Texas A&M Health Science Center, TX, USA.
Am J Geriatr Psychiatry. 2010 Feb;18(2):177-86. doi: 10.1097/JGP.0b013e3181c65864.
To estimate the frequency of depressive symptoms and selected psychiatric disorders in the Women's Health Initiative Memory Study (WHIMS) cohort and related them to cognitive syndromes.
WHIMS was a randomized, double-blinded, placebo-controlled prevention clinical trial examining whether opposed and unopposed hormone therapy reduced the risk of dementia in healthy postmenopausal women. Participants scoring below a designated cutpoint on a cognitive screener received a comprehensive neuropsychiatric workup and adjudicated outcome of no cognitive impairment, mild cognitive impairment, or probable dementia.
Seven thousand four hundred seventy-nine WHIMS participants between age 65 and 79 years and free of dementia at the time of enrollment in WHIMS. Five hundred twenty-one unique participants contributed complete data required for these analyses.
Depressive symptoms were measured with the 15-item Geriatric Depression Scale and the presence of selected psychiatric disorders (major depression, generalized anxiety, and panic and alcohol abuse) was made using the PRIME-MD.
The 18% of women had at least one psychiatric disorder with depression being the most common (16%) followed by general anxiety or panic (6%) and alcohol abuse (1%). Depression and the presence of a psychiatric disorder were associated with impaired cognitive status. Participants having a psychiatric disorder were more than twice as likely to be diagnosed with cognitive impairment as those with no psychiatric disorder (odds ratio = 2.06, 95% confidence interval = 1.17-3.60). Older age, white race, and diabetes were also associated with cognitive impairment.
The frequency of a psychiatric disorder is associated with poorer cognitive functioning among older women enrolled in WHIMS. That approximately one in five women had a probable psychiatric disorder, most typically depression, highlights the need for greater detection and treatment efforts in this population.
评估妇女健康倡议记忆研究(WHIMS)队列中抑郁症状和某些精神障碍的发生频率,并将其与认知综合征相关联。
WHIMS 是一项随机、双盲、安慰剂对照的预防临床试验,旨在研究相反和不相反的激素治疗是否降低了健康绝经后妇女患痴呆的风险。在认知筛选器上得分低于指定切点的参与者接受了全面的神经精神病学评估,并对无认知障碍、轻度认知障碍或可能的痴呆做出了裁定结果。
7479 名年龄在 65 至 79 岁之间且在 WHIMS 入组时无痴呆的 WHIMS 参与者。521 名独特的参与者提供了进行这些分析所需的完整数据。
抑郁症状采用 15 项老年抑郁量表(Geriatric Depression Scale)进行测量,采用 PRIME-MD 确定是否存在某些精神障碍(重度抑郁、广泛性焦虑、惊恐和酒精滥用)。
18%的女性至少有一种精神障碍,其中最常见的是抑郁(16%),其次是广泛性焦虑或惊恐(6%)和酒精滥用(1%)。抑郁和精神障碍的存在与认知状态受损有关。有精神障碍的参与者被诊断为认知障碍的可能性是没有精神障碍的参与者的两倍多(比值比=2.06,95%置信区间=1.17-3.60)。年龄较大、白种人以及糖尿病也与认知障碍相关。
在 WHIMS 中,精神障碍的发生频率与老年女性认知功能较差有关。大约五分之一的女性可能患有精神障碍,最常见的是抑郁症,这突出表明需要在这一人群中加强检测和治疗力度。