Bennett Sophia, Thomas Alan J
Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, United Kingdom.
Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, United Kingdom.
Maturitas. 2014 Oct;79(2):184-90. doi: 10.1016/j.maturitas.2014.05.009. Epub 2014 May 29.
The relationship between depression and dementia is complex and still not well understood. A number of different views exist regarding how the two conditions are linked as well as the underlying neurobiological mechanisms at work. This narrative review examined longitudinal and cross sectional studies in the existing literature and determined the evidence supporting depression being a risk factor, a prodrome, a consequence, or an independent comorbidity in dementia. Overall there is convincing evidence to support both the notion that early life depression can act as a risk factor for later life dementia, and that later life depression can be seen as a prodrome to dementia. There is also evidence to support both conditions showing similar neurobiological changes, particularly white matter disease, either indicating shared risk factors or a shared pattern of neuronal damage. These findings highlight the need to examine if effective treatment of depressive episodes has any effect in reducing the prevalence of dementia, as well as clinicians being vigilant for late life depression indicating the incipient development of dementia, and therefore carefully following up these individuals for future cognitive impairment.
抑郁症与痴呆症之间的关系复杂，目前仍未得到充分理解。关于这两种病症如何关联以及背后起作用的神经生物学机制，存在多种不同观点。这篇叙述性综述研究了现有文献中的纵向和横断面研究，并确定了支持抑郁症作为痴呆症的风险因素、前驱症状、后果或独立共病的证据。总体而言，有令人信服的证据支持以下两种观点：早年抑郁症可作为晚年痴呆症的风险因素，以及晚年抑郁症可被视为痴呆症的前驱症状。也有证据支持这两种病症表现出相似的神经生物学变化，尤其是白质病变，这要么表明存在共同的风险因素，要么表明存在共同的神经元损伤模式。这些发现凸显了有必要研究抑郁发作的有效治疗是否对降低痴呆症患病率有任何作用，以及临床医生要警惕晚年抑郁症可能预示着痴呆症的初期发展，因此要对这些个体进行仔细随访，以关注其未来的认知障碍情况。
