基于潜变量混合增长模型的中国中老年抑郁症状发展轨迹与痴呆症关系研究  

A study on the relationship between the developmental trajectory of depressive symptoms and dementia in middle-aged and elderly Chinese based on a latent variable mixed growth model

作　　者：熊屹立 刘声悦 杨金燕 葛晓燕 XIONG Yi-li;LIU Sheng-yue;YANG Jin-yan;GE Xiao-yan(School of Stomatology,Jinzhou Medical University,Jinzhou,Liaoning 121001,China;不详)

机构地区：[1]锦州医科大学口腔医学院,辽宁锦州121001 [2]西南医科大学口腔医学院 [3]锦州医科大学公共卫生学院卫生统计学教研室,辽宁锦州121001

出　　处：《现代预防医学》2023年第7期1171-1175,共5页Modern Preventive Medicine

基　　金：辽宁省大学生创新创业训练计划项目(S202210160014);2022年辽宁省教育厅高校基本科研项目面上项目(LJKMZ20221237)。

摘　　要：目的探讨中国中老年抑郁症状发展变化趋势的异质性,揭示不同抑郁组别变化轨迹,以及其与痴呆症状之间的关系,以期为医护人员在临床前期为抑郁症状人群实施干预措施提供科学建议。方法数据来源于中国健康与养老追踪调查(CHARLS)项目,采用潜变量混合增长模型构建抑郁评分模型,对不同抑郁组别变化轨迹进行分类,采用Cox比例风险模型探究不同抑郁组别变化轨迹与痴呆症状之间的关系。结果研究纳入受试者1996例,其抑郁症状呈现出三种不同的轨迹变化,分别定义为抑郁低危人群、抑郁高危人群、抑郁晚发人群。与抑郁低危人群相比,抑郁高危人群更容易出现中老年人群痴呆症状(HR=1.227,95%CI:1.052~1.429);与抑郁低危人群相比,抑郁晚发人群也更容易出现中老年人群痴呆症状(HR=1.332,95%CI:1.120~1.584)。结论中老年人抑郁发展轨迹存在异质性,潜变量增长混合模型有助于精准区分痴呆风险人群,今后应积极检查情感状态,对于出现抑郁症状患者应早期干预和治疗,并定期随访其认知功能,以便及时调整治疗方案,延缓痴呆的发生。Objective To explore the heterogeneity of depressive symptoms in middle-aged and elderly people in China,reveal the change trajectory of different depression groups,and investigate their relationship with dementia symptoms,to provide scientific advice for medical staff to implement intervention measures for depressive symptoms in the preclinical stage.Methods The data were downloaded from the China Health and Retirement Longitudinal Survey(CHARLS)project.The latent growth mixture model was used to construct a depression score model to classify the change trajectories of different depression groups.Cox proportional-hazards model was used to explore the relationship between the change trajectories of different depression groups and dementia symptoms.Results A total of 1996 subjects were included in the study,and their depressive symptoms showed three different trajectories,which were defined as“low-risk group of depression”,“high-risk group of depression”,and“late-onset depression group”.Compared with“low-risk group of depression”,“high-risk group of depression”was more likely to develop dementia symptoms in middle-aged and elderly people(HR=1.227,95%CI:1.052-1.429).Similarly,“late-onset depression group”was also more likely to develop dementia symptoms in middle-aged and elderly people(HR=1.332,95%CI:1.120-1.584).Conclusion There is heterogeneity in the development trajectory of depression in the middle-aged and elderly,and the mixed model of latent variable growth is helpful to accurately distinguish the people at risk of dementia.In the future,the emotional state should be actively checked,and patients with depressive symptoms should be intervened and treated early,and their cognitive function should be followed up regularly,so as to adjust the treatment plan in time and delay the occurrence of dementia.

关 键 词：潜变量增长混合模型 痴呆症 抑郁症状 中老年人 

分 类 号：R749.4[医药卫生—神经病学与精神病学]