Fernández Fernández Roberto, Martín Javier Ibias, Antón María Araceli Maciá
Department of Psychiatry, Infanta Cristina University Hospital, Madrid (Fernández Fernández); Department of Methodology of Behavioral Sciences, National University of Distance Education (UNED), Madrid (all authors).
J Neuropsychiatry Clin Neurosci. 2024 Spring;36(2):101-109. doi: 10.1176/appi.neuropsych.20230043. Epub 2023 Dec 19.
Dementia is a syndrome characterized by the deterioration of cognitive function beyond what is expected. The increased risk of developing this syndrome resulting from established modifiable risk factors, such as depressive episodes, is currently a subject of interest. The aim of this study was to review the scientific evidence that addresses the relationship between depression and dementia. A bibliographic search of the PubMed and PsycInfo databases for articles published over the past 20 years was conducted with the following medical subject heading terms: depression or depressive, dementia, and incidence or cohort studies. After articles meeting the inclusion criteria were selected, relevant moderating variables were grouped as sample characteristics, methodological characteristics, extrinsic characteristics, and outcome variables. The 26 selected studies resulted in a sample comprising 1,760,262 individuals. Statistical analysis revealed a pooled relative risk for the development of dementia of 1.82 (95% CI=1.62-2.06). The primary variables evaluated were the diagnostic methods for depression and dementia and the presence of depression. Other variables, such as mean age, methodological quality of each study, follow-up time, and publication year, were also evaluated. Age was statistically but not clinically significant. No relevant publication bias or alterations in the results were found when accounting for the quality of the studies. It is recommended that new moderating variables be evaluated or that existing variables be reformulated in future studies.
痴呆是一种以认知功能衰退超过预期为特征的综合征。由诸如抑郁发作等已确定的可改变风险因素导致患此综合征风险增加,目前是一个受关注的课题。本研究的目的是回顾阐述抑郁与痴呆之间关系的科学证据。使用以下医学主题词对过去20年发表在PubMed和PsycInfo数据库中的文章进行文献检索:抑郁或抑郁症、痴呆、发病率或队列研究。在选择符合纳入标准的文章后,将相关的调节变量分为样本特征、方法学特征、外部特征和结果变量。所选的26项研究产生了一个包含1,760,262名个体的样本。统计分析显示,患痴呆症的合并相对风险为1.82(95%置信区间=1.62 - 2.06)。评估的主要变量是抑郁和痴呆的诊断方法以及抑郁的存在情况。还评估了其他变量,如平均年龄、每项研究的方法学质量、随访时间和发表年份。年龄在统计学上有意义,但在临床上无显著意义。在考虑研究质量时,未发现相关的发表偏倚或结果改变。建议在未来研究中评估新的调节变量或重新制定现有变量。