晚发性抑郁的生物学机制

Biological Mechanism of Late-onset Depression and Clinical Strategy

晚发性抑郁是指发病年龄大于60岁的一组抑郁综合征,发病机制至今尚不明确。研究表明,晚发性抑郁的遗传因素不明显,而血管损害则与之密切相关;多数患者伴有明显的执行功能损害,痴呆的发病风险增高。围绕晚发性抑郁的两个基本特征:血管损害与认知障碍做一回顾,初步探讨了晚发性抑郁生物学机制对临床决策的影响,并由此展望了未来的研究方向。

Late-onset depression（LOD） is known as a depressive syndrome that occurs more than sixty years old. Genetic factors are generally thought to be of less significance in late-onset depressed patients, and subjects with LOD show a stronger relationship with vascular disease. Executive dysfunction is common in LOD with a increasing risk of dementia. Vascular impairment and cognitive dysfunction, two pivotal factors involved in LOD, are reviewed in this article. Furthermore, we discussed how the biological mechanisms affect clinical decision-making of LOD, and made a prospective view of research direction.