Division of Geriatric Medicine, Department of Health Sciences, Skane University Hospital in Malmö, Lund University, Sweden.
Am J Geriatr Psychiatry. 2013 Sep;21(9):863-71. doi: 10.1016/j.jagp.2012.11.007. Epub 2013 Jan 17.
The aim of this study was to examine the longitudinal impact of blood pressure variations and vascular risk factors on depressive symptoms in the elderly.
Longitudinal and cross-sectional cohort study.
Urban population of elderly men, city of Malmö, Sweden.
A total of 809 randomly included men took part in a prospective cohort study, "Men born in 1914", and 171 survivors reached the age of 81 years.
Depressive symptoms were estimated at the age of 81 using the Zung Self-Rating Depression Scale (ZSDS). Vascular risk factors were identified at both 68 and 81 years of age.
At the age of 68, diagnosis of hypertension and on-going antihypertensive therapy were more frequent in subjects with high than low ZSDS scores. In contrast, at age 81, the highest ZSDS scores correlated with low systolic blood pressure (SBP). Declining SBP between the ages of 68 and 81 was more frequent in high-scoring than in low-scoring groups. Subjects with high ZSDS scores took more drugs and had more clinical diagnoses at age 81. Those taking hypnotics and sedatives had higher ZSDS scores, lower SBP at 81, and showed more frequent decrease in SBP during the observation period.
Depressive symptoms in octogenarian men could be predicted by hypertension earlier in life, and were strongly associated with decreasing SBP during the last decade.
本研究旨在探讨血压变化和血管危险因素对老年人抑郁症状的纵向影响。
纵向和横断面队列研究。
瑞典马尔默市的老年男性城市人群。
共有 809 名随机入选的男性参加了一项前瞻性队列研究“1914 年出生的男性”，其中 171 名幸存者达到 81 岁。
在 81 岁时使用zung 自评抑郁量表（ZSDS）评估抑郁症状。血管危险因素在 68 岁和 81 岁时均被确定。
在 68 岁时，与 ZSDS 评分低的患者相比，高血压的诊断和持续的降压治疗在 ZSDS 评分高的患者中更为常见。相比之下，在 81 岁时，ZSDS 评分最高与收缩压（SBP）较低相关。与评分低的组相比，在 68 岁至 81 岁之间 SBP 下降的患者更为常见。ZSDS 评分高的患者在 81 岁时服用的药物更多，临床诊断更多。服用催眠药和镇静剂的患者 ZSDS 评分较高，81 岁时 SBP 较低，且在观察期间 SBP 下降更为频繁。
在 80 岁男性中，抑郁症状可由早年的高血压预测，并且与最后十年 SBP 的下降密切相关。
