Chen Mu-Hong, Li Cheng-Ta, Tsai Chia-Fen, Lin Wei-Chen, Chang Wen-Han, Chen Tzeng-Ji, Pan Tai-Long, Su Tung-Ping, Bai Ya-Mei
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
J Am Med Dir Assoc. 2015 Jun 1;16(6):504-8. doi: 10.1016/j.jamda.2015.01.084. Epub 2015 Feb 27.
Both major depression and bipolar disorder are associated with an increased risk of developing dementia. However, the differential risk of dementia between major depression and bipolar disorder is rarely investigated.
Using the Taiwan National Health Insurance Research Database, a total of 2291 patients aged ≥ 55 years (major depression: 1946 and bipolar disorder: 345) and 2291 age-and sex-matched controls were enrolled between 1998 and 2008, and followed to the end of 2011. Participants who developed dementia during the follow-up were identified.
Both patients with bipolar disorder [hazard ratio (HR) 5.58, 95% confidence interval (CI) 4.26-7.32] and those with major depression (HR 3.02, 95% CI 2.46-3.70) had an increased risk of developing dementia in later life, after adjusting for demographic data and medical comorbidities. The sensitivity tests after excluding the 1-year (bipolar disorder: HR 4.73, 95% CI 3.50-6.35; major depression: HR 2.62, 95% CI 2.11-3.25) and 3-year (HR 3.92, 95% CI 2.78-5.54; HR 2.21, 95% CI 1.73-2.83, respectively) follow-up duration also revealed consistent findings. Furthermore, patients with bipolar disorder were associated with an 87% increased risk (HR 1.87, 95% CI 1.48-2.37) of subsequent dementia compared with patients with major depression.
Midlife individuals with bipolar disorder or major depression were associated with an elevated risk of developing dementia in later life. Further studies may be required to clarify the underlying mechanisms among major depression, bipolar disorder, and dementia, and to investigate whether prompt intervention may decrease this risk.
重度抑郁症和双相情感障碍都与患痴呆症的风险增加有关。然而，很少有人研究重度抑郁症和双相情感障碍之间患痴呆症的风险差异。
利用台湾国民健康保险研究数据库，在1998年至2008年间共纳入了2291名年龄≥55岁的患者（重度抑郁症患者：1946例，双相情感障碍患者：345例）以及2291名年龄和性别匹配的对照，并随访至2011年底。确定随访期间患痴呆症的参与者。
在调整人口统计学数据和合并症后，双相情感障碍患者[风险比（HR）5.58，95%置信区间（CI）4.26 - 7.32]和重度抑郁症患者（HR 3.02，95% CI 2.46 - 3.70）在晚年患痴呆症的风险均增加。排除1年（双相情感障碍：HR 4.73，95% CI 3.50 - 6.35；重度抑郁症：HR 2.62，95% CI 2.11 - 3.25）和3年（HR分别为3.92，95% CI 2.78 - 5.54；HR 2.21，95% CI 1.73 - 2.83）随访期后的敏感性测试也得出了一致的结果。此外，与重度抑郁症患者相比，双相情感障碍患者后续患痴呆症的风险增加了87%（HR 1.87，95% CI 1.48 - 2.37）。
中年患有双相情感障碍或重度抑郁症的个体在晚年患痴呆症的风险升高。可能需要进一步研究来阐明重度抑郁症、双相情感障碍和痴呆症之间的潜在机制，并研究及时干预是否可以降低这种风险。
