Invernizzi Sandra, Bodart Alice, Lefebvre Laurent, Loureiro Isabelle Simoes
Departement of Cognitive Psychology and Neuropsychology, University of Mons, Mons, Belgium.
Fonds National de La Recherche Scientifique, Brussel, Belgium.
Eur J Ageing. 2023 Aug 10;20(1):34. doi: 10.1007/s10433-023-00780-z.
The cognitive complaints encountered in late-life depression (LLD) make it difficult to distinguish from amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD) based on an analysis of neurocognitive disorders. The hypothesis of the early impairment of semantic memory in AD and aMCI is considered a potential differential cognitive clue, but the absence of this impairment has not yet been confirmed in LLD.
Based on the PRISMA method, we systematically seek neuropsychological assessments of individuals with LLD, the present study included 31 studies representing 3291 controls and 2820 people with LLD. Wherever possible, studies that tested simultaneously groups with LLD, AD (or aMCI) were also included. The results of the group of neuropsychological tasks relying on semantic memory were analyzed in two groups of tasks with high- or low-executive demand. The mean average effect of LLD was calculated and compared to the incremental effect of aMCI or AD on the scores. Linear regressions including education, age, and severity and type of depression were run to seek their power of prediction for the mean average effects.
LLD has a medium effect on scores at semantic and phonemic fluency and naming and a small average effect on the low-executive demand tasks. Differences in education is a predictor of the effect of LLD on phonemic fluency and naming but not on semantic fluency or on low-executive demand tasks. Except for semantic fluency, aMCI did not demonstrate an incremental effect on the scores compared to LLD, while AD did, for all the tasks except phonemic fluency.
Assessment of semantic memory can be a discriminating clue for the distinction between depression and Alzheimer's disease but some methodological variables are highly influential to the scores, especially education. However, high-executive semantic tasks alone do not allow us to clearly distinguish LLD from AD or aMCI, as both pathologies seem to have a largely dialectical influential relationship, but low-executive semantic tasks appear as more sensible to this pathological distinction.
老年期抑郁症（LLD）中出现的认知主诉使得基于神经认知障碍分析难以将其与遗忘型轻度认知障碍（aMCI）和阿尔茨海默病（AD）区分开来。AD和aMCI中语义记忆早期受损的假说被认为是一个潜在的认知鉴别线索，但LLD中这种损伤的缺失尚未得到证实。
基于PRISMA方法，我们系统地查找了LLD患者的神经心理学评估，本研究纳入了31项研究，代表3291名对照和2820名LLD患者。只要有可能，同时测试LLD组、AD（或aMCI）组的研究也被纳入。在高执行需求或低执行需求的两组任务中分析了依赖语义记忆的神经心理学任务组的结果。计算了LLD组的平均效应，并与aMCI或AD对分数的增量效应进行比较。进行了包括教育程度、年龄以及抑郁严重程度和类型的线性回归，以寻求它们对平均效应的预测能力。
LLD对语义和音素流畅性及命名的分数有中等效应，对低执行需求任务有较小的平均效应。教育程度差异是LLD对音素流畅性和命名效应的预测因素，但不是对语义流畅性或低执行需求任务的预测因素。除语义流畅性外，与LLD相比，aMCI在分数上没有显示出增量效应，而AD在除音素流畅性外的所有任务中显示出增量效应。
语义记忆评估可以作为区分抑郁症和阿尔茨海默病的鉴别线索，但一些方法学变量对分数有很大影响，尤其是教育程度。然而，仅靠高执行语义任务并不能使我们清楚地将LLD与AD或aMCI区分开来，因为这两种病理似乎在很大程度上存在辩证的影响关系，但低执行语义任务对这种病理区分似乎更敏感。
