Research Unit, Institut d'Assistència Sanitària, Salt, Girona, Spain.
Int J Geriatr Psychiatry. 2012 Jan;27(1):67-75. doi: 10.1002/gps.2691. Epub 2011 Feb 9.
To estimate the mortality risk related to different mood disorders in a geriatric sample of subjects aged 70 years and over without dementia.
All non-demented subjects at baseline who participate on a second phase of a population-based cohort study were included. Adjusted Cox proportional hazards models were used to determine the association between depression and 5-year survival of 451 elderly people without dementia originally recruited for a representative community dementia cohort study. Baseline evaluation included the Cambridge Mental Disorders of the Elderly Examination Schedule. Depressive disorders (major and minor episode) were assessed according DSM-IV criteria and classified according the age of onset (late vs. early). The late-onset depression was classified according to the presence or absence of depression-executive dysfunction syndrome (DEDS).
The initial cohort size was 451 subjects, among which 10.9% (n = 49) suffered a major depressive episode and 10.4% (n = 47) a minor depressive disorder. Among the total affective disorders, 77.9% (n = 74) were late-onset depressions and 29.5% (n = 28) had executive dysfunction. After 5 years, the vital status of 94% (n = 424) of the participants was known and the mortality was 18.9% (n = 80). Late-onset major depressive episode with executive dysfunction was related to mortality after adjustment by age, gender, marital status, level of education, comorbidity (or health global status) and cognitive impairment (HR = 3.70; 95% CI = 1.55-8.83). The executive dysfunction was found to be an independent mortality risk factor (HR = 2.05; 95% CI = 1.15-3.64).
There is a statistically significant association between mortality and late-onset major depression with executive dysfunction.
评估无痴呆的 70 岁及以上老年人群中不同心境障碍相关的死亡率风险。
本研究纳入了参加基于人群的队列研究第二阶段的所有无痴呆的基线期非痴呆受试者。采用校正后的 Cox 比例风险模型，确定抑郁与 451 名无痴呆的老年人 5 年生存率之间的关系，这些老年人最初是为代表社区痴呆队列研究而招募的。基线评估包括剑桥老年精神障碍检查时间表。根据 DSM-IV 标准评估抑郁障碍（大发作和小发作），并根据发病年龄（晚发型与早发型）进行分类。晚发型抑郁根据是否存在抑郁-执行功能障碍综合征（DEDS）进行分类。
初始队列规模为 451 例受试者，其中 10.9%（n=49）患有重性抑郁发作，10.4%（n=47）患有轻度抑郁障碍。在所有情感障碍中，77.9%（n=74）为晚发型抑郁，29.5%（n=28）存在执行功能障碍。5 年后，94%（n=424）的参与者的生存状态已知，死亡率为 18.9%（n=80）。校正年龄、性别、婚姻状况、教育程度、合并症（或健康总体状况）和认知障碍后，伴有执行功能障碍的晚发型重性抑郁发作与死亡率相关（HR=3.70；95%CI=1.55-8.83）。执行功能障碍是独立的死亡风险因素（HR=2.05；95%CI=1.15-3.64）。
死亡率与伴有执行功能障碍的晚发型重性抑郁之间存在统计学显著关联。
