Utrecht University, Department of Psychology, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands.
Icelandic Heart Association, Kopavogur, Iceland.
Neurobiol Aging. 2022 Mar;111:14-23. doi: 10.1016/j.neurobiolaging.2021.09.025. Epub 2021 Nov 27.
Late-life depression (LLD) increases risk for dementia and brain pathology, but possibly this is only true for one or more symptom profiles of LLD. In 4354 participants (76 ± 5 years; 58% female) from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, we identified five LLD symptom profiles, based on the Geriatric Depression Scale-15 (no LLD (57%); apathy (31%); apathy with emptiness (2%), mild LLD (8%) and severe LLD (2%)). Cox regression analyses showed that severe LLD, mild LLD and apathy increased risk of dementia up to 12 years, compared to no LLD. Additionally, hippocampal volume loss and white matter lesion increase, were assessed on 1.5 T MR images, at baseline and after 5 years follow-up. Only severe LLD showed increased WML volume over time, but not on hippocampal volume loss. WML increase over time mediated partially the relation between mild LLD and dementia but not for the other symptom profiles. It appears that hippocampal atrophy and LLD are independent predictors for dementia incidence, whereas for mild LLD the risk for dementia is partially mediated by WML changes.
老年期抑郁症（LLD）会增加痴呆和脑部病变的风险，但这可能仅适用于 LLD 的一种或多种症状特征。在来自 Age, Gene/Environment Susceptibility (AGES)-Reykjavik 研究的 4354 名参与者（76±5 岁；58%为女性）中，我们基于老年抑郁量表-15（不存在 LLD（57%）；淡漠（31%）；空虚感淡漠（2%）、轻度 LLD（8%）和重度 LLD（2%））确定了五种 LLD 症状特征。Cox 回归分析显示，与不存在 LLD 相比，重度 LLD、轻度 LLD 和淡漠会使痴呆的风险增加长达 12 年。此外，还在基线和 5 年随访时的 1.5T MR 图像上评估了海马体积损失和脑白质病变（WML）增加情况。只有重度 LLD 显示随着时间的推移 WML 体积增加，但海马体积损失没有增加。WML 随时间增加部分介导了轻度 LLD 与痴呆之间的关系，但对其他症状特征没有影响。这表明海马萎缩和 LLD 是痴呆发病的独立预测因素，而对于轻度 LLD，痴呆的风险部分由 WML 变化介导。
