Department of Microbiology, Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain.
Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain.
Acta Psychiatr Scand. 2019 Jan;139(1):6-14. doi: 10.1111/acps.12966. Epub 2018 Oct 10.
To evaluate whether clinically significant anxiety is an independent risk factor for dementia, taking into account both depression among potentially confounding factors and the competing risk of death.
During the Zaragoza Dementia and Depression (ZARADEMP) study, a random sample of community dwellers aged 55 years or older was assessed (n = 4803), and a two-wave, 4.5-year follow-up was completed. Geriatric Mental State (GMS)-AGECAT criteria were used to diagnose anxiety and DSM-IV criteria were applied to diagnose incident dementia. The multivariate Fine and Gray regression model was implemented to calculate dementia risk.
Compared with non-cases (GMS-AGECAT criteria), the incidence rate of dementia was significantly higher in subcases of anxiety, and particularly significant in the cases of anxiety (incidence rate ratio (IRR): 2.77; P = 0.010). Cases of anxiety, but not subcases, at baseline were significantly associated with dementia risk (adjusted subdistribution hazard ratio (SHR): 2.7; P = 0.019).
Clinically significant anxiety is associated with an almost threefold increase in the risk of dementia in the population, even when controlling for depression and considering mortality in the competing risks model.
评估临床上显著的焦虑是否是痴呆的独立风险因素，同时考虑到潜在混杂因素中的抑郁以及死亡的竞争风险。
在萨拉戈萨痴呆和抑郁（ZARADEMP）研究中，对随机抽取的年龄在 55 岁及以上的社区居民进行评估（n=4803），并完成了为期 4.5 年的两波随访。使用老年精神状态（GMS）-AGECAT 标准来诊断焦虑，使用 DSM-IV 标准来诊断新发痴呆。实施多变量 Fine 和 Gray 回归模型来计算痴呆风险。
与非病例（GMS-AGECAT 标准）相比，焦虑亚病例的痴呆发生率显著更高，而焦虑病例的发生率则更为显著（发病率比（IRR）：2.77；P=0.010）。基线时存在焦虑病例，而不是亚病例，与痴呆风险显著相关（调整后的亚分布风险比（SHR）：2.7；P=0.019）。
即使在控制抑郁并考虑竞争风险模型中的死亡率的情况下，临床上显著的焦虑与人群中痴呆风险增加近三倍相关。
