Lam Linda C W, Tam Cindy W C, Chiu Helen F K, Lui Victor W C
Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong.
Int J Geriatr Psychiatry. 2007 May;22(5):431-7. doi: 10.1002/gps.1694.
The relationships between apathy, depression and functional impairment in questionable dementia (QD) and Alzheimer's disease (AD) are complex. This study aimed to explore the interactions between severity of apathy, depression and functional performance; and to investigate the effects of apathy alone, depression alone and coexistence of apathy and depression on the functional performance in subjects with QD and AD.
One hundred ninety-five subjects with QD and 96 subjects with mild AD were recruited. Apathy and depression were rated using the Neuropsychiatric Inventory and functional disability was measured using the Disability Assessment for Dementia (DAD).
Severity of apathy and depression symptoms were associated with poorer functional performance in QD and apathy was associated with poorer functional performance in AD. In QD, subjects with apathy, depression, or coexistence of apathy and depression had poorer functional performance than those with neither apathy nor depression. The coexistence of apathy and depression did not produce more severe functional disability than apathy alone or depression alone. In AD, subjects with apathy had poorer functional performance than those without apathy. Depression in the absence of apathy was not associated with more severe functional disability.
Apathy and depression symptoms are common in the early course of AD. Apathy and depression had different effects on functional performances in the subjects with QD from those with AD.
在可疑痴呆（QD）和阿尔茨海默病（AD）中，淡漠、抑郁与功能损害之间的关系较为复杂。本研究旨在探讨淡漠严重程度、抑郁严重程度与功能表现之间的相互作用；并研究单纯淡漠、单纯抑郁以及淡漠与抑郁共存对QD和AD患者功能表现的影响。
招募了195名QD患者和96名轻度AD患者。使用神经精神科问卷评定淡漠和抑郁，使用痴呆残疾评估量表（DAD）测量功能残疾情况。
在QD中，淡漠和抑郁症状的严重程度与较差的功能表现相关，在AD中，淡漠与较差的功能表现相关。在QD中，有淡漠、抑郁或淡漠与抑郁共存的患者比既无淡漠也无抑郁的患者功能表现更差。淡漠与抑郁共存并未比单纯淡漠或单纯抑郁导致更严重的功能残疾。在AD中，有淡漠的患者比无淡漠的患者功能表现更差。无淡漠时的抑郁与更严重的功能残疾无关。
淡漠和抑郁症状在AD病程早期较为常见。淡漠和抑郁对QD患者功能表现的影响与对AD患者的影响不同。
