首次发作晚发抑郁障碍患者认知功能特征  

Cognitive characteristics of first-episode late-onset depression

作　　者：张娜[1] 王华丽[1] 于欣[1] 

机构地区：[1]北京大学精神卫生研究所卫生部精神卫生学重点实验室,100191

出　　处：《中华老年心脑血管病杂志》2010年第6期484-487,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(30500178,30971044);科技部“863”计划(2007AA02Z421);美国国立老龄研究所与Fogarty国际中心(R21AG028180-01A2)

摘　　要：目的考查首次发作晚发抑郁障碍(LOD)患者的认知功能特征。方法 LOD患者26例(LOD组)、轻度认知损害(MCI)患者35例(MCI组)和健康体检者44例(对照组),采用认知功能筛检工具(CASI)评估总体认知功能,跨文化神经心理成套测验评估不同领域认知功能,老年抑郁量表-30项评估情绪状况。结果 LOD组和MCI组CASI总分明显低于对照组(P<0.05)。与对照组比较,LOD组患者言语记忆和视觉记忆各测验评分、言语流畅性(1 min)和连线测验A评分、注意力和集中注意能力评分均明显降低(P<0.05);而MCI组患者仅言语记忆相关测验评分(CASI短时记忆、物品即刻回忆、物品5 min延迟回忆、段落逻辑记忆)、言语流畅性测验评分明显低于对照组(P<0.05)。结论 LOD患者存在神经认知功能缺陷,且累及认知领域较MCI更广泛,推测与LOD额叶和颞叶功能受损有关。Objective To explore the cognitive profiles of first-episode late-onset depression （LOD）. Methods Twenty-six LOD patients（LOD group）,35 individuals with mild cognitive impairment（MCI group） and 44 healthy elderly controls（NC group） were recruited. General cognitive function was assessed with cognitive abilities screening instrument（CASI）. All subjects were assessed with cross-cultural neuropsychological test battery covering muhiple cognitive domains. Severity of depression was evaluated with Geriatric Depression Scale（30 items）. Results The total score of CASI of LOD and MCI groups were significantly lower than that of NC group （P 0.05）. Compared with controls, the performance of verbal and visual learning and memory, verbal fluency and trail making test A score,and tasks of attention and concentration were significantly poorer in LOD group （P 〈 0.05）. Only performance scores of verbal learning and memory（shortterm memory of CASI, immediate memory of objects, 5 rain delayed recall memory of objects, logical memory） and verbal fluency were significantly lower in MCI group than in controls （P〈0.05）. Conclusion Cognitive function involving multiple cognitive domains was impaired in LOD patients. It is suggested that cognitive impairment in LOD may be explained by the abnormalities in frontal and temporal lobes.

关 键 词：抑郁症 认知障碍 记忆 痴呆 危险因素 神经心理学测验 

分 类 号：R749.4[医药卫生—神经病学与精神病学]