Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
Department of Psychology, The University of Texas at El Paso, El Paso, Texas, USA.
Int J Geriatr Psychiatry. 2021 May;36(5):665-676. doi: 10.1002/gps.5465. Epub 2020 Dec 2.
Older adults with late-life major depression (LLMD) are at increased risk of dementia. Dispersion, or within-person performance variability across cognitive tests, is a potential marker of cognitive decline. This study examined group differences in dispersion between LLMD and nondepressed healthy controls (HC) and investigated whether dispersion was a predictor of cognitive performance 1 year later in LLMD. We also explored demographic, clinical, and structural imaging correlates of dispersion in LLMD and HC. We hypothesized that dispersion would be greater in LLMD compared with HC and would be associated with worse cognitive performance 1 year later in LLMD.
Participants were enrolled in the Neurobiology of Late-Life Depression, a naturalistic longitudinal investigation of the predictors of poor illness course in LLMD.
The baseline sample consisted of 121 older adults with LLMD and 39 HC; of these subjects, 94 LLMD and 35 HC underwent magnetic resonance imaging (MRI). One-year cognitive data were available for 107 LLMD patients.
All participants underwent detailed clinical and structural MRI at baseline. LLMD participants also completed a comprehensive cognitive evaluation 1 year later.
Higher test dispersion was evident in LLMD when compared with nondepressed controls. Greater baseline dispersion predicted 1-year cognitive decline in LLMD patients even when controlling for baseline cognitive functioning and demographic and clinical confounders. Dispersion was correlated with white matter lesions in LLMD but not HC. Dispersion was also correlated with anxiety in both LLMD and HC.
Dispersion is a marker of neurocognitive integrity that requires further exploration in LLMD.
患有老年期迟发性抑郁症（LLMD）的老年人痴呆的风险增加。分散，即认知测试中个体之间的表现变异性，是认知能力下降的潜在标志物。本研究检查了 LLMD 和无抑郁健康对照组（HC）之间的分散组间差异，并探讨了分散是否可以预测 LLMD 患者 1 年后的认知表现。我们还探讨了 LLMD 和 HC 中分散的人口统计学，临床和结构成像相关性。我们假设，与 HC 相比，LLMD 的分散度更大，并且与 LLMD 患者 1 年后的认知表现更差相关。
参与者被招募到老年期抑郁症的神经生物学研究中，该研究是对 LLMD 不良病程预测因素的自然性纵向研究。
基线样本包括 121 名患有 LLMD 的老年人和 39 名 HC；其中 94 名 LLMD 和 35 名 HC 接受了磁共振成像（MRI）检查。有 107 名 LLMD 患者可获得 1 年的认知数据。
所有参与者在基线时均进行了详细的临床和结构 MRI 检查。 LLMD 参与者还在 1 年后完成了全面的认知评估。
与无抑郁对照组相比，LLMD 中的测试分散度更高。即使在控制基线认知功能以及人口统计学和临床混杂因素的情况下，基线时的分散度更高也预示着 LLMD 患者 1 年后的认知下降。在 LLMD 中，分散度与白质病变有关，但在 HC 中则没有。在 LLMD 和 HC 中，分散度与焦虑有关。
分散度是神经认知完整性的标志物，需要在 LLMD 中进一步探索。
