IADL functions, cognitive deficits, and severity of depression - A preliminary study
IADL functions, cognitive deficits, and severity of depression - A preliminary study
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DOI：
10.1176/appi.ajgp.13.3.244
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发表时间：
2005-03-01
影响因子：
7.2
通讯作者：
Alexopoulos, GS
中科院分区：
文献类型：
--
作者：
Kiosses, DN;Alexopoulos, GS
目的：尽管老年抑郁症患者的认知功能障碍与工具性日常生活活动（IADL）障碍存在相关性，但不同IADL障碍与抑郁症严重程度和特定认知障碍之间的关系仍有待澄清。作者研究了抑郁症严重程度与注意力、启动/持续、建构、概念化和记忆等认知领域与9种不同IADL的关系。方法：研究对象为105例非痴呆老年患者，但至少有一项IADL受损，有抑郁症病史或存在。分别采用费城多水平评定量表（MAI）和24项汉密尔顿抑郁量表（Ham-D）评估IADL受损情况和抑郁严重程度。采用简易精神状态检查量表（MMSE）和Mattis痴呆评定量表（DRS）评估认知功能障碍。结果：6名IADL受至少一个认知领域损害的影响。执行功能障碍的一个方面，启动/持续行为的异常评分是影响大多数IADL的认知障碍;它干扰了购买杂货、做饭、服药和理财的能力。在启动/持续的损害有一个最突出的影响，在抑郁症状的存在，并影响购物杂货和准备饭菜。缺乏兴趣和动力，抑郁综合征的一部分，加上执行功能障碍导致的行为异常，可能是这种相互作用的原因。结论：这些关系可能为开发针对与特定认知功能障碍和抑郁症相关的功能缺陷的干预措施提供背景。
Objective: Despite the documented association of cognitive dysfunction with impairment in instrumental activities of daily living (IADLs) in geriatric depression, the relationship among deficits in distinct IADLs with severity of depression and specific cognitive impairments remains to be clarified. The authors examined the relationship of depression severity and the cognitive domains of attention, initiation/perseveration, construction, conceptualization, and memory to nine distinct IADLs. Methods: The subjects were 105 nondemented elderly patients but with impairment in at least one IADL and a history or presence of major depression. Impairment in IADLs and severity of depression were assessed with the Philadelphia Multilevel Assessment Instrument (MAI) and the 24-item Hamilton Depression Rating Scale (Ham-D), respectively. Cognitive dysfunction was assessed with the Mini-Mental State Exam (MMSE) and the Mattis Dementia Rating Scale (DRS). Results: Six IADLs were influenced by impairment in at least one of the cognitive domains. Abnormal scores in initiation/ perseveration, an aspect of executive dysfunction, was the cognitive impairment affecting most IADLs; it interfered with the ability to shop for groceries, prepare meals, take medicine, and manage money. Impairment in initiation/ perseveration had a most prominent effect in the presence of depressive symptoms and affected shopping for groceries and preparing meals. Lack of interest and motivation, part of the depressive syndrome, compounded by behavioral abnormalities resulting from executive dysfunction, may account for this interaction. Conclusions: These relationships may provide the background for developing interventions targeting functional deficits associated with specific cognitive dysfunctions and depression.