Neuvonen Elisa, Lehtisalo Jenni, Ngandu Tiia, Levälahti Esko, Antikainen Riitta, Hänninen Tuomo, Laatikainen Tiina, Lindström Jaana, Paajanen Teemu, Soininen Hilkka, Strandberg Timo, Tuomilehto Jaakko, Kivipelto Miia, Solomon Alina
Institute of Clinical Medicine/Neurology, University of Eastern Finland, 70211 Kuopio, Finland.
Population Health Unit, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland.
J Clin Med. 2022 Mar 7;11(5):1449. doi: 10.3390/jcm11051449.
Depression and cognition are associated, but the role of depressive symptoms in lifestyle interventions to prevent dementia needs further study. We investigated the intervention effect on depressive symptoms and their associations with cognition in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER; NCT01041989), a two-year multidomain lifestyle trial. One thousand two-hundred and sixty individuals (60-77 years) at risk for dementia were randomised into a multidomain intervention (diet, exercise, cognitive training, and vascular/metabolic risk monitoring) or control group (regular health advice). Depressive symptoms (Zung scale) and cognition (modified Neuropsychological Test Battery) were evaluated at baseline, 12, and 24 months. One thousand one-hundred and twenty-five participants had baseline Zung data. Mean Zung score decreased 0.73 (SD 5.6) points in the intervention and 0.36 (5.6) points in the control group, with nonsignificant between-group difference (group × time coefficient -0.006, 95% CI -0.019 to 0.007). Overall, higher baseline Zung score was associated with less improvement in global cognition (-0.140, = 0.005) and memory (-0.231, = 0.005). Participants with clinically significant baseline depressive symptoms (Zung ≥ 40 points) had less intervention benefit to executive functioning (group × time × Zung -0.096, 95% CI -0.163 to -0.028). Change in Zung score was not associated with change in cognition. Clinically significant depressive symptoms warrant more attention when designing dementia-prevention interventions.
抑郁症与认知功能相关，但抑郁症状在预防痴呆症的生活方式干预中的作用仍需进一步研究。我们在芬兰预防认知障碍和残疾老年干预研究（FINGER；NCT01041989）中调查了对抑郁症状的干预效果及其与认知的关联，这是一项为期两年的多领域生活方式试验。1260名有痴呆症风险的个体（60 - 77岁）被随机分为多领域干预组（饮食、运动、认知训练和血管/代谢风险监测）或对照组（常规健康建议）。在基线、12个月和24个月时评估抑郁症状（zung量表）和认知功能（改良神经心理测试电池）。1125名参与者有基线zung数据。干预组的平均zung评分下降了0.73（标准差5.6）分，对照组下降了0.36（5.6）分，组间差异无统计学意义（组×时间系数 -0.006，95%置信区间 -0.019至0.007）。总体而言，较高的基线zung评分与整体认知功能（-0.140，P = 0.005）和记忆力（-0.231，P = 0.005）的改善较少相关。有临床显著基线抑郁症状（zung≥40分）的参与者在执行功能方面的干预获益较少（组×时间×zung -0.096，95%置信区间 -0.163至 -0.028）。zung评分的变化与认知功能的变化无关。在设计预防痴呆症的干预措施时，具有临床意义的抑郁症状值得更多关注。
