Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA.
Int J Geriatr Psychiatry. 2012 Jan;27(1):89-96. doi: 10.1002/gps.2697. Epub 2011 Feb 24.
Depression in non-demented persons has been identified as a possible risk factor for incident Alzheimer's disease (AD).
Latent Growth Curve models were developed of baseline depressive symptoms as a predictor of longitudinal changes in cognition. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS). Memory was assessed by the California Verbal Learning Task (CVLT). Executive control function (ECF) was assessed by the Executive Interview (EXIT25) and Trail-Making Test Part B (Trails-B). Five hundred forty-seven non-institutionalized older retirees living in a single comprehensive care retirement community participated.
Depressive symptoms were significantly associated only with the 3-year rate of decline in psychomotor speed, as measured by Trails A, and ECF, as measured by the EXIT25. Both associations withstood adjustment for age, gender, education, and baseline level of care.
Depressive symptoms are associated with longitudinal decline in cognition. However, this association selectively involves executive control, not memory, and possibly only a subset of 'executive' functions. Although depressive symptoms may hasten conversion from mild cognitive impairment (MCI) to dementia, depression-related conversion is not likely to be mediated by evolution of the AD pathological process.
非痴呆人群的抑郁被认为是阿尔茨海默病（AD）发病的一个潜在危险因素。
采用潜在增长曲线模型，以基线抑郁症状为预测因子，对认知的纵向变化进行分析。采用老年抑郁量表（GDS）的 15 项条目评估抑郁症状。采用加利福尼亚词语学习测验（CVLT）评估记忆。采用执行功能测试（EXIT25）和连线测试 B 部分（Trails-B）评估执行控制功能（ECF）。共有 547 名居住在单一综合性退休社区的非住院老年退休人员参与了该研究。
抑郁症状仅与 Trails A 测量的精神运动速度和 EXIT25 测量的 ECF 的 3 年下降率显著相关。这两个关联均经年龄、性别、教育程度和基线护理水平调整后仍存在。
抑郁症状与认知的纵向下降有关。然而，这种关联选择性地涉及执行控制，而不是记忆，可能只涉及“执行”功能的一个子集。尽管抑郁症状可能会加速从轻度认知障碍（MCI）向痴呆的转化，但与抑郁相关的转化不太可能是由 AD 病理过程的演变介导的。
