Yang Bei, Yu Hongmei, Xing Min, He Runlian, Liang Ruifeng, Zhou Liye
Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China.
Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China.
Arch Gerontol Geriatr. 2017 Sep;72:25-31. doi: 10.1016/j.archger.2017.05.003. Epub 2017 May 10.
To examine whether there was a bidirectional association between cognition and depressive symptoms in Alzheimer's disease (AD), and to explore the role of socio-demographic factors and daily performance in this association.
We conducted a longitudinal study of 104 community-dwelling patients with confirmed AD from Taiyuan, China. We assessed cognition and depressive symptoms (dependent variables) with the Montreal Cognitive Assessment (MoCA) and the Geriatric Depression Scale-30 (GDS-30), respectively. Socio-demographic information and daily performance were treated as explanatory variables. A multivariate multilevel model was built to investigate the interrelationship between patients' cognition and depression, as well as the effect of related factors on both outcomes.
MoCA scores were negatively correlated with GDS-30 both at the subject level (correlation coefficient r=-0.68, χ=19.26, P<0.001) and time point level (r=-0.35, χ=35.68, P<0.001) in patients with AD. Multivariate analysis showed several significant factors for cognitive function, including educational level, personality, hobbies, exercise, reading, aluminum utensil use, dietary restriction and hypertension (regression coefficients: 0.60, 0.52, 0.51, 0.48, 0.45, -0.48, 0.67, and -0.74, respectively). Significant factors for depressive symptoms included family status, employment before retirement, homemaking, reading, aluminum utensil use, dietary restriction, and hypertension (regression coefficients: 3.09, -1.33, -1.62, -1.31, 0.96, -1.15, and 1.14, respectively).
These findings indicated that cognition was negatively associated with depression in patients with AD, and both were influenced by reading, aluminum utensil use, dietary restriction, and hypertension. Considering patient factors may help to slow the progression of dementia.
研究阿尔茨海默病（AD）患者认知与抑郁症状之间是否存在双向关联，并探讨社会人口学因素和日常表现在此关联中的作用。
我们对来自中国太原的104名确诊为AD的社区居住患者进行了一项纵向研究。我们分别使用蒙特利尔认知评估量表（MoCA）和老年抑郁量表30项版（GDS - 30）评估认知和抑郁症状（因变量）。社会人口学信息和日常表现作为解释变量。构建多元多层次模型以研究患者认知与抑郁之间的相互关系，以及相关因素对这两个结果的影响。
在AD患者中，MoCA评分在个体水平（相关系数r = - 0.68，χ = 19.26，P < 0.001）和时间点水平（r = - 0.35，χ = 35.68，P < 0.001）均与GDS - 30呈负相关。多变量分析显示认知功能的几个显著因素，包括教育水平、性格、爱好、运动、阅读、铝制餐具使用、饮食限制和高血压（回归系数分别为：0.60、0.52、0.51、0.48、0.45、 - 0.48、0.67和 - 0.74）。抑郁症状的显著因素包括家庭状况、退休前就业情况、家务、阅读、铝制餐具使用、饮食限制和高血压（回归系数分别为：3.09、 - 1.33、 - 1.62、 - 1.31、0.96、 - 1.15和1.14）。
这些发现表明AD患者的认知与抑郁呈负相关，且二者均受阅读、铝制餐具使用、饮食限制和高血压的影响。考虑患者因素可能有助于减缓痴呆症的进展。
