Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
Alzheimers Dement. 2021 Aug;17(8):1383-1390. doi: 10.1002/alz.12303. Epub 2021 Mar 3.
Whether depression is a prodromal phase or risk factor for dementia is under debate. We aimed to unveil the nature of depression-dementia association by looking into the time window of depression occurrence.
Dementia-free twins (n = 41,727) from the Swedish Twin Registry were followed-up for 18 years. Data were analyzed using generalized estimating equation (GEE) for all individuals and conditional logistic regression for co-twin matched pairs.
In the GEE model, multi-adjusted odds ratios (ORs; 95% confidence intervals [CIs]) of dementia were 1.46 (1.09-1.95) for mid-life, 2.16 (1.82-2.56) for late-life, 2.24 (1.49-3.36) for mid- to late-life, and 2.65 (1.17-5.98) for lifelong depression. The ORs in conditional logistic regression and in GEE did not differ significantly (P = 0.60). Education ≥8 years attenuated dementia risk associated with mid-life depression.
Not only late-life depression, but also mid-life depression is associated with dementia. Genetic and early-life environmental factors could not account for this association. Education ≥8 years might buffer the impact of mid-life depression on dementia.
抑郁症是痴呆的前驱期还是危险因素仍存在争议。我们旨在通过研究抑郁症发生的时间窗来揭示抑郁与痴呆之间的关联性质。
从瑞典双胞胎登记处中筛选出无痴呆的双胞胎（n=41727），随访时间为 18 年。使用广义估计方程（GEE）对所有个体进行数据分析，并对同卵双胞胎匹配对进行条件逻辑回归分析。
在 GEE 模型中，中年、晚年、中年至晚年和终生抑郁症发生的多因素调整比值比（OR；95%置信区间[CI]）分别为 1.46（1.09-1.95）、2.16（1.82-2.56）、2.24（1.49-3.36）和 2.65（1.17-5.98）。条件逻辑回归和 GEE 中的 OR 差异无统计学意义（P=0.60）。教育程度≥8 年可降低与中年抑郁症相关的痴呆风险。
不仅晚年抑郁症，中年抑郁症也与痴呆相关。遗传和生命早期环境因素无法解释这种关联。教育程度≥8 年可能会缓冲中年抑郁症对痴呆的影响。
