上海社区老年抑郁障碍与遗忘型轻度认知功能损害患者的认知功能对照研究

摘要

Objective:To study the neuropsychological difference between elderly patients with depressive disorder(DD)and amnestic mild cognitive impairment(aMCI)in Shanghai community. Method:Thirteen DD patients and 7 subclinical depression patients met the American diagnostic and statistical manual of mental disorders 4th edition clinical formulary checks as DD group in 1 068 community elders. Selecting 20 aMCI pa-tients and 20 normal controls with age,gender,and education matched were as aMCI group and normal control group(NC). All participants were assessed by neuropsychological assessment mini mental state examination (MMSE)and Montreal cognitive assessment scale(MoCA). Results:There were significant differences a-mong the 3 groups in the total score of MMSE,scoes of orientation to place,calculation and attention,three-step instruction,the total score of MoCA,scores of copy pattern,attention,calculation,delayed recall,and time orien-tation(P ﹤ 0. 05 or P ﹤ 0. 001). Compared with aMCI group,the total score of MMSE(P = 0. 034),calculation and attention(P = 0. 009),the total score of MoCA(P = 0. 002),calculation(P = 0. 006),abstract thinking (P = 0. 030),and time orientation(P = 0. 044)in DD group were significantly higher. Conclusion:The de-gree of impaired cognitive function in elderly DD patients in community is lighter than aMCI patients.%目的：探讨上海社区老年抑郁障碍与遗忘型轻度认知功能损害（ aMCI）患者之间认知功能的神经心理学差异。方法：1068例社区老人中符合美国精神障碍诊断与统计手册第4版临床定式检查（SCID）的老年抑郁障碍患者13例及亚临床抑郁患者7例，共20例作为抑郁障碍组（DD 组），并选取性别、年龄、教育程度均匹配的 aMCI 患者20例（aMCI 组）及正常老人20名（NC 组）作为对照，采用简明精神状态量表（MMSE）、蒙特利尔认知评估量表（MoCA）进行认知功能的测评。结果：3组在 MMSE总分及地点定向力、计算与注意力、三步指令评分，以及 MoCA 总分、复制图、注意、计算、延迟回忆、时间定向评分差异有统计学意义（P ﹤0.05或 P ﹤0.001）。DD 组 MMSE 总分（P ＝0.034）、计算力与注意力（P ＝0.009）以及 MoCA 总分（P ＝0.002）、计算（P ＝0.006）、抽象思维（P ＝0.030）、时间定向（P ＝0.044）评分明显好于 aMCI 组。结论：社区老年抑郁障碍患者认知功能受损程度较老年 aMCI 患者轻。