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老年期伴有自杀意念的抑郁症患者的嗅觉识别功能障碍。

Odor identification dysfunction in late-life depression with suicidal ideation.

机构信息

The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Geriatric Neuroscience Center, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China.

Geriatric Neuroscience Center, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China.

出版信息

J Affect Disord. 2024 Dec 15;367:768-776. doi: 10.1016/j.jad.2024.08.227. Epub 2024 Sep 2.

Abstract

BACKGROUND

Suicide is more prevalent among older adults compared to younger individuals. Late-life depression (LLD) poses the highest risk for suicide. However, early recognition of suicidal ideation is challenging. Dysfunction in odor identification (OI), a characteristic of LLD, may hold potential for early identification of suicidal ideation. This study aims to compare OI between LLD patients with suicidal ideation (LLD-S) and LLD patients without suicidal ideation (LLD-NS), and examine its relationship with cognitive function.

METHODS

A total of 262 LLD-NS patients, 63 LLD-S patients, and 316 healthy normal older adults (HOAs) underwent OI testing, standardized clinical interviews, and comprehensive neuropsychological assessments.

RESULTS

(1) LLD-S patients exhibited lower OI scores and poorer cognitive performance (including global cognition, information processing speed, memory, language, executive function, and visuospatial ability) compared to LLD-NS patients and HOAs. (2) There were interactive effects between suicidal ideation and OI dysfunction, leading to lower scores in information processing speed and visuospatial ability. (3) OI dysfunction mediated the differences in cognition between the LLD-NS and LLD-S groups.

LIMITATIONS

The present study was a cross-sectional design.

CONCLUSIONS

LLD-S patients had worse odor identification than LLD-NS patients and HOAs, suggesting that OI testing could be a valuable approach for identifying suicidal ideation in LLD and screening for suicide risk. The presence of both OI impairment and suicidal ideation was associated with poorer cognitive performance in LLD.

摘要

背景

与年轻人相比,老年人的自杀率更高。老年期抑郁症(LLD)是自杀的最高风险因素。然而,早期识别自杀意念具有挑战性。嗅觉识别功能障碍(OI)是 LLD 的特征之一,可能有助于早期识别自杀意念。本研究旨在比较有自杀意念的 LLD 患者(LLD-S)和无自杀意念的 LLD 患者(LLD-NS)之间的 OI,并探讨其与认知功能的关系。

方法

共有 262 名 LLD-NS 患者、63 名 LLD-S 患者和 316 名健康正常老年人(HOA)接受了 OI 测试、标准化临床访谈和全面的神经心理学评估。

结果

(1)与 LLD-NS 患者和 HOA 相比,LLD-S 患者的 OI 得分较低,认知表现较差(包括整体认知、信息处理速度、记忆、语言、执行功能和视空间能力)。(2)自杀意念和 OI 功能障碍之间存在交互作用,导致信息处理速度和视空间能力得分较低。(3)OI 功能障碍介导了 LLD-NS 和 LLD-S 组之间认知差异。

局限性

本研究为横断面设计。

结论

LLD-S 患者的嗅觉识别能力比 LLD-NS 患者和 HOA 差,这表明嗅觉识别测试可能是识别 LLD 中自杀意念和筛查自杀风险的一种有价值的方法。OI 损伤和自杀意念的存在与 LLD 中的认知表现较差有关。

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