Fossati Philippe, Coyette Françoise, Ergis Anne-Marie, Allilaire Jean-François
Department of Psychiatry, Salpétrière Hospital, 47 Boulevard de l'Hôpital, 75651 Paris Cedex 13, France.
J Affect Disord. 2002 Apr;68(2-3):261-71. doi: 10.1016/s0165-0327(00)00362-1.
Despite many studies demonstrating memory and executive impairments in young and old depressed patients, the relationships between age, executive functioning and memory have not been evaluated in depression. The aim of this study was to investigate if older patients were more vulnerable than younger patients to the impact of depression on memory and if the differences between young and old depressed could be related to executive functioning.
Forty-nine inpatients, with unipolar and bipolar depression, ranging in age from 19 to 72 years were compared with 70 controls on a verbal memory task. Age cut-off of 45 years was used as a categorical variable to divide subjects into subgroups. A subset of patients (n=41) was also evaluated with the modified version of the Wisconsin Card Sorting Test and separated into a non-dysexecutive group and a group of patients with mild-executive impairment.
Depressed patients exhibited memory deficits with a pattern of memory failure -- impaired free recall and normal cued recall and recognition -- interpreted as a retrieval problem. Both age and executive function influenced memory performance in depression, however neither group x age interaction nor age x executive status interaction were significant. Multiple regression analysis showed that free recall scores were related to age and psychomotor retardation in depressed patients.
Age and executive functioning have different influences on the memory performance of depressed patients. Our findings support an 'executive memory decline hypothesis' in young as well as old depressed patients. The memory deficits in depression may be associated with both trait and state factors and raise questions about the long-term cognitive functioning of patients with recurrent affective disorders.
尽管许多研究表明年轻和老年抑郁症患者存在记忆和执行功能障碍，但年龄、执行功能与记忆之间的关系在抑郁症中尚未得到评估。本研究的目的是调查老年患者是否比年轻患者更容易受到抑郁症对记忆的影响，以及年轻和老年抑郁症患者之间的差异是否与执行功能有关。
49名年龄在19至72岁之间的单相和双相抑郁症住院患者与70名对照者在一项言语记忆任务上进行了比较。以45岁为年龄界限作为分类变量将受试者分为亚组。还对一部分患者（n=41）进行了改良版威斯康星卡片分类测验评估，并分为非执行功能障碍组和轻度执行功能障碍组。
抑郁症患者表现出记忆缺陷，其记忆失败模式为——自由回忆受损而线索回忆和识别正常——被解释为检索问题。年龄和执行功能均影响抑郁症患者的记忆表现，然而组×年龄交互作用和年龄×执行状态交互作用均不显著。多元回归分析表明，抑郁症患者的自由回忆分数与年龄和精神运动迟缓有关。
年龄和执行功能对抑郁症患者的记忆表现有不同影响。我们的研究结果支持年轻和老年抑郁症患者的“执行记忆衰退假说”。抑郁症中的记忆缺陷可能与特质因素和状态因素均有关，并引发了关于复发性情感障碍患者长期认知功能的问题。
