老年糖尿病共患抑郁障碍

Depression among older adults with diabetes mellitus

目的 系统综述国内外老年糖尿病共患抑郁障碍的流行病学资料、危险因素、可能机制、治疗干预等,为今后该病的早期诊断、病情评估、治疗提供新思路.方法 通过系统检索CBM、CNKI、VIP、万方、PubMed、EMBASE、Cochrane图书馆,纳入2000～2015年有关老年糖尿病共患抑郁障碍的文献41篇.结果 老年糖尿病共患抑郁障碍的发病率高,症状不典型,病理机制复杂,较少引起患者和医务人员的重视,对患者的预后影响大,早期预防和治疗有效.结论 老年糖尿病和抑郁常共病,两者对预后有负性协同效应,已引起人们重视.但有关二者的回顾性调查研究较多,前瞻性研究较少,尤其是随机双盲对照研究更少,应进一步从多角度加强该病的研究,从而提高该病的病因、诊断、治疗、预后水平.

Objective Systematic review of the epidemiology,risk factors,possible mechanisms and treatment of the depression among older adults with diabetes mellitus,and to provide new ideas for the early diagnosis,evaluation and treatment of the disease in the future.Methods Forty-one studies from 2000 to 2015 were identified manualy and online by using CBM,CNKI,VIP,Wanfang databases,PubMed,EMBASE and the Cochrane library.Results Among older adults with DM,depression was highly prevalent,and their clinical manifestations were not typical.The mechanisms of depression was not entirely clear and it less likely to cause the attention of patients and medical staff and it seriously affected the prognosis of diabetic patients.Early prevention and treatment were effective.Conclusion Diabetes mellitus and depression are frequently comorbid in older adult patients.Considering the negative synergistic effects on the health outcomes resulted by comorbid depression and DM.There are a lot of researches about the two disease＇s retrospective study,but the prospective study is less,especially the ran-domized double blind controlled study.Further study should be strengthened to improve the etiology,diagnosis,treatment and prognosis of the disease.