Persistence of neuropsychologic deficits in the remitted state of late-life depression
Persistence of neuropsychologic deficits in the remitted state of late-life depression
复制标题
DOI：
10.1097/01.jgp.0000203130.45421.69
复制
发表时间：
2006-05-01
影响因子：
7.2
通讯作者：
Becker, JT
中科院分区：
文献类型：
--
作者：
Bhalla, RK;Butters, MA;Becker, JT
目的：晚年抑郁症 (LLD) 中的认知障碍很普遍，令人丧失能力，并且尽管抑郁症状有所缓解，但认知障碍仍然持续存在。本文描述了 LLD 缓解期间的神经心理功能。方法：作者检查了 56 名 60 岁或以上的非痴呆受试者（最初表现为非精神病性单相重性抑郁发作）和 40 名非痴呆受试者（与年龄和教育程度相当、无抑郁病史）的综合神经心理学电池的纵向表现。受试者在基线（处于抑郁状态）和一年后（病情缓解时）进行评估。结果：一年后，尽管抑郁症有所缓解，但 45% 的 LLD 受试者仍存在认知障碍。视觉空间能力、信息处理速度和记忆延迟最常受到损害； 94% 基线时受损的患者一年后仍然受损。抑郁期间认知功能正常的患者中有 23% 一年后出现障碍。结论：大多数在抑郁发作期间出现认知障碍的老年人在抑郁缓解后仍然会受到损害。此外，很大一部分老年抑郁症患者在抑郁时认知能力完好，但一年后可能会受到损害，尽管他们的抑郁症已经缓解。
Objective: Cognitive impairment in late-life depression (LLD) is prevalent, disabling, and persists despite the remission of depressive symptoms. This article characterizes neuropsychologic functioning during remission in LLD. Methods: The authors examined longitudinal performance on a comprehensive neuropsychologic battery in 56 nondemented subjects age 60 or older who initially presented with an episode of nonpsychotic unipolar major depression and 40 nondemented, age- and education-equated comparison subjects with no history of depression. Subjects were assessed at baseline (in a depressed state) and one year later (when remitted). Results: After one year, 45% of the LLD subjects were cognitively impaired despite remission of depression. Visuospatial ability, information-processing speed, and delayed memory were most frequently impaired; 94% of the patients who were impaired at baseline remained impaired one year later. Twenty-three percent of the patients who were cognitively normal while depressed developed impairment one year later. Conclusions: Most older individuals who are cognitively impaired during a depressive episode remain impaired when their depression remits. In addition, a substantial proportion of older depressed individuals who are cognitively intact when depressed are likely to be impaired one year later, although their depression has remitted.