Department for Geriatric Psychiatry, Psychiatric Clinic, and Centre for Age-Related Medicine, Stavanger University Hospital, Norway.
Dement Geriatr Cogn Disord. 2011;32(2):143-9. doi: 10.1159/000332016. Epub 2011 Oct 5.
To explore the course of depression in people with mild dementia and identify predictors for depression at 1-year follow-up.
Patients with mild dementia (n = 199) were assessed using Montgomery and Åsberg Depression Rating Scale (MADRS) and the depression item from Neuropsychiatric Inventory (NPI) at baseline and after 1 year. A score above 6 on MADRS indicates at least mild depression. Linear and logistic regression analyses were performed to identify predictors of change in depression scores.
Among subjects with depression at baseline, 68.1% remained depressed at follow-up, whereas 31.9% had remitted, based on MADRS. Among patients without depression at baseline, 77.1% remained non-depressed at follow-up, whereas 22.9% had incident depression. The proportion with persistent depression was higher in the combined dementia with Lewy bodies (DLB)/Parkinson's disease with dementia (PDD) group (45.5%) compared to AD (28%) (p < 0.05). Greater decline on the Mini Mental State Examination (p < 0.001) and higher baseline MADRS score (p < 0.001) were significant predictors of increased MADRS score.
Two thirds of patients with depression at baseline were still depressed at follow-up, more so in DLB with PDD compared to AD. Cognitive decline was associated with worsening of depressive symptoms.
探讨轻度痴呆患者抑郁的病程，并确定 1 年后抑郁的预测因素。
采用蒙哥马利和 Åsberg 抑郁评定量表（MADRS）和神经精神问卷（NPI）中的抑郁项对 199 例轻度痴呆患者进行评估。MADRS 评分高于 6 分表示至少有轻度抑郁。采用线性和逻辑回归分析确定抑郁评分变化的预测因素。
在基线时有抑郁的受试者中，68.1%在随访时仍有抑郁，而 31.9%已缓解，依据是 MADRS。在基线时无抑郁的患者中，77.1%在随访时仍无抑郁，而 22.9%有新发抑郁。在合并路易体痴呆（DLB）/帕金森病痴呆（PDD）的患者中，持续性抑郁的比例（45.5%）高于阿尔茨海默病（AD）（28%）（p<0.05）。简易精神状态检查（MMSE）评分下降更大（p<0.001）和基线 MADRS 评分更高（p<0.001）是 MADRS 评分增加的显著预测因素。
基线时有抑郁的患者中，三分之二在随访时仍有抑郁，在 DLB 与 PDD 中比 AD 更明显。认知能力下降与抑郁症状恶化相关。
