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焦虑对老年住院抑郁症患者认知功能的影响:一项多中心观察性研究的结果

The effect of anxiety on cognition in older adult inpatients with depression: results from a multicenter observational study.

作者信息

Martinussen Liva Jenny, Šaltytė Benth Jūratė, Almdahl Ina Selseth, Borza Tom, Selbæk Geir, Mcpherson Bodil, Korsnes Maria Stylianou

机构信息

Department of Old Age Psychiatry, Oslo University Hospital, Norway.

Institute of Clinical Medicine, Campus Ahus, University of Oslo, Norway.

出版信息

Heliyon. 2019 Aug 28;5(8):e02235. doi: 10.1016/j.heliyon.2019.e02235. eCollection 2019 Aug.

Abstract

Late-life depression is associated with reduced cognitive function beyond normal age-related cognitive deficits. As comorbid anxiety frequently occur in late-life depression, this study aimed to examine the association between anxiety symptoms and cognitive function among older inpatients treated for depression. We hypothesized that there would be an overall additive effect of comorbid anxiety symptoms on dysfunction across cognitive domains. The study included 142 patients treated for late-life depression in hospital, enrolled in the Prognosis of Depression in the Elderly study. Anxiety symptoms were measured at admission using the anxiety subscale of the Hospital Anxiety and Depression Scale. Patients completed cognitive tasks at admission and discharge. Linear mixed and generalized linear mixed models were estimated to investigate the effect of anxiety, on continuous and categorical cognitive scores, respectively, while controlling for depression. Anxiety severity at admission was not associated with performance in any of the cognitive domains. Patients with more symptoms of anxiety at admission demonstrated a significant improvement in immediate recall during the hospital stay. Patients with a score above cutoff indicating clinically significant symptoms on the anxiety subscale performed better on general cognitive function, as measured by the Mini Mental Status Examination at admission, than those below cutoff for anxiety. In conclusion, comorbid anxiety symptoms had no additive effect on cognitive dysfunction in late-life depression in our sample of inpatients.

摘要

老年期抑郁症与超出正常年龄相关认知缺陷的认知功能减退有关。由于共病焦虑在老年期抑郁症中经常出现,本研究旨在探讨老年抑郁症住院患者焦虑症状与认知功能之间的关联。我们假设共病焦虑症状对各认知领域功能障碍会产生总体累加效应。该研究纳入了142名因老年期抑郁症住院治疗的患者,这些患者参与了老年抑郁症预后研究。入院时使用医院焦虑抑郁量表的焦虑分量表测量焦虑症状。患者在入院时和出院时完成认知任务。分别估计线性混合模型和广义线性混合模型,以研究焦虑对连续和分类认知得分的影响,同时控制抑郁因素。入院时的焦虑严重程度与任何认知领域的表现均无关联。入院时焦虑症状较多的患者在住院期间即时回忆方面有显著改善。焦虑分量表得分高于临界值表明存在临床显著症状的患者,在入院时通过简易精神状态检查表测量的一般认知功能方面,比焦虑得分低于临界值的患者表现更好。总之,在我们的住院患者样本中,共病焦虑症状对老年期抑郁症的认知功能障碍没有累加效应。

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