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Dementia is a neurodegenerative disease characterized by a gradual decline in cognitive ability
.
It prevents patients from performing activities of daily living independently, and often has a devastating impact on the lives of patients and their caregivers
manage
Depression has been recognized as a risk factor for dementia
.
According to a recent meta-analysis of some epidemiological studies, depression in later life is associated with an increased risk of dementia
Blood vessel
A systematic review report pointed out that the cognitive decline of patients with depression in later life is related to vascular dysfunction, including white matter hyperplasia
.
Conversely, the risk factors for dementia in cardiovascular disease patients also include depression
Cardiovascular
However, the interaction between depression and cardiovascular disease, that is, whether one disease will strengthen the association of another disease with the risk of dementia, remains unclear
.
Compared with dementia, the prevention and treatment of these two diseases are mature and known to be effective
prevention
Therefore, clarifying the mutual influence of depression and cardiovascular disease on the risk of dementia can help identify those who can benefit more from healthcare services at the same cost
.
In this way, Yoo Jin Jang and others of Seoul National University in South Korea used a nationwide population cohort to evaluate the relationship between depression and cardiovascular disease and subsequent dementia
.
It was also investigated whether the interaction between these two conditions had an additional relationship with the increased risk of dementia
They conducted a population-based cohort study and analyzed all personal data of individuals over 50 years of age from the National Health Insurance Service-National Sample Cohort of Korea
.
Individuals who were not diagnosed with dementia at baseline were included and followed up from January 1, 2005 to December 31, 2013
diagnosis
The interaction between depression and cardiovascular disease is estimated based on the interaction of attributable ratio (AP), relative excess risk due to interaction (RERI), synergy index (SI), and multiplication
.
A total of 242,237 participants were included in the analysis sample, of which 12,735 (5.
3%) suffered from dementia
.
Compared with participants without depression or CVD, the adjusted hazard ratio for the incidence of dementia in patients with simple depression was 2.
35 (95% confidence interval [CI] 2.
21-2.
49), and for simple CVD was 3.
25 (95% CI 3.
11) -3.
39), while the combined depression and CVD was 5.
02 (95%CI 4.
66-5.
42)
.
The additive interaction between depression and CVD was statistically significant (AP-0.
08, 95%CI 0.
01-0.
16; RERI-0.
42, 95%CI 0.
03-0.
82; SI-1.
12, 95%CI 1.
01-1.
24)
.
The multiplicative interaction is also significant, but the effect is negative (0.
The additive interaction between depression and CVD is statistically significant
The significance of this study is that in the long-term follow-up of this population-based nationwide cohort, depression and cardiovascular disease are associated with an increased risk of dementia , and their coexistence increases the risk of dementia more than the sum of the individual risks.
.
Original source:
Jang YJ, Kang C, Myung W, et al.
Additive interaction of mid- to late-life depression and cerebrovascular disease on the risk of dementia: a nationwide population-based cohort study.
Alz Res Therapy.
Additive interaction of mid- to late-life depression and cerebrovascular disease on the risk of dementia: a nationwide population-based cohort study.
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