Depressive symptoms, vascular disease, and mild cognitive impairment - Findings from the cardiovascular health study
Depressive symptoms, vascular disease, and mild cognitive impairment - Findings from the cardiovascular health study
复制标题
DOI：
10.1001/archpsyc.63.3.273
复制
发表时间：
2006-03-01
影响因子：
--
通讯作者：
Yaffe, K
中科院分区：
文献类型：
--
作者：
Barnes, DE;Alexopoulos, GS;Yaffe, K
背景：抑郁症状在痴呆患者中很常见，可能与痴呆风险增加有关。目的：验证以下假设：（1）抑郁症状与轻度认知功能障碍（MCI）（一种常发生于痴呆之前的临床前状态）的发生风险增加有关;（2）抑郁症状与MCI之间的相关性可归因于潜在的血管疾病。设计：前瞻性，基于人群的，纵向研究。设置：从4个美国社区招募的65岁或以上的成年人随机样本。参与者：受试者是2220名心血管健康研究认知研究的参与者，基线时具有高认知功能。使用流行病学研究中心的10项抑郁量表测量基线时的抑郁症状，并将其分为无（0-2分），低（3-7分）和中度或高度（>= 8分）。基线时的血管疾病指标包括经证实的卒中、短暂性脑缺血发作、糖尿病或高血压史;颈动脉狭窄;踝臂血压指数;以及脑磁共振成像显示的小或大梗死或白色病变。轻度认知功能障碍诊断后6年的后续行动的基础上的共识，一组痴呆症专家使用标准的临床critics.Main结果测量：MCI的诊断。结果：基线抑郁症状与MCI的风险增加（10.0%，13.3%，和19.7%的那些没有，低，中度或高度抑郁症状，分别）。通过调整血管疾病指标和人口统计学，这种关联仅略有减弱。血管疾病的措施也与MCI的风险增加，这些协会没有减少调整抑郁症状或demographics.Conclusion：抑郁症状与MCI的风险增加，这种关联是独立的基础血管疾病。
Context: Depressive symptoms are common in patients with dementia and may be associated with increased risk of developing dementia. It has been hypothesized that depressive symptoms and dementia may be attributable to underlying vascular disease in some older persons.Objectives: To test the hypotheses (1) that depressive symptoms are associated with increased risk of developing mild cognitive impairment (MCI), a preclinical state that often precedes dementia, and (2) that the association between depressive symptoms and MCI is attributable to underlying vascular disease.Design: Prospective, population-based, longitudinal study.Setting: Random sample of adults 65 years or older recruited from 4 US communities.Participants: Subjects were 2220 participants in the Cardiovascular Health Study Cognition Study with high cognitive function at baseline. Depressive symptoms were measured at baseline using the 10-item Center for Epidemiological Studies Depression Scale and were classified as none (0-2 points), low (3-7 points), and moderate or high (>= 8 points). Vascular disease measures at baseline included confirmed history of stroke, transient ischemic attack, diabetes mellitus, or hypertension; carotid artery stenosis; ankle-arm blood pressure index; and small or large infarcts or white matter disease on cerebral magnetic resonance imaging. Mild cognitive impairment was diagnosed after 6 years of follow-up based on the consensus of a team of dementia experts using standard clinical criteria.Main Outcome Measure: Diagnosis of MCI.Results: Depressive symptoms at baseline were associated with increased risk of MCI (10.0%, 13.3%, and 19.7% for those with no, low, and moderate or high depressive symptoms, respectively). This association was diminished only slightly by adjustment for vascular disease measures and demographics. Vascular disease measures also were associated with increased risk of MCI, and these associations were not diminished by adjustment for depressive symptoms or demographics.Conclusion: Depressive symptoms were associated with increased risk of MCI, and this association was independent of underlying vascular disease.