Memory Research Center, Department of Neurology, Hospital General Abel Zubizarreta, GCBA Buenos Aires, Argentina.
Neuropsychiatr Dis Treat. 2009;5:517-26. doi: 10.2147/ndt.s7320. Epub 2009 Oct 12.
To contrast early-onset (<60 years) and late-onset (>60 years) depression in geriatric patients by evaluating differences in cognition, vascular comorbidity and sociological risk factors. Both patient groups were compared with normal subjects.
We recruited 76 patients with depressive symptoms (37 late onset and 39 early onset) and 17 normal controls matched by age and educational level. All subjects were assessed using a semistructured neuropsychiatric interview and an extensive neuropsychological battery. Vascular and sociological risk factors were also evaluated.
We found a significant variation in performance between depressive patients and normal controls in most cognitive functions, especially memory (P < 0.0001), semantic fluency (P < 0.0001), verbal fluency, and digit-symbol (P < 0.0001). Late-onset depression patients scored lower and exhibited more severe impairment in memory domains than early-onset depression patients (P < 0.05). Cholesterol levels and marital status were significantly (P < 0.05) different between the depressive groups. Both depressed groups (early- and late-onset) were more inactive than controls (P < 0.05; odds ratio: 6.02).
Geriatric depression may be a manifestation of brain degeneration, and the initial symptom of a dementia. It is important to consider this in the treatment of patients that exhibit late-onset depressive symptoms.
通过评估认知、血管合并症和社会学危险因素方面的差异,对比老年患者中的早发性(<60 岁)和晚发性(>60 岁)抑郁症。将这两个患者组与正常对照组进行比较。
我们招募了 76 名有抑郁症状的患者(37 名晚发性和 39 名早发性)和 17 名年龄和教育程度相匹配的正常对照者。所有受试者均采用半结构式神经精神访谈和广泛的神经心理学测试进行评估。还评估了血管和社会学危险因素。
我们发现,在大多数认知功能(尤其是记忆[P<0.0001]、语义流畅性[P<0.0001]、词语流畅性和数字符号[P<0.0001])中,抑郁患者与正常对照组之间的表现存在显著差异。晚发性抑郁症患者的记忆力比早发性抑郁症患者更差,且损害程度更严重(P<0.05)。胆固醇水平和婚姻状况在抑郁组之间存在显著差异(P<0.05)。与对照组相比,两个抑郁组(早发性和晚发性)的活动量都更少(P<0.05;优势比:6.02)。
老年抑郁症可能是大脑退化的表现,也是痴呆症的初始症状。对于表现为晚发性抑郁症状的患者,在治疗中考虑这一点很重要。