主观认知下降患者的轻微抑郁和焦虑症状特征分析  

An analysis of minimal depressive symptoms and minimal anxiety symptoms in patients with subjective cognitive decline

作　　者：崔瑞萍 高佩阳 陈彦明 王煜东 谭梦姗[4] 谭兰[4] CUI Ruiping;GAO Peiyang;CHEN Yanming;WANG Yudong;TAN Mengshan;TAN Lan(Qingdao Medical College of Qingdao University,Qingdao 266071,China)

机构地区：[1]青岛大学青岛医学院,山东青岛266071 [2]首都医科大学临床医学院 [3]山东第二医科大学临床医学院 [4]青岛市市立医院神经内科

出　　处：《精准医学杂志》2025年第2期121-126,共6页Journal of Precision Medicine

基　　金：国家自然科学基金面上项目(8227052436)。

摘　　要：目的分析主观认知下降(subjective cognitive decline,SCD)患者轻微抑郁症状(MDS)和轻微焦虑症状(MAS)特征,以便为阿尔茨海默病的早期干预和治疗提供依据。方法选取中国人阿尔茨海默病生物标记和生活方式研究(CABLE)队列中的1982例研究对象,参考SCD国际工作组制定的标准将所有研究对象分为非SCD组和SCD组,参考李克特量表评估研究对象的SCD严重程度,并将SCD组进一步分为SCD-nonplus亚组和SCD-plus亚组。依据汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)对所有研究对象进行评分,并评估其MDS和MAS状况。采用多元线性回归模型和逻辑回归模型分析SCD状况与HAMD、HAMA评分和MDS、MAS状况的相关性。采用单因素方差分析比较非SCD组、SCD-nonplus亚组和SCD-plus亚组研究对象的HAMD和HAMA评分差异。采用中介模型分析HAMD评分、HAMA评分在SCD严重程度与中国修订版简易精神状态检查(CM-MMSE)评分中的中介作用。结果多元线性回归模型分析结果显示,SCD状况与HAMD和HAMA评分呈正相关(β=0.045、0.057,t=4.528、5.832,P<0.05);逻辑回归模型分析结果显示,SCD状况与MDS和MAS状况呈正相关(β=0.579、0.741,Z=4.242、5.329,P<0.05)。SCD-plus亚组的HAMD评分和HAMA评分显著高于非SCD组和SCD-nonplus亚组(t=-7.058~-2.321,P<0.05)。中介模型分析结果显示,HAMD评分部分中介了SCD严重程度与CM-MMSE评分的关系。结论SCD患者,特别是SCD-plus患者,MDS和MAS较重,提示两者可能在阿尔茨海默病的早期识别和干预中具有潜在价值。Objective To investigate the characteristics of minimal depressive symptoms(MDS)and minimal anxiety symptoms(MAS)in patients with subjective cognitive decline(SCD),and to provide a basis for early prevention and treatment of Alzheimer’s disease.Methods From the Chinese Alzheimer’s Biomarker and LifestylE(CABLE)study cohort,a total of 1982 participants were included.Based on the criteria established by the international SCD initiative workgroup,the participants were divided into non-SCD group and SCD group(further divided into SCD-nonplus group and SCD-plus group by the severity of SCD assessed using a Likert scale).All the participants were evaluated for MDS and MAS status using the Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA).Multiple linear regression and logistic regression models were employed to analyze the relationships between SCD status and HAMD and HAMA scores as well as MDS and MAS status.One-way analysis of variance was performed to compare HAMD and HAMA scores between the non-SCD group,SCD-nonplus group,and SCD-plus group.A mediation model was utilized to analyze the mediating effects of HAMD and HAMA scores on the relationship between SCD severity and Chinese Modified Mini-Mental State Examination(CM-MMSE)score.Results The multiple linear regression analysis showed that SCD status was positively associated with HAMD and HAMA scores(β=0.045,0.057,t=4.528,5.832,P<0.05).The logistic regression analysis revealed that SCD status was positively associated with MDS and MAS status(β=0.579,0.741,Z=4.242,5.329,P<0.05).The HAMD and HAMA scores in the SCD-plus group were significantly higher than those in the non-SCD group and the SCD-nonplus group(t=-7.058--2.321,P<0.05).The mediation analysis indicated that HAMD score partially mediated the relationship between SCD severity and CM-MMSE score.Conclusion Patients with SCD,particularly those with SCD-plus,present with more severe MDS and MAS,suggesting that MDS and MAS may have potential value in the early identification and prevention of

关 键 词：认知功能障碍 抑郁 焦虑 精神病状态评定量表 阿尔茨海默病 

分 类 号：R741[医药卫生—神经病学与精神病学]