The course of geriatric depression with "reversible dementia": a controlled study.
The course of geriatric depression with "reversible dementia": a controlled study.
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DOI：
10.1176/ajp.150.11.1693
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发表时间：
1993-11
期刊：
影响因子：
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通讯作者：
G. Alexopoulos;B. Meyers;R. Young;S. Mattis;T. Kakuma
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文献类型：
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作者：
G. Alexopoulos;B. Meyers;R. Young;S. Mattis;T. Kakuma
目的1)研究抑郁症改善后痴呆综合征消退的老年抑郁症患者不可逆性痴呆的发生率，并与非痴呆的抑郁症患者进行比较。方法选择连续住院的57例老年抑郁症患者为研究对象。在进入这项研究时，23名受试者也符合“可逆性痴呆症”的标准，而34名受试者没有痴呆症。经过系统的临床评估后，受试者平均每年进行一次随访，平均时间为33.8个月。结果抑郁症伴可逆性痴呆组发生不可逆性痴呆的比例(43%)明显高于单纯抑郁组(12%)。生存分析显示，可逆性痴呆组在随访时患痴呆症的几率是单纯抑郁症患者的4.69倍。在进入这项研究时，没有发现临床特征可以区分在随访期内发展为不可逆性痴呆的受试者和那些保持非痴呆状态的受试者。结论老年抑郁症伴可逆性痴呆是一个临床实体，包括一组早期痴呆患者。因此，识别可逆性痴呆综合征是彻底的诊断检查和频繁的随访的指征，以便识别可治疗的神经疾病。
OBJECTIVE The goals of this longitudinal investigation were 1) to study the rate of development of irreversible dementia in elderly depressed patients with a dementia syndrome that subsided after improvement of depression and 2) to compare it with that of depressed, never-demented patients. METHOD The subjects were 57 elderly patients consecutively hospitalized for major depression. At entry into the study, 23 subjects also met criteria for "reversible dementia," while 34 were without dementia. After a systematic clinical evaluation, the subjects were followed up at approximately yearly intervals for an average of 33.8 months. RESULTS Irreversible dementia developed significantly more frequently in the depressed group with reversible dementia (43%) than in the group with depression alone (12%). Survival analysis showed that the group with reversible dementia had a 4.69-times higher chance of having developed dementia at follow-up than the patients with depression alone. No clinical characteristics at entry into the study were found to discriminate the subjects who developed irreversible dementia during the follow-up period from those who remained nondemented. CONCLUSIONS These findings suggest that geriatric depression with reversible dementia is a clinical entity that includes a group of patients with early-stage dementing disorders. Therefore, identification of a reversible dementia syndrome is an indication for a thorough diagnostic workup and frequent follow-ups in order to identify treatable neurological disorders.