Chu Chung-Shiang, Sun I-Wen, Begum Aysha, Liu Shen-Ing, Chang Ching-Jui, Chiu Wei-Che, Chen Chin-Hsin, Tang Hwang-Shen, Yang Chia-Li, Lin Ying-Chin, Chiu Chih-Chiang, Stewart Robert
Department of Psychiatry, Cardinal Tien Hospital, New Taipei City, Taiwan.
Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.
PLoS One. 2017 Mar 7;12(3):e0173027. doi: 10.1371/journal.pone.0173027. eCollection 2017.
The goal of this study is to investigate associations between subjective memory complaint and objective cognitive performance in older people with previous major depression-a high-risk sample for cognitive impairment and later dementia. A cross-sectional study was carried out in people aged 60 or over with previous major depression but not fulfilling current major depression criteria according to DSM-IV-TR. People with dementia or Mini-Mental State Examination score less than 17 were excluded. Subjective memory complaint was defined on the basis of a score ≧4 on the subscale of Geriatric Mental State schedule, a maximum score of 8. Older people aged equal or over 60 without any psychiatric diagnosis were enrolled as healthy controls. Cognitive function was evaluated using a series of cognitive tests assessing verbal memory, attention/speed, visuospatial function, verbal fluency, and cognitive flexibility in all participants. One hundred and thirteen older people with previous major depression and forty-six healthy controls were enrolled. Subjective memory complaint was present in more than half of the participants with depression history (55.8%). Among those with major depression history, subjective memory complaint was associated with lower total immediate recall and delayed verbal recall scores after adjustment. The associations between subjective memory complaint and worse memory performance were stronger in participants with lower depressive symptoms (Hamilton Depression Rating Scale score<7). The results suggest subjective memory complaint may be a valid appraisal of memory performance in older people with previous major depression and consideration should be given to more proactive assessment and follow-up in these clinical samples.
本研究的目的是调查既往有重度抑郁症的老年人（认知障碍和晚期痴呆的高危人群）主观记忆主诉与客观认知表现之间的关联。对年龄在60岁及以上、既往有重度抑郁症但不符合DSM-IV-TR现行重度抑郁症标准的人群进行了一项横断面研究。排除患有痴呆症或简易精神状态检查表得分低于17分的人。主观记忆主诉是根据老年精神状态检查表分量表得分≧4（满分8分）来定义的。年龄在60岁及以上且无任何精神疾病诊断的老年人被纳入作为健康对照。使用一系列认知测试对所有参与者的语言记忆、注意力/速度、视觉空间功能、语言流畅性和认知灵活性进行评估。共招募了113名既往有重度抑郁症的老年人和46名健康对照。有抑郁病史的参与者中超过一半（55.8%）存在主观记忆主诉。在有重度抑郁病史的人群中，调整后主观记忆主诉与较低的总即时回忆和延迟语言回忆得分相关。在抑郁症状较轻（汉密尔顿抑郁量表得分<7）的参与者中，主观记忆主诉与较差记忆表现之间的关联更强。结果表明，主观记忆主诉可能是对既往有重度抑郁症的老年人记忆表现的有效评估，在这些临床样本中应考虑进行更积极的评估和随访。
