晚年抑郁症在亚临床心血管疾病与全因死亡率相关性中的作用：心血管健康研究。
Role of Late-Life Depression in the Association of Subclinical Cardiovascular Disease With All-Cause Mortality: Cardiovascular Health Study.
机构信息
1 Johns Hopkins University, Baltimore, MD, USA.
2 Northwestern University, Chicago, IL, USA.
出版信息
J Aging Health. 2019 Apr;31(4):652-666. doi: 10.1177/0898264317744921. Epub 2017 Nov 28.
OBJECTIVES
To evaluate whether late-life depression mediates the association of subclinical cardiovascular disease (CVD) with all-cause mortality.
METHOD
Using data from 3,473 Cardiovascular Health Study participants, the Cox proportional hazards model was used to examine the direct and indirect (via late-life depression) effects of the association between baseline subclinical CVD and all-cause mortality with weights derived from multivariable logistic regression of late-life depression on subclinical CVD.
RESULTS
Subclinical CVD led to a higher risk of all-cause mortality (hazard ratio [HR] = 1.51, 95% confidence interval, [CI] = [1.42, 1.94]). Total effect of subclinical CVD on all-cause mortality was decomposed into direct (HR = 1.41, 95% CI = [1.37, 1.58]) and indirect (HR = 1.07, 95% CI = [1.01, 1.23]) effects; 16.3% of the total effect of subclinical CVD on all-cause mortality was mediated by late-life depression.
DISCUSSION
Late-life depression accounts for little, if any, of the association between subclinical CVD, a risk factor of all-cause mortality, and all-cause mortality.
目的
评估老年期抑郁是否在亚临床心血管疾病（CVD）与全因死亡率之间的关联中起中介作用。
方法
使用来自 3473 名心血管健康研究参与者的数据，Cox 比例风险模型用于检查亚临床 CVD 与全因死亡率之间的关联的直接和间接（通过老年期抑郁）效应，其中亚临床 CVD 的权重来自老年期抑郁对亚临床 CVD 的多变量逻辑回归。
结果
亚临床 CVD 导致全因死亡率的风险增加（危险比 [HR] = 1.51，95%置信区间，[CI] = [1.42，1.94]）。亚临床 CVD 对全因死亡率的总效应被分解为直接（HR = 1.41，95%CI = [1.37，1.58]）和间接（HR = 1.07，95%CI = [1.01，1.23]）效应；亚临床 CVD 对全因死亡率的总效应有 16.3%是由老年期抑郁介导的。
讨论
老年期抑郁在亚临床 CVD（全因死亡率的一个危险因素）与全因死亡率之间的关联中几乎没有起到任何作用。
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