Associations between depression and anxiety in midlife and dementia more than 30 years later: The HUNT Study.

IF 4 Q1 CLINICAL NEUROLOGY
Ragnhild Holmberg Aunsmo, Bjørn Heine Strand, Kaarin J Anstey, Sverre Bergh, Mika Kivimäki, Sebastian Köhler, Steinar Krokstad, Gill Livingston, Fiona E Matthews, Geir Selbæk
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引用次数: 0

Abstract

Introduction: It is unclear how midlife depression and anxiety affect dementia risk. We examined this in a Norwegian cohort followed for 30 years.

Methods: Dementia status at age 70+ in the fourth wave of the Trøndelag Health Study (HUNT4, 2017-2019, N = 9745) was linked with anxiety and depression from HUNT1 (1984-1985), HUNT2 (1995-1997), HUNT3 (2006-2008), and HUNT4. Longitudinal anxiety and depression score, and prevalence trajectories during 1984-2019 by dementia status at HUNT4 were fitted using mixed effects regression adjusting for age, sex, education, and lifestyle and health factors.

Results: Dementia at HUNT4 was associated with higher case prevalence at all waves, from 1.9 percentage points (pp) (95% CI: 0.1-3.7) higher at HUNT1 to 7.6 pp (95% CI: 5.7-9.6) higher at HUNT4.

Discussion: Our findings show that depression and anxiety was more common more than 30 years before dementia onset in those who later developed dementia.

Highlights: Older individuals with dementia had a higher prevalence of mixed anxiety- and depressive symptoms (A + D), both concurrently with and more than three decades prior to their dementia diagnosis.Older individuals with dementia had higher levels of anxiety, both concurrently and up to two decades prior to their dementia diagnosis.Depressive symptoms increased by time among those who developed dementia, but not among others.Results were similar for all cause dementia, Alzheimer's disease, and other types of dementia; however, for vascular dementia, the difference was not significant until dementia was present.

亨特研究:中年抑郁和焦虑与30多年后痴呆之间的关系。
目前尚不清楚中年抑郁和焦虑如何影响痴呆风险。我们对一个挪威队列进行了30年的研究。方法:在Trøndelag健康研究(HUNT4, 2017-2019, N = 9745)的第四波中,70岁以上的痴呆状态与HUNT1(1984-1985)、HUNT2(1995-1997)、HUNT3(2006-2008)和HUNT4的焦虑和抑郁有关。采用混合效应回归对年龄、性别、教育、生活方式和健康因素进行调整,拟合HUNT4中纵向焦虑和抑郁评分以及1984-2019年痴呆状态的患病率轨迹。结果:HUNT4痴呆与所有波较高的病例患病率相关,从HUNT1高1.9个百分点(95% CI: 0.1-3.7)到HUNT4高7.6个百分点(95% CI: 5.7-9.6)。讨论:我们的研究结果表明,在那些后来发展为痴呆症的人发病前30多年,抑郁和焦虑更为常见。重点:老年痴呆症患者的焦虑和抑郁混合症状(a + D)患病率更高,这两种症状与痴呆症诊断同时发生或在其诊断前30多年发生。老年痴呆症患者的焦虑水平更高,在他们被诊断为痴呆症之前的20年里都是如此。在痴呆患者中,抑郁症状随着时间的推移而加重,而在其他人群中则没有。全因痴呆、阿尔茨海默病和其他类型痴呆的结果相似;然而,对于血管性痴呆,这种差异在痴呆出现之前并不显著。
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来源期刊
CiteScore
7.80
自引率
7.50%
发文量
101
审稿时长
8 weeks
期刊介绍: Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.
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