Department of Clinical Neuroscience, Bristol Medical School, University of Bristol, Bristol, UK.
Department of Clinical Neuroscience, Bristol Medical School, University of Bristol, Bristol, UK.
J Affect Disord. 2022 Jun 1;306:232-239. doi: 10.1016/j.jad.2022.03.043. Epub 2022 Mar 23.
Later-life depression appears to be different to depression in younger adults. The underlying pathology may also differ. Depression is linked to dementia but whether it is a risk factor or an early sign of a developing dementia remains unclear. Neuroinflammation is increasingly recognised in both depression and Alzheimer's Disease.
To investigate the link between depression, inflammation and dementia. We hypothesised that recurrent depression has adverse effects on performance in cognitive tests in middle to older age and that this effect is modified by anti-inflammatory medication.
We identified UK based cohort studies which included individuals aged >50, had medical information, results from detailed cognitive testing and had used reliable measures to assess depression. Individuals with recurrent depression had ≥ 2 episodes of depression. Controls had no history of depression. The presence/absence of inflammatory illness was assessed using a standardised list of inflammatory conditions. Individuals with dementia, chronic neurological and psychotic conditions were excluded. Logistic and linear regression were used to examine the effect of depression on cognitive test performance and the mediating effect of chronic inflammation.
Unexpectedly in both studies there was evidence that those with recurrent depression performed better in some cognitive tasks (e.g Mill Hill vocabulary) but worse in others (e.g. reaction time). In UK Biobank there was no evidence that anti-inflammatories moderated this effect.
Cross-sectional assessment of cognition.
Although previous recurrent depression has small effects on cognitive test performance this does not appear to be mediated by chronic inflammatory disease.
老年抑郁症似乎与年轻成年人的抑郁症不同。潜在的病理学也可能不同。抑郁症与痴呆症有关，但它是痴呆症的危险因素还是痴呆症的早期迹象尚不清楚。神经炎症在抑郁症和阿尔茨海默病中都越来越受到关注。
研究抑郁症、炎症和痴呆之间的联系。我们假设反复发作的抑郁症对中年及以上人群认知测试的表现有不良影响，而抗炎药物会改变这种影响。
我们确定了英国的队列研究，这些研究纳入了年龄>50 岁的个体，有医疗信息、详细认知测试结果，并使用可靠的方法评估抑郁症。反复发作抑郁症的个体有≥2 次的抑郁发作。对照组没有抑郁史。使用炎症疾病的标准清单评估炎症性疾病的存在/不存在。排除痴呆、慢性神经和精神疾病的个体。逻辑回归和线性回归用于检查抑郁症对认知测试表现的影响，以及慢性炎症的中介作用。
在两项研究中都出乎意料地发现，有反复发作抑郁症的个体在一些认知任务（如米尔山词汇）中表现更好，但在其他任务（如反应时间）中表现更差。在英国生物库中，没有证据表明抗炎药会影响这种效果。
认知的横断面评估。
尽管以前反复发作的抑郁症对认知测试表现有较小的影响，但这似乎不是由慢性炎症性疾病介导的。
