老年人抑郁症与痴呆症相继发生的间隔时间的影响：一项基于全国人口的研究。

Impacts of intervals between sequential development of depression and dementia in older adults: A nationwide population-based study.

作者信息

Yang Szu-Nian, Chueh Chen-Han, Peng Li-Ning, Tsai Yi-Wen

机构信息

Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital Beitou Branch, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Armed Forces Taoyuan General Hospital, Taoyuan, Taiwan.

Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan.

出版信息

Arch Gerontol Geriatr. 2022 Jul-Aug;101:104693. doi: 10.1016/j.archger.2022.104693. Epub 2022 Mar 22.

DOI:10.1016/j.archger.2022.104693

PMID:35390572

Abstract

BACKGROUND

Depression has been reported as a risk factor for dementia, as well as the continuation of dementia development. This study aimed to stratify older people with dementia (PwD) into three groups (no depression, early depression and recent depression) to compare their inpatient health care utilization and to explore related clinical impacts.

METHODS

Overall, 11,612 PwD were identified from Taiwan's National Health Insurance Research Database and were further divided into 9,257 PwD without depression, 1,179 PwD with recent depression (< 2 years from dementia diagnosis), and 1,176 PwD with early depression (> 2 years from dementia diagnosis). Three matched cohort pairs (Cohort 1: no depression versus recent depression, Cohort 2: no depression versus early depression, and Cohort 3: recent depression versus early depression) were constructed to compare inpatient health care utilization three years after dementia onset.

RESULTS

The incidence of hospitalization related to mental illness among PwD with a recent or early depression onset were significantly higher than their matched cohort without depression. The recent depression group had a greater rate ratio (RR) with a longer length of stay due to depression (RR: 8.29, 95% CI: 2.74-25.12) compared to the no depression group, and the early depression group had 4.24 times (95% CI: 1.56-11.59) and 6.40 times (95% CI: 2.18-18.82) longer length of stay than the no depression group due to depression, and mood disorders.

CONCLUSIONS

Depression significantly increased inpatient health care utilization of depression and mood disorder among older PwD with early depression.

摘要

背景

抑郁症已被报道为痴呆症的一个风险因素，也是痴呆症发展的延续因素。本研究旨在将老年痴呆症患者（PwD）分为三组（无抑郁症、早期抑郁症和近期抑郁症），以比较他们的住院医疗服务利用率，并探讨相关的临床影响。

方法

总体而言，从台湾国民健康保险研究数据库中识别出11612名PwD，并进一步分为9257名无抑郁症的PwD、1179名近期抑郁症（自痴呆症诊断起<2年）的PwD和1176名早期抑郁症（自痴呆症诊断起>2年）的PwD。构建了三对匹配队列（队列1：无抑郁症与近期抑郁症，队列2：无抑郁症与早期抑郁症，队列3：近期抑郁症与早期抑郁症），以比较痴呆症发病三年后的住院医疗服务利用率。

结果

近期或早期抑郁症发作的PwD中与精神疾病相关的住院发生率显著高于其匹配的无抑郁症队列。与无抑郁症组相比，近期抑郁症组因抑郁症住院时间更长，率比（RR）更高（RR：8.29，95%CI：2.74-25.12），早期抑郁症组因抑郁症和情绪障碍住院时间分别比无抑郁症组长4.24倍（95%CI：1.56-11.59）和6.40倍（95%CI：2.18-18.82）。