Kryza-Lacombe Maria, Kassel Michelle T, Insel Philip S, Rhodes Emma, Bickford David, Burns Emily, Butters Meryl A, Tosun Duygu, Aisen Paul, Raman Rema, Saykin Andrew J, Toga Arthur W, Jack Clifford R, Weiner Michael W, Nelson Craig, Mackin R Scott
Mental Illness Research Education and Clinical Centers, Veterans Affairs Medical Center, San Francisco, CA, USA.
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA.
J Int Neuropsychol Soc. 2024 Nov;30(9):807-811. doi: 10.1017/S1355617724000262. Epub 2024 Sep 18.
Anxiety is a common comorbid feature of late-life depression (LLD) and is associated with poorer global cognitive functioning independent of depression severity. However, little is known about whether comorbid anxiety is associated with a domain-specific pattern of cognitive dysfunction. We therefore examined group differences (LLD with and without comorbid anxiety) in cognitive functioning performance across multiple domains.
Older adults with major depressive disorder ( = 228, ages 65-91) were evaluated for anxiety and depression severity, and cognitive functioning (learning, memory, language, processing speed, executive functioning, working memory, and visuospatial functioning). Ordinary least squares regression adjusting for age, sex, education, and concurrent depression severity examined anxiety group differences in performance on tests of cognitive functioning.
Significant group differences emerged for confrontation naming and visuospatial functioning, as well as for verbal fluency, working memory, and inhibition with lower performance for LLD with comorbid anxiety compared to LLD only, controlling for depression severity.
Performance patterns identified among older adults with LLD and comorbid anxiety resemble neuropsychological profiles typically seen in neurodegenerative diseases of aging. These findings have potential implications for etiological considerations in the interpretation of neuropsychological profiles.
焦虑是老年期抑郁症(LLD)的常见共病特征,且与较差的整体认知功能相关,与抑郁严重程度无关。然而,关于共病焦虑是否与特定领域的认知功能障碍模式相关,目前知之甚少。因此,我们研究了多个领域认知功能表现的组间差异(伴有和不伴有共病焦虑的LLD)。
对患有重度抑郁症的老年人(n = 228,年龄65 - 91岁)进行焦虑和抑郁严重程度以及认知功能(学习、记忆、语言、处理速度、执行功能、工作记忆和视觉空间功能)的评估。通过对年龄、性别、教育程度和并发抑郁严重程度进行调整的普通最小二乘法回归,检验焦虑组在认知功能测试表现上的差异。
在控制抑郁严重程度的情况下,伴有共病焦虑的LLD与仅患有LLD相比,在对质命名、视觉空间功能以及言语流畅性、工作记忆和抑制方面出现了显著的组间差异,伴有共病焦虑的LLD表现较差。
在患有LLD和共病焦虑的老年人中发现的表现模式类似于衰老神经退行性疾病中常见的神经心理学特征。这些发现对神经心理学特征解释中的病因学考虑具有潜在意义。