Objetivo. Realizar un metaanálisis de estudios de cohortes prospectivos, con base poblacional, que investiguen el riesgo de demencia y enfermedad de Alzheimer (EA) según la depresión clínicamente relevante, diagnosticada con criterios del Geriatric Mental State (GMS).
Pacientes y métodos. Se realizó una búsqueda sistemática de los estudios publicados en PubMed y Web of Science hasta enero de 2018 para identificar todos los estudios longitudinales sobre la asociación entre la depresión clínicamente relevante (diagnosticada con criterios del GMS) y el riesgo de demencia y EA en los ancianos. Se calculó el riesgo relativo agrupado para examinar la depresión como un posible factor de riesgo para la demencia en estudios comunitarios, así como la fracción poblacional de demencia y EA atribuible a la depresión.
Resultados. Seis estudios cumplieron los criterios de inclusión para la revisión sistemática. Todos ellos proporcionaron suficiente información para realizar un metaanálisis. Los participantes con depresión clínicamente relevante tuvieron un riesgo un 54% más elevado de demencia (p = 0,026) y una fracción atribuible poblacional del 8,6%. Los pacientes con EA tuvieron un riesgo un 50% más alto (p = 0,038) y una fracción atribuible poblacional del 10,8%.
Conclusión. La depresión clínicamente relevante se asocia con un mayor riesgo de demencia y EA en la comunidad, con un impacto potencial mayor que otros factores de riesgo conocidos. Los estudios futuros deben explorar los mecanismos que vinculan la depresión con la demencia y la EA, así como si un tratamiento eficaz de la depresión clínicamente relevante podría prevenir la demencia y el desarrollo de la EA.
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