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生活方式多领域干预、ω-3 补充剂,还是两者兼用来降低有记忆主诉的老年人出现临床相关抑郁症状的风险?MAPT 试验的二次分析。

Lifestyle multidomain intervention, omega-3 supplementation, or both for reducing the risk of developing clinically relevant depressive symptoms in older adults with memory complaints? Secondary analysis from the MAPT trial.

机构信息

Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, 37 allée Jules Guesdes, 31000 Toulouse, France.

Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, 37 allée Jules Guesdes, 31000 Toulouse, France; UMR INSERM, 1027 University of Toulouse III, Toulouse, France.

出版信息

Exp Gerontol. 2019 Jun;120:28-34. doi: 10.1016/j.exger.2019.02.010. Epub 2019 Feb 26.

DOI:10.1016/j.exger.2019.02.010
PMID:30817982
Abstract

BACKGROUND

We tested the associations of a lifestyle multidomain intervention (MI), omega-3 supplementation (O3) or their combination with the change of clinically meaningful depressive symptoms in older adults.

METHODS

Secondary analysis of the 3-year Multidomain Alzheimer Preventive Trial (MAPT), in which 1679 people, ≥70 years with memory complaints were randomized into: MI, O3, MI + O3, or placebo. MI was composed of nutritional and physical activity counselling and cognitive training. O3 supplementation corresponded to a daily dose of 1000 mg of omega-3. Discrete-time cox regressions were performed for each outcome. Three binary variables of incidence of depressive symptoms were created from the 15-item geriatric depression scale (GDS-15): minimum clinically meaningful depressive symptoms (≥2-point increase in GDS-15), moderate depressive symptoms (GDS-15 ≥ 5), and severe depressive symptoms (GDS-15 ≥ 10) DS.

RESULTS

Discrete-time cox proportional hazards have found no associations for all of the analysis. The incidence of severe depressive symptoms across groups were, respectively: 1.1, 2.4, 2.3 and 2.5 per 100 person year for MI + O3, for O3, for MI, for placebo. There was a trend for a decreased risk of developing severe DS compared to placebo in the MI + O3 group (p = 0.085 after adjustment).

CONCLUSIONS

To conclude, we did not find any association of a lifestyle multidomain intervention with the onset of clinically depressive symptoms in older adults with memory complaints. A study with a more intensive multidomain intervention might bring further insights on this topic.

摘要

背景

我们测试了生活方式多领域干预(MI)、ω-3 补充剂(O3)或它们的组合与老年人临床有意义的抑郁症状变化的关联。

方法

对为期 3 年的多领域阿尔茨海默病预防试验(MAPT)进行二次分析,其中 1679 名有记忆问题的≥70 岁的人被随机分为:MI、O3、MI+O3 或安慰剂。MI 由营养和身体活动咨询以及认知训练组成。O3 补充剂的日剂量为 1000mg 的 ω-3。对每种结果都进行了离散时间 Cox 回归分析。从 15 项老年抑郁量表(GDS-15)中创建了三个关于抑郁症状发生率的二进制变量:最小临床有意义的抑郁症状(GDS-15 增加≥2 分)、中度抑郁症状(GDS-15≥5)和严重抑郁症状(GDS-15≥10)。

结果

离散时间 Cox 比例风险分析未发现所有分析的关联。各组严重抑郁症状的发生率分别为:MI+O3 组为每 100 人年 1.1、2.4、2.3 和 2.5,O3 组为 2.4、2.3 和 2.5,MI 组为 2.4、2.3 和 2.5,安慰剂组为 2.4、2.3 和 2.5。与安慰剂相比,MI+O3 组发生严重 DS 的风险呈下降趋势(调整后 p=0.085)。

结论

总之,我们没有发现生活方式多领域干预与有记忆问题的老年人临床抑郁症状的发生有任何关联。一项更强化的多领域干预研究可能会进一步深入探讨这一主题。

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