BJPsych：老年抑郁增加痴呆事件发生风险

　　近期，《英国精神病学杂志》网络版刊登的一项系统回顾和荟萃分析的结果显示，老年抑郁与全因痴呆、血管性痴呆及阿尔兹海默氏病的发病风险增高有关。以目前的结果来看，设计相关的临床试验，研究老年抑郁的预防对降低痴呆，特别是血管性痴呆及阿尔兹海默氏病发病风险的影响是十分有价值的。

　　目前，医学界普遍认为老年抑郁或许会增加痴呆事件，特别是阿尔兹海默氏病及血管性痴呆的发病风险。本研究由23项以社区人群为基础的前瞻性队列试验组成，采用随机效应模型及一般反向方差分析法，评价老年抑郁症患者合并痴呆、阿尔兹海默氏病及血管性痴呆的风险。

　　结果发现，老年抑郁与全因痴呆（1.85, 95% CI 1.67-2.04, P<0.001），阿尔兹海默氏病 (1.65, 95% CI 1.42-1.92, P<0.001)及血管性痴呆(2.52, 95% CI 1.77-3.59, P<0.001)发病风险的显著增高有关。对其中的5项试验进行亚组分析发现，老年抑郁患者血管性痴呆的发病风险显著高于阿尔兹海默氏病的发病风险（P=0.03）。

与痴呆相关的拓展阅读：

• PLoS ONE：胆固醇诱发老年性痴呆症和心脏病的作用机制
• Aging Cell：研究发现糖尿病与​​老年痴呆症发病相关
• Neurology：Framingham评分更能预测痴呆？
• AAN 2013：新型运动方式改善痴呆患者功能
• 荟萃分析：脑蛋白水解物对血管性痴呆可能有益 更多信息请点击：有关痴呆更多资讯

Late-life depression and risk of vascular dementia and Alzheimer’s disease: systematic review and meta-analysis of community-based cohort studies
Background
Late-life depression may increase the risk of incident dementia, in particular of Alzheimer’s disease and vascular dementia.
Aims
To conduct a systematic review and meta-analysis to evaluate the risk of incident all-cause dementia, Alzheimer’s disease and vascular dementia in individuals with late-life depression in population-based prospective studies.
Method
A total of 23 studies were included in the meta-analysis. We used the generic inverse variance method with a random-effects model to calculate the pooled risk of dementia, Alzheimer’s disease and vascular dementia in older adults with late-life depression.
Results
Late-life depression was associated with a significant risk of all-cause dementia (1.85, 95% CI 1.67-2.04, P<0.001), Alzheimer’s disease (1.65, 95% CI 1.42-1.92, P<0.001) and vascular dementia (2.52, 95% CI 1.77-3.59, P<0.001). Subgroup analysis, based on five studies, showed that the risk of vascular dementia was significantly higher than for Alzheimer’s disease (P = 0.03).
Conclusions
Late-life depression is associated with an increased risk for all-cause dementia, vascular dementia and Alzheimer’s disease. The present results suggest that it will be valuable to design clinical trials to investigate the effect of late-life depression prevention on risk of dementia, in particular vascular dementia and Alzheimer’s disease.