年轻时抑郁,到了老年更易痴呆
学术经纬
2021/10/09
论文
论文标题:Depressive Symptoms Imputed Across the Life Course Are Associated with Cognitive Impairment and Cognitive Decline
作者:Brenowitz, Willa D., Zeki Al Hazzouri, Adina, Vittinghoff, Eric, Golden, Sherita H., Fitzpatrick, Annette L., Yaffe, Kristine
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期刊:Journal of Alzheimer's Disease
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日期:2021-09-28
数字识别码:10.3233/JAD-210588
摘要:Abstract: Background:Depressive symptoms may increase risk for dementia, but findings are controversial because late-life depression may be a prodromal dementia symptom. Life course data on depression and dementia risk may clarify this association; however, data is limited. Objective:To impute adult depressive symptoms trajectories across adult life stages and estimate the association with cognitive impairment and decline. Methods:Using a pooled study of 4 prospective cohorts (ages 20–89), we imputed adult life course depressive symptoms trajectories based on Center for Epidemiologic Studies Depression Scale-10 (CESD-10) and calculated time-weighted averages for early adulthood (ages 20–49), mid-life (ages 50–69), and late-life (ages 70–89) for 6,122 older participants. Adjusted pooled logistic and mixed-effects models estimated associations of imputed depressive symptoms with two cognitive outcomes: cognitive impairment defined by established criteria and a composite cognitive score. Results:In separate models, elevated depressive symptoms in each life stage were associated with cognitive outcomes: early adulthood OR for cognitive impairment = 1.59 (95%CI: 1.35,1.87); mid-life OR = 1.94 (95%CI:1.16, 3.26); and late-life OR = 1.77 (95%CI:1.42, 2.21). When adjusted for depressive symptoms in the other life-stages, elevated depressive symptoms in early adulthood (OR = 1.73; 95%CI: 1.42,2.11) and late-life (OR = 1.43; 95%CI: 1.08,1.89) remained associated with cognitive impairment and were also associated with faster rates of cognitive decline (p < 0.05). Conclusion:Imputing depressive symptom trajectories from pooled cohorts may help expand data across the life course. Our findings suggest early adulthood depressive symptoms may be a risk factor for cognitive impairment independent of mid- or late-life depressive symptoms.
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所属学科:认知科学神经科学医学生物
药明康德内容团队编辑
来自学业、工作、社交、家庭等各方面的压力,可能让不少年轻人不知不觉产生了抑郁症状。根据一项新的研究结果,科学家提醒年轻人不可忽视心理健康,因为这可能对后半生有着深远的影响。
加州大学旧金山分校(UCSF)的研究人员发现,青年时期抑郁可能加快认知衰退的速度,增加日后老年痴呆的风险。这项研究近日发表在专业学术期刊Journal of Alzheimer’s Disease上。
研究人员汇总了来自4个队列15000多名成年人的健康数据,根据筛查抑郁症的量表工具,采用创新的统计方法估算出了抑郁症状在青年(20~49岁)、中年(50~60岁)、老年(70~89岁)三个人生阶段的平均发展轨迹。随后,应用预测轨迹,结合其中6000多名老年参与者的认知能力评分,研究人员分析了抑郁症状发展轨迹与大脑认知功能衰退之间的关系。
总的来说,抑郁症状越严重的人,认知能力越低,认知衰退速度越快。但他们发现,其中在青年时期就有中重度抑郁症状的人,老年时认知障碍的发生概率提高了73%,比那些到老年后患抑郁症的人发生认知障碍的可能性更高。
“青年时期有中度或高度抑郁症状的人,认知能力在十年后下降了。”研究人员指出。
图片来源:123RF
抑郁为何会增加痴呆症的风险,对此研究论文的第一作者Willa Brenowitz博士分析可能有几种机制,比如相关激素对大脑的损伤。“一种机制是,大脑负责应激反应的系统过度活跃,增加了应激激素糖皮质激素的产生,导致大脑海马体受损,而海马体是形成记忆和储存记忆必不可缺的一部分。”她说。
这项研究的通讯作者Kristine Yaffe教授补充说,在数据统计过程中他们发现,13%的青年人、26%的中年人和大约1/3的老年人有中度到重度的抑郁症状,因此认识到抑郁症在认知衰退中的作用非常重要。
她认为:“是否可以在青年时期就识别出抑郁症并进行治疗,从而改善大脑衰老的后果,比如预防阿尔茨海默病或其他失智症,这是一个非常关键的问题。” 研究人员相信,如果可以尽早预防,这将改变人生。
参考资料
[1] Happiness in Early Adulthood May Protect Against Dementia. Retrieved Sep. 30, 2021 from
https://www.ucsf.edu/news/2021/09/421506/happiness-early-adulthood-may-protect-against-dementia[2] Willa D Brenowitz et al., (2021) Depressive Symptoms Imputed Across the Life Course Are Associated with Cognitive Impairment and Cognitive Decline. DOI: 10.3233/JAD-210588
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文章标签心理健康抑郁老年痴呆认知衰退Cognitive impairmentdementiadepressionimputationlife course认知障碍痴呆归责生命历程阿尔茨海默病
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Journal of Alzheimer's Disease
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Depressive Symptoms Imputed Across the Life Course Are Associated with
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