a Department of Psychology , Florida State University , Tallahassee , FL , USA.
Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2014;21(1):99-128. doi: 10.1080/13825585.2013.795514. Epub 2013 May 9.
Older adults with major depressive disorder (MDD) may also have preclinical Alzheimer's disease (AD). Differential diagnosis is quite challenging due to the overlapping symptoms of MDD and AD. In the current study, we predicted that impaired long-term memory (an area most affected in early AD), but not executive function (an area affected in MDD and AD), would distinguish older depressed patients who developed AD from those who did not. Patients (N = 120) assessed as having MDD but not dementia at baseline were administered tests of cognitive function and followed longitudinally for subsequent diagnosis of AD. Using structural equation modeling we found a latent construct of long-term memory to be associated with AD to a greater extent than executive functioning. Additional analyses to enhance clinical utility of findings indicated that individual tests of episodic memory were most predictive of AD status. Tests of long-term memory can be utilized by the clinician when assessing for preclinical AD among depressed elderly.
患有重度抑郁症（MDD）的老年人也可能患有临床前阿尔茨海默病（AD）。由于 MDD 和 AD 的症状重叠，鉴别诊断极具挑战性。在当前的研究中，我们预测，与执行功能（MDD 和 AD 均受影响的区域）相比，受损的长期记忆（AD 早期受影响最严重的区域）会区分出患有 AD 的老年抑郁患者和未患有 AD 的患者。在基线时评估患有 MDD 但无痴呆的患者接受认知功能测试，并进行纵向随访以随后诊断 AD。使用结构方程模型，我们发现，与执行功能相比，长期记忆的潜在结构与 AD 的关联程度更大。为增强研究结果的临床实用性而进行的额外分析表明，情景记忆的个别测试对 AD 状态最具预测性。当评估抑郁老年人的临床前 AD 时，临床医生可以使用长期记忆测试。
