Fujise Noboru, Ikeda Manabu
Department of Psychiatry and Neuropathobiology, Faculty of Life Sciences, Kumamoto University.
Seishin Shinkeigaku Zasshi. 2012;114(3):276-82.
It has been noted the relationship between depression and dementia in elderly. The prevalence of depression in Alzheimer's disease (AD) was reported 20 to 30% in population-based study. Apathy was more frequently observed than depression among demented outpatients in our study. Whereas the apathy has been considered to be a kind of depression traditionally, it has been found that the apathy is distinct from depression recently. In our clinical practice, we frequently realize the close relationship between depression and dementia. It has been reported that risk of AD was 1.71 (odds ratio) in the history of depression more than 25 years ago, and interval between diagnoses of depression and AD was positively related to increased risk of developing AD, suggesting that rather than a prodrome, depression may be a risk factor for AD. Furthermore, Rotterdam Scan Study reported recently that the risk of AD increased to 3.76 in the history of pre-senile depression, while 2.34 in the history of senile depression. On the other hand, it is interesting but still controversial whether depression is associated with the conversion from mild cognitive impairment (MCI) into dementia. The underlying neuropathological condition that causes MCI or dementia might also cause depressive symptoms.
人们已经注意到老年人中抑郁症与痴呆症之间的关系。在基于人群的研究中，阿尔茨海默病（AD）患者中抑郁症的患病率报告为20%至30%。在我们的研究中，痴呆门诊患者中冷漠比抑郁症更常见。传统上，冷漠被认为是一种抑郁症，但最近发现冷漠与抑郁症不同。在我们的临床实践中，我们经常意识到抑郁症与痴呆症之间的密切关系。据报道，25年多前有抑郁症病史的人患AD的风险为1.71（比值比），抑郁症诊断与AD之间的间隔与患AD风险的增加呈正相关，这表明抑郁症可能是AD的一个风险因素，而不是前驱症状。此外，鹿特丹扫描研究最近报告称，老年前期抑郁症病史者患AD的风险增加到3.76，而老年抑郁症病史者为2.34。另一方面，抑郁症是否与轻度认知障碍（MCI）转化为痴呆症有关，这很有趣但仍存在争议。导致MCI或痴呆症的潜在神经病理学状况也可能导致抑郁症状。
