Verkaik Renate, Nuyen Jasper, Schellevis François, Francke Anneke
NIVEL, Utrecht, The Netherlands.
Int J Geriatr Psychiatry. 2007 Nov;22(11):1063-86. doi: 10.1002/gps.1809.
To gain more insight into the association between severity of Alzheimer's Disease (AD) and prevalence of comborbid depression.
A systematic literature review based on the Cochrane methodology was performed. PubMed, PsychINFO and EMBASE databases were searched for existing studies that fulfilled predefined inclusion criteria. The studies were divided into: (1) those that analysed the association between severity of AD and prevalence of depressive symptoms ('continuous' approach) and (2) those that investigated the association between severity of AD and diagnosed depression ('categorical' approach). The quality of existing studies was rated and the results were synthesized with a best evidence synthesis.
Twenty-four studies fulfilled the inclusion criteria. Nineteen reported results for a continuous approach and seven for a categorical approach. Three of the four high quality studies within the continuous approach did not find a significant association between severity of AD and prevalence of depressive symptoms. None of the three high quality studies using the categorical approach found a significant association between the severity of AD and the prevalence of diagnosed depression.
There is evidence for a lack of association between the severity of AD and the prevalence of comorbid depressive symptoms or diagnosed depression. Until new studies contradict this conclusion, prevention and intervention strategies for comorbid depression in AD should be aimed at all patients irrespective their disease severity.
更深入了解阿尔茨海默病（AD）的严重程度与共病抑郁症患病率之间的关联。
基于Cochrane方法进行系统文献综述。检索PubMed、PsychINFO和EMBASE数据库，查找符合预定义纳入标准的现有研究。这些研究分为：（1）分析AD严重程度与抑郁症状患病率之间关联的研究（“连续”方法），以及（2）调查AD严重程度与诊断出的抑郁症之间关联的研究（“分类”方法）。对现有研究的质量进行评分，并采用最佳证据综合法对结果进行综合分析。
24项研究符合纳入标准。19项报告了“连续”方法的结果，7项报告了“分类”方法的结果。“连续”方法中的4项高质量研究中有3项未发现AD严重程度与抑郁症状患病率之间存在显著关联。采用“分类”方法的3项高质量研究均未发现AD严重程度与诊断出的抑郁症患病率之间存在显著关联。
有证据表明AD严重程度与共病抑郁症状或诊断出的抑郁症患病率之间缺乏关联。在新的研究对此结论提出反驳之前，AD共病抑郁症的预防和干预策略应针对所有患者，无论其疾病严重程度如何。
