Croisile B, Astier J-L, Beaumont C, Mollion H
Service de neuropsychologie, centre mémoire de ressources et de recherche de Lyon, hôpital neurologique, 59, boulevard Pinel, 69677 Bron cedex, France.
Encephale. 2011 Apr;37(2):127-32. doi: 10.1016/j.encep.2010.10.003. Epub 2010 Dec 3.
Patients with major depression (MD) express frequent memory complaints leading to consultations in memory clinics. The 5-word test (5WT) is a verbal memory test with semantic cueing, which has shown its sensitivity and its specificity in identifying patients with Alzheimer's disease (AD). Our objective was to evaluate memory performances of aged patients with MD compared with controls and AD patients.
Characteristics of the 5WT were investigated in a sample of 37 patients with MD (66.8±7.5 years) compared with 36 normal controls (67.3±6.8 years) and 35 mild AD patients (67.5±6.1 years).
Duration of depression was 15.3±11.5 years. Memory complaints of MD patients were ancient (4.6±5.5 years) and severe (McNair memory questionnaire=47.6±20.7). The Total score of MD patients did not differ from controls but was greater than those of AD patients. Learning and Memory scores of MD patients were significantly lower than those of controls and significantly greater than those of AD patients. Forgetting rate between Learning and Memory scores was more important in AD (72.4%) than in controls (2.8%) and MD (13.6%). No intrusions were recorded in controls, three MD patients each made one intrusion, whereas 80% of AD patients made between one to six intrusions (mainly during cued delayed recall). Receiver operating characteristic curves determined the most significant cut-off scores of the Total score. It appeared easy to discriminate AD patients from controls (cut-off=9, sensitivity=94.3%, specificity=100%) or MD patients (cut-off=8, sensitivity=88.5%, specificity=89.2%) whereas it was more difficult to discriminate MD patients from controls (cut-off=10, specificity=88.9%, sensitivity=37.8%).
MD patients had significant difficulties with the 5WT as compared to controls, without being of the magnitude of those observed in AD patients.
The 5WT allows a reliable evaluation of memory in MD patients. The presence of true memory deficits with the 5WT could not be ascribed to depression but to other pathological conditions. Consequently, further memory testing should be conducted.
重度抑郁症（MD）患者常诉说存在记忆问题，因而会前往记忆门诊咨询。5 词测试（5WT）是一种带有语义提示的言语记忆测试，已显示出其在识别阿尔茨海默病（AD）患者方面的敏感性和特异性。我们的目的是评估老年 MD 患者与对照组及 AD 患者相比的记忆表现。
在 37 例 MD 患者（66.8±7.5 岁）的样本中研究 5WT 的特征，并与 36 名正常对照组（67.3±6.8 岁）和 35 例轻度 AD 患者（67.5±6.1 岁）进行比较。
抑郁持续时间为 15.3±11.5 年。MD 患者的记忆问题出现时间较早（4.6±5.5 年）且较为严重（麦克奈尔记忆问卷评分为 47.6±20.7）。MD 患者的总分与对照组无差异，但高于 AD 患者。MD 患者的学习和记忆得分显著低于对照组，且显著高于 AD 患者。AD 组学习与记忆得分之间的遗忘率（72.4%）高于对照组（2.8%）和 MD 组（13.6%）。对照组未记录到错误回忆，3 例 MD 患者各出现一次错误回忆，而 80%的 AD 患者出现一至六次错误回忆（主要在提示延迟回忆期间）。受试者工作特征曲线确定了总分的最显著临界值。区分 AD 患者与对照组（临界值 = 9，敏感性 = 94.3%，特异性 = 100%）或 MD 患者（临界值 = 8，敏感性 = 88.5%，特异性 = 89.2%）似乎很容易，而区分 MD 患者与对照组则较困难（临界值 = 10，特异性 = 88.9% , 敏感性 =37.8%）。
与对照组相比，MD 患者在 5WT 测试中存在显著困难，但程度不及 AD 患者。
5WT 可对 MD 患者进行可靠的记忆评估。5WT 测试中出现的真正记忆缺陷并非由抑郁所致，而是由其他病理状况引起。因此，应进行进一步的记忆测试。
