Godin Ophélia, Dufouil Carole, Ritchie Karen, Dartigues Jean-François, Tzourio Christophe, Pérès Karine, Artero Sylvaine, Alpérovitch Annick
INSERM U708, Université Pierre et Marie Curie-Paris 6, Paris, France.
Neuroepidemiology. 2007;28(2):101-8. doi: 10.1159/000101508. Epub 2007 Apr 4.
The relationship between depression and dementia in the elderly has been extensively studied but the tools used to define depressed subjects are heterogeneous between studies. The objective of this study was to examine the relationship between depression and cognitive performances by using multiple measures of depressive state.
A sample of 7,869 nondemented community-dwelling persons aged >or=65 years participated in the study. Depressive symptoms were evaluated by the Center for Epidemiological Study Depression Scale and the Mini-International Neuropsychiatric Interview was used to assess history of major depressive episodes (MDE). Cognitive function was evaluated by several tests including the Mini-Mental State Examination (MMSE), Trail Making Test, Isaacs Set Test and Benton Visual Retention Test.
When studied in separate models, depressive symptoms were significantly related to lower cognitive performances for all neuropsychological tests after adjusting for potential confounders (p<0.0001), whereas subjects with current MDE had significantly lower performances in MMSE and Isaacs Set Test. When studied concomitantly, only high levels of depressive symptoms were related to lower cognitive performance, whereas existence of MDE (past or current) was no longer associated with cognitive performances.
These data suggest that once current depressive symptoms are taken into account, major depression (past or current) is not associated with lower cognitive performances in a community-based sample of elderly people aged >or=65 years.
老年人群中抑郁症与痴呆症之间的关系已得到广泛研究，但不同研究用于定义抑郁受试者的工具存在差异。本研究的目的是通过使用多种抑郁状态测量方法来检验抑郁症与认知表现之间的关系。
7869名年龄≥65岁、居住在社区且无痴呆症的人群参与了本研究。采用流行病学研究中心抑郁量表评估抑郁症状，并用简易国际神经精神访谈评估重度抑郁发作（MDE）史。通过多项测试评估认知功能，包括简易精神状态检查表（MMSE）、连线测验、艾萨克斯成套测验和本顿视觉保持测验。
在单独模型中进行研究时，调整潜在混杂因素后，所有神经心理学测试中抑郁症状均与较低的认知表现显著相关（p<0.0001），而当前患有MDE的受试者在MMSE和艾萨克斯成套测验中的表现显著较低。同时进行研究时，只有高水平的抑郁症状与较低的认知表现相关，而MDE（过去或当前）的存在与认知表现不再相关。
这些数据表明，在年龄≥65岁的社区老年人群样本中，一旦考虑到当前的抑郁症状，重度抑郁症（过去或当前）与较低的认知表现无关。
