5-羟色胺选择性重摄取抑制剂联合计算机化的认知训练治疗伴有认知障碍的老年抑郁症患者的研究

A randomized,controlled study of computerized cognitive training combined with SSRI in elderly patients with depression and cognitive impairment

目的探讨5-羟色胺选择性重摄取抑制剂(SSRI)联合计算机化的认知训练(CCT)对伴有认知障碍的老年抑郁症(LLD)患者的临床治疗效果。方法本研究为前瞻性随机对照临床研究。选取2021年5月至2022年12月于首都医科大学附属北京安定医院门诊及住院治疗的118例伴有认知障碍的LLD患者,按照随机数表法分为干预组(57例)和对照组(61例)。干预组给予临床常规SSRI类抗抑郁药治疗联合CCT干预,对照组给予临床常规SSRI类抗抑郁药治疗联合空白对照方法,两组均治疗12周。分别在治疗前及治疗后8、12周对两组患者进行阿尔茨海默病认知评估量表(ADAS-cog)、老年抑郁量表(GDS)及日常生活能力量表(ADL)评分,以评估其认知功能、精神心理状况及社会功能。结果在治疗后8周及12周时,两组的ADAS-cog、GDS量表评分均明显低于治疗前,且干预组明显低于对照组,差异均有统计学意义(P<0.05)。治疗后8周及12周时,干预组的ADL评分明显高于治疗前,且治疗后12周干预组的ADL评分明显高于对照组,差异均有统计学意义(P<0.05),而对照组治疗前后的ADL评分比较差异无统计学意义(P>0.05)。结论SSRI类抗抑郁药联合CCT治疗能够显著改善伴有认知障碍的LLD患者的认知功能和抑郁症状,可作为该类人群的有效选择。

Objective To explore the clinical efficacy of serotonin-selective reuptake inhibitor(SSRI)combined with computerized cognitive training(CCT)in the treatment of senile depression patients with cognitive impairment.Method 118 elderly depression patients with cognitive impairment from May 2021 to December 2022 in Beijing Anding Hospital Affiliated to Capital Medical University were selected as study subjects and were randomly divided into intervention group(n=57)and control group(n=61).This study is a randomized controlled study.The intervention group received conventional SSRI combined with electronic cognitive training,while the control group received SSRI combined with a blank control group.Both groups were treated for 12 weeks.The scores of Alzheimer disease assessment scale-cognitive(ADAS-cog),the geriatric depression scale(GDS)and activity of daily living scale(ADL)were evaluated at baseline and 8 and 12 weeks after treatment,respectively,to compare the clinical efficacy of the two groups.Result At 8 weeks and 12 weeks after treatment,the scores of ADAS-cog and GDS scales in both groups were significantly lower than before treatment,and the intervention group was significantly lower than the control group,with statistical significance(P<0.05).At 8 weeks and 12 weeks after treatment,the ADL score of the intervention group was significantly higher than that before treatment,and at 12 weeks after treatment,the ADL score of the intervention group was significantly higher than that of the control group,with statistical significance(P<0.05),while the ADL score of the control group before and after treatment had no statistical significance(P>0.05).Conclusion CCT combined with SSRI can significantly improve cognitive function and depressive symptoms in elderly depression patients with cognitive impairment,making it an effective choice for this group of people.