Is apathy in late-life depressive illness related to age-at-onset, cognitive function or vascular risk?
Is apathy in late-life depressive illness related to age-at-onset, cognitive function or vascular risk?
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DOI：
10.1017/s1041610204000766
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发表时间：
2004-12-01
影响因子：
7
通讯作者：
Heeren, TJ
中科院分区：
文献类型：
--
作者：
Lampe, IK;Heeren, TJ
背景：冷漠已被证明是退行性、血管性或创伤性脑疾病的一个重要特征。它的存在与抑郁得分高、年龄大、额叶任务表现不佳以及更严重的深部白质高强度有关。在晚年抑郁症中，缺乏兴趣或动力往往比抑郁情绪更突出，尤其是在晚发型中。假设在老年抑郁症患者的异质性样本中，冷漠与晚发性抑郁症、认知功能障碍或血管危险因素有关。方法：对29例老年（大于等于60岁）伴有DSM-IV型重度抑郁或心境恶劣障碍的住院患者实施冷漠评价量表（AES）。采用Montgomery-Asberg抑郁评定量表（MADRS）和认知功能量表（MMSE）对抑郁程度进行测量。在患者的医疗记录中追踪到血管危险因素的存在。结果：86%的患者表现为冷漠。ae -评分与阴性症状评分相关，但与MADRS总分和mmse总分无关。早发性抑郁症患者（n = 16）与晚发性抑郁症患者（n = 13）之间、有无血管危险患者之间的aes -评分无差异。结论：冷漠是老年中重度抑郁症患者的主要特征，与抑郁症的阴性症状有关。进一步的研究应该包括较轻的抑郁症患者，并调查抑郁症严重程度与冷漠之间的关系。
Background: Apathy has been shown to be an important feature of degenerative, vascular or traumatic brain disorder. Its presence is associated with high depression scores, higher age, low performance on frontal tasks, and more severe deep white matter hyperintensities. In late-life depression, lack of interest or motivation are often more prominent than depressed mood, especially in the late-onset type. It was hypothesized that in a heterogeneous sample of elderly depressed patients, apathy is associated with late-onset type of depression, cognitive dysfunction or vascular risk factors.Method: The Apathy Evaluation Scale (AES) was administered to twenty-nine elderly (greater than or equal to 60 years) inpatients with a DSM-IV major depression or dysthymic disorder. The severity of the depression was measured with the Montgomery-Asberg Depression Rating Scale (MADRS) and cognitive function with the Mini-mental State Examination (MMSE). The presence of vascular risk factors was traced in the patient's medical records.Results: Apathy was found in 86% of the patients. The AES-score was correlated with the negative symptom score, but not with total MADRS or MMSE-score. No difference in AES-score between early-onset depressed (n = 16) and late-onset depressed (n = 13) patients was found, and between patients with or without vascular risk.Conclusion: Apathy is a main feature of moderate to severe depressive illness in elderly patients and related to the negative symptoms of the disorder. Further studies should include less severely depressed patients and investigate the relation between depression severity and apathy.