Pálsson S, Larsson L, Tengelin E, Waern M, Samuelsson S, Hällstro T, Skoog I
Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Göteborg, Sweden.
Psychol Med. 2001 Jan;31(1):39-49. doi: 10.1017/s0033291799003050.
Hospital-based studies report that depression in the elderly is associated with brain atrophy. This notion could not be confirmed in a population study on 85-year-olds. We aimed to assess depression in relation to brain atrophy and cognition in 70- and 74-year-old women. METHODS; A representative sample of 70- and 74-year-old women (N = 501) was examined with a psychiatric examination including the Mini-Mental State Examination (MMSE), measuring global cognitive function, and computerized tomography (CT) of the brain (N = 268). Depression was diagnosed according to DSM-III-R. Previous depression was diagnosed by history and by information from previous examinations in this 24-year longitudinal study.
The prevalence of depression was 11.6%, including 8.4% with major depression (MDD). Among those who were currently mentally healthy, 43.0% had a history of previous depression. Women with current MDD had lower scores on the MMSE than the mentally healthy women. This association was only found in women with a lower level of education. Current depressives, previous depressives and mentally healthy women without a history of depression did not differ on CT with regard to brain atrophy or white matter lesions. The association between MDD and lower cognitive performance was independent of the association of cognitive performance with structural brain changes on CT.
Brain atrophy on CT is not associated with depression in the general population, despite the fact that individuals with depression have a worse cognitive performance. The finding that cognitive performance was not decreased in individuals with previous depression suggests that cognitive dysfunction is a state phenomenon in depression.
基于医院的研究报告称，老年人的抑郁症与脑萎缩有关。但这一观点在一项针对85岁老人的人群研究中未能得到证实。我们旨在评估70岁和74岁女性中抑郁症与脑萎缩及认知的关系。
对70岁和74岁女性的代表性样本（N = 501）进行了精神检查，包括简易精神状态检查表（MMSE）以测量整体认知功能，以及脑部计算机断层扫描（CT）（N = 268）。根据《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）诊断抑郁症。在这项为期24年的纵向研究中，既往抑郁症通过病史及以往检查信息进行诊断。
抑郁症患病率为11.6%，其中重度抑郁症（MDD）患病率为8.4%。在目前精神健康的人群中，43.0%有既往抑郁症病史。患有当前MDD的女性在MMSE上的得分低于精神健康女性。这种关联仅在教育程度较低的女性中发现。当前抑郁症患者、既往抑郁症患者以及无抑郁症病史的精神健康女性在CT检查的脑萎缩或白质病变方面没有差异。MDD与较低认知表现之间的关联独立于认知表现与CT上脑结构变化的关联。
尽管抑郁症患者的认知表现较差，但CT上的脑萎缩与普通人群的抑郁症无关。既往抑郁症患者认知表现未下降这一发现表明，认知功能障碍是抑郁症中的一种状态现象。
