Brain and Ageing Research Program, School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick Campus, Building R1f, UNSW, NSW 2052, Sydney, Australia.
J Psychiatr Res. 2011 Dec;45(12):1600-7. doi: 10.1016/j.jpsychires.2011.08.001. Epub 2011 Aug 26.
Depressive symptoms are common in the elderly and they have been associated with cognitive and functional impairment. However, relatively less is known about the relationship of a lifetime history of depression to cognitive impairment and functional status. The aim of this cross-sectional study was to assess whether current depressive symptoms and past depression are associated with cognitive or functional impairment in a community-based sample representative of east Sydney, Australia. We also examined whether there was an interaction between current and past depression in their effects on cognitive performance. Eight hundred non-demented aged participants received a neuropsychological assessment, a past psychiatric history interview and the 15-item Geriatric Depression Scale. The Bayer-Activities of Daily Living scale was completed by an informant to determine functional ability. Clinically relevant depressive symptoms were present in 6.1% of the sample and 16.6% reported a history of depression. Participants with current depression had significantly higher levels of psychological distress and anxiety, and lower life satisfaction and performed worse on memory and executive function compared to participants without current depression. After controlling for anxiety the effect on executive function was no longer significant while the effect on memory remained significant. A history of depression was associated with worse executive function, higher levels of psychological distress and anxiety, and lower life satisfaction. After controlling for psychological distress the effect of past depression on executive function was no longer significant. There were no significant interactions between current and past depression in their effects on cognitive performance. There were no differences between participants with or without current depression and with or without past depression on functional abilities. These results support the view that current and past depressive episodes are associated with poorer cognitive performance but not with functional abilities.
抑郁症状在老年人中很常见，并且与认知和功能障碍有关。然而，关于抑郁症的一生病史与认知障碍和功能状态的关系，人们了解得相对较少。本横断面研究的目的是评估在澳大利亚东悉尼具有代表性的社区样本中，当前的抑郁症状和过去的抑郁是否与认知或功能障碍有关。我们还检查了当前和过去的抑郁在其对认知表现的影响之间是否存在相互作用。800 名非痴呆老年参与者接受了神经心理学评估、过去的精神病病史访谈和 15 项老年抑郁量表评估。由知情人完成 Bayer-日常生活活动量表，以确定功能能力。样本中有 6.1%的人出现临床相关的抑郁症状，16.6%的人有抑郁病史。与没有当前抑郁的参与者相比，当前患有抑郁的参与者的心理困扰和焦虑程度明显更高，生活满意度更低，记忆力和执行功能更差。在控制了焦虑之后，对执行功能的影响不再显著，而对记忆的影响仍然显著。抑郁症病史与较差的执行功能、更高的心理困扰和焦虑水平以及更低的生活满意度有关。在控制了心理困扰之后，过去的抑郁对执行功能的影响不再显著。当前和过去的抑郁在其对认知表现的影响之间没有显著的相互作用。在功能能力方面，有或没有当前抑郁的参与者与有或没有过去抑郁的参与者之间没有差异。这些结果支持当前和过去的抑郁发作与较差的认知表现有关，但与功能能力无关的观点。
