Steffens David C, Welsh-Bohmer Kathleen A, Burke James R, Plassman Brenda L, Beyer John L, Gersing Kenneth R, Potter Guy G
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA.
J Geriatr Psychiatry Neurol. 2004 Dec;17(4):202-11. doi: 10.1177/0891988704269819.
A methodology is presented for following a cohort of older depressed patients to examine neurocognitive outcomes of depression. A total of 265 depressed individuals and 138 healthy, nondepressed controls age 60 and older who completed at least 1 year of follow-up data underwent periodic clinical evaluation by a geriatric psychiatrist. A subset of 141 patients and 137 controls had neuropsychological testing. A consensus panel of experts reviewed 63 depressed subjects with suspected cognitive impairment. Twenty-seven individuals in the depressed group were assigned diagnoses of dementia, including 11 with Alzheimer's disease, 8 with vascular dementia, and 8 with dementia of undetermined etiology. In addition, 25 individuals had other forms of cognitive impairment, and 11 were considered cognitively normal. Among elderly controls, 2 developed substantial cognitive impairment with clinical diagnoses of dementia. Among the depressed group, the incidence rates for dementia for this age are much higher than would be expected. These results are consistent with prior evidence linking depression and later dementia. Future studies are needed to examine neuroimaging and genetic, clinical, and social predictors of neurocognitive decline in depression.
本文介绍了一种对老年抑郁症患者队列进行跟踪研究的方法，以检查抑郁症的神经认知结果。共有265名抑郁症患者和138名60岁及以上的健康非抑郁症对照者完成了至少1年的随访数据，并接受了老年精神病医生的定期临床评估。其中141名患者和137名对照者进行了神经心理学测试。一个专家共识小组对63名疑似认知障碍的抑郁症患者进行了评估。抑郁症组中有27人被诊断为痴呆症，其中11人患有阿尔茨海默病，8人患有血管性痴呆，8人病因不明。此外，25人有其他形式的认知障碍，11人认知正常。在老年对照组中，有2人出现了严重的认知障碍并被临床诊断为痴呆症。在抑郁症组中，这个年龄段的痴呆症发病率远高于预期。这些结果与之前将抑郁症与后期痴呆症联系起来的证据一致。未来需要进行研究，以检查抑郁症患者神经认知衰退的神经影像学、遗传、临床和社会预测因素。
