Department of Neuropsychiatry, University of Tsukuba, Tsukuba, Japan.
Int J Geriatr Psychiatry. 2012 Mar;27(3):271-9. doi: 10.1002/gps.2715. Epub 2011 Mar 29.
The aim of the study was to estimate the prevalence of DSM-III-R major depressive episodes (MDEs), depressive symptoms cases (DSCs) (defined as a score of ≥6 on the Geriatric Depression Scale but falling short of MDE), and coexisting mild cognitive impairment (MCI) among Japanese community-dwelling older people.
Prevalence was estimated based on screening evaluation, individual interviews, and door-to-door visits. MDE and DSC were diagnosed, and the cognitive status of the participants was determined to be dementia, MCI, or normal.
A total of 1888 subjects of 2698 candidates (70.0%) participated. The prevalence of MDE and DSC were estimated to be 4.5% (95% CI, 3.4-6.0) and 11.5% (95% CI, 4.2-28.0), respectively. MCI was more prevalent in subjects with depression (26.2%) than those with normal mood (17.9%). Although no prototypical profile of cognitive dysfunction was revealed, multiple MCI was more prevalent in subjects with depression (12.2%) than subjects with normal mood (3.8%). Conversely, subjects with MCI (26.3%) were more likely to develop depression compared with those with normal cognitive function (18.0%).
The prevalence of depression in our subjects seems to be similar with that of previous studies. MCI was more prevalent in subjects with depression than those with normal mood. Individuals with depression showed no particular association with any of the four MCIs. Given that depression and MCI are often associated with each other and that MCI is a predictor for development of dementia, the risk of developing dementia in the depressed older people with coexisting MCI should be acknowledged.
本研究旨在评估 DSM-III-R 重性抑郁发作(MDE)、抑郁症状病例(DSC)(定义为老年抑郁量表评分≥6,但不符合 MDE)和共存轻度认知障碍(MCI)在日本社区居住的老年人中的患病率。
患病率基于筛查评估、个体访谈和上门访问进行估计。MDE 和 DSC 被诊断,参与者的认知状态被确定为痴呆、MCI 或正常。
共有 2698 名候选人中的 1888 名(70.0%)参加了研究。MDE 和 DSC 的患病率估计分别为 4.5%(95%CI,3.4-6.0)和 11.5%(95%CI,4.2-28.0)。患有抑郁症的受试者中 MCI 的患病率(26.2%)高于情绪正常的受试者(17.9%)。尽管没有揭示出典型的认知功能障碍模式,但抑郁症患者中存在多种 MCI 的比例(12.2%)高于情绪正常的受试者(3.8%)。相反,患有 MCI 的受试者(26.3%)比认知功能正常的受试者(18.0%)更有可能发展为抑郁症。
我们研究对象中的抑郁患病率似乎与之前的研究相似。患有抑郁症的受试者中 MCI 的患病率高于情绪正常的受试者。患有抑郁症的受试者与任何一种 MCI 均无明显关联。鉴于抑郁和 MCI 常相互关联,且 MCI 是痴呆发展的预测因素,应认识到患有共存 MCI 的抑郁老年患者发生痴呆的风险。