Dean Katherine, Oulhaj Abderrahim, Zamboni Giovanna, deJager Celeste A, Wilcock Gordon K
Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
Am J Geriatr Psychiatry. 2014 Jul;22(7):727-34. doi: 10.1016/j.jagp.2012.12.025. Epub 2013 Apr 20.
To establish whether, in a cohort with normal cognition, severity of depressive symptoms at baseline was related to the time taken for conversion to mild cognitive impairment (MCI) and whether this interacted with other potential risk factors, including APOE ε4 status and demographic and cognitive variables.
In a population-based cohort study, 126 cognitively normal subjects were assessed for depressive symptoms at baseline using the Geriatric Depression Scale (GDS) and were then followed over 20 years with regular cognitive assessments. The interval-censored accelerated failure time model was used to establish whether GDS and other factors, including APOE ε4 status, predicted the median time to development of MCI.
Fifty subjects developed MCI. In APOE ε4 noncarriers, the degree of depressive symptoms at baseline predicted the time to development of MCI: An increase in GDS of 1 standard deviation (3.85) was associated with shortening of the median time to conversion to MCI by 25.4% (p = 0.0024, z = -5.6). This relationship remained statistically significant after controlling for cognitive and other confounding variables. The relationship was not significant in APOE ε4 carriers.
Depressive symptoms (measured by GDS) predict time to conversion to MCI in cognitively normal people who do not carry the APOE ε4 allele. This may explain conflicting results of previous studies where APOE ε4 status was not taken into account when exploring the relationship between depression and MCI. It may also have a clinical application in helping to identify people at greater risk of developing MCI.
确定在认知正常的队列中，基线时抑郁症状的严重程度是否与转化为轻度认知障碍（MCI）所需的时间相关，以及这是否与其他潜在风险因素相互作用，包括APOE ε4状态、人口统计学和认知变量。
在一项基于人群的队列研究中，使用老年抑郁量表（GDS）对126名认知正常的受试者进行基线抑郁症状评估，然后对他们进行为期20年的定期认知评估。采用区间删失加速失效时间模型来确定GDS和其他因素（包括APOE ε4状态）是否能预测MCI发生的中位时间。
50名受试者发展为MCI。在APOE ε4非携带者中，基线时抑郁症状的程度可预测MCI的发生时间：GDS增加1个标准差（3.85）与转化为MCI的中位时间缩短25.4%相关（p = 0.0024，z = -5.6）。在控制了认知和其他混杂变量后，这种关系仍具有统计学意义。在APOE ε4携带者中，这种关系不显著。
抑郁症状（通过GDS测量）可预测未携带APOE ε4等位基因的认知正常人群转化为MCI的时间。这可能解释了先前研究中在探索抑郁与MCI之间的关系时未考虑APOE ε4状态而产生的相互矛盾的结果。它在帮助识别发生MCI风险更高的人群方面可能也具有临床应用价值。
