The trajectory of depressive symptoms over time and the presence of depressive symptoms at a single time point with the risk of dementia among US older adults: A national prospective cohort study.

IF 5 3区 医学 Q1 CLINICAL NEUROLOGY
Psychiatry and Clinical Neurosciences Pub Date : 2024-03-01 Epub Date: 2023-12-07 DOI:10.1111/pcn.13620
Min Du, Min Liu, Jue Liu
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引用次数: 0

Abstract

Aim: This study aims to assess the association between trajectories of depressive symptoms and the risk of dementia, and to compare the predictive ability of trajectories using multiple data points with depressive symptoms at a single data point.

Methods: We included 5306 older adults from the Health and Retirement Study. We assessed depressive symptoms using the Center for Epidemiology Depression Scale (CES-D), and identified its 8- year trajectories (2002-2010) using latent class trajectory modeling. We calculated hazard ratios (HR) using Cox proportional hazards models. The concordance index (C-index) was used to compare the discriminative power of the models.

Results: We identified two trajectories of depressive symptoms, characterized by maintaining low CES-D scores, and moderate starting scores that steadily increased throughout the follow-up period. During 40,199 person-years, compared to the low trajectory, the increasing trajectory of depressive symptoms was associated with a higher risk of dementia (HR = 1.35; 95% CI: 1.09-1.67) (C-index = 0.759). For every point increase in the degree of depressive symptoms (CES-D scores) in 2010, the risk of dementia increased by 7% (95% CI: 1.03-1.12) (C-index = 0.760). The presence of depressive symptoms (CES-D scores ≥3) in 2010 was not associated with an increased risk of dementia (HR = 1.18; 95% CI: 0.98-1.43) (C-index = 0.759). The C-index values of cox models showed similar discriminative power.

Conclusions: The increasing trajectory of depressive symptoms at multiple data points and the degree of depressive symptoms at a single data point were associated with an increased risk of subsequent dementia among older adults.

美国老年人抑郁症状随时间的发展轨迹以及抑郁症状在单一时间点与痴呆风险的关系:一项全国前瞻性队列研究
目的:本研究旨在评估抑郁症状轨迹与痴呆风险之间的关联,并比较多数据点轨迹与单数据点抑郁症状的预测能力。方法:我们纳入了来自健康与退休研究的5306名老年人。我们使用流行病学中心抑郁量表(CES-D)评估抑郁症状,并使用潜在类别轨迹模型确定其8年轨迹(2002-2010)。使用Cox比例风险模型计算风险比(HR)。采用一致性指数(C-index)比较模型的判别能力。结果:我们确定了两种抑郁症状轨迹,其特征是维持较低的CES-D评分,以及在整个随访期间稳步增加的中等起始评分。在40199人年期间,与低轨迹相比,抑郁症状的增加轨迹与痴呆的高风险相关(HR=1.35;95% CI: 1.09-1.67) (C-index=0.759)。2010年,抑郁症状程度(CES-D评分)每增加1分,痴呆的风险增加7% (95% CI: 1.03-1.12) (C-index=0.760)。2010年抑郁症状(CES-D评分≥3)的存在与痴呆风险增加无关(HR=1.08;95% CI: 0.98-1.43) (C-index=0.759)。cox模型的c指数值具有相似的判别能力。结论:在多个数据点上抑郁症状的增加轨迹和在单个数据点上抑郁症状的程度与老年人随后发生痴呆的风险增加相关。这篇文章受版权保护。版权所有。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.40
自引率
4.20%
发文量
181
审稿时长
6-12 weeks
期刊介绍: PCN (Psychiatry and Clinical Neurosciences) Publication Frequency: Published 12 online issues a year by JSPN Content Categories: Review Articles Regular Articles Letters to the Editor Peer Review Process: All manuscripts undergo peer review by anonymous reviewers, an Editorial Board Member, and the Editor Publication Criteria: Manuscripts are accepted based on quality, originality, and significance to the readership Authors must confirm that the manuscript has not been published or submitted elsewhere and has been approved by each author
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