Anstey Kaarin J, Burns Richard, Butterworth Peter, Windsor Tim D, Christensen Helen, Sachdev Perminder
Centre for Mental Health Research, Australian National University, Canberra ACT 0200, Australia.
Psychosom Med. 2009 Nov;71(9):937-43. doi: 10.1097/PSY.0b013e3181beab60. Epub 2009 Oct 15.
To evaluate cardiovascular risk factors (CVRF) and life events (LE) as predictors of depressive symptoms in a mid-life and an early late-life cohort to determine whether they had independent or interacting effects, and whether there were age differences in the effects.
Cohorts aged 40 to 44 years (n = 2530) and 60 to 64 years (n = 2551) at baseline (Wave 1) were followed up after 4 years (Wave 2) as part of the PATH Through Life Study based in Canberra and Queanbeyan, Australia. Cross-sectional analyses evaluated rates of CVRF and LE in depressed compared with nondepressed participants. Hierarchical generalized linear models were used to evaluate demographic variables, CVRF (diabetes, smoking, alcohol, body mass index, cholesterol medication, hypertension), LE, and Wave 1 depressive symptoms as predictors of depressive symptoms at Wave 2.
At baseline, those with high levels of depressive symptoms were more likely to report smoking, using cholesterol-lowering medications, hypertension, diabetes, past stroke, and higher body mass index. Predictors of depressive symptoms at Wave 2 in the cohort of 40- to 44-year-old persons included Wave 1 depressive symptoms, diabetes, and LE at Wave 2. In the cohort of 60- to 64-year-old individuals, Wave 1 depression, stroke, smoking, low education, and Wave 2 LE predicted depressive symptoms. There was no evidence of interactions between CVRF and LE.
LE and CVRF are independent sets of risk factors for depressive symptoms with different effects in the 40- to 44-year-old and 60- to 64-year-old cohorts. These findings have implications for preventative strategies for depression.
评估心血管危险因素（CVRF）和生活事件（LE）作为中年及中老年人群抑郁症状预测因素的作用，以确定它们是否具有独立或交互作用，以及在影响方面是否存在年龄差异。
作为澳大利亚堪培拉和昆比恩开展的“人生之路研究”的一部分，对基线期（第1波）年龄在40至44岁（n = 2530）和60至64岁（n = 2551）的队列进行了4年随访（第2波）。横断面分析评估了抑郁组与非抑郁组参与者的CVRF和LE发生率。采用分层广义线性模型评估人口统计学变量、CVRF（糖尿病、吸烟、饮酒、体重指数、胆固醇药物治疗、高血压）、LE以及第1波抑郁症状作为第2波抑郁症状的预测因素。
在基线期，抑郁症状水平较高者更有可能报告吸烟、使用降胆固醇药物、患有高血压、糖尿病、既往中风以及体重指数较高。在40至44岁队列中，第2波抑郁症状的预测因素包括第1波抑郁症状、糖尿病和第2波LE。在60至64岁个体队列中，第1波抑郁、中风、吸烟、低教育水平和第2波LE可预测抑郁症状。没有证据表明CVRF和LE之间存在交互作用。
LE和CVRF是抑郁症状的独立危险因素，在40至44岁和60至64岁队列中具有不同影响。这些发现对抑郁症的预防策略具有启示意义。
