Speed of Processing and Depression Affect Function in Older Adults with Mild Cognitive Impairment
Speed of Processing and Depression Affect Function in Older Adults with Mild Cognitive Impairment
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DOI：
10.1016/j.jagp.2013.01.005
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发表时间：
2013-07-01
影响因子：
7.2
通讯作者：
Roose, Steven P.
中科院分区：
文献类型：
--
作者：
Brown, Patrick J.;Liu, Xinhua;Roose, Steven P.
目的：评估抑郁和认知对遗忘型和非遗忘型轻度认知功能障碍（aMCI和非aMCI）老年人功能的影响。设计：该研究使用来自国家阿尔茨海默氏症协调中心的基线数据。设置：数据收集于美国多个阿尔茨海默病中心。参与者：样本共包括3,117名MCI患者，平均年龄= 7437岁，SD：9.37（aMCI，n = 2,488;非aMCI，n = 629）。测量：10项Pfeffer功能活动问卷评估功能。结果如下：抑郁症状（老年抑郁量表）、记忆障碍（逻辑记忆II）和处理速度下降（数字符号替代测试）与功能障碍显著相关（p <0.001）。在总MCI和aMCI子样本中，加工速度部分介导抑郁对功能的影响，完全介导执行功能障碍对功能的影响（p <0.001），而在非aMCI子样本中，加工速度介导执行功能的影响，但不介导抑郁对功能的影响（p = 0.20）。结论：研究结果表明，处理速度是抑郁症和执行功能障碍对认知受损老年人功能障碍的影响的核心。未来的研究需要更好地了解与年龄相关和疾病特异性的处理速度下降的生理基础，并解决临床样本处理速度评估中的问题。
Objectives: To evaluate the effect of depression and cognition on function in older adults with amnestic and nonamnestic mild cognitive impairment (aMCI and non-aMCI). Design: The study uses baseline data from the National Alzheimer's Coordinating Center. Setting: Data were collected at multiple Alzheimer's Disease Centers in the United States. Participants: The sample included a total of 3,117 individuals with MCI, mean age = 7437 years, SD: 9.37 (aMCI, n = 2,488; non-aMCI, n = 629). Measurements: The 10-item Pfeffer Functional Activities Questionnaire assessed function. Results: Depressive symptoms (Geriatric Depression Scale), memory impairment (Logical Memory II), and processing speed decrements (Digit Symbol Substitution Test) were significantly associated with functional impairment (p < 0.001). Processing speed partially mediated the effect of depression on function and fully mediated the effect of executive dysfunction on function (p < 0.001) in the total MCI and aMCI subsample, while in the non-aMCI subsample, processing speed mediated the effect of executive function but not the effect of depression (p = 0.20) on function. Conclusions: The findings show that processing speed is central to the effect that depression and executive dysfunction have on functional impairment in cognitively impaired older adults. Future studies are needed to better understand the physiologic underpinnings in age-related and disease-specific decrements in processing speed, and to address the problems in the assessment of processing speed in clinical samples.