不同抑郁程度的老年抑郁症患者认知功能损害比较

Comparison of the cognitive impairment in late-life depressive patients with different degree of depression

目的:比较不同抑郁程度的老年抑郁症(LLD)患者认知功能损害。方法:根据汉密尔顿抑郁量表17项(HAMD-17)评估结果,将62例LLD患者(LLD组)分为重度LLD组(HAMD-17≥24分,29例)及轻中度LLD组(HAMD-17为7~23分,33例);采用蒙特利尔认知评估量表(MoCA)对入组者进行认知功能评估,结果与51名正常对照者(NC组)比较。结果:MoCA总分LLD组[(20.8±4.0)分]显著低于NC组[(26.1±2.5)分](t=-8.584,P<0.01);除数字广度外,LLD组在视空间、画钟实验、命名、注意力、计算、语言复述、语言流畅、抽象、延迟记忆、定向力得分与NC组比较差异有统计学意义(P均<0.01)。重度LLD组MoCA总分[(19.2±4.1)分]显著低于轻中度LLD组[(22.2±3.5)分](t=3.108,P=0.03);画钟实验(P=0.012)、命名(P=0.031)、语言复述(P=0.016)、抽象能力(P=0.009)评分明显低于轻中度LLD组。结论:LLD患者存在广泛的认知功能损害,抑郁程度越重的LLD患者其认知功能损害越明显。

Objective:To compare the cognitive impairment in late-life depressive(LLD)patients with different degree of depression.Method:According to the evaluation results of Hamilton depression scale-17 items(HAMD-17),62 LLD patients were divided into severe depression group(HAMD-17≥24,29 cases)and moderate depression group(HAMD-17 was 7-23,33 cases).Cognitive function of the two groups were assessed by Montreal cognitive assessment(MoCA);the results were compared with 51 normal controls(NC group).Results:The MoCA scores in LLD patients(20.8±4.0)were significantly lower than those in the NC group(26.1±2.5)(t=-8.584,P<0.01).With exception of the score of digital memory breadth,the scores of visual space,clock experiment,naming,attention,calculation,language retelling,language fluency,abstraction,delayed memory,directional force in the LLD group were statistically different from those of the NC group(all P<0.01).The total scores of MoCA in severe depression group(19.2±4.1)were significantly lower than those in the moderate depression group(22.2±3.5)(t=3.108,P=0.03);especially the scores of inclock drawing test(P=0.012),naming(P=0.031),repeating(P=0.016),and abstract ability(P=0.009).Conclusion:LLD patients have extensive cognitive impairment,and the greater the degree of depression,the more obvious the cognitive impairment.