Becker James T, Chang Yue-Fang, Lopez Oscar L, Dew Mary Amanda, Sweet Robert A, Barnes Deborah, Yaffe Kristine, Young Jeffrey, Kuller Lewis, Reynolds Charles F
Department of Psychiatry, School of Medicine, Graduate School of Public Health, University of Pittsburgh, 3501 Forbes Avenue, Pittsburgh, PA 15213, USA.
Am J Geriatr Psychiatry. 2009 Aug;17(8):653-63. doi: 10.1097/jgp.0b013e3181aad1fe.
To determine the relationship between depressed mood and the development of Alzheimer disease in cognitively normal individuals.
Longitudinal and observational.
Community-based cohort study.
A total of 288 participants in the Cardiovascular Health Study-Cognition Study (mean age: 77.52, SD =3.65, range: 70-89). All of the participants were adjudicated as cognitively normal in 1998/1999, and all had at least three visits before 1998/1999 with measures of cognition and mood state. The mean length of follow-up from 1998-1999 to 2007 was 7.1 years (range: 1-9 years, median =9 years).
The Center for Epidemiological Studies-Depression Scale (CESD) was used to index mood state, and the Modified Mini-Mental State Examination (3MSE) was the index of cognitive function among participants before 1998/1999. These measures were considered in two ways: participants were classified according to: 1) whether they showed a high-negative correlation between their CESD and 3MSE scores (i.e., indicating that greater depression was linked to poorer cognition) and 2) whether they showed persistently elevated CESD scores. The study outcome, development of dementia (N = 48), was based on consensus classifications, which was based on detailed neuropsychological and neurological exams.
The authors could find no consistent relationship between mood state, either alone or in relation to cognitive status, and the subsequent development of dementia. Those individuals whose cognitive functions were highly correlated with their mood state were no more likely to develop dementia than other participants. Those who had persistently depressed mood were also no more likely to develop dementia than those without persistently depressed mood.
Within the confines of this prospective, community-based study of elderly adults, the authors could not find strong evidence to support the hypothesis that mood disturbance was linked with the development of dementia.
确定认知功能正常个体的抑郁情绪与阿尔茨海默病发生之间的关系。
纵向观察性研究。
基于社区的队列研究。
心血管健康研究-认知研究中的288名参与者（平均年龄：77.52岁，标准差=3.65，范围：70-89岁）。所有参与者在1998/1999年被判定为认知功能正常，且在1998/1999年之前均至少有三次就诊，进行了认知和情绪状态测量。从1998 - 1999年到2007年的平均随访时间为7.1年（范围：1 - 9年，中位数=9年）。
采用流行病学研究中心抑郁量表（CESD）来衡量情绪状态，在1998/1999年之前，改良简易精神状态检查表（3MSE）作为参与者认知功能指标。这些测量指标从两方面进行考量：参与者根据以下情况分类：1）他们的CESD和3MSE分数之间是否呈现高度负相关（即表明抑郁程度越高与认知功能越差相关）；2）他们的CESD分数是否持续升高。研究结果，即痴呆症的发生（n = 48），基于共识分类，该分类基于详细的神经心理学和神经学检查。
作者未发现情绪状态单独或与认知状态相关时与随后痴呆症发生之间存在一致关系。认知功能与情绪状态高度相关的个体与其他参与者相比，患痴呆症的可能性并无更高。情绪持续低落的个体与情绪未持续低落的个体相比，患痴呆症的可能性也没有更高。
在这项针对老年人的前瞻性社区研究范围内，作者未找到有力证据支持情绪障碍与痴呆症发生相关的假设。
