老年抑郁症患者认知功能损害程度及其影响因素分析

Study on extent and correlated influencing factors of cognitive function injury of depressed elderly patients

目的探讨老年抑郁症患者认知功能损害程度及其相关危险因素,为早期预防认知功能损害提供依据。方法选取158例老年抑郁症患者,依据是否发生认知功能损害分为损害组(n=103)和未损害组(n=55);采用问卷调查表和量表对两组患者进行评估,比较两组患者的MMSE、ADL评分,分析影响认知功能损害的相关危险因素。结果158例老年抑郁症患者中,认知功能损害发生率为65.2%(103/158);受损组的MMSE评分、主观支持度、客观支持度及支持利用度均明显低于未受损组(P<0.05),而受损组的ADL评分则明显高于未受损组(P<0.01);影响认知功能损害的因素包括独居(OR=3.228)、糖尿病(OR=2.578)、生活事件(OR=4.302)和社会支持(OR=0.541)。结论老年抑郁症患者存在较高的认知功能损害发生率,认知功能受损患者的精神状态及日常生活能力均有不同程度的下降;认知功能受损的高危因素包括独居、糖尿病、经历多次生活事件及社会支持度低下等。

Objective To explore the extent and correlated influencing factors of cognitive function injury of depressed elderly patients, provide basis for preventing cognitive function injury. Methods Totally 158 depressed elderly patients were divided into injury group （n= 103） and non-injury group （n=55）. With questionnaire and scales we evaluated both groups of patients, compared MMSE and ADL scores between both groups, then analyzed the influencing factors of the correlated risk fac- tors of cognitive function injury. Results The incidence rate of cognitive function injury was 65.2% in these 158 cases of de- pressed elderly patients. The scores of MMSE, subjective support degree, objective support degree and support availability in the injury group were much lower than those in the non-injury group （ P〈0.05 ）. But ADL score in the injury group was much higher than that in the non-injury group （ P〈0.05 ）. Conclusion There was a high incidence rate of cognitive function injury in these depressed elderly patients, the mental status and activity of daily living of the patients with cognitive function injury descend in some extent. The high risk factors of cognitive function injury of depressed elderly patients include living alone, diabetes, experi- ence many life events, and low social support.