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老年美国退伍军人的抑郁和认知功能障碍:BDNF Val66Met 多态性和体育锻炼的调节作用。

Depression and Cognitive Dysfunction in Older U.S. Military Veterans: Moderating Effects of BDNF Val66Met Polymorphism and Physical Exercise.

机构信息

Department of Psychological Sciences (BLP), Kansas State University, Manhattan, KS.

Department of Psychiatry (VW, BMF, SMS, IE, RHP), Yale University School of Medicine, New Haven, CT.

出版信息

Am J Geriatr Psychiatry. 2020 Sep;28(9):959-967. doi: 10.1016/j.jagp.2020.02.001. Epub 2020 Feb 7.

Abstract

OBJECTIVE

Depression is associated with increased risk for cognitive dysfunction, yet little is known about genetic and behavioral factors that may moderate this association. Using data from a nationally representative sample of older U.S. military veterans, we examined the direct and interactive effects of depression, brain-derived neurotropic factor (BDNF) Val66Met genotype, and physical exercise on cognitive functioning.

METHODS

One thousand three hundred eighty-six older European-American U.S. military veterans (mean age = 63) completed a web-based survey and cognitive assessment. Analyses of covariance were conducted to evaluate the effects of depression, BDNF Met allele carrier status, and physical exercise on these measures.

RESULTS

Depressed veterans scored worse than nondepressed veterans on subjective measures of cognitive functioning (Cohen d's = 0.34-0.57) and objective measures of visual learning (d = 0.39) and working memory (d = 0.28). Among depressed veterans, those who were Met allele carriers scored worse than Val/Val homozygotes on subjective cognitive measures (d's = 0.52-0.97) and an objective measure of visual learning (d = 0.36). Engagement in physical exercise moderated the association between depression and cognitive function, with depressed exercisers scoring better than depressed nonexercisers on a subjective measure of reasoning, and objective measures of processing speed, attention, and visual learning (d = 0.58-0.99): further, in depressed Met allele carriers, exercisers scored better than nonexercisers on subjective cognitive (d's = 0.80-1.92), and objective measures of visual learning (d = 0.8-1.31) and working memory (d = 0.67).

CONCLUSION

Depression is associated with moderate decrements in cognitive functioning in older U.S. military veterans, and this association is moderated by BDNF Val66Met genotype and physical exercise. Prevention and treatment efforts designed to promote physical exercise may help preserve cognitive functioning in at-risk veterans.

摘要

目的

抑郁症与认知功能障碍的风险增加有关,但对于可能调节这种关联的遗传和行为因素知之甚少。利用来自美国全国代表性老年退伍军人样本的数据,我们研究了抑郁、脑源性神经营养因子(BDNF)Val66Met 基因型和体育锻炼对认知功能的直接和交互影响。

方法

1386 名年龄较大的欧洲裔美国退伍军人(平均年龄 63 岁)完成了一项基于网络的调查和认知评估。协方差分析用于评估抑郁、BDNF Met 等位基因携带者状态和体育锻炼对这些指标的影响。

结果

与非抑郁退伍军人相比,抑郁退伍军人在主观认知功能(Cohen d'值为 0.34-0.57)和客观视觉学习(d 值为 0.39)和工作记忆(d 值为 0.28)方面的得分较差。在抑郁退伍军人中,Met 等位基因携带者在主观认知指标(d 值为 0.52-0.97)和客观视觉学习指标(d 值为 0.36)上的得分低于 Val/Val 纯合子。体育锻炼的参与调节了抑郁与认知功能之间的关联,与抑郁非锻炼者相比,抑郁锻炼者在主观推理和客观处理速度、注意力和视觉学习指标(d 值为 0.58-0.99)上的得分更好:此外,在抑郁 Met 等位基因携带者中,锻炼者在主观认知(d 值为 0.80-1.92)和客观视觉学习(d 值为 0.8-1.31)和工作记忆(d 值为 0.67)方面的得分均优于非锻炼者。

结论

抑郁与美国老年退伍军人认知功能的中度下降有关,这种关联受 BDNF Val66Met 基因型和体育锻炼的调节。旨在促进体育锻炼的预防和治疗努力可能有助于保护高危退伍军人的认知功能。

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