Modifiable Risk Factors Associated With Cognitive Decline in Late Life Depression: Findings From the Canadian Longitudinal Study on Aging: Facteurs de risque modifiables associés au déclin cognitif dans la dépression en fin de vie : constatations de l'Étude longitudinale canadienne sur le vieillissement.

IF 3.3 3区 医学 Q2 PSYCHIATRY
Melissa Wong, Alex Kiss, Nathan Herrmann, Krista L Lanctôt, Damien Gallagher
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引用次数: 0

Abstract

Objective: Depression in later life is associated with a two-fold increased risk of dementia. It is not clear to what extent potentially modifiable risk factors account for this association.

Method: Older adults (age 50 + ) with objective health measures (n = 14,014) from the Canadian Longitudinal Study on Aging were followed for a mean duration of 35 months. Linear regression analyses were used to determine if clinically significant depression (Centre for Epidemiologic Studies Depression scale score (CESD) ≥ 10) was associated with global cognitive decline, assessed with a neuropsychological battery during follow-up, and if modifiable risk factors mediated this association.

Results: Depression was associated with an excess of risk factors for cognitive decline including: vascular disease, hypertension, diabetes, apnoea during sleep, higher body mass index, smoking, physical inactivity and lack of social participation. In regression analyses depression remained independently associated with cognitive decline over time (beta -0.060, P = 0.038) as did cerebrovascular disease (beta -0.197, P < 0.001), HbA1C (beta -0.059, P < 0.001), visual impairment (beta -0.070, P = 0.007), hearing impairment (beta -0.098, P < 0.001) and physical inactivity (beta -0.075, P = 0.014). In mediation analyses, we found that cerebrovascular disease (z = -3.525, P < 0.001), HbA1C (z = -4.976, P < 0.001) and physical inactivity (z = -3.998, P < 0.001) partially mediated the association between depression and cognitive decline.

Conclusions: In this large sample of Canadian older adults incorporating several objective health measures, older adults with depression were at increased risk of cognitive decline and had an excess of potentially modifiable risk factors. Clinicians should pay particular attention to control of diabetes, physical inactivity and risk factors for cerebrovascular disease in older adults presenting with depression as they can contribute to accelerated cognitive decline and may be addressed during routine clinical care.

与晚年抑郁症认知能力下降有关的可改变风险因素:加拿大老龄化纵向研究的发现。
目的:晚年抑郁与痴呆症风险增加两倍有关。目前尚不清楚潜在的可改变风险因素在多大程度上导致了这种关联:方法:对加拿大老龄化纵向研究(Canadian Longitudinal Study on Aging)中具有客观健康指标的老年人(50 岁以上)(n = 14,014 人)进行了平均为期 35 个月的跟踪调查。通过线性回归分析,确定临床上明显的抑郁症(流行病学研究中心抑郁量表评分(CESD)≥10)是否与随访期间用神经心理学电池评估的总体认知能力下降有关,以及可改变的风险因素是否介导了这种关联:抑郁症与认知能力下降的多种风险因素有关,包括:血管疾病、高血压、糖尿病、睡眠呼吸暂停、体重指数较高、吸烟、缺乏运动和缺乏社会参与。在回归分析中,随着时间的推移,抑郁症仍与认知能力下降独立相关(贝塔值-0.060,P = 0.038),脑血管疾病(贝塔值-0.197,P = 0.007)和听力障碍(贝塔值-0.098,P = 0.014)也是如此。在中介分析中,我们发现脑血管疾病(z = -3.525,P z = -4.976,P z = -3.998,P 结论)和听力障碍(z = -0.197,P P = 0.007,P P = 0.014)对老年人的心理健康有重要影响:在这一包含多种客观健康测量指标的加拿大老年人大样本中,患有抑郁症的老年人认知能力下降的风险增加,而且潜在的可改变风险因素过多。临床医生应特别注意控制患有抑郁症的老年人的糖尿病、缺乏运动和脑血管疾病的风险因素,因为这些因素可能导致认知能力加速衰退,可在常规临床护理中加以解决。
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
7.00
自引率
2.50%
发文量
69
审稿时长
6-12 weeks
期刊介绍: Established in 1956, The Canadian Journal of Psychiatry (The CJP) has been keeping psychiatrists up-to-date on the latest research for nearly 60 years. The CJP provides a forum for psychiatry and mental health professionals to share their findings with researchers and clinicians. The CJP includes peer-reviewed scientific articles analyzing ongoing developments in Canadian and international psychiatry.
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