Changes in cognitive functioning following treatment of late-life depression
Changes in cognitive functioning following treatment of late-life depression
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DOI：
10.1176/appi.ajp.157.12.1949
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发表时间：
2000-12-01
影响因子：
17.7
通讯作者：
Reynolds, CF
中科院分区：
文献类型：
--
作者：
Butters, MA;Becker, JL;Reynolds, CF
目的：对各种临床特征与认知功能之间关系的认识正在不断提高，但对老年抑郁症治疗的认知反应知之甚少。本研究的目的是探讨老年抑郁症患者对治疗的认知反应。方法：研究对象包括45例经12周抗抑郁治疗后获得缓解的老年痴呆患者和20例老年对照患者。所有受试者在治疗前后都接受了一系列临床测量，包括认知筛查工具。结果：作为一个群体，老年抑郁症患者在治疗后整体认知功能有小幅改善。在基线时伴有认知障碍的抑郁症患者中，与认知正常的抑郁症患者相比，Mattis痴呆评定量表概念化和开始/坚持性领域的表现显著提高。尽管治疗后认知功能有所改善，但伴有认知障碍的老年抑郁症患者的认知功能总体水平在基线时仍处于轻度受损状态，尤其是在记忆和开始/坚持领域。结论：有认知障碍的老年抑郁症患者在接受抗抑郁药物治疗后，可能在特定领域有所改善，但不一定能达到正常的表现水平，尤其是在记忆和执行功能方面。这一亚组的晚期抑郁症患者很可能有发展为进行性痴呆的高风险。
Objective: Knowledge of the relationship between various clinical characteristics and cognitive functioning is advancing, but little is known about the cognitive response to treatment for geriatric depression. The purpose of this study was to examine the cognitive response to treatment for patients with late-life depression.Method: Subjects included 45 nondemented, elderly depressed patients who achieved remission after 12 weeks of antidepressant treatment and 20 elderly comparison subjects. All subjects were administered a battery of clinical measures, including cognitive screening instruments, before and after treatment.Results: As a group, the elderly depressed patients showed a small improvement in overall cognitive functioning after treatment. Among depressed patients with concomitant cognitive impairment at baseline, performance on the Mattis Dementia Rating Scale domains of conceptualization and initiation/perseveration improved significantly relative to those of depressed patients with normal cognition. Despite the improvement following treatment, the overall level of cognitive functioning in the elderly depressed patients with cognitive impairment at baseline remained mildly impaired, especially in the memory and initiation/perseveration domains.Conclusions: Elderly depressed patients with cognitive impairment may experience improvement in specific domains following antidepressant treatment but may not necessarily reach normal levels of performance, particularly in memory and executive functions. This subgroup of late-life depression patients is likely at high risk of developing progressive dementia.