PDF(Pubmed)
Abstract：
Chronic stress and depression are potential risk factors for mild cognitive impairment and dementia, including Alzheimer disease. The aim was to investigate whether any such risk is additive.
Cohort study including 1 362 548 people (665 997 women, 696 551 men) with records in the Region Stockholm administrative healthcare database (VAL). Exposure was a recorded ICD-10 diagnosis of chronic stress, depression, or both, recorded in 2012 or 2013. Outcome was a diagnosis of Alzheimer disease, other dementia, or mild cognitive impairment recorded from 2014 through 2022. Odds ratios with 99% confidence intervals (CI) adjusted for age, sex, neighborhood socioeconomic status, diabetes, and cardiovascular disorders were calculated.
During the exposure period, 4 346 patients were diagnosed with chronic stress, 40 101 with depression, and 1 898 with both. The average age at baseline was around 40 years in all groups. In the fully adjusted model, the odds ratio of Alzheimer disease was 2.45 (99% CI 1.22-4.91) in patients with chronic stress, 2.32 (99% CI 1.85-2.90) in patients with depression, and 4.00 (99% CI 1.67-9.58) in patients with chronic stress and depression. The odds ratio of mild cognitive impairment was 1.87 (99% CI 1.20-2.91) in patients with chronic stress, 2.85 (99% CI 2.53-3.22) in patients with depression, and 3.87 (99% CI 2.39-6.27) in patients with both. When other dementia was analyzed, the odds ratio was significant only in patients with depression, 2.39 (99% CI 1.92-2.96).
Documented chronic stress increased the risk of mild cognitive impairment and Alzheimer disease. The same was seen with depression. The novel finding is the potential additive effect of chronic stress to depression, on risk of MCI and AD.
Cohort study including 1 362 548 people (665 997 women, 696 551 men) with records in the Region Stockholm administrative healthcare database (VAL). Exposure was a recorded ICD-10 diagnosis of chronic stress, depression, or both, recorded in 2012 or 2013. Outcome was a diagnosis of Alzheimer disease, other dementia, or mild cognitive impairment recorded from 2014 through 2022. Odds ratios with 99% confidence intervals (CI) adjusted for age, sex, neighborhood socioeconomic status, diabetes, and cardiovascular disorders were calculated.
During the exposure period, 4 346 patients were diagnosed with chronic stress, 40 101 with depression, and 1 898 with both. The average age at baseline was around 40 years in all groups. In the fully adjusted model, the odds ratio of Alzheimer disease was 2.45 (99% CI 1.22-4.91) in patients with chronic stress, 2.32 (99% CI 1.85-2.90) in patients with depression, and 4.00 (99% CI 1.67-9.58) in patients with chronic stress and depression. The odds ratio of mild cognitive impairment was 1.87 (99% CI 1.20-2.91) in patients with chronic stress, 2.85 (99% CI 2.53-3.22) in patients with depression, and 3.87 (99% CI 2.39-6.27) in patients with both. When other dementia was analyzed, the odds ratio was significant only in patients with depression, 2.39 (99% CI 1.92-2.96).
Documented chronic stress increased the risk of mild cognitive impairment and Alzheimer disease. The same was seen with depression. The novel finding is the potential additive effect of chronic stress to depression, on risk of MCI and AD.
摘要：
背景：慢性应激和抑郁是轻度认知障碍和痴呆的潜在危险因素，包括阿尔茨海默病。目的是调查是否有任何此类风险是累加的。
方法：队列研究包括1.362.548人（665997名女性，696.551名男性），记录在斯德哥尔摩地区行政医疗数据库（VAL）中。暴露是记录的ICD-10慢性应激的诊断，抑郁症,或者两者兼而有之,记录在2012年或2013年。结果是阿尔茨海默病的诊断，其他痴呆症,或从2014年到2022年记录的轻度认知障碍。根据年龄调整的99%置信区间(CI)的赔率，性别,邻里社会经济地位，糖尿病,并计算了心血管疾病。
结果：在暴露期间，4.346例患者被诊断为慢性应激，40.101患有抑郁症，两者都有1.898。所有组的基线平均年龄约为40岁。在完全调整的模型中，慢性应激患者患阿尔茨海默病的比值比为2.45（99%CI1.22-4.91），抑郁症患者的2.32（99%CI1.85-2.90），和4.00（99%CI1.67-9.58）在慢性应激和抑郁症患者。慢性应激患者轻度认知障碍的比值比为1.87(99%CI1.20-2.91),抑郁症患者的2.85（99%CI2.53-3.22），和3.87（99%CI2.39-6.27）的患者。当分析其他痴呆症时，比值比仅在抑郁症患者中显著，2.39（99%CI1.92-2.96）。
结论：记录的慢性应激增加了轻度认知障碍和阿尔茨海默病的风险。抑郁症也是如此。新发现是慢性压力对抑郁症的潜在累加效应，MCI和AD的风险。
方法：队列研究包括1.362.548人（665997名女性，696.551名男性），记录在斯德哥尔摩地区行政医疗数据库（VAL）中。暴露是记录的ICD-10慢性应激的诊断，抑郁症,或者两者兼而有之,记录在2012年或2013年。结果是阿尔茨海默病的诊断，其他痴呆症,或从2014年到2022年记录的轻度认知障碍。根据年龄调整的99%置信区间(CI)的赔率，性别,邻里社会经济地位，糖尿病,并计算了心血管疾病。
结果：在暴露期间，4.346例患者被诊断为慢性应激，40.101患有抑郁症，两者都有1.898。所有组的基线平均年龄约为40岁。在完全调整的模型中，慢性应激患者患阿尔茨海默病的比值比为2.45（99%CI1.22-4.91），抑郁症患者的2.32（99%CI1.85-2.90），和4.00（99%CI1.67-9.58）在慢性应激和抑郁症患者。慢性应激患者轻度认知障碍的比值比为1.87(99%CI1.20-2.91),抑郁症患者的2.85（99%CI2.53-3.22），和3.87（99%CI2.39-6.27）的患者。当分析其他痴呆症时，比值比仅在抑郁症患者中显著，2.39（99%CI1.92-2.96）。
结论：记录的慢性应激增加了轻度认知障碍和阿尔茨海默病的风险。抑郁症也是如此。新发现是慢性压力对抑郁症的潜在累加效应，MCI和AD的风险。
