Taylor Warren D, Wagner H Ryan, Steffens David C
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, DUMC 3903, Durham, NC 27710, USA.
Am J Geriatr Psychiatry. 2002 Sep-Oct;10(5):632-5.
Elderly depressed patients often exhibit cognitive deficits, which may improve with drug therapy. The authors investigated the relationship of baseline depression severity and cognitive improvement with antidepressant treatment in depressed patients with mild cognitive impairment.
Mini-Mental State Exam (MMSE) and Montgomery-Asberg Depression Rating Scale (MADRS) scores were measured in 52 depressed geriatric patients without dementia at baseline, 6, and 12 months, during an intent-to-treat period. A repeated-measures regression model tested the effect of MADRS score on MMSE.
MMSE changes were significant and linear over time, with an average increase of 0.72 in the MMSE per 6-month interval. The final model showed that for every point increase in baseline MADRS, the average 6-month increase in MMSE decreased by 0.12. Repeated MADRS measurements did not significantly alter its predictive value.
Greater baseline depression severity in older subjects with mild cognitive deficits is associated with less improvement in those deficits even with successful antidepressant therapy.
老年抑郁症患者常表现出认知缺陷，药物治疗可能会改善这些缺陷。作者研究了轻度认知障碍抑郁症患者基线抑郁严重程度与抗抑郁治疗后认知改善之间的关系。
在52例无痴呆的老年抑郁症患者的意向性治疗期间，于基线、6个月和12个月时测量简易精神状态检查表（MMSE）和蒙哥马利-艾斯伯格抑郁评定量表（MADRS）得分。重复测量回归模型检验了MADRS得分对MMSE的影响。
MMSE随时间变化显著且呈线性，每6个月间隔MMSE平均增加0.72。最终模型显示，基线MADRS每增加1分，MMSE平均6个月增加量减少0.12。重复的MADRS测量未显著改变其预测价值。
轻度认知缺陷的老年受试者基线抑郁严重程度越高，即使抗抑郁治疗成功，这些缺陷的改善也越少。
