Department of Neurology, Daping Hospital, Army Military Medical University, Chongqing, China.
Graduate School of Bengbu Medical College, Bengbu City, China.
Int J Neurosci. 2020 Nov;130(11):1136-1141. doi: 10.1080/00207454.2020.1730369. Epub 2020 Feb 27.
Depression, which affects about 52% of Alzheimer's disease (AD) patients, can worsen cognitive impairment and increase mortality and suicide rates. We hope to provide clinical evidence for the prevention and treatment of depression in AD patients by investigating related risk factors of depression in AD patients. 158 AD inpatients of the Department of Neurology, Daping Hospital from September 2017 to March 2019 were enrolled. General information, laboratory tests, cognitive and emotional function assessments of the inpatients were collected. Logistic regression was used to analyze the risk factors of depression in AD patients, and the relationship between 17 Hamilton depression scale scores and HbA1c levels in AD patients was further analyzed. The prevalence of age, gender, hypertension, hyperlipidemia, Type 2 diabetes mellitus (T2DM), and white matter lesions (WML) in the AD with depression group was significantly different from without depression group. Hypertension, T2DM, and WML are independent risk factors for depression in AD patients. The depression scores of AD patients with HbA1c>6.5% were significantly higher than AD patients with HbA1c ≤ 6.5%, and there were significant difference in depression scale scores between using anti-diabetes drugs group and not using anti-diabetes drugs group whose HbA1c level is >6.5%, while no difference in depression scores between using anti-diabetes drugs group and not using anti-diabetes drugs group whose HbA1c level is ≤6.5%. T2DM is an independent risk factor for AD patients with depression. Increased HbA1c levels aggravate depression in AD patients, and controlling HbA1c levels and anti-diabetes drugs can reduce the severity of depression in AD patients.
抑郁症影响大约 52%的阿尔茨海默病(AD)患者,可使认知障碍恶化,增加死亡率和自杀率。我们希望通过研究 AD 患者抑郁的相关危险因素,为 AD 患者抑郁的预防和治疗提供临床依据。选取 2017 年 9 月至 2019 年 3 月我院神经内科收治的 158 例 AD 住院患者,收集患者的一般资料、实验室检查、认知和情绪功能评估,采用 Logistic 回归分析 AD 患者抑郁的危险因素,并进一步分析 AD 患者 17 项汉密尔顿抑郁量表(HAMD)评分与 HbA1c 水平的关系。AD 伴发抑郁组患者在年龄、性别、高血压、高血脂、2 型糖尿病(T2DM)、脑白质病变(WML)等方面与无抑郁组患者比较差异有统计学意义。高血压、T2DM、WML 是 AD 患者发生抑郁的独立危险因素。HbA1c>6.5%的 AD 患者抑郁评分显著高于 HbA1c≤6.5%的患者,且 HbA1c 水平>6.5%时,使用与未使用降糖药物的患者在抑郁量表评分方面差异有统计学意义,而 HbA1c 水平≤6.5%时,使用与未使用降糖药物的患者在抑郁量表评分方面差异无统计学意义。T2DM 是 AD 伴发抑郁的独立危险因素。HbA1c 水平升高加重 AD 患者的抑郁,控制 HbA1c 水平及使用降糖药物可减轻 AD 患者的抑郁严重程度。