18歲時的良好體適能可能代表未來憂鬱風險較低


  【24drs.com】新研究顯示,18歲時的良好體適能與未來嚴重憂鬱風險降低有關。
  
  瑞典Gothenburg大學Sahlgrenska學院Maria A. Aberg博士表示,不論肌肉強度,18歲時心血管適能較低者,與成年時、甚至三、四十年後的嚴重憂鬱風險增加有關,不過,躁鬱症方面則未發現此關聯。
  
  這些結果強化了心血管疾病是因憂鬱症病因所致的理論。
  
  瑞典這篇超過100萬名男性的研究結果線上刊載於6月14日英國精神病學期刊。
  
  Aberg博士等人曾經研究動物的大腦可塑性多年;這些研究和其他介入研究的結果認為,體能活動可改善已經確認有憂鬱症者的認知和情緒。
  
  Aberg博士解釋,可能的機轉是,體能活動可以扭轉憂鬱和躁鬱症時降低的神經可塑性。之前的人類研究顯示,久坐的生活型態增加了憂鬱風險,但這些研究多數是根據對研究對象的訪談且結果尚無定論,我們認為,確實需要一個大型且追蹤期長的研究來客觀測量體能表現。
  
  研究者對出生於1950-1987年間、18歲時登記從軍、沒有心智疾病史的瑞典男性進行了一個前瞻世代研究;登記時,共有1,117,292名男性接受廣泛的生理和心理檢查,包括心血管和肌肉適能檢查。
  
  在1969-2008年間追蹤這些男性,研究者使用來自「Swedish National Hospital Discharge Register」的資料,看有多少人接受住院治療憂鬱症;研究顯示,18歲時心血管適能表現不佳的男性,後來發生憂鬱症住院的風險增加。
  
  控制身體質量指數、徵兵測試中心、家庭因素等項目之後,成年時嚴重憂鬱和18歲時心血管適能較低有關的風險比(HR)為1.96(95%信心區間[CI],1.71 - 2.23);躁鬱症方面則無此關聯(HR,1.11;95% CI,0.84 - 1.47)。
  
  Aberg博士表示,醫師們可以告訴他們的青少年病患及家長,腦部需要兩種類型的訓練:認知挑戰與體能活動;她希望政府和學校當局給予運動更高的位階與更多資源;再者,針對發生憂鬱的特定高風險族群及早給予心血管訓練是相當重要的。
  
  賓州大學精神科主席、Shively/Tan名譽教授Alan J. Gelenberg醫師對此研究發表評論時表示,這是篇令人振奮的研究;當他看到這篇研究時,他和系上的幾位研究者分享,因為它相當漂亮地往前邁進一步。
  
  Gelenberg醫師表示,就運動、體適能和心情異常的關聯而言,可說是尚未有全貌的一個謎題;這篇包括了上百萬樣本的研究提供了其中一部分,讓我們更能剖析一些重要變項。
  
  現在,我們有缺乏體適能、肥胖、糖尿病、心血管問題的流行病學,但是,就我的領域而言,我們對於這些問題不僅止於心臟和內分泌與血管系統;似乎也和腦部健康有關。
  
  資料來源:http://www.24drs.com/professional/list/content.asp?x_idno=6871&x_classno=0&x_chkdelpoint=Y
  

Physically Fit at 18 May Mean Less Depression Later in Life

By Fran Lowry
Medscape Medical News

June 28, 2012 — Good physical fitness at age 18 years is associated with a reduced risk for serious depression later in life, a new study shows.

"Lower cardiovascular fitness, independent of muscle strength, at age 18 years was associated with increased risk of serious depression in adulthood, even 31 to 40 years later, although no such association could be shown for bipolar disorder," lead author Maria A. Aberg, MD, PhD, Sahlgrenska Academy, University of Gothenburg, in Sweden, told Medscape Medical News.

"These results strengthen the theory of a cardiovascular contribution to the etiology of depression," she added.

The results, which are from a study that included more than 1 million Swedish men, was published online June 14 in the British Journal of Psychiatry.

Preventing Depression?

Dr. Aberg and her team have been studying brain plasticity in animal models for many years; the results from those studies, as well as intervention studies, suggest that physical exercise may improve cognition and mood in persons with an already established depression.

"A proposed mechanism is that physical exercise could reverse the reduced neuronal plasticity that is observed in both depression and bipolar disorders. Previous human studies have shown that a sedentary lifestyle increases the risk of depression, but most of these have been based on interviews with adults and the results have been inconclusive, and we felt that there was a real need for a large study with long follow-up times and objective measures of physical performance," Dr. Aberg explained.

The researchers carried out a prospective cohort study of all Swedish men born between 1950 and 1987 with no history of mental illness who were enlisted for mandatory military service at the age of 18 years.

When enlisting, all 1,117,292 men were given extensive physical and psychological examinations, including tests of their cardiovascular and muscle fitness.

The men were followed between 1969 and 2008. The researchers used data from the Swedish National Hospital Discharge Register to see how may had received inpatient treatment for depression.

The study showed that the men who performed poorly on the cardiovascular fitness tests at age 18 years were at greater risk of being hospitalized with depression in later life.

After controlling for factors that included body mass index, conscription test center, and familial factors, the hazard ratio (HR) associated with lower cardiovascular fitness at age 18 for serious depression in adulthood was 1.96 (95% confidence interval [CI], 1.71 - 2.23).

There was no such association found for bipolar disorder (HR, 1.11; 95% CI, 0.84 - 1.47).

"Doctors can tell their teenage patients and their parents that the brain needs two types of training, both cognitive challenges and physical exercise," Dr. Aberg said.

She added that she hoped politicians and school administrators would give sport a higher status and also more resources. "Moreover, targeting specific high-risk groups for developing depression with cardiovascular training early in life is of high importance."

Incremental Step Forward

Alan J. Gelenberg, MD, Shively/Tan Professor and chair, Department of Psychiatry, Penn State University, Hershey, Pennsylvania, called this an "exciting" study when commenting on it for Medscape Medical News.

"When I saw this study, I shared it with a couple of the researchers in my own department, because it's a very nice incremental step forward," he said.

"In terms of linking exercise, physical fitness, and mood disorders, it is a puzzle that we don't have the full picture. This is another piece, and given the fact that the study deals with more than a million human beings, it does give us some ability to dissect apart important variables," Dr. Gelenberg said.

"Now we are having an epidemic of lack of fitness, obesity, diabetes, and cardiovascular problems, but we are learning in my field that these problems are not just restricted to the heart and the endocrine and vascular system; it also seems to have effects on brain health," he said.

Dr. Aberg and Dr. Gelenberg have disclosed no relevant financial relationships.

Br J Psych. Published online June 14, 2012.

    
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