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首页> 外文期刊>JAMA psychiatry >Association of Midlife Cardiorespiratory Fitness With Incident Depression and Cardiovascular Death After Depression in Later Life
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Association of Midlife Cardiorespiratory Fitness With Incident Depression and Cardiovascular Death After Depression in Later Life

机译：中期生命抑郁症与抑郁症后抑郁症后生命抑郁症的关联

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Importance? Cardiorespiratory fitness (hereinafter referred to as fitness) as estimated by exercise testing is a modifiable risk factor independently associated with chronic diseases, cardiovascular disease (CVD) events, and mortality, but the association of fitness at midlife with incidence of later-life depression and the risk of CVD mortality after a depression diagnosis is unknown.Objective? To determine whether fitness measured in midlife would be inversely associated with later-life CVD mortality with antecedent depression.Design, Setting, and Participants? This retrospective cohort study at a single-center, community-based preventive medicine clinic was performed as part of the Cooper Center Longitudinal Study. Data were collected from January 13, 1971, through December 31, 2009, and analyzed from October 6, 2015, through August 14, 2017. Participants included generally healthy men and women who presented for preventive medicine examinations at midlife and who were eligible for Medicare from 1999 to 2010. Those with a self-reported history of depression, myocardial infarction, or stroke at examination were excluded.Exposures? Objective midlife fitness estimated from results of treadmill exercise testing.Main Outcomes and Measures? Depression diagnosis from Medicare claims files using established algorithms and CVD mortality from National Death Index records.Results? A total of 17?989 participants (80.2% men) with a mean (SD) age of 50.0 (8.7) years were included. After 117?218 person-years of Medicare follow-up, 2701 depression diagnoses, 610 deaths due to CVD without prior depression, and 231 deaths due to CVD after depression were observed. A high level of fitness in midlife was associated with a 16% lower risk of depression (hazard ratio [HR], 0.84; 95% CI, 0.74-0.95) compared with a low level of fitness. A high fitness level was also associated with a 61% lower risk of death due to CVD without depression (HR, 0.39; 95% CI, 0.31-0.48) compared with a low level of fitness. After a diagnosis of depression, a high fitness level was associated with a 56% lower risk of death due to CVD (HR, 0.44; 95% CI, 0.31-0.64) compared with a low fitness level.Conclusions and Relevance? Midlife fitness is associated with a lower risk of later-life depression, CVD mortality, and CVD mortality after incident later-life depression. These findings suggest the importance of midlife fitness in primary prevention of depression and subsequent CVD mortality in older age and should encourage physicians to consider fitness and physical activity in promoting healthy aging.
机译：重要性？通过运动测试估计的心肺气体健身（以下称为健身）是与慢性疾病，心血管疾病（CVD）事件和死亡率独立相关的可改性风险因素，但在中期的健身与后续生命抑郁发病率的关联抑郁症诊断后CVD死亡率的风险是未知的。目的？确定中午测量的健身是否与前后生命的CVD死亡率与先进的抑郁症有关.Design，Setting和参与者？这种回顾性队列在单一中心的基于社区的预防医学诊所进行了研究，作为Cooper Center纵向研究的一部分进行。从1971年1月13日，2009年12月31日，2015年10月31日，2017年10月6日分析了数据。参与者包括在中期举行预防医学考试的健康男人和妇女，他有资格获得Medicare从1999年到2010年。抑郁症，心肌梗死或中风的自我报告历史的人被排除在一起.ExpoSures？目标中期健身估计跑步机锻炼测试结果。来自Medicare索赔文件的抑郁症诊断使用国家死亡指数记录的已建立的算法和CVD死亡率。结果？总共17名（80.2％）的平均（SD）年龄为50.0岁（8.7）年。在117岁以下？218人的Medicare随访中，2701年抑郁症诊断，由于CVD而没有先前抑郁症的死亡，并且观察到抑郁症后由于CVD引起的231人死亡。中期的高度健身与抑郁症风险降低16％（危险比[HR]，0.84; 95％CI，0.74-0.95），与低水平的适应度相比。由于CVD而没有抑郁症（HR，0.39; 95％CI，0.31-0.48），高适应性水平也与较低的死亡风险降低了61％，而具有低水平的健身。在抑郁症诊断后，由于CVD（HR，0.44; 95％CI，0.31-0.64）与低健身水平相比，高健康水平与降低死亡风险降低56％。结论和相关性？中期健身与事故后寿命抑郁后的后生命抑郁症，CVD死亡率和CVD死亡率的风险较低。这些调查结果表明中期地区健康在较老年人的抑郁症初级预防和随后的CVD死亡率中的重要性，并应鼓励医生考虑促进健康老龄化的健康和体力活动。

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