Associate Research Fellow,Brainnetome Center Institute of Automation,Chinese Academy of Sciences,China and Visiting Research Fellow,Institute of Cognitive Neuroscience,University College London,UK.
Associate Professor,Department of Geriatric Psychiatry,Affiliated Wuhan Mental Health Center,Tongji Medical College of Huazhong University of Science & Technology,China.
Br J Psychiatry. 2018 Nov;213(5):638-644. doi: 10.1192/bjp.2018.155. Epub 2018 Aug 22.
Little is known about the effect of persistent depressive symptoms on the trajectory of cognitive decline.AimsWe aimed to investigate the longitudinal association between the duration of depressive symptoms and subsequent cognitive decline over a 10-year follow-up period.
The English Longitudinal Study of Ageing cohort is a prospective and nationally representative cohort of men and women living in England aged ≥50 years. We examined 7610 participants with two assessments of depressive symptoms at wave 1 (2002-2003) and wave 2 (2004-2005), cognitive data at wave 2 and at least one reassessment of cognitive function (wave 3 to wave 7, 2006-2007 to 2014-2015).
The mean age of the 7610 participants was 65.2 ± 10.1 years, and 57.0% were women. Of these, 1157 (15.2%) participants had episodic depressive symptoms and 525 participants (6.9%) had persistent depressive symptoms. Compared with participants without depressive symptoms at wave 1 and wave 2, the multivariable-adjusted rates of global cognitive decline associated with episodic depressive symptoms and persistent depressive symptoms were faster by -0.065 points/year (95% CI -0.129 to -0.000) and -0.141 points/year (95% CI -0.236 to -0.046), respectively (P for trend < 0.001). Similarly, memory, executive and orientation function also declined faster with increasing duration of depressive symptoms (all P for trend < 0.05).
Our results demonstrated that depressive symptoms were significantly associated with subsequent cognitive decline over a 10-year follow-up period. Cumulative exposure of long-term depressive symptoms in elderly individuals could predict accelerated subsequent cognitive decline in a dose-response pattern.Declaration of interestNone.
关于持续性抑郁症状对认知衰退轨迹的影响知之甚少。
我们旨在调查抑郁症状持续时间与随后认知能力下降之间的纵向关联,随访时间为 10 年。
英国老龄化纵向研究是一项针对居住在英格兰的≥50 岁男性和女性的前瞻性、全国代表性队列研究。我们检查了 7610 名参与者,他们在第 1 波(2002-2003 年)和第 2 波(2004-2005 年)接受了两次抑郁症状评估、在第 2 波和至少一次重新评估认知功能(第 3 波至第 7 波,2006-2007 年至 2014-2015 年)获得了认知数据。
7610 名参与者的平均年龄为 65.2±10.1 岁,57.0%为女性。其中,1157 名(15.2%)参与者有发作性抑郁症状,525 名(6.9%)有持续性抑郁症状。与第 1 波和第 2 波时没有抑郁症状的参与者相比,与发作性抑郁症状和持续性抑郁症状相关的全球认知衰退的多变量调整率分别快 0.065 分/年(95%CI-0.129 至-0.000)和 0.141 分/年(95%CI-0.236 至-0.046)(趋势 P<0.001)。同样,记忆、执行和定向功能也随着抑郁症状持续时间的增加而更快下降(所有趋势 P<0.05)。
我们的研究结果表明,抑郁症状与随后的认知衰退在 10 年的随访期间显著相关。在老年人中,长期抑郁症状的累积暴露可能会以剂量反应模式预测随后认知能力的加速下降。
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