Feng L, Lim W-S, Chong M-S, Lee T-S, Gao Q, Nyunt M S Z, Feng L, Kua E-H, Ng T-P
Dr. Lei Feng, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, email:
J Nutr Health Aging. 2017;21(2):161-164. doi: 10.1007/s12603-016-0765-3.
Depression is prevalent among patients with late life neurocognitive disorders but its role as an independent risk factor is not established. We aimed to examine the longitudinal relationship between depression and the incidence of mild neurocognitive disorders (NCD) in a Chinese population.
We analyzed data from 889 community-living Chinese elderly in the Singapore Longitudinal Aging Study (SLAS) cohort. All subjects were cognitively normal at baseline based on their performance on the Mini-Mental State Examination (MMSE). Depression was defined as total score of 5 or more on the 15-item Geriatric Depression Scale. Incident cases of mild NCD were ascertained at follow up after an average of 45 moths (range: 10-62). Odds ratios (OR) of associations were calculated in logistic regression models that adjusted for potential confounders.
A total of 59 mild NCD cases were identified. Increased risk of mild NCD was observed for subjects who had depressive symptom at baseline (OR=2.56, 95%CI 1.17-5.60) after controlling for age, gender, education, hypertension, diabetes mellitus, heart disease, APOE genotype and length of follow-up. The interaction between depression and APOE genotype was not statistically significant.
Depressive symptom was independently associated with increased risk of mild NCD among Chinese elderly. Effective management of late life depression may potentially reduce incident cases of NCD in the population.
抑郁症在老年神经认知障碍患者中很常见，但其作为独立危险因素的作用尚未确定。我们旨在研究中国人群中抑郁症与轻度神经认知障碍（NCD）发病率之间的纵向关系。
我们分析了新加坡纵向衰老研究（SLAS）队列中889名居住在社区的中国老年人的数据。根据简易精神状态检查表（MMSE）的表现，所有受试者在基线时认知功能正常。抑郁症定义为15项老年抑郁量表总分达到5分及以上。在平均随访45个月（范围：10 - 62个月）后确定轻度NCD的发病病例。在调整了潜在混杂因素的逻辑回归模型中计算关联的比值比（OR）。
共识别出59例轻度NCD病例。在控制了年龄、性别、教育程度、高血压、糖尿病、心脏病、APOE基因型和随访时间后，观察到基线时有抑郁症状的受试者发生轻度NCD的风险增加（OR = 2.56，95%CI 1.17 - 5.60）。抑郁症与APOE基因型之间的相互作用无统计学意义。
抑郁症状与中国老年人轻度NCD风险增加独立相关。有效管理老年抑郁症可能会降低人群中NCD的发病病例。
