Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
J Affect Disord. 2021 Dec 1;295:752-758. doi: 10.1016/j.jad.2021.08.152. Epub 2021 Sep 3.
This study aimed to evaluate the heterogeneous association of depressive subtypes with cognitive function, according to age and sex.
This cross-sectional study utilized the baseline data from the Cardiovascular and Metabolic Disease Etiology Research Center cohort and included 5271 midlife participants. For identifying depressive subtypes of the Beck Depression Inventory Ⅱ items, factor analyses were utilized and yielded two factors -melancholic- and somatic-depressive subtypes. The information of Mini-Mental State Examination was used for screening cognitive function. The association between depressive subtypes and cognitive function was analysed using multiple regression after adjusting for all covariates.
We observed heterogeneous association between depressive subtypes and cognitive dysfunction in midlife participants. The results of sex- and age- stratified analyses indicated that the somatic subtype was associated with dysfunction in cognitive ability. Among women, especially those aged over 60 years, MMSE scores decreased as the somatic depression scores increased. These results might suggest that the somatic subtype, rather than the melancholic subtype, has a greater association with cognitive assessment in a general midlife population, particularly older women.
Although a confirmatory factor analysis was performed, depressive subtypes need validation and reliability tests.
Given this heterogeneity, characterisation of depressive subtypes according to sex and age may improve our understanding of how each depressive symptom is associated differently with cognitive dysfunction in midlife.
本研究旨在根据年龄和性别评估抑郁亚型与认知功能的异质关联。
本横断面研究利用心血管和代谢疾病病因学研究中心队列的基线数据，纳入了 5271 名中年参与者。为了识别贝克抑郁量表Ⅱ项中的抑郁亚型，我们进行了因子分析，得出了两个因子 - 忧郁型和躯体型抑郁亚型。使用简易精神状态检查的信息来筛选认知功能。在调整了所有协变量后，我们使用多元回归分析了抑郁亚型与认知功能之间的关系。
我们观察到抑郁亚型与中年参与者认知功能障碍之间存在异质关联。性别和年龄分层分析的结果表明，躯体型与认知能力障碍有关。在女性中，尤其是年龄在 60 岁以上的女性中，随着躯体抑郁评分的增加，MMSE 评分下降。这些结果可能表明，在一般中年人群中，特别是老年女性中，躯体型而非忧郁型与认知评估的关联更大。
尽管进行了验证性因子分析，但抑郁亚型仍需要验证和可靠性测试。
鉴于这种异质性，根据性别和年龄对抑郁亚型进行特征描述可能有助于我们更好地理解每个抑郁症状如何与中年认知功能障碍不同程度地相关。
