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疼痛与抑郁症状并存是否会加速认知衰退?

Does the coexistence of pain and depressive symptoms accelerate cognitive decline?

作者信息

Tofani Patrícia Silva, Máximo Roberta de Oliveira, Cochar-Soares Natália, Ramírez Paula Camila, Luiz Mariane Marques, Lima Sara Souza, Silva Thaís Barros Pereira da, Souza Thales Batista de, Silveira Letícia Coelho, Guandalini Valdete Regina, Steptoe Andrew, de Oliveira Cesar, Alexandre Tiago da Silva

机构信息

Department of Physiotherapy, Federal University of Sergipe, Lagarto, Brazil.

Postgraduate Program in Gerontology, Federal University of São Carlos, São Carlos, Brazil.

出版信息

Aging Ment Health. 2025 Feb;29(2):334-342. doi: 10.1080/13607863.2024.2392737. Epub 2024 Aug 19.

Abstract

OBJECTIVES

Investigate whether the coexistence of pain and depressive symptoms is a risk factor for cognitive decline in individuals aged 50 or older.

METHOD

Longitudinal trajectory study involving 4,718 participants from the English Longitudinal Study of Ageing (ELSA). Joint pain was self-reported, and intensity was classified as mild, moderate/intense. Depressive symptoms were investigated using the Centre for Epidemiologic Studies Depression Scale ( ≥ 4). The sample was divided into six groups: no pain and no depression (NP/NDe), mild pain and no depression (MP/NDe), moderate/intense pain and no depression (M-IP/NDe), no pain and depression (NP/De), mild pain and depression (MP/De), and moderate/intense pain and depression (M-IP/De). The outcome of interest was performance in memory, executive function, and global cognition. Generalised linear mixed models were used to analyse performance in the cognitive domains and global cognition score as a function of pain and depressive symptoms during 12 years of follow-up.

RESULTS

Over time, individuals with M-IP/De had a greater memory decline (-0.038 SD/year, 95%CI: -0.068 to -0.007) and the global cognition score (-0.033 SD/year, 95%CI: -0.063 to -0.002) than those with NP/NDe.

CONCLUSION

The coexistence of moderate/intense pain and depressive symptoms is a risk factor for the decline of global cognition and memory.

摘要

目的

调查疼痛与抑郁症状并存是否是50岁及以上个体认知衰退的危险因素。

方法

纵向轨迹研究,涉及来自英国老龄化纵向研究(ELSA)的4718名参与者。关节疼痛通过自我报告,强度分为轻度、中度/重度。使用流行病学研究中心抑郁量表(≥4)调查抑郁症状。样本分为六组:无疼痛且无抑郁(NP/NDe)、轻度疼痛且无抑郁(MP/NDe)、中度/重度疼痛且无抑郁(M-IP/NDe)、无疼痛且有抑郁(NP/De)、轻度疼痛且有抑郁(MP/De)、中度/重度疼痛且有抑郁(M-IP/De)。感兴趣的结果是记忆、执行功能和整体认知方面的表现。使用广义线性混合模型分析随访12年期间认知领域的表现和整体认知得分与疼痛和抑郁症状的关系。

结果

随着时间推移,与NP/NDe组相比,M-IP/De组个体的记忆衰退更大(-0.038标准差/年,95%置信区间:-0.068至-0.007),整体认知得分也更低(-0.033标准差/年,95%置信区间:-0.063至-0.002)。

结论

中度/重度疼痛与抑郁症状并存是整体认知和记忆衰退的危险因素。

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