후기 발병 우울증과 알츠하이머형 치매 발생과의 관련성
The Relationship between Late-Onset Depression and Alzheimer’s Disease
1
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
Objectives:With the elderly population rising sharply, there is a rising interest in dementia, and recently researches on risk factors for dementia, particularly of Alzheimer’s disease have been actively conducted. The purpose of this research is to examine the effect of the late-onset depression as a risk factor for Alzheimer’s disease. Methods:The subjects were divided into the group of the patients who were diagnosed with depression in the National Health Insurance Corporation Ilsan Hospital from March 1, 2000 to December 31, 2009 and the corresponding control group, which was the group of the patients who were diagnosed with osteoarthritis for the same period. Of the above patients, the following cases were excluded from the final analysis. The excluded cases were those who were first diagnosed with either of the two diseases at the age of less than 50, and those who were diagnosed with major psychiatric disorder or neurologic disorder. As a result, a total of 5,347 people, made up of 1,697 depression patients and 3,650 osteoarthritis patients, were selected. Two groups were compared through survival analysis. Results:Form the Log-Rank tests, it could be confirmed that there were significant differences (p<0.01) among the two groups. Even when many confounding factors including age and gender were controlled, the degree of occurrence of Alzheimer’s disease was found to be higher in the group of late-onset depression patients than in the group of osteoarthritis patients (HR : 2.53-2.80). Conclusion:The late-onset depression can become independently the risk factor for Alzheimer’s disease. Therefore it can be expected that the rate of occurrence of Alzheimer’s disease may be reduced through active medical treatment of depression.
Abstract
Objectives:With the elderly population rising sharply, there is a rising interest in dementia, and recently researches on risk factors for dementia, particularly of Alzheimer’s disease have been actively conducted. The purpose of this research is to examine the effect of the late-onset depression as a risk factor for Alzheimer’s disease. Methods:The subjects were divided into the group of the patients who were diagnosed with depression in the National Health Insurance Corporation Ilsan Hospital from March 1, 2000 to December 31, 2009 and the corresponding control group, which was the group of the patients who were diagnosed with osteoarthritis for the same period. Of the above patients, the following cases were excluded from the final analysis. The excluded cases were those who were first diagnosed with either of the two diseases at the age of less than 50, and those who were diagnosed with major psychiatric disorder or neurologic disorder. As a result, a total of 5,347 people, made up of 1,697 depression patients and 3,650 osteoarthritis patients, were selected. Two groups were compared through survival analysis. Results:Form the Log-Rank tests, it could be confirmed that there were significant differences (p<0.01) among the two groups. Even when many confounding factors including age and gender were controlled, the degree of occurrence of Alzheimer’s disease was found to be higher in the group of late-onset depression patients than in the group of osteoarthritis patients (HR : 2.53-2.80). Conclusion:The late-onset depression can become independently the risk factor for Alzheimer’s disease. Therefore it can be expected that the rate of occurrence of Alzheimer’s disease may be reduced through active medical treatment of depression.
참고문헌 (44)
- Kim YR, "Depression and cognitive impairment in the elderly", J Korean Geriatr Psychiatry, 11, pp.20~24 (2007)
- Berger AK, "The occurrence of depressive symptoms in the preclinical phase of AD: a population-based study", Neurology, 53, pp.1998~2002 (1999)
- Brommelhoff JA, "Depression as a risk factor or prodromal feature for dementia? Findings in a population-based sample of Swedish twins", Psychol Aging, 24, pp.373~384 (2009)
- Ownby RL, "Depression and risk for Alzheimer disease: systemic review, metaregression analysis", Arch Gen Psychiatry, 63, pp.530~538 (2006)
- Jorm AF, "Is depression a risk factor for dementia or cognitive decline", Gerontology, 46, pp.219~227 (2000)
- Espiritu DAV, "Depression, cognitive impairment and function in Alzheimer’s disease", Int J Geriatr Psychiatry, 16, pp.1098~1103 (2001)
- Speck CE, "History of depression as a risk factor for Alzheimer’s disease", Epidemiology, 6, pp.366~369 (1996)
- Buntinx F, "Is depression in elderly people followed by dementia? A retrospective cohort study based in general practice", Age Ageing, 25, pp.231~233 (1996)
