Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China.
Department of Geriatric Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China.
J Affect Disord. 2022 Sep 1;312:9-16. doi: 10.1016/j.jad.2022.06.001. Epub 2022 Jun 8.
Evidence suggests the occurrence of depressive symptoms in mid- to late-life inflates the risk for ageing-related morbidity compared to people without depressive symptoms. The eventual association between depressive symptoms in mid- to late-life and long-term (over 10-year) risks for incident dementia, coronary heart disease (CHD), stroke, and morbidity is to be established.
This longitudinal cohort study utilized Health and Retirement Study (HRS) of U.S residents aged ≥ 50 years who were interviewed every 2-year during follow-up (average follow-up: 11.6 ± 2.85 years). Trajectories of depressive symptoms were assessed by the Center for Epidemiologic Studies Depression (CES-D) scale from 1994 to 2000 at baseline. Incident dementia, CHD, stroke and all-cause mortality were determined from 2000 to 2018.
Among 7810 individuals who were free from dementia, CHD and stroke, five trajectories of depressive symptoms were identified: non-depressed (36.7 %), mild (48.8 %), worsening (7.8 %), improving (4.1 %) and persistent (2.7 %). Compared with those in the non-depressed group, participants with mild, worsening and persistent depressive symptoms had significantly greater hazards of incident dementia (multivariable adjusted hazard ratios and 95 % confidence intervals: 1.32 [1.17-1.48], 1.58 [1.30-1.93], 2.82 [2.17-3.67], respectively), CHD (1.13 [1.03-1.24], 1.47 [1.25-1.73], 1.34 [1.03-1.74], respectively), stroke (1.30 [1.12-1.52], 1.58 [1.23-2.04], 1.71 [1.16-2.53], respectively) and all-cause mortality (1.17 [1.07-1.27], 1.46 [1.27-1.68], 1.66 [1.35-2.06], respectively). The hazards of incident events, except for CHD, were not significantly greater in individuals with improving depressive symptoms.
The present findings suggest even sub-clinical threshold depressive symptoms were associated with the hazards of ageing related diseases while such associations were not significant with managed depressive symptoms.
有证据表明，与没有抑郁症状的人相比，中老年人群出现抑郁症状会增加与年龄相关的发病风险。目前尚需确定中老年人群抑郁症状与长期（超过 10 年）发生痴呆、冠心病（CHD）、中风和发病风险之间的最终关联。
本纵向队列研究利用美国≥50 岁居民的健康与退休研究（HRS），在随访期间每 2 年进行一次访谈（平均随访时间：11.6±2.85 年）。通过中心流行病学研究抑郁量表（CES-D）从 1994 年至 2000 年基线评估抑郁症状轨迹。从 2000 年至 2018 年确定痴呆、CHD、中风和全因死亡率的发生情况。
在 7810 名无痴呆、CHD 和中风的个体中，确定了五种抑郁症状轨迹：无抑郁（36.7%）、轻度（48.8%）、恶化（7.8%）、改善（4.1%）和持续（2.7%）。与无抑郁组相比，轻度、恶化和持续抑郁症状的参与者发生痴呆的风险显著增加（多变量调整后的风险比和 95%置信区间：1.32[1.17-1.48]、1.58[1.30-1.93]、2.82[2.17-3.67]）、冠心病（1.13[1.03-1.24]、1.47[1.25-1.73]、1.34[1.03-1.74]）、中风（1.30[1.12-1.52]、1.58[1.23-2.04]、1.71[1.16-2.53]）和全因死亡率（1.17[1.07-1.27]、1.46[1.27-1.68]、1.66[1.35-2.06]）。改善抑郁症状的个体发生上述事件的风险虽不显著，但除冠心病外，其他风险均不显著增加。
本研究结果表明，即使是亚临床阈值的抑郁症状也与与年龄相关疾病的发病风险相关，而管理性抑郁症状与这些关联不显著。
