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遗忘型轻度认知损害伴阈下抑郁的认知缺陷特征。

Characteristics of Cognitive Deficit in Amnestic Mild Cognitive Impairment With Subthreshold Depression.

机构信息

1 School of Mental Health, Wenzhou Medical University, Wenzhou, China.

2 Peking University Institute of Mental Health (Sixth Hospital), Beijing, China.

出版信息

J Geriatr Psychiatry Neurol. 2019 Nov;32(6):344-353. doi: 10.1177/0891988719865943.

Abstract

It is widely recognized that depression may precipitate the incidence of dementia in the elderly individuals and individuals with amnestic mild cognitive impairment (aMCI) in particular. However, the association between subthreshold depression (SD) and cognitive deficits in patients with aMCI remains unclear. To address this, we collected demographic information and conducted a battery of neuropsychological cognitive assessments in 33 aMCI participants with SD (aMCI/SD+), 33 nondepressed aMCI participants (aMCI/SD-), and 53 normal controls (NC). Both aMCI groups showed significantly poorer performance in most cognitive domains relative to the NC group (ie, memory, language, processing speed, and executive function). Notably, the aMCI/SD+ group showed significantly poorer attention/working memory compared with the aMCI/SD- group. Multiple linear regression analyses revealed a significant negative association between the severity of depressive symptoms and attention/working memory capacity (β = - .024, = .024), accounting for 8.28% of the variations in this cognitive domain. All statistical analyses were adjusted by age, sex, and years of education. A logistic regression model had an accuracy of 72.4% in discriminating between the aMCI/SD+ and aMCI/SD- groups based on individual cognitive profiles over 6 domains. Our findings indicate that patients with aMCI with and without SD have distinct patterns of cognitive impairment. This finding may facilitate the diagnosis and treatment of SD in patients with aMCI.

摘要

人们普遍认为,抑郁可能会促使老年人和遗忘型轻度认知障碍(aMCI)患者发生痴呆。然而,亚临床抑郁(SD)与 aMCI 患者认知缺陷之间的关系尚不清楚。为了解决这个问题,我们收集了人口统计学信息,并对 33 名有 SD 的 aMCI 患者(aMCI/SD+)、33 名无抑郁的 aMCI 患者(aMCI/SD-)和 53 名正常对照(NC)进行了一系列神经心理学认知评估。两个 aMCI 组在大多数认知领域的表现明显比 NC 组差(即记忆、语言、处理速度和执行功能)。值得注意的是,aMCI/SD+组的注意力/工作记忆明显比 aMCI/SD-组差。多元线性回归分析显示,抑郁症状的严重程度与注意力/工作记忆能力呈显著负相关(β=-.024,=.024),占该认知域变化的 8.28%。所有统计分析均通过年龄、性别和受教育年限进行调整。基于 6 个认知域的个体认知特征,逻辑回归模型在区分 aMCI/SD+和 aMCI/SD-组方面的准确率为 72.4%。我们的研究结果表明,有和没有 SD 的 aMCI 患者存在明显不同的认知障碍模式。这一发现可能有助于 aMCI 患者中 SD 的诊断和治疗。

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