Amsterdam Public Health Research Institute, Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
Amsterdam Public Health Research Institute, Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
Am J Geriatr Psychiatry. 2017 Sep;25(9):966-977. doi: 10.1016/j.jagp.2017.04.004. Epub 2017 Apr 7.
The occurrence of well-established risk factors for depression differs across the lifespan. Risk factors may be more strongly associated with depression at ages when occurrence, and therefore expectance, is relatively low ("on-time off-time" hypothesis). This large-scale study examined absolute and relative risks of established risk factors for depression across the lifespan.
Participants were 2,215 currently or never depressed adults aged 18 to 93 years from two cohort studies: NESDA and NESDO. The occurrence of 19 established risk factors (absolute risk) was examined in different age groups. In addition, the relative risk of these risk factors for depression was compared across age groups by examining risk factor × age interaction.
The occurrence of all risk factors differed significantly across age groups. Although most risk factors had significant associations with depression across the lifespan, for five risk factors the strength of the association was age-dependent. Stronger associations with depression in younger age were found for childhood abuse, pain, higher body mass index (BMI) and number of chronic diseases, whereas low income imposed a stronger risk in older age. Associations with depression were strongest in age groups where occurrence was lowest.
Although the exposure to risk factors changes across the lifespan, the relative risk associating them to depression remains similar for most risk factors. Some specific risk factors (low income, and health factors pain, BMI, and number of chronic diseases), however, seem more strongly associated with depression in ages in which occurrence is lowest and least expected.
已确立的抑郁症风险因素在整个生命周期中的发生情况有所不同。风险因素可能与发生频率较低的年龄段（“按时失时”假说）的抑郁症相关性更强。这项大规模研究考察了整个生命周期中已确立的抑郁症风险因素的绝对风险和相对风险。
参与者为来自两项队列研究（NESDA 和 NESDO）的 2215 名目前或从未患过抑郁症的 18 至 93 岁成年人。在不同年龄组中检查了 19 种已确立的风险因素（绝对风险）的发生情况。此外，通过检查风险因素×年龄的交互作用，比较了这些风险因素在不同年龄组中与抑郁症的相对风险。
所有风险因素的发生情况在年龄组之间存在显著差异。尽管大多数风险因素与整个生命周期中的抑郁症有显著关联，但对于五种风险因素，关联的强度随年龄而变化。在年轻年龄组中，与抑郁症的关联更强的风险因素包括儿童期虐待、疼痛、更高的身体质量指数（BMI）和慢性疾病数量，而在老年年龄组中，低收入则带来更强的风险。与抑郁症的关联在发生频率最低的年龄组最强。
尽管风险因素的暴露在整个生命周期中发生变化，但与这些风险因素相关联的相对风险对于大多数风险因素仍然相似。然而，一些特定的风险因素（如低收入以及健康因素疼痛、BMI 和慢性疾病数量）与发生频率和预期最低的年龄段的抑郁症相关性更强。
