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抑郁与新发痴呆。一项基于人群的 8 年前瞻性研究。

Depression and incident dementia. An 8-year population-based prospective study.

机构信息

Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.

出版信息

PLoS One. 2013;8(3):e59246. doi: 10.1371/journal.pone.0059246. Epub 2013 Mar 19.

Abstract

AIMS

The aim of the study was to investigate the impact of depression (categorical diagnosis; major depression, MD) and depressive symptoms (dimensional diagnosis and symptom patterns) on incident dementia in the German general population.

METHODS

Within the Leipzig Longitudinal Study of the Aged (LEILA 75+), a representative sample of 1,265 individuals aged 75 years and older were interviewed every 1.5 years over 8 years (mean observation time 4.3 years; mean number of visits 4.2). Cox proportional hazards and binary logistic regressions were used to estimate the effect of baseline depression and depressive symptoms on incident dementia.

RESULTS

The incidence of dementia was 48 per 1,000 person-years (95% confidence interval (CI) 45-51). Depressive symptoms (Hazard ratio HR 1.03, 95% CI 1.01-1.05), and in particular mood-related symptoms (HR 1.08, 95% CI 1.03-1.14), showed a significant impact on the incidence of dementia only in univariate analysis, but not after adjustment for cognitive and functional impairment. MD showed only a significant impact on incidence of dementia in Cox proportional hazards regression, but not in binary logistic regression models.

DISCUSSION

The present study using different diagnostic measures of depression on future dementia found no clear significant associations of depression and incident dementia. Further in-depth investigation would help to understand the nature of depression in the context of incident dementia.

摘要

目的

本研究旨在探讨抑郁(分类诊断;重度抑郁症,MD)和抑郁症状(维度诊断和症状模式)对德国一般人群中痴呆症发病的影响。

方法

在莱比锡老龄化纵向研究(LEILA 75+)中,对 1265 名年龄在 75 岁及以上的代表性样本进行了每 1.5 年一次的访谈,共进行了 8 年(平均观察时间为 4.3 年;平均访问次数为 4.2 次)。使用 Cox 比例风险和二项逻辑回归来估计基线抑郁和抑郁症状对新发痴呆症的影响。

结果

痴呆症的发病率为每 1000 人年 48 例(95%置信区间[CI] 45-51)。抑郁症状(风险比 HR 1.03,95% CI 1.01-1.05),特别是情绪相关症状(HR 1.08,95% CI 1.03-1.14),仅在单变量分析中对痴呆症的发病率有显著影响,但在调整认知和功能障碍后则没有。MD 在 Cox 比例风险回归中仅对痴呆症的发病率有显著影响,但在二项逻辑回归模型中则没有。

讨论

本研究使用不同的抑郁诊断方法对未来的痴呆症进行了研究,结果发现抑郁与痴呆症发病之间没有明显的关联。进一步的深入调查将有助于理解抑郁在痴呆症发病中的性质。

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