Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea.
Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea.
Aust N Z J Psychiatry. 2021 Aug;55(8):809-816. doi: 10.1177/0004867420972763. Epub 2020 Nov 16.
Subsyndromal depression is prevalent and associated with poor outcomes in late life, but its effect on the risk of dementia has barely been investigated. This study is aimed to investigate the effect of subsyndromal depression on dementia risk in cognitively normal older adults and patients with mild cognitive impairment.
Data were collected from a nationwide, population-based, prospective cohort study on a randomly sampled Korean elderly population aged 60 years or older, which has been followed every 2 years. Using 6-year follow-up data of 4456 non-demented elderly, the authors examined the risk of dementia associated with late-onset subsyndromal depression using multivariate Cox proportional hazard models. After standardized diagnostic interviews, subsyndromal depression and dementia were diagnosed by the operational diagnostic criteria and , 4th edition criteria, respectively.
Subsyndromal depression tripled the risk of dementia in non-demented elderly individuals (hazard ratio = 3.02, 95% confidence interval = [1.56, 5.85], < 0.001). In subgroup analyses, subsyndromal depression was associated with the risk of dementia in cognitively normal participants only (hazard ratio = 4.59, 95% confidence interval = [1.20, 17.54], = 0.026); chronic/recurrent subsyndromal depression with increasing severity during the follow-up period was associated with the risk of dementia (hazard ratio = 15.34, 95% confidence interval = [4.19, 56.18], < 0.001).
Late-onset subsyndromal depression is a potential predictor of incident dementia when it is chronic or recurrent with increasing severity in cognitively normal older adults.
亚综合征性抑郁在老年人群中较为普遍，与不良结局相关，但它对痴呆风险的影响几乎没有被研究过。本研究旨在调查认知正常的老年人和轻度认知障碍患者中，亚综合征性抑郁对痴呆风险的影响。
数据来自一项全国性、基于人群的前瞻性队列研究，该研究对年龄在 60 岁或以上的随机抽样韩国老年人进行了随访，每两年进行一次随访。利用 4456 名非痴呆老年人的 6 年随访数据，作者使用多变量 Cox 比例风险模型检查了迟发性亚综合征性抑郁与痴呆相关的风险。在经过标准化的诊断访谈后，使用操作性诊断标准和第 4 版标准分别诊断亚综合征性抑郁和痴呆。
亚综合征性抑郁使非痴呆老年人痴呆的风险增加了两倍（风险比=3.02，95%置信区间[1.56，5.85]， < 0.001）。在亚组分析中，亚综合征性抑郁仅与认知正常的参与者的痴呆风险相关（风险比=4.59，95%置信区间[1.20，17.54]， = 0.026）；在随访期间，慢性/复发性亚综合征性抑郁且严重程度逐渐增加与痴呆风险相关（风险比=15.34，95%置信区间[4.19，56.18]， < 0.001）。
在认知正常的老年人中，迟发性亚综合征性抑郁是痴呆的潜在预测因子，当它是慢性或复发性的，且严重程度逐渐增加时。
