Olfactory Dysfunction and Depression Trajectories in Community-Dwelling Older Adults.

IF 4.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY Journals of Gerontology Series A-Biological Sciences and Medical Sciences Pub Date : 2024-01-01 DOI:10.1093/gerona/glad139
Vidyulata Kamath, Kening Jiang, Kevin J Manning, R Scott Mackin, Keenan A Walker, Danielle Powell, Frank R Lin, Honglei Chen, Willa D Brenowitz, Kristine Yaffe, Eleanor M Simonsick, Jennifer A Deal
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Abstract

Background: We examined the relationship between baseline olfactory performance and incident significant depressive symptoms and longitudinal depression trajectories in well-functioning older adults. Inflammation and cognitive status were examined as potential mediators.

Methods: Older adults (n = 2 125, 71-82 years, 51% female, 37% Black) completed an odor identification task at Year 3 (our study baseline) of the Health, Aging, and Body Composition study. Cognitive assessments, depressive symptoms, and inflammatory markers were ascertained across multiple visits over 8 years. Discrete-time complementary log-log models, group-based trajectory models, and multivariable-adjusted multinomial logistic regression were employed to assess the relationship between baseline olfaction and incident depression and longitudinal depression trajectories. Mediation analysis assessed the influence of cognitive status on these relationships.

Results: Individuals with lower olfaction had an increased risk of developing significant depressive symptoms at follow-up (hazard ratio = 1.04, 95% confidence interval [CI]: 1.00, 1.08). Of the 3 patterns of longitudinal depression scores identified (stable low, stable moderate, and stable high), poorer olfaction was associated with a 6% higher risk of membership in the stable moderate (relative risk ratio [RRR] = 1.06, 95% CI: 1.02, 1.10)/stable high (RRR = 1.06, 95% CI: 1.00, 1.12) groups, compared to the stable low group. Poor cognitive status, but not inflammation, partially mediated the relationship between olfactory performance and incident depression symptom severity.

Conclusions: Suboptimal olfaction could serve as a prognostic indicator of vulnerability for the development of late-life depression. These findings underscore the need for a greater understanding of olfaction in late-life depression and the demographic, cognitive, and biological factors that influence these relationships over time.

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居住在社区的老年人嗅觉功能障碍和抑郁轨迹。
背景:我们在功能良好的老年人中研究了基线嗅觉表现与事件显著抑郁症状和纵向抑郁轨迹之间的关系。炎症和认知状态作为潜在的介质进行了检查。方法:老年人(n = 2 125, 71-82岁,51%女性,37%黑人)在健康、衰老和身体成分研究的第3年(我们的研究基线)完成了气味识别任务。认知评估、抑郁症状和炎症标志物在8年的多次访问中被确定。采用离散时间互补对数-对数模型、基于群体的轨迹模型和多变量调整多项逻辑回归来评估基线嗅觉与事件抑郁和纵向抑郁轨迹之间的关系。中介分析评估了认知状态对这些关系的影响。结果:嗅觉较低的个体在随访中出现显著抑郁症状的风险增加(风险比= 1.04,95%可信区间[CI]: 1.00, 1.08)。在确定的3种纵向抑郁评分模式(稳定低、稳定中等和稳定高)中,与稳定低组相比,较差的嗅觉与稳定中等组(相对风险比[RRR] = 1.06, 95% CI: 1.02, 1.10)/稳定高组(RRR = 1.06, 95% CI: 1.00, 1.12)的成员风险增加6%相关。嗅觉表现与事件抑郁症状严重程度之间的关系部分由认知状态差介导,而非炎症介导。结论:嗅觉不佳可作为老年抑郁症易感性的预后指标。这些发现强调有必要更好地了解嗅觉在晚年抑郁症中的作用,以及随着时间的推移影响这些关系的人口统计学、认知和生物学因素。
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来源期刊
CiteScore
10.00
自引率
5.90%
发文量
233
审稿时长
3-8 weeks
期刊介绍: Publishes articles representing the full range of medical sciences pertaining to aging. Appropriate areas include, but are not limited to, basic medical science, clinical epidemiology, clinical research, and health services research for professions such as medicine, dentistry, allied health sciences, and nursing. It publishes articles on research pertinent to human biology and disease.
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