特定的抑郁维度与老年人认知衰退速度加快有关。
Specific depression dimensions are associated with a faster rate of cognitive decline in older adults.
作者信息
Soleimani Laili, Schnaider Beeri Michal, Grossman Hillel, Sano Mary, Zhu Carolyn W
机构信息
Department of Psychiatry The Icahn School of Medicine at Mount Sinai New York New York USA.
The Joseph Sagol Neuroscience Center Sheba Medical Center Tel-Hashomer Israel.
出版信息
Alzheimers Dement (Amst). 2022 Mar 15;14(1):e12268. doi: 10.1002/dad2.12268. eCollection 2022.
INTRODUCTION
Understanding the relationship between different depression presentations and cognitive outcome may elucidate high-risk sub-groups for cognitive decline.
METHODS
In this study we utilized longitudinal data from the National Alzheimer's Coordinating Center (NACC) on 16,743 initially not demented older adults followed every 12 months for an average of 5 years. Depression dimensions were defined based on the 15-item Geriatric Depression Scale (GDS-15), that is, dysphoric mood, Withdrawal-Apathy-Vigor (WAV), anxiety, hopelessness, and subjective memory complaint (SMC).
RESULTS
After adjustment for sociodemographic and clinical covariates, SMC and hopelessness were associated with faster decline in global cognition and all cognitive domains and WAV with decline executive function. Dysphoric mood and anxiety were not associated with a faster cognitive decline in any of the cognitive domains.
DISCUSSION
Different depression dimensions had different associations with the rate of cognitive decline, suggesting distinct pathophysiology and the need for more targeted interventions.
引言
了解不同抑郁表现与认知结果之间的关系，可能会阐明认知衰退的高危亚组。
方法
在本研究中，我们使用了来自国家阿尔茨海默病协调中心（NACC）的纵向数据，该数据涉及16743名最初未患痴呆症的老年人，他们每12个月接受一次随访，平均随访5年。抑郁维度是根据15项老年抑郁量表（GDS-15）定义的，即烦躁情绪、退缩-冷漠-活力（WAV）、焦虑、绝望和主观记忆主诉（SMC）。
结果
在对社会人口统计学和临床协变量进行调整后，SMC和绝望与整体认知及所有认知领域的更快衰退相关，WAV与执行功能衰退相关。烦躁情绪和焦虑与任何认知领域的更快认知衰退均无关联。
讨论
不同的抑郁维度与认知衰退率有不同的关联，这表明存在不同的病理生理学机制，需要更有针对性的干预措施。
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