Abstract：
BACKGROUND: The association between depression and dementia is still unclear, particularly regarding depression as a potential risk factor preceding dementia. Therefore, we aimed to verify if the presence of depression at baseline may increase the risk of dementia and cognitive impairment during 15 years of follow-up in the SHARE (Survey of Health, Aging and Retirement in Europe) study.
METHODS: Depressive symptoms were defined using the EURO-D, with a score ≥4 indicative of depression. Incident dementia was ascertained using self-reported data and caregivers\' information, cognitive impairment using objective cognitive tests. Cox regression analysis, adjusted for 10 baseline confounders, was run and hazard ratios (HRs), with their 95% confidence intervals, were estimated.
RESULTS: In total 22,789 participants were included in the present analysis (mean age 64.2 years) and were predominantly female. The prevalence of depression at baseline was 24.9%. Over 15 years of follow-up, the onset of dementia occurred a median 2 years earlier in people with depression compared to those without. Depression at the baseline significantly increased the risk of dementia in the overall sample (HR = 1.74; 95% CI: 1.54-1.95) and the risk of cognitive impairment (HR = 1.15; 95% CI: 1.06-1.25). For dementia, the association was stronger in people less than 60 years (HR = 2.07; 95% CI: 1.42-3.02) than in participants aged ≥80 years (HR = 1.47; 95% CI: 1.14-1.91). A similar trend was observed for cognitive impairment. Among the single items of the EURO-D, loss of concentration was the strongest individual variable predicting the onset of dementia.
CONCLUSIONS: Depression increased the risk of dementia and cognitive impairment, particularly in younger adults, whereas loss of concentration was the strongest individual predicting variable of dementia. These findings demonstrate the need for early detection of depression for preventing future cognitive worsening.
METHODS: Depressive symptoms were defined using the EURO-D, with a score ≥4 indicative of depression. Incident dementia was ascertained using self-reported data and caregivers\' information, cognitive impairment using objective cognitive tests. Cox regression analysis, adjusted for 10 baseline confounders, was run and hazard ratios (HRs), with their 95% confidence intervals, were estimated.
RESULTS: In total 22,789 participants were included in the present analysis (mean age 64.2 years) and were predominantly female. The prevalence of depression at baseline was 24.9%. Over 15 years of follow-up, the onset of dementia occurred a median 2 years earlier in people with depression compared to those without. Depression at the baseline significantly increased the risk of dementia in the overall sample (HR = 1.74; 95% CI: 1.54-1.95) and the risk of cognitive impairment (HR = 1.15; 95% CI: 1.06-1.25). For dementia, the association was stronger in people less than 60 years (HR = 2.07; 95% CI: 1.42-3.02) than in participants aged ≥80 years (HR = 1.47; 95% CI: 1.14-1.91). A similar trend was observed for cognitive impairment. Among the single items of the EURO-D, loss of concentration was the strongest individual variable predicting the onset of dementia.
CONCLUSIONS: Depression increased the risk of dementia and cognitive impairment, particularly in younger adults, whereas loss of concentration was the strongest individual predicting variable of dementia. These findings demonstrate the need for early detection of depression for preventing future cognitive worsening.
摘要：
背景：抑郁症和痴呆之间的关系尚不清楚，特别是关于抑郁症作为痴呆之前的潜在危险因素。因此,我们的目的是验证在15年的随访期间，基线时抑郁症的存在是否会增加痴呆和认知障碍的风险（健康调查，欧洲的老龄化和退休)研究。
方法：使用EURO-D定义抑郁症状，评分≥4表示抑郁。使用自我报告的数据和护理人员的信息来确定痴呆事件，使用客观认知测验的认知障碍。Cox回归分析，调整了10个基线混杂因素，运行率和危险比(HR)，他们95%的置信区间，估计。
结果：共有22,789名参与者被纳入本分析（平均年龄64.2岁），主要是女性。基线时抑郁症的患病率为24.9%。经过15年的随访，与无抑郁症患者相比,抑郁症患者的痴呆发病时间平均早2年.基线抑郁显著增加了总体样本中痴呆的风险(HR=1.74;95%CI:1.54-1.95)和认知障碍的风险(HR=1.15;95%CI:1.06-1.25)。对于痴呆症，与年龄≥80岁的参与者(HR=1.47;95%CI:1.14~1.91)相比,60岁以下人群(HR=2.07;95%CI:1.42~3.02)的关联性更强.对于认知障碍观察到类似的趋势。在EURO-D的单个项目中，注意力丧失是预测痴呆发作的最强个体变量.
结论：抑郁症增加了痴呆和认知障碍的风险，特别是在年轻人中，而浓度下降是预测痴呆变量的最强个体。这些发现表明需要早期发现抑郁症以防止未来的认知恶化。
方法：使用EURO-D定义抑郁症状，评分≥4表示抑郁。使用自我报告的数据和护理人员的信息来确定痴呆事件，使用客观认知测验的认知障碍。Cox回归分析，调整了10个基线混杂因素，运行率和危险比(HR)，他们95%的置信区间，估计。
结果：共有22,789名参与者被纳入本分析（平均年龄64.2岁），主要是女性。基线时抑郁症的患病率为24.9%。经过15年的随访，与无抑郁症患者相比,抑郁症患者的痴呆发病时间平均早2年.基线抑郁显著增加了总体样本中痴呆的风险(HR=1.74;95%CI:1.54-1.95)和认知障碍的风险(HR=1.15;95%CI:1.06-1.25)。对于痴呆症，与年龄≥80岁的参与者(HR=1.47;95%CI:1.14~1.91)相比,60岁以下人群(HR=2.07;95%CI:1.42~3.02)的关联性更强.对于认知障碍观察到类似的趋势。在EURO-D的单个项目中，注意力丧失是预测痴呆发作的最强个体变量.
结论：抑郁症增加了痴呆和认知障碍的风险，特别是在年轻人中，而浓度下降是预测痴呆变量的最强个体。这些发现表明需要早期发现抑郁症以防止未来的认知恶化。
