Department of Psychiatry, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan County, Taiwan; Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Department of Psychiatry, Mackay Memorial Hospital Taipei, Taipei, Taiwan.
Psychiatry Res. 2020 Aug;290:113051. doi: 10.1016/j.psychres.2020.113051. Epub 2020 May 21.
Differences in cognitive function have been suggested in people with late-life depression between those with early- (EOD) and late-onset (LOD), possibly reflecting different etiologies. The cutoff point for EOD and LOD was the first depressive episode before age 60 or later. However, depressive symptoms at the time of disorder are important confounders. The study aimed to compare cognitive function in older people with EOD and LOD in the euthymic state. A sample of 135 participants aged 60+ with a history of major depressive disorder in remission, received neuropsychological evaluation including tests of memory, attention, processing speed, visuospatial function, language, and executive function. Individual test scores and a derived composite score were investigated as dependent variables against age of onset using multiple linear regressions adjusted for potential confounders, including residual depressive symptoms. We found EOD (N = 67) and LOD (N = 68) groups did not differ significantly in overall composite cognitive scores after adjustment. Of individual test scores, only those for immediate recall were significantly lower in participants with EOD compared to LOD. In conclusion, the study found no associations between cognitive function and age of onset in this sample of people with depressive disorder in remission. Active or residual depressive symptoms might have confounded this relationship in previous research.
认知功能的差异在老年期抑郁症患者中有所体现，其分为早发性（EOD）和晚发性（LOD），这可能反映了不同的病因。EOD 和 LOD 的截止点是指 60 岁之前或之后的首次抑郁发作。然而，发病时的抑郁症状是重要的混杂因素。本研究旨在比较处于缓解期的 EOD 和 LOD 老年患者的认知功能。一项包含 135 名年龄在 60 岁及以上、有缓解期重度抑郁症病史的参与者的样本，接受了神经心理学评估，包括记忆、注意力、处理速度、视空间功能、语言和执行功能测试。使用多元线性回归，针对潜在混杂因素（包括残留的抑郁症状）进行调整，将个体测试分数和派生的综合分数作为因变量，与发病年龄进行比较。我们发现，调整后 EOD（N=67）和 LOD（N=68）组的总体综合认知评分无显著差异。在个体测试分数中，只有 EOD 组的即刻回忆分数明显低于 LOD 组。总之，在这项缓解期抑郁障碍患者的样本中，研究未发现认知功能与发病年龄之间存在关联。在之前的研究中，活跃或残留的抑郁症状可能混淆了这种关系。
