Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Br J Psychiatry. 2013 May;202(5):329-35. doi: 10.1192/bjp.bp.112.118307.
Late-life depression may increase the risk of incident dementia, in particular of Alzheimer's disease and vascular dementia.
To conduct a systematic review and meta-analysis to evaluate the risk of incident all-cause dementia, Alzheimer's disease and vascular dementia in individuals with late-life depression in population-based prospective studies.
A total of 23 studies were included in the meta-analysis. We used the generic inverse variance method with a random-effects model to calculate the pooled risk of dementia, Alzheimer's disease and vascular dementia in older adults with late-life depression.
Late-life depression was associated with a significant risk of all-cause dementia (1.85, 95% CI 1.67-2.04, P<0.001), Alzheimer's disease (1.65, 95% CI 1.42-1.92, P<0.001) and vascular dementia (2.52, 95% CI 1.77-3.59, P<0.001). Subgroup analysis, based on five studies, showed that the risk of vascular dementia was significantly higher than for Alzheimer's disease (P = 0.03).
Late-life depression is associated with an increased risk for all-cause dementia, vascular dementia and Alzheimer's disease. The present results suggest that it will be valuable to design clinical trials to investigate the effect of late-life depression prevention on risk of dementia, in particular vascular dementia and Alzheimer's disease.
老年期抑郁症可能会增加痴呆症的发病风险，尤其是阿尔茨海默病和血管性痴呆。
进行系统回顾和荟萃分析，以评估基于人群的前瞻性研究中，老年期抑郁症患者发生所有原因痴呆、阿尔茨海默病和血管性痴呆的风险。
共有 23 项研究纳入荟萃分析。我们使用具有随机效应模型的通用倒数方差法计算老年期抑郁症患者发生痴呆、阿尔茨海默病和血管性痴呆的汇总风险。
老年期抑郁症与全因痴呆（1.85，95%CI 1.67-2.04，P<0.001）、阿尔茨海默病（1.65，95%CI 1.42-1.92，P<0.001）和血管性痴呆（2.52，95%CI 1.77-3.59，P<0.001）的发病风险显著相关。基于 5 项研究的亚组分析显示，血管性痴呆的发病风险明显高于阿尔茨海默病（P = 0.03）。
老年期抑郁症与全因痴呆、血管性痴呆和阿尔茨海默病的发病风险增加相关。本研究结果表明，设计临床试验以调查老年期抑郁症预防对痴呆症（特别是血管性痴呆和阿尔茨海默病）发病风险的影响将具有重要价值。
