Bhalla Rishi K, Butters Meryl A, Mulsant Benoit H, Begley Amy E, Zmuda Michelle D, Schoderbek Beth, Pollock Bruce G, Reynolds Charles F, Becker James T
Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Am J Geriatr Psychiatry. 2006 May;14(5):419-27. doi: 10.1097/01.JGP.0000203130.45421.69.
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.
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).
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.
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.
老年期抑郁症（LLD）中的认知障碍普遍存在、导致残疾，且即便抑郁症状缓解仍会持续。本文描述了LLD缓解期的神经心理功能。
作者对56名60岁及以上的非痴呆受试者进行了全面神经心理测验的纵向评估，这些受试者最初表现为非精神病性单相重度抑郁发作，另有40名年龄和教育程度匹配、无抑郁病史的非痴呆对照受试者。在基线（抑郁状态）和一年后（缓解时）对受试者进行评估。
一年后，45%的LLD受试者尽管抑郁已缓解，但仍存在认知障碍。视觉空间能力、信息处理速度和延迟记忆最常受损；基线时受损的患者中有94%在一年后仍存在损伤。23%抑郁时认知正常的患者在一年后出现了损伤。
大多数在抑郁发作期间存在认知障碍的老年人在抑郁缓解后仍存在损伤。此外，相当一部分抑郁时认知完好的老年抑郁个体尽管抑郁已缓解，但一年后可能会出现损伤。
