Tiemeier Henning, van Dijck Wim, Hofman Albert, Witteman Jacqueline C M, Stijnen Theo, Breteler Monique M B
Departments of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
Arch Gen Psychiatry. 2004 Apr;61(4):369-76. doi: 10.1001/archpsyc.61.4.369.
Depression in late life has been associated with vascular abnormalities. Several studies have demonstrated that persons with brain infarcts are more likely to have depressive disorders. Furthermore, depression is related to the subsequent development of ischemic heart disease.
To investigate the relationship between atherosclerosis at different locations and depression in the general population.
Cross-sectional population-based study.
The Rotterdam Study, a population-based cohort study.
In 4019 men and women 60 years and older, we assessed atherosclerosis at different locations, including common carotid intima-media thickness, plaques in the carotid arteries, the ankle-brachial blood pressure index, and aortic atherosclerosis. An overall measure of extracoronary atherosclerosis was obtained in 3747 persons by computing the principal component of these extracoronary atherosclerosis measures. In a subgroup of 1986 persons, we additionally measured coronary calcifications.
All subjects were screened for depressive symptoms. Screen-positive subjects had a psychiatric interview to diagnose depressive disorder.
More severe extracoronary atherosclerosis was associated with a higher prevalence of depressive disorders. For every 1-standard deviation increase, the prevalence increased by 30%. Furthermore, we found a strong relationship of severe coronary and aortic calcifications with depressive disorders (odds ratio, 3.89; 95% confidence interval, 1.55-9.77; and odds ratio, 2.00; 95% confidence interval, 1.02-3.96, respectively).
Atherosclerosis and depression are associated in the elderly. This finding is compatible with the vascular depression hypothesis. However, the cross-sectional nature of the study does not allow causal inferences. In particular, earlier depressive episodes may have contributed to the development of atherosclerosis.
老年期抑郁症与血管异常有关。多项研究表明，脑梗死患者更易患抑郁症。此外，抑郁症与缺血性心脏病的后续发展有关。
研究普通人群中不同部位动脉粥样硬化与抑郁症之间的关系。
基于人群的横断面研究。
鹿特丹研究，一项基于人群的队列研究。
在4019名60岁及以上的男性和女性中，我们评估了不同部位的动脉粥样硬化情况，包括颈总动脉内膜中层厚度、颈动脉斑块、踝臂血压指数和主动脉粥样硬化。通过计算这些冠状动脉外粥样硬化指标的主成分，在3747人中获得了冠状动脉外粥样硬化的总体测量值。在1986人的亚组中，我们还测量了冠状动脉钙化情况。
对所有受试者进行抑郁症状筛查。筛查呈阳性的受试者接受精神科访谈以诊断抑郁症。
冠状动脉外粥样硬化越严重，抑郁症的患病率越高。每增加1个标准差，患病率增加30%。此外，我们发现严重的冠状动脉钙化和主动脉钙化与抑郁症有很强的相关性（优势比分别为3.89；95%置信区间为1.55 - 9.77；以及优势比为2.00；95%置信区间为1.02 - 3.96）。
老年人中动脉粥样硬化与抑郁症有关。这一发现与血管性抑郁假说相符。然而，该研究的横断面性质不允许进行因果推断。特别是，早期的抑郁发作可能促成了动脉粥样硬化的发展。
