复进行抑郁症状评估，在此期间没有痴呆。他们的平均（SD）基线年龄为74.0（2.8）岁，53.1% （n = 1322）为女性。确定了以下3种抑郁症状轨迹：持续轻度症状（62.0% [n = 1542]的参与者），中度和加重症状（32.2%[n = 801]的参与者），以及重度和加重症状（5.8% [n = 145]的参与者）。与持续最小的轨迹相比，抑郁症状高且增加的轨迹与痴呆风险显著增加相关（完全调整后的风险比为1.94；95% CI为1.30-2.90），而中度且增加的轨迹与完全调整后的痴呆风险无关。敏感性分析表明，高且不断增加的轨迹与痴呆发病率有关，而个别时间点的抑郁症状则无关。具有高抑郁症状和不断增加的纵向模式的老年人患痴呆症的风险很高。个体抑郁症状的发展轨迹可能比一次性抑郁症状评估更准确地告知痴呆风险。
Depression has been identified as a risk factor for dementia. However, most studies have measured depressive symptoms at only one time point, and older adults may show different patterns of depressive symptoms over time. To investigate the association between trajectories of depressive symptoms and risk of dementia in older adults. This was a prospective cohort investigation of black and white community-dwelling older adults in the Health, Aging, and Body Composition study. Participants were enrolled between May 1997 and June 1998 and followed up through 2001–2002. The dates of this analysis were September 2014 to December 2015. The setting was community research centers in Memphis, Tennessee, and Pittsburgh, Pennsylvania. Trajectories of depressive symptoms were assessed from baseline to year 5. Symptoms were measured with the Center for Epidemiologic Studies Depression Scale Short Form, and trajectories were calculated using latent class growth curve analysis. Incident dementia through year 11, determined by dementia medication use, hospital records, or significant cognitive decline (≥1.5 SD race-specific decline on the Modified Mini-Mental State Examination). We examined the association between depressive symptom trajectories and dementia incidence using Cox proportional hazards regression models adjusted for demographics, health factors that differed between groups, and cognition during the depressive symptom assessment period (baseline to year 5). The analytic cohort included 2488 black and white older adults with repeated depressive symptom assessments from baseline to year 5 who were free of dementia throughout that period. Their mean (SD) age at baseline was 74.0 (2.8) years, and 53.1% (n = 1322) were female. The following 3 depressive symptom trajectories were identified: consistently minimal symptoms (62.0% [n = 1542] of participants), moderate and increasing symptoms (32.2%[n = 801] of participants), and high and increasing symptoms (5.8% [n = 145] of participants). Compared with the consistently minimal trajectory, having a high and increasing depressive symptom trajectory was associated with significantly increased risk of dementia (fully adjusted hazard ratio, 1.94; 95% CI, 1.30–2.90), while the moderate and increasing trajectory was not associated with risk of dementia after full adjustment. Sensitivity analyses indicated that the high and increasing trajectory was associated with dementia incidence, while depressive symptoms at individual time points were not. Older adults with a longitudinal pattern of high and increasing depressive symptoms are at high risk for dementia. Individuals’ trajectory of depressive symptoms may inform dementia risk more accurately than one-time assessment of depressive symptoms.
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影响因子：
11
作者：
Taylor, W. D.;Aizenstein, H. J.;Alexopoulos, G. S.
通讯作者：
Alexopoulos, G. S.
DOI：
10.20982/tqmp.05.1.p011
发表时间：
2009-01-01
期刊：
TUTORIALS IN QUANTITATIVE METHODS FOR PSYCHOLOGY
影响因子：
--
作者：
Andruff, Heather;Carraro, Natasha;Louvet, Benoit
通讯作者：
Louvet, Benoit
影响因子：
7.2
作者：
Cui, Xingjia;Lyness, Jeffrey M.;Conwell, Yeates
通讯作者：
Conwell, Yeates
DOI：
10.1093/geronb/60.3.p136
发表时间：
2005-05-01
影响因子：
6.2
作者：
Skarupski, KA;de Leon, CFM;Evans, DA
通讯作者：
Evans, DA
记忆力可预测老年人抑郁症状的变化： 双向纵向分析
DOI：
10.1093/geronb/gbr035
发表时间：
2011-09-01
影响因子：
6.2
作者：
Jajodia, Archana;Borders, Ashley
通讯作者：
Borders, Ashley