老年抑郁症患者认知功能损害的随访研究

Follow- up study of persistent cognitive impairment of senile depression

目的探讨老年抑郁症患者抑郁症状与认知功能损害的关系及其对老年抑郁症转归的影响。方法以2010年1月-2011年12月就诊于青岛市精神卫生中心的老年抑郁症患者为研究组(SD组,n=64),均符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3),选择同期于青岛大学附属医院进行健康体检的老年人为正常对照组(NC组,n=60)。于基线期和24个月后对两组进行颅脑CT检查和尿液中AD7c-NTP的含量检测,并采用汉密尔顿抑郁量表(HAMD)、简明精神状态评价量表(MMSE)、日常生活能力量表(ADL)评定抑郁等精神症状。结果24个月时,SD组HAMD评分低于基线水平,但仍高于NC组(P<0.01);SD组MMSE评分低于基线水平及NC组(P<0.01);24个月时,SD组患者尿中AD7c-NTP含量较基线期和NC组水平高(P<0.05或0.01);基线期SD组、NC组MMSE评分均与受教育程度呈正相关(P<0.05),24个月后,SD组MMSE评分与受教育程度呈正相关(P<0.01),与年龄、HAMD评分呈负相关(P<0.01),NC组MMSE与受教育程度呈正相关(P<0.01),与年龄呈负相关(P<0.01)。结论老年抑郁症患者存在一定的认知功能损害,抑郁症状可能影响认知功能的恢复,可能是认知功能损害的危险因素。

Objective To investigate the relationship ketween the depressive symptoms of senile depression and cognitive impair=ment,and to clarify its influence on the prognosis of senile depression. Methods We choosed the patients which visited Qingdao Men=tal Health Center from Jan 2010 to Dec 2011 as the senile depression group(SD,n=64),All the patients meet the diagnosis standard of Chinese Classification and Diagnostic Criteria of Mental Disease,third edition(CCMD-3). The normal control group(NC,n=60)con=tained normal mental state elderly people whict did health examination in the affiliated hospital of Qingdao University at the same time. The results of cranial computed tomography,urinay AD7c-NTP levels,Hamilton Depression Scale(HAMD),Mini-Mental State Ex=amination( MMSE),Activities Daily Living Scale( ADL)were investigated in koth two groups. After a 24-month-follow up,We re=peat the tests akove to detect the cognitive function and investigate the relationship ketween senile depression and Alzheimerˊs disease. Results In patients with senile depression,the score of HAMD,24 months later,significantly decreased than the kaseline,and still was significantly higher than that of normal mental state elderly people(P﹤0. 01). The score of MMSE in SD group wsa significantly decreased than kaseline level,and also than that in NC group(P﹤0. 01). Compared with NC group,the urinay AD7c-NTP levels was significantly higher in Senile depression group(P﹤0. 01),and the urinay AD7c-NTP levels of patients with senile depression also higher than its kaseline(P﹤0. 05). The score of MMSE showed positive related to the culture in koth two groups(kase line P﹤0. 05, 24th month P﹤0. 01). At the end of 24th month,the score of MMSE in SD group showed negative related to age and the score of HAMD(koth P﹤0. 01),while the score of MMSE showed negative related to age in NC group(P﹤0. 01). Conclusion Patients with senile depression have some cognitive impairment,depression symptoms may affect the recovery of cognitive function. So we infer that depression may ke a risd factor for cognitive impairment.