抑郁与阿尔茨海默病关系暧昧

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Depression and Alzheimer's Risk Linked
But exact nature of the association isn't clear, study finds
但是研究尚不清楚这种关系的本质

By Steven Reinberg
HealthDay Reporter
《每日健康》记者Steven Reinberg

MONDAY, April 7 (HealthDay News) -- Depression appears to more than double the risk of developing Alzheimer's disease, Dutch researchers report.
4月7日（每日健康新闻）－－荷兰的研究者们报道，抑郁能使患阿尔茨海默病的风险性加倍。

Depression has been linked to an increased risk of Alzheimer's, and many have suspected that risk is tied to changes in the brain caused by depression. The theory has been that depression shrinks specific areas, leaving the brain vulnerable to the development of Alzheimer's. However, this study found that's not the case.
抑郁与阿尔茨海默病风险性增加相关，而且很多学者认为这种风险性与抑郁所致的大脑改变有关。

\"We don't know yet whether depression contributes to the development of Alzheimer's disease or whether another unknown factor causes both depression and dementia,\" lead researcher Dr. Monique M.B. Breteler, from the Erasmus University Medical Center in Rotterdam, said in a statement. \"We'll need to do more studies to understand the relationship between depression and dementia.\"
主要研究者、鹿特丹Erasmus大学医学中心医生Monique学士在一个声明中说：“我们不清楚究竟是抑郁导致了阿尔茨海默病还是有某种未知因素导致了抑郁和阿尔茨海默病同时发生。我们需要更多的研究来弄清楚抑郁和阿尔茨海默病之间的关系。”

In the study, Breteler, and her colleagues collected data on 486 people, aged 60 to 90, who did not have dementia.
在这个研究中，Breteler和他的同事们收集了486名年龄在60到90岁且没有痴呆的研究对象的数据。

Among these individuals, 134 had had at least one episode of depression, according to the report in the April 8 issue of Neurology.
根据4月8日发行的《Neurology》，在这些研究对象中，有134人至少有过一次抑郁。

During an average six years of follow-up, 33 people developed Alzheimer's disease. The researchers found that those who had had an episode of depression were 2.5 times more likely to develop Alzheimer's compared with people who had never had depression. For people whose depression occurred before they were 60, the risk for developing Alzheimer's was fourfold greater than people who had never had depression, the researchers reported.
在这个平均为6年的随访中，33人发展为阿尔茨海默病。研究者们发现有过抑郁的人发展为阿尔茨海默病的风险是从无抑郁者的2.5倍。研究者们还发现60岁以前发生抑郁的人风险是无抑郁症的4倍。

One goal of Breteler's research was to determine if depression causes changes in the brain that increase the risk of Alzheimer's disease, as had been suspected by other scientists.
Breteler研究的目的之一就是确定是否象人们所怀疑的那样－－抑郁引起了脑部的改变从而导致阿尔茨海默病。

Researchers have proposed that depression leads to a loss of cells in the areas of the brain called the hippocampus and the amygdala, thereby increasing the risk for Alzheimer's. However, Breteler's group didn't find any difference in the size of those areas of the brain in people with or without depression.
已有研究者提出抑郁导致大脑海马和杏仁体区细胞减少，从而增加了患阿尔茨海默病的风险性。然而，Breteler研究组并未发现抑郁和非抑郁者这些区域的不同。

In addition, Breteler's team found that people who had symptoms of depression at the start of the study were no more likely to develop Alzheimer's than those who did not have the symptoms.
此外，Breteler研究组发现那些在研究开始时有抑郁症状的人比那些无症状者发展成阿尔茨海默病的风险并未增加。

Even though the study found a connection between depression and Alzheimer's, experts continue to debate whether such a connection really exists.
虽然研究发现抑郁和阿尔茨海默病相关，但是专家们还在继续探讨是否存在联系。

\"There are quite a few papers about the association between depression and Alzheimer's, with conflicting results,\" said Yaakov Stern, a professor of clinical neuropsychology at Columbia University in New York City. \"No one really knows if there is a connection between depression and Alzheimer's.\"
美国纽约哥伦比亚大学临床神经病学教授Yaakov Stern说：“现在有很多关于抑郁与阿尔茨海默病关系的论文，但是结果相互矛盾。没人真正知道抑郁与阿尔茨海默病之间的关系。”

Another expert questioned whether treating depression could prevent dementia.
另有专家质疑治疗抑郁是否能预防痴呆。

\"Depression may be a risk factor for developing dementia. I believe that's true,\" said Dr. Gary Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City. \"Depression is also one of the side effects of dementia.
纽约Montefiore医学中心老年精神病主任Gary Kennedy医生说：“抑郁也许是痴呆的危险因素。我相信这是确切的。抑郁也可能只是痴呆的一个副反应。”

\"So there is an overlap relationship that makes it very difficult to look at the more interesting question of whether, if we treat depression could we prevent dementia,\" Kennedy said.
Kennedy说：“这种错综复杂的关系导致很难说清楚我们治疗抑郁能否预防痴呆。”

Kennedy noted that studies have shown that depression in older people appears to be an early sign of developing dementia. However, whether that's the beginning of dementia or an independent risk factor for dementia isn't known, he said.
Kennedy说研究显示老年抑郁患者更早发展成痴呆，然而尚不清楚抑郁是否是痴呆的开端或独立危险因素。

Even though the clinical implications for the association between depression and dementia aren't clear, Kennedy believes that older people with depression should have their depression treated. \"There's even more reason to make sure depression is aggressively treated,\" he said.
即使临床上抑郁与痴呆的关系尚不明了，但是Kennedy认为老年抑郁患者还是应当治疗。他说：“有很多的理由证实抑郁应当积极治疗。”

Adding to the debate about the relationship between Alzheimer's and depression, a paper in the April issue of the Archives of General Psychiatry also suggests that that depression may be a risk factor for Alzheimer's.
4月份《the Archives of General Psychiatry》的一篇论文也认为抑郁可能是阿尔茨海默病的一个危险因素，更增加了阿尔茨海默病与抑郁关系的争论。

In the study, Robert S. Wilson, of Rush University Medical Center in Chicago, and his colleagues found that among 917 older men and women, those who had symptoms of depression at the beginning of the study were more likely to develop Alzheimer's.
在这个研究中，芝加哥Rush大学医学中心的Robert S. Wilson和他的同事们发现在917名老年男性和女性中，研究开始时有抑郁症状的更易发展为阿尔茨海默病。

\"Understanding the mechanisms linking depressive symptoms with dementia could suggest novel approaches to delaying dementia onset, because animal research suggests diverse means by which the adverse effects of chronic stress may be modified,\" Wilson's team wrote.
Wilson的研究组写到：“理解了抑郁症状与痴呆之间的联系机制就能够找到延缓痴呆发作的新途径，因为动物实验证实慢性应激可以通过各种方法得以改善。”