如皋衰老队列中抑郁症状与认知功能受损的关联分析

Association between depression symptoms and cognition impairment in Rugao Longevity and Ageing Study

目的在中国人群中探究老年人抑郁症状与认知功能受损的关系。方法纳入如皋衰老队列中认知和抑郁数据完整的1 526名老年参与者,收集其人口学数据。采用老年抑郁量表(GDS)-15测评抑郁症状,采用简易智能精神状态检查量表(MMSE)评价认知功能。采用线性回归对GDS-15评分与MMSE评分进行相关性分析。根据受教育程度将入组人群进一步分为文盲组、小学组和中学组,采用logistic回归计算总体和不同教育程度患者抑郁症状对认知功能受损的OR值及其95%CI。以年龄、性别、婚姻状况、受教育程度、职业、吸烟情况、饮酒情况、自报健康状况作为协变量,对各模型进行校正。结果在原始模型中,GDS-15评分与MMSE评分显著相关(β=-0.67,P<0.001),抑郁症状越重,认知能力越差;在校正各协变量以后,差异仍均有统计学意义(P值均<0.001)。logistics回归分析发现,有抑郁症状的老年人认知功能受损的风险更高(OR=2.20,95%CI为1.67~2.93,P<0.001)。进一步按照受教育程度分组进行分析发现,文盲组(OR=2.22, 95%CI为1.45~3.48,P<0.001)和小学组(OR=1.83, 95%CI为1.08~3.07,P=0.024)中有抑郁症状的老年人认知功能受损的风险更高。在校正各协变量后,以上结果仍保持一致。结论抑郁症状显著增加老年人认知功能受损的风险,对老年人抑郁症状的干预可能有助于预防和减缓老年人认知功能下降的症状。

Objective To explore the relationship between depressive symptoms and cognition impairment in the elderly in China.Methods Demographic data of 1 526 older people from the Rugao Longevity and Ageing Study(RuLAS)were collected.Geriatric Depression Scale(GDS)-15 was used to access depressive symptoms.Mini-mental state examination(MMSE)was used to evaluate the cognitive ability.Linear regression was applied to analyze the relationship between GDS scores and MMSE score.Moreover,based on the grouping of education levels,logistic regression was used to calculate the odds ratios(OR)of depressive symptoms to cognition impairment.All the results were adjusted by adding demographic covariates,such as age,sex,marital status,education,occupation,smoking,tobacco,and physical condition.Results In the crude model,GDS-15 scores were significantly associated with MMSE scores(β=-0.67,P<0.001),indicating that the worse depressive symptoms,the poorer the cognitive function.The result was consistent after adjusting the covariates(P<0.001).Logistic regression analysis showed that older adults with depressive symptoms had a high risk of cognition impairment(OR=2.20,95%CI:1.67-2.93,P<0.001).In the crude model,depressive symptoms in older adults in the illiterate group(OR=2.22,95%CI:1.45-3.48,P<0.001)and primary school group(OR=1.83,95%CI:1.08-3.07,P=0.024)significantly increased the risk of cognition impairment.These results did not change after adjusting covariates.Conclusion Depression symptoms significantly increase the risk of cognition impairment in the elderly.Clinical interventions of depressive symptoms may help to prevent and ameliorate the symptoms of cognitive decline in the elderly.(Shanghai Med J,2019,42:291-295)