期刊
INTERNATIONAL PSYCHOGERIATRICS
卷 33, 期 8, 页码 791-801出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S1041610220003622
关键词
depressive symptoms; pseudodementia; cognitive impairment; KLoSA
The study found that depressive symptoms accompanied by cognitive dysfunction in older adults increase the risk of cognitive impairment. Such a combination of depressive symptoms and cognitive dysfunction poses a similar risk for cognitive impairment as pure cognitive dysfunction.
Objectives: Geriatric depression complicates cognitive health in older adults. This study aims to investigate the impact of depressive symptoms on cognitive impairment in community-dwelling older adults, depending on whether cognitive dysfunction accompanied. Design: A community-based longitudinal cohort study. Setting: This study analyzed data from the Korean Longitudinal Study of Aging (KLoSA) from 2006 to 2018. Participants: Among 10,254 individuals who were registered in the KLoSA study, a total of 9119 subjects met the criteria, and 4547 subjects were included in the final analysis. The subjects were grouped into 4 categories based on depressive symptoms and cognitive dysfunction at baseline assessment: normal control (NC, n = 3341), depression only (Dep-only, n = 652), cognitive dysfunction only (CD-only, n = 393), and depression with cognitive dysfunction (Dep-CD, n = 161). Measurements: Cognitive impairment 10 years later was defined as K-MMSE scores below two percentile on demographically adjusted norms. Results: Ten-year survival, that is, not experiencing cognitive impairment, was 80 +/- 1% in NC group, 72 +/- 2% in Dep-only group, 52 +/- 3% in CD-only group, and 44 +/- 5% in Dep-CD group. The hazard ratio (HR) of the Dep-only group (HR = 1.18, 95% CI, 0.97-1.43, n.s.) did not differ from that of the NC group, but the HR of the Dep-CD group was significantly higher (HR = 2.85, 95% CI, 2.23-3.66, p < 0.001) than the NC group. When the Dep-CD group was compared to the CD-only group, the HR was 1.13 (95% CI, 0.85-1.49, n.s.), which indicates that it did not significantly differ from the CD-only group. Conclusions: Our findings suggest that depressive symptoms with cognitive dysfunction are associated with a higher risk of cognitive impairment. Furthermore, cognitive dysfunction occurring with depressive symptoms is as much a risk for cognitive impairment as is pure cognitive dysfunction. Thus, healthcare providers should pay close attention to the community-dwelling elderly when depressive symptoms occur with cognitive dysfunction.
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