Weill Cornell Medicine, Weill Cornell Institute of Geriatric Psychiatry (DK, VW, JA, LO, LA, MC, SB, GSA), White Plains, NY.
Weill Cornell Medicine, Weill Cornell Institute of Geriatric Psychiatry (DK, VW, JA, LO, LA, MC, SB, GSA), White Plains, NY.
Am J Geriatr Psychiatry. 2020 Jul;28(7):764-771. doi: 10.1016/j.jagp.2020.01.009. Epub 2020 Jan 25.
Poststroke depression (PSD) has a heterogeneous presentation and is often accompanied by cognitive impairment. This study aimed to identify distinct dimensions of depressive symptoms in older adults with PSD and to evaluate their relationship to cognitive functioning.
Cross-sectional factor and correlational analyses of patients with poststroke depression.
Patients were recruited from the community and from acute inpatient stroke rehabilitation hospitals.
Participants had suffered a stroke and met DSM-IV criteria for major depression (≥18 Montgomery Åsberg Depression Scale; MADRS).
None.
MADRS was used to quantify depression severity at study entry. Neuropsychological assessment at the time of study entry consisted of measures of Global Cognition, Attention, Executive Function, Processing Speed, Immediate Memory, Delayed Memory, and Language.
There were 135 (age ≥50) older adult participants with PSD and varying degrees of cognitive impairment (MMSE Total ≥20). Factor analysis of the MADRS identified three factors, that is sadness, distress, and apathy. Items comprising each factor were totaled and correlated with neuropsychological domain z-score averages. Symptoms of the apathy factor (lassitude, inability to feel) were significantly associated with greater impairment in executive function, memory, and global cognition. Symptoms of the sadness and distress factors had no relationship to cognitive impairment.
PSD consists of three correlated dimensions of depressive symptoms. Apathy symptoms are associated with cognitive impairment across several neuropsychological domains. PSD patients with prominent apathy may benefit from careful attention to cognitive functions and by interventions that address both psychopathology and behavioral deficits resulting from cognitive impairment.
脑卒中后抑郁（PSD）表现多样，常伴有认知障碍。本研究旨在确定 PSD 老年患者抑郁症状的不同维度，并评估其与认知功能的关系。
PSD 患者的横断面因子和相关性分析。
从社区和急性住院脑卒中康复医院招募患者。
参与者患有中风，符合 DSM-IV 重性抑郁障碍标准（≥18 项蒙哥马利抑郁量表；MADRS）。
无。
MADRS 用于在研究开始时量化抑郁严重程度。研究开始时的神经心理学评估包括总体认知、注意力、执行功能、处理速度、即刻记忆、延迟记忆和语言的测量。
共有 135 名（年龄≥50 岁）老年 PSD 患者，伴有不同程度的认知障碍（MMSE 总分≥20）。MADRS 的因子分析确定了三个因子，即悲伤、痛苦和冷漠。每个因子的项目总和与神经心理学域 z 评分平均值相关。冷漠因子的症状（乏力、无法感受）与执行功能、记忆和总体认知的损害程度显著相关。悲伤和痛苦因子的症状与认知障碍无关。
PSD 由三个相关的抑郁症状维度组成。冷漠症状与多个神经心理学领域的认知障碍相关。有明显冷漠症状的 PSD 患者可能需要仔细注意认知功能，并通过针对精神病理学和认知障碍导致的行为缺陷的干预措施来获益。
