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抑郁中无助感的影响:诊断轻度认知障碍并分析其对老年人认知衰退的作用。

Implications of helplessness in depression: diagnosing mild cognitive impairment and analyzing its effects on cognitive decline in older adults.

作者信息

Lee Boung Chul, Choe Young Min, Suh Guk-Hee, Keum Musung, Kim Shin Gyeom, Kim Hyun Soo, Hwang Jaeuk, Yi Dahyun, Kim Jee Wook

机构信息

Department of Neuropsychiatry, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea.

Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Republic of Korea.

出版信息

Front Aging Neurosci. 2024 May 27;16:1378676. doi: 10.3389/fnagi.2024.1378676. eCollection 2024.

Abstract

BACKGROUND

This study focuses on how elements of depression correlate with mild cognitive impairment (MCI) in older adults and the diagnostic efficacy of combining these components with the Mini-Mental State Examination (MMSE). The study also investigated the connection between individual depression components and overall cognitive function, as measured by the total score (TS) of the consortium to establish a registry for Alzheimer's disease (AD) assessment battery.

METHODS

The study included 196 nondemented adults aged 65 to 90 years at a university hospital and community. Comprehensive clinical assessments including the 30-item Geriatric Depression Scale (GDS) to measure components of depressive symptoms, TS, and blood nutritional biomarkers.

RESULTS

Our stepwise logistic regression analysis highlighted the 'helplessness item' (odds ratio = 4.531, 95% CI = 2.218 to 9.258,  < 0.001) as a significant predictor for MCI diagnosis. Further, models incorporating 'helplessness item + MMSE' demonstrated markedly enhanced accuracy in diagnosing MCI, surpassing the performance of the MMSE used independently. Notably, the group characterized by helplessness showed a significant reduction in TS (B = -5.300, SE = 1.899, β = -0.162,  = 0.006), with this trend being particularly pronounced in individuals exhibiting lower levels of physical activity. Interestingly, this correlation did not manifest in participants with higher physical activity levels.

CONCLUSION

Our findings suggest that helplessness is highly effective in diagnosing MCI and is linked to a decrease in cognitive function. Therefore, when addressing MCI and AD-related cognitive decline, clinicians should consider helplessness.

摘要

背景

本研究聚焦于老年人抑郁症的各个要素如何与轻度认知障碍(MCI)相关联,以及将这些要素与简易精神状态检查表(MMSE)相结合的诊断效力。该研究还调查了个体抑郁成分与整体认知功能之间的联系,整体认知功能通过阿尔茨海默病(AD)评估电池注册联盟的总分(TS)来衡量。

方法

该研究纳入了一所大学医院和社区中196名年龄在65至90岁之间的非痴呆成年人。进行了全面的临床评估,包括使用30项老年抑郁量表(GDS)来测量抑郁症状成分、TS以及血液营养生物标志物。

结果

我们的逐步逻辑回归分析突出了“无助感项目”(比值比 = 4.531,95%置信区间 = 2.218至9.258,< 0.001)作为MCI诊断的重要预测指标。此外,纳入“无助感项目 + MMSE”的模型在诊断MCI时显示出显著提高的准确性,超过了单独使用MMSE的表现。值得注意的是,以无助感为特征的组TS显著降低(B = -5.300,标准误 = 1.899,β = -0.162, = 0.006),这种趋势在身体活动水平较低的个体中尤为明显。有趣的是,这种相关性在身体活动水平较高的参与者中并未表现出来。

结论

我们的研究结果表明,无助感在诊断MCI方面非常有效,并且与认知功能下降有关。因此,在处理MCI和与AD相关的认知衰退时,临床医生应考虑无助感。

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Somatic symptoms of helplessness and hopelessness.无助和绝望的躯体症状。
Scand J Psychol. 2021 Jun;62(3):393-400. doi: 10.1111/sjop.12713. Epub 2021 Feb 21.

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