- Zubenko GS, "A collaborative study of the emergence and clinical features of the major depressive syndrome of Alzheimer’s disease", Am J Psychiatry, 160, pp.857~866 (2003)
- Devanand DP, "Depressed mood and the incidence of Alzheimer’s disease in the elderly living in the community", Arch. Gen. Psychiatry, 53, pp.175~182 (1996)
- Schmand B, "Subjective memory complaints in the elderly: depressive symptoms and future dementia", Br J Psychiatry, 171, pp.373~376 (1997)
- Dal Forno G, "Depressive symptoms, sex, and risk for Alzheimer’s disease", Ann Neurol, 57, pp.381~387 (2005)
- Dillon C, "Late- versus early-onset geriatric depression in a memory research center", Neuropsychiatr Dis Treat, 5, pp.517~526 (2009)
- Alexopoulos GS, "Geriatric depression in primary care", Int J Geriatr Psychiatry, 11, pp.397~400 (1996)
- Schweitzer I, "Is late onset depression a prodrome to dementia", Int J Geriatr Psychiatry, 17, pp.997~1005 (2002)
- Muliyala KP, "The complex between depression and dementia", Ann Indian Acad Neurol, 13, pp.S69~S73 (2010)
- van Reekum R, "Late-life depression as a possible predictor of dementia: cross-sectional and short-term follow-up results", Am J Geriatr Psychiatry, 7, pp.151~159 (1999)
- van Reekum R, "Is late-life depression a predictor of Alzheimer’s disease? Results from a historical cohort study", Int J Geriatr Psychiatr, 20, pp.80~82 (2005)
- Jorm AF, "History of depression as a risk factor for dementia: an updated review", Aust N Z J Psychiatry, 35, pp.776~781 (2001)
- Alexopoulos GS, "Geriatric depression: age of onset and dementia", Biol Psychiatry, 34, pp.141~145 (1993)
- 국민건강보험, "2002-2009년 노인성 질환자 진료 추이 분석결과" (2011)
- 국민건강보험, "5년간 노인우울증 질환자 1.7배 증가" (2011)
- Kessing LV, "Increased risk of developing dementia in patients with major affective disorders compared to patients with other medical illnesses", J Affect Disord, 73, pp.261~269 (2003)
- Gabrie SEl, "Comorbidity in arthritis", J Rheumatol, 26, pp.2475~2479 (1999)
- Lindsay J, "Risk factors for Alzheimer’s disease: a prospective analysis from the Canadian Study of Health and Aging", Am J Epidemiol, 156, pp.445~453 (2002)
- Saunders PA, "Heavy drinking as a risk factor for depression and dementia in elderly men: findings from the Liverpool longitudinal community study", Br J Psychiatry, 159, pp.213~216 (1991)
- Fratiglioni L, "Risk factors for late-onset Alzheimer’s disease: a population-based, case-control study", Ann Neurol, 33, pp.258~266 (1993)
- Dickstein DL, "Role of vascular risk factors and vascular dysfunction in Alzheimer’s disease", Mt Sinai J Med, 77, pp.82~102 (2010)
- Schmidt R, "Vascular risk factors in dementia", J Neurol, 247, pp.81~87 (2000)
- Korczyn AD, "Depression and dementia", Neurol Sci, 283, pp.139~142 (2009)
- Butters MA, "Pathways linking late-life depression to persistent cognitive impairment and dementia", Dialogues Clin Neurosci, 10, pp.345~357 (2008)
- Elkis H, "Metaanalysis of studies of ventricular enlargement and cortical sulcal prominence in mood disorders: comparisons with controls or patients with schizophrenia", Arch Gen Psychiatry, 52, pp.735~746 (1995)
- Jacoby RJ, "Computed tomography in the elderly affective disorder", Br J Psychiatry, 136, pp.270~275 (1980)
- Videbech P, "Hippocampal volume and depression: a meta-analysis of MRI studies", Am J Psychiatry, 161, pp.1957~1966 (2004)
- Hickie I, "Reduced hippocampal volumes and memory loss in patients with early-and late-onset depression", Br J Psychiatry, 186, pp.197~202 (2005)
- Bremner JD, "Hippocampal volume reduction in major depression", Am J Psychiatry, 57, pp.115~117 (2000)
- Sweet RA, "Neuropathologic correlates of late onset major depression", Neuropsychopharmacology, 29, pp.2242~2250 (2004)
- Uzun S, "Side effects of treatment with benzodiazepines", Psychiatr Danub, 22, pp.90~93 (2010)
- Landi F, "Anticholinergic drugs and physical function among frail elderly population", Clin Pharmacol Ther, 81, pp.235~241 (2007)
- Jorm AF, "Psychiatric history and related exposures as risk factors for Alzheimer’s disease: a collaborative re-analysis of case-control studies. EURODEM Risk Factors Research Group", Int J Epidemiol, 20, pp.S43~S47 (1991)
- Prince M, "Do antiarthritic drugs decrease the risk for cognitive decline? An analysis based on data from the MRC Treatment Trial of Hypertension in Older Adults", Neurology, 50, pp.374~379 (1998)
- yden KM, "Dose NSAID use modify cognitive trajectories in the elderly? The Cache Country Study", Neurology, 69, pp.275~282 (2007)
- Potter PE, "Investigational medications for treatment of patients with Alzheimer disease", J Am Osteopath Assoc, 110, pp.S27~S36 (2010)
- García-Peña C, "Depressive symptoms and APOE polymorphisms in an elderly population-based sample", Psychiatr Genet, 20, pp.215~220 (2010)