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老年期抑郁症、认知障碍与阿尔茨海默病的关系。

Late-Life Depression, Cognitive Impairment, and Relationship with Alzheimer's Disease.

机构信息

Department of Cognitive Psychology and Neuropsychology, University of Mons, Mons, Belgium.

出版信息

Dement Geriatr Cogn Disord. 2021;50(5):414-424. doi: 10.1159/000519453. Epub 2021 Nov 25.

Abstract

This narrative review aimed to explore the existing knowledge in order to examine the multiple forms of late-life depression (LLD) within a non-neurodegenerative or a neurodegenerative context, in particular Alzheimer's disease (AD). This review will first provide information about different pathogenic hypotheses proposed to describe LLD when it is not linked to a neurodegenerative context. Within the presentation of these syndromes, the literature reports thymic and cognitive specific features and highlights a common preponderance of cognitive impairment, and particularly executive. This review will also report data from research works that have addressed the role of depressive symptoms (DSs) in incidence of AD and mild cognitive impairment (MCI) conversion to AD. These findings support the claim that the relationship between DS (or LLD) and the cognitive decline encountered in AD can be of 2 types: (1) risk factor or (2) prodrome. They also support the hypothesis that the effect of DS on the incidence of AD can be identified between specific characteristics of these symptoms such as a very first apparition late in life, an increasing severity of DS, and a poor response to medical treatment. Finally, longitudinal and cross-sectional research will be presented, aiming to identify the predictive value of DS (or LLD) on AD incidence and/or conversion of MCI (and specifically amnestic MCI). This final section shows that specific features of LLD, such as being of early- or late-onset, can be considered as indices of AD incidence.

摘要

本叙述性综述旨在探讨现有知识,以检查非神经退行性或神经退行性背景下(特别是阿尔茨海默病 [AD])老年期抑郁症 (LLD) 的多种形式。本综述将首先提供有关不同发病假说的信息,这些假说用于描述与神经退行性背景无关的 LLD。在这些综合征的介绍中,文献报告了胸腺和认知特异性特征,并强调了认知障碍的共同优势,特别是执行功能障碍。本综述还将报告研究工作的数据,这些工作涉及抑郁症状 (DS) 在 AD 发病和轻度认知障碍 (MCI) 向 AD 转化中的作用。这些发现支持了这样一种说法,即 DS(或 LLD)与 AD 中遇到的认知衰退之间的关系可能有 2 种类型:(1) 风险因素或 (2) 前驱期。它们还支持这样一种假设,即 DS 对 AD 发病的影响可以通过这些症状的特定特征来识别,例如生命后期首次出现、DS 严重程度不断增加以及对药物治疗的反应不佳。最后,将呈现纵向和横断面研究,旨在确定 DS(或 LLD)对 AD 发病和/或 MCI(特别是遗忘型 MCI)转化的预测价值。最后一部分表明,LLD 的特定特征,例如早发性或晚发性,可以被视为 AD 发病的指标。

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