老年期抑郁症患者认知功能及日常生活能力的相关研究
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摘要
目的探讨老年期抑郁症患者治疗前后认知功能、日常生活能力的变化。方法收集2015年7月～2017年7月的老年期抑郁症患者(观察组,艾司西酞普兰片治疗)及健康老年人(对照组),各80例,观察24周。对抑郁情况、认知功能及日常生活能力等进行研究。结果观察组治疗前MMSE、ADL评分均较对照组差(P<0.01);治疗后较前改善(P<0.01),但与对照组比较差异有统计学意义(P<0.01)。观察组治疗前MMSE评分与GDS、ADL均呈负相关(P<0.01);治疗24周末的MMSE及ADL变化值与GDS减分率均无相关性(P>0.05)。ADL变化值与MMSE变化值负相关(P<0.01)。结论急性期老年抑郁症患者存在认知功能及日常生活能力受损;治疗后也未完全恢复。
Objective To investigate the changes of cognitive function and daily living ability in elderly patients with depression before and after treatment. Methods 80 patients with senile depression(observation group, treated by escitalopram tablets) and healthy elderly patients(control group) were collected from July 2015 to July 2017, and they were observed for 24 weeks. The depression, cognitive function and daily living ability were studied. Results The scores of MMSE and ADL in the observation group before treatment were worse than those in the control group(P<0.01); the improvement was improved after treatment(P<0.01), However, the difference was statistically significant compared with the control group(P<0.01). The MMSE scores in the observation group before treatment were negatively correlated with GDS and ADL(P<0.01); there was no correlation between MMSE and ADL change values and GDS reduction rate at the end of 24 weeks of treatment(P>0.05). The ADL change value was negatively correlated with the MMSE change value(P<0.01). Conclusion Patients with senile acute depression have impairment of cognitive function and daily living ability;it is not able to fully recover after treatment.
Objective To investigate the changes of cognitive function and daily living ability in elderly patients with depression before and after treatment. Methods 80 patients with senile depression(observation group, treated by escitalopram tablets) and healthy elderly patients(control group) were collected from July 2015 to July 2017, and they were observed for 24 weeks. The depression, cognitive function and daily living ability were studied. Results The scores of MMSE and ADL in the observation group before treatment were worse than those in the control group(P<0.01); the improvement was improved after treatment(P<0.01), However, the difference was statistically significant compared with the control group(P<0.01). The MMSE scores in the observation group before treatment were negatively correlated with GDS and ADL(P<0.01); there was no correlation between MMSE and ADL change values and GDS reduction rate at the end of 24 weeks of treatment(P>0.05). The ADL change value was negatively correlated with the MMSE change value(P<0.01). Conclusion Patients with senile acute depression have impairment of cognitive function and daily living ability;it is not able to fully recover after treatment.
引文
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[18]Ormel J,Rijsdijk FV,Sullivan M,et al.Temporal and reciprocal relationship between IADL/ADL disability and depressive symptoms in late life[J].J Gerontol B Psychol Sci Soc Sci,2002,57(4):338-347.
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[20]李漫漫,付轶男,吴茂春,等.老年人日常生活活动能力与抑郁相关性的研究[J].现代预防医学,2017,44(21):3957-3961.
[2]袁杰,瞿正万,江琦,等.上海市浦东社区老人抑郁障碍与认知功能障碍流行病学调查[J].临床精神医学杂志,2013,23(2):86-88.
[3]Dranovsky A,Hen R.Hippocampal neurogenesis:regulation by stress and antidepressant[J].Biol Psychiatry,2006,59(11):1136-143.
[4]Panza F,Frisardi V,Capurso C,et a1.Late-life depression,mild cognitive impairment,and dementia:Possible continuum?[J].Am J Geriatr Psychiatry,2010,18(2):98-116.
[5]Korczyn AD,Halperin I.Depression and dementia[J].JNeurol Sci,2009,283(1-2):139-142.
[6]Li G,Wang LY,Shofer JB,et a1.Temporal relationship between depression and dementia:findings from a large community-based 15-year follow-up study[J].Arch Gen Psychiatry,2011,68(9):970-977.
[7]于恩彦.实用老年精神医学[M].浙江大学出版社,2013:23.
[8]张抗,李文元,冯硕,等.临床试验中脱落、退出和失访病例的统计学处理和报告规范[J].中医杂志,2016,57(14):1204-1207.
[9]Dybedal GS,Tanum L,Sundet K.et al.Neuropsychologicalfunctioning in late-lifedepression[J].Front Psychol,2013,4(7):381.
[10]Luo LL,Chert X,Chai Y,et a1.A distinct pattern of memory and attention deficiency in patients with depression[J].Chin Med J(Engl),2013,126(6):1144-1149.
[11]Greenstein AS,Paranthaman R,Burns A,et al.Cerebrovascular damage in late-life depression is associated with structural and functional abnormalities of subcutaneous small arteries[J].Hypertension,2010,56(4):734-740.
[12]Aizenstein HJ,Andreescu C,Edelman KL,et al.fMRIcorrelates of white matter hyperintensities in late-life depression[J].Am J Psychiatry,2011,168(10):1075-1082.
[13]衣磊,于慧,崔维珍.老年抑郁症患者认知功能损害的随访研究[J].四川精神卫生,2015,28(3):230-233.
[14]侯正华,袁勇贵,柏峰,等.老年抑郁症恢复期患者白质长纤维束完整性与认知功能改变的随访研究[J].中华精神科杂志,2014,47(1):12-16.
[15]Moss MP,Roubideaux YD,Jacobsen C,et al.Functional Disability and Associated Factors Among Older Zuni Indians[J].Journal of Cross-Cultural Gerontology,2004,19(1):1-12.
[16]张秀军,孙业桓,倪进发,等.安徽省部分地区农村老年人日常生活能力依赖现状及与慢性病关系[J].中华流行病学杂志,2006,27(12):1096-1097.
[17]Coll-Planas L,Nyqvist F,Puig T,et al.Social capital interventions targeting older People and their impact on health:Asystematicreview[J].Journal of Epidemiology and Community Health,2017,71(7):663-672.
[18]Ormel J,Rijsdijk FV,Sullivan M,et al.Temporal and reciprocal relationship between IADL/ADL disability and depressive symptoms in late life[J].J Gerontol B Psychol Sci Soc Sci,2002,57(4):338-347.
[19]Johnson LA,Hall JR,O’Bryan SE,et al.A depressive endophenotype of mild cognitive impairment and Alzheimer's disease[J].PLoS One,2013,8(7):e68848.
[20]李漫漫,付轶男,吴茂春,等.老年人日常生活活动能力与抑郁相关性的研究[J].现代预防医学,2017,44(21):3957-3961.