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心理社会风险因素与阿尔茨海默病:抑郁、睡眠障碍和焦虑的关联效应。

Psychosocial risk factors and Alzheimer's disease: the associative effect of depression, sleep disturbance, and anxiety.

机构信息

a School of Social Work, Robert Stempel College of Public Health and Social Work , Florida International University , Miami , FL , USA.

b Oral Health Policy and Epidemiology, Simmons College School of Social Work , Harvard School of Dental Medicine , Boston , MA , USA.

出版信息

Aging Ment Health. 2018 Dec;22(12):1577-1584. doi: 10.1080/13607863.2017.1387760. Epub 2017 Oct 27.

Abstract

OBJECTIVES

Alzheimer's disease (AD) dementia is a neurodegenerative condition, which leads to impairments in memory. This study predicted that sleep disturbance, depression, and anxiety increase the hazard of AD, independently and as comorbid conditions.

METHODS

Data from the National Alzheimer's Coordinating Center was used to analyze evaluations of 12,083 cognitively asymptomatic participants. Survival analysis was used to explore the longitudinal effect of depression, sleep disturbance, and anxiety as predictors of AD. The comorbid risk posed by depression in the last two years coupled with sleep disturbance, lifetime depression and sleep disturbance, clinician-verified depression and sleep disturbance, sleep disturbance and anxiety, depression in the last two years and anxiety, lifetime depression and anxiety, and clinician-verified depression and anxiety were also analyzed as predictors of AD through main effects and additive models.

RESULTS

Main effects models demonstrated a strong hazard of AD development for those reporting depression, sleep disturbance, and anxiety as independent symptoms. The additive effect remained significant among comorbid presentations.

CONCLUSION

Findings suggest that sleep disturbance, depression, and anxiety are associated with AD development among cognitively asymptomatic participants. Decreasing the threat posed by psychological symptoms may be one avenue for possibly delaying onset of AD.

摘要

目的

阿尔茨海默病(AD)痴呆是一种神经退行性疾病,会导致记忆力受损。本研究预测,睡眠障碍、抑郁和焦虑会独立增加 AD 的发病风险,也会作为共病情况增加风险。

方法

本研究使用国家阿尔茨海默病协调中心的数据,对 12083 名认知无症状参与者进行了评估。生存分析用于探索抑郁、睡眠障碍和焦虑作为 AD 预测因子的纵向影响。通过主要效应和附加模型,还分析了过去两年的抑郁共病风险加上睡眠障碍、终生抑郁和睡眠障碍、临床医生核实的抑郁和睡眠障碍、睡眠障碍和焦虑、过去两年的抑郁和焦虑、终生抑郁和焦虑以及临床医生核实的抑郁和焦虑作为 AD 预测因子的情况。

结果

主要效应模型表明,报告有抑郁、睡眠障碍和焦虑的个体独立出现这些症状,其 AD 发病风险很高。在共病情况下,附加效应仍然显著。

结论

研究结果表明,睡眠障碍、抑郁和焦虑与认知无症状参与者的 AD 发病有关。降低心理症状带来的威胁可能是延缓 AD 发病的一种途径。

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本文引用的文献

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2016 Alzheimer's disease facts and figures.2016 年阿尔茨海默病事实和数据。
Alzheimers Dement. 2016 Apr;12(4):459-509. doi: 10.1016/j.jalz.2016.03.001.
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2015 Alzheimer's disease facts and figures.2015 年阿尔茨海默病事实和数据。
Alzheimers Dement. 2015 Mar;11(3):332-84. doi: 10.1016/j.jalz.2015.02.003.

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