Dal Forno Gloria, Palermo Mark T, Donohue Janet E, Karagiozis Helen, Zonderman Alan B, Kawas Claudia H
Clinical Neurosciences, University Campus BioMedico and Associazione Fatebenefratelli per la Ricerca (A.Fa.R.), Via dei Compositori 130-132, 00128 Rome, Italy.
Ann Neurol. 2005 Mar;57(3):381-7. doi: 10.1002/ana.20405.
Depression associates with increased risk for dementia and Alzheimer's disease (AD), although it is unclear whether it represents an actual risk factor or a prodrome. To determine the relative hazard of premorbid depressive symptomatology for development of dementia and AD, we studied risk for incident dementia and AD over a 14-year period in 1,357 community-dwelling men and women participating in the 40-year prospective Baltimore Longitudinal Study of Aging. Screening for depressive symptoms, comprehensive medical and neuropsychological evaluations were prospectively collected every 2 years. Time-dependent proportional hazards of development of AD or dementia were calculated separately for men and women, with symptoms of depression detected at 2-, 4-, and 6-year intervals before onset of dementia symptoms. Vascular risk factors were analyzed as covariates. Premorbid depressive symptoms significantly increased risk for dementia, particularly AD in men but not in women. Hazard ratios were approximately two times greater than for individuals without history of depressive symptoms, an effect independent of vascular disease. We conclude that the impact of depressive symptoms on risk for dementia and AD may vary with sex. Further studies assessing separately the role of depression as a risk factor in men and women are necessary.
抑郁症与痴呆症和阿尔茨海默病（AD）风险增加相关，尽管尚不清楚它是一个真正的风险因素还是前驱症状。为了确定病前抑郁症状对痴呆症和AD发生的相对风险，我们在1357名参与为期40年的巴尔的摩老龄化纵向研究的社区居住男性和女性中，研究了14年内发生痴呆症和AD的风险。每2年前瞻性收集抑郁症状筛查、全面的医学和神经心理学评估。分别计算男性和女性发生AD或痴呆症的时间依赖性比例风险，在痴呆症症状出现前2年、4年和6年间隔检测到抑郁症状。将血管危险因素作为协变量进行分析。病前抑郁症状显著增加痴呆症风险，男性患AD的风险尤其增加，而女性则不然。风险比大约是无抑郁症状病史个体的两倍，这种影响与血管疾病无关。我们得出结论，抑郁症状对痴呆症和AD风险的影响可能因性别而异。有必要进一步分别评估抑郁症作为男性和女性风险因素的作用的研究。
