Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada.
Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada.
Am J Geriatr Psychiatry. 2024 Jul;32(7):867-878. doi: 10.1016/j.jagp.2024.01.225. Epub 2024 Feb 2.
To identify data-driven cognitive profiles in older adults with remitted major depressive disorder (rMDD) with or without mild cognitive impairment (MCI) and examine how the profiles differ regarding demographic, clinical, and neuroimaging measures.
Secondary cross-sectional analysis using latent profile analysis.
Multisite clinical trial in Toronto, Canada.
One hundred seventy-eight participants who met DSM-5 criteria for rMDD without MCI (rMDD-MCI; n = 60) or with MCI (rMDD + MCI; n = 118).
Demographic, clinical, neuroimaging measures, and domain scores from a neuropsychological battery assessing verbal memory, visuospatial memory, processing speed, working memory, language, and executive function.
We identified three latent profiles: Profile 1 (poor cognition; n = 75, 42.1%), Profile 2 (intermediate cognition; n = 75, 42.1%), and Profile 3 (normal cognition; n = 28, 15.7%). Compared to participants with Profile 3, those with Profile 1 or 2 were older, had lower education, experienced a greater burden of medical comorbidities, and were more likely to have MCI. The profiles did not differ on the severity of residual symptoms, age of onset of rMDD, number of depressive episodes, psychotropic medication, cerebrovascular risk, ApoE4 carrier status, or family history of depression, dementia, or Alzheimer's disease. The profiles differed in cortical thickness of 15 regions, with the most prominent effects for left precentral and pars opercularis, and right inferior parietal and supramarginal.
Older patients with rMDD can be grouped cross-sectionally based on data-driven cognitive profiles that differ from the absence or presence of a diagnosis of MCI. Future research should determine the differential risk for dementia of these data-driven subgroups.
确定缓解期重度抑郁症（rMDD）伴有或不伴有轻度认知障碍（MCI）的老年患者的基于数据的认知特征，并探讨这些特征在人口统计学、临床和神经影像学测量方面的差异。
使用潜在剖面分析进行二次横断面分析。
加拿大多伦多的多地点临床试验。
符合 DSM-5 标准的 rMDD 无 MCI（rMDD-MCI；n=60）或有 MCI（rMDD+MCI；n=118）的 178 名参与者。
人口统计学、临床、神经影像学测量以及神经心理学测试中的各领域得分，该测试评估了言语记忆、视空间记忆、加工速度、工作记忆、语言和执行功能。
我们确定了三个潜在的特征：特征 1（认知较差；n=75，42.1%）、特征 2（认知中等；n=75，42.1%）和特征 3（认知正常；n=28，15.7%）。与特征 3 相比，特征 1 或 2 的参与者年龄更大、教育程度更低、患有更多的合并症且更有可能患有 MCI。这些特征在残留症状的严重程度、rMDD 的发病年龄、抑郁发作次数、精神药物使用、脑血管风险、ApoE4 携带状态或抑郁症、痴呆或阿尔茨海默病的家族史方面没有差异。这些特征在 15 个区域的皮质厚度上存在差异，其中左中央前回和额下回的作用最为显著，而右顶下小叶和缘上回的作用次之。
缓解期重度抑郁症的老年患者可以根据数据驱动的认知特征进行分组，这些特征与是否存在 MCI 诊断不同。未来的研究应确定这些数据驱动亚组的痴呆风险差异。
