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抑郁症对轻度认知障碍3年随访发展的影响:一项基于人群的研究。

The Impact of Depression on the Development of Mild Cognitive Impairment over 3 Years of Follow-Up: A Population-Based Study.

作者信息

Lara Elvira, Koyanagi Ai, Domènech-Abella Joan, Miret Marta, Ayuso-Mateos Jose Luis, Haro Josep Maria

机构信息

Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.

出版信息

Dement Geriatr Cogn Disord. 2017;43(3-4):155-169. doi: 10.1159/000455227. Epub 2017 Feb 9.

DOI:10.1159/000455227
PMID:28178703
Abstract

BACKGROUND/AIMS: In the absence of effective treatments for dementia, major efforts are being directed towards identifying the risk factors of the prodromal phase of the disease. We report the incidence rates of mild cognitive impairment (MCI) in a Spanish population sample and assess the effect of depression at baseline on incident MCI (or MCI subtypes) at a 3-year follow-up.

METHODS

A total of 1,642 participants (age ≥50 years) were examined as part of a Spanish nationally representative longitudinal study. MCI was defined as the presence of cognitive concerns, objective evidence of impairment in one or more cognitive domains, preservation of independence in functional abilities, and no dementia. Depression was assessed through an adaptation of the Composite International Diagnostic Interview (CIDI 3.0). Binary and multinomial logistic regression analyses were carried out to assess the associations.

RESULTS

The overall MCI incidence rate was 33.19 (95% CI = 26.02, 43.04) per 1,000 person-years. Depression at baseline predicted the onset of MCI at follow-up after controlling for sociodemographics, cognitive functioning, and other physical health conditions (OR = 2.79; 95% CI = 1.70, 4.59). The effect of baseline depression on incident MCI subtypes was as follows: amnestic MCI, OR = 3.81 (95% CI = 1.96, 7.43); nonamnestic MCI, OR = 2.03 (95% CI = 0.98, 4.21).

CONCLUSION

Depression significantly increases the risk for MCI. Targeting depression among those at risk for dementia may help delay or even prevent the onset of dementia.

摘要

背景/目的:在缺乏有效治疗痴呆症方法的情况下,主要精力正集中于确定该疾病前驱期的风险因素。我们报告了西班牙人群样本中轻度认知障碍(MCI)的发病率,并评估了基线时抑郁对3年随访期内新发MCI(或MCI亚型)的影响。

方法

作为一项西班牙全国代表性纵向研究的一部分,共对1642名参与者(年龄≥50岁)进行了检查。MCI被定义为存在认知问题、一个或多个认知领域存在客观损害证据、功能能力保持独立且无痴呆。通过改编的综合国际诊断访谈(CIDI 3.0)评估抑郁情况。进行二元和多项逻辑回归分析以评估相关性。

结果

总体MCI发病率为每1000人年33.19(95%置信区间=26.02,43.04)。在控制了社会人口统计学、认知功能和其他身体健康状况后,基线时的抑郁可预测随访期内MCI的发病(比值比=2.79;95%置信区间=1.70,4.59)。基线抑郁对新发MCI亚型的影响如下:遗忘型MCI,比值比=3.81(95%置信区间=1.96,7.43);非遗忘型MCI,比值比=2.03(95%置信区间=0.98,4.21)。

结论

抑郁显著增加MCI风险。针对痴呆症高危人群的抑郁进行干预可能有助于延缓甚至预防痴呆症的发病。

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