Chronic psychological distress and risk of Alzheimer's disease in old age
Chronic psychological distress and risk of Alzheimer's disease in old age
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DOI：
10.1159/000095761
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发表时间：
2006-01-01
影响因子：
5.7
通讯作者：
Bennett, David A.
中科院分区：
文献类型：
--
作者：
Wilson, Robert S.;Arnold, Steven E.;Bennett, David A.
来自Rush Memory and Aging Project的临床和病理数据被用来检验这一假设，即抑郁倾向与阿尔茨海默病(AD)风险增加有关。600多名没有痴呆症的老年人完成了神经质的6项测量，这是心理困扰倾向的稳定指标。此后，每隔一年，他们都会接受统一的评估，包括AD的临床分类和18项认知测试的实施。那些死亡的人接受了脑部尸检，从中得出了AD病理的综合衡量标准。在平均约3年的随访中，55人被临床诊断为阿尔茨海默病。在控制了年龄、性别和教育的分析中，具有高水平抑郁倾向(得分=24，90%)的人患AD的可能性是那些不倾向于抑郁(得分=6，10%)的人的2.7倍。对抑郁症状的调整或认知、社交和体力活动的频率并没有实质上改变这种效果。痛苦倾向也与认知能力下降的速度更快有关。在45名死亡并接受脑部尸检的参与者中，抑郁倾向与AD病理的不同指标无关，在控制了AD病理后，与认知呈负相关。结果支持这一假设，即抑郁倾向与痴呆症风险的增加有关，并表明这种联系可能是基于AD病理以外的神经生物机制。版权所有(C)2006 S.Karger AG，巴塞尔。
Clinical and pathological data from the Rush Memory and Aging Project were used to test the hypothesis that distress proneness is associated with increased risk of Alzheimer's disease (AD). More than 600 older persons without dementia completed a 6-item measure of neuroticism, a stable indicator of proneness to psychological distress. At annual intervals thereafter, they underwent uniform evaluations that included clinical classification of AD and administration of 18 cognitive tests. Those who died underwent brain autopsy from which composite measures of AD pathology were derived. During a mean of about 3 years of follow-up, 55 people were clinically diagnosed with AD. In analyses that controlled for age, sex, and education, persons with a high level of distress proneness (score = 24, 90th percentile) were 2.7 times more likely to develop AD than those not prone to distress (score = 6, 10th percentile). Adjustment for depressive symptomatology or frequency of cognitive, social, and physical activity did not substantially change this effect. Distress proneness was also associated with more rapid cognitive decline. Among 45 participants who died and underwent brain autopsy, distress proneness was unrelated to diverse measures of AD pathology and was inversely related to cognition after controlling for AD pathology. The results support the hypothesis that distress proneness is associated with increased risk of dementia and suggest that neurobiologic mechanisms other than AD pathology may underlie the association. Copyright (c) 2006 S. Karger AG, Basel.