抑郁焦虑与老年人睡眠质量的关联分析

目的分析抑郁、焦虑情绪对社区老年人睡眠质量的影响, 为预防老年睡眠障碍提供依据。方法采用整群抽样。自行设计调查表、匹兹堡睡眠质量指数量表(PSQI)、抑郁症状筛查量表(PHQ-9)、广泛性焦虑量表(GAD-7)对955名60岁及以上社区老年人进行调查。了解社区老年人睡眠质量现况以及评估抑郁焦虑对睡眠质量的影响。结果被调查者睡眠障碍、抑郁、焦虑检出率分别为234(24.5%)、182(19.1%)、137(14.3%)。抑郁、焦虑评分与老年人睡眠质量各维度得分及总分呈正相关(rs:0.115～0.558, 均P<0.01)。调整性别、年龄、睡前进食、睡前饮茶等混杂因素发现:抑郁、焦虑是老年睡眠障碍的危险因素, 抑郁老年人患睡眠障碍的风险是非抑郁老年人的3.555倍(95%CI:2.235～5.653, P<0.05);焦虑老年人患睡眠障碍的风险是非焦虑老年人的1.812倍(95%CI:1.070～3.070, P<0.05)。抑郁、焦虑对老年睡眠障碍的多因素调整人群归因危险度分别为32.56%、16.09%, 抑郁与焦虑的综合作用为38.87%。结论抑郁、焦虑是老年睡眠...     

部队干休所老年人睡眠障碍疾患的调查

目的了解干休所离退休老年人睡眠障碍疾患的类型、患病率和严重程度。方法对石家庄市28个部队干休所1964例65岁及以上的离退休老年人进行人户调查，筛选出有睡眠障碍症状者，由专科医生复查并作出诊断。结果（1）1964例老年人中，有各种睡眠障碍症状者1488例，患病率为75．8％；（2）有失眠症状者911例，符合失眠症诊断标准者212例，患病率为10．8％；（3）睡眠打鼾者1216例，其中习惯性打鼾312例，睡眠呼吸暂停52例，患病率分别为15．9％和2．6％；（4）不宁腿和夜间肌阵挛的患病率分别为12．9％和12．3％。结论睡眠障碍是老年人群中带有普遍性的健康问题，睡眠障碍调查应采用统一的方法和标准。     

基于脑-肠轴学说探讨老年功能性消化不良患者睡眠障碍对焦虑抑郁和下消化道症状影响

背景功能性消化不良(functional dyspepsia,FD)是老年患者常见疾病之一,病情容易反复,严重影响患者身心健康.肠-脑互动异常是FD发病主要病因,大多伴有不同程度的睡眠障碍和焦虑、抑郁等负面心理.目前,对于老年FD患者与睡眠障碍和焦虑抑郁、下消化道症状的研究报道较少.目的基于脑-肠轴学说探讨观察老年FD患者睡眠障碍对焦虑抑郁和下消化道症状影响分析.方法选择2017-02/2019-09在我院就诊的236例老年FD患者为研究对象,课题负责人发放量表,对符合罗马Ⅳ标准的老年FD患者进行调查,评估其下消化道症状严重程度,睡眠质量和焦虑和抑郁评分变化情况.结果214例老年FD患者中存在睡眠障碍者103例(48.13%),存在焦虑、抑郁者182例(85.05%).有睡眠障碍老年FD患者的下腹痛发生率为35.92%,下腹不适(非疼痛)发生率为33.98%、羊粪样或硬便发生率为21.36%、用劲排便发生率为32.04%、排便不尽感发生率为43.69%和便急感的发生率为27.18%,均高于无睡眠障碍老年FD患者,差异比较均有统计学意义(P<0.05).有睡眠障碍的老年FD睡眠障碍患者焦虑自评量表评分为65.34分±7.29分,抑郁自评量表评分为66.17分±8.26分,均高于无睡眠障碍的老年FD患者(P<0.05).结论老年FD患者常同时存在睡眠障碍与焦虑、抑郁,睡眠障碍与老年FD患者的下消化道症状关系密切.     

地震后患者抑郁、焦虑及睡眠障碍发生状况的分析

对四川地震灾区伤病员进行抑郁、焦虑及睡眠障碍等精神心理问题评定,发现患者出现抑郁、焦虑症状的人数均占41.8%左右,睡眠障碍占73%,睡眠障碍与抑郁、焦虑症状密切相关.     

老年住院慢性便秘患者的焦虑抑郁状态和睡眠状况

目的研究老年住院慢性便秘(CC)患者的焦虑状态、抑郁状态和睡眠障碍的情况及其与结肠传输功能之间的关系。方法调查105例老年CC的长期住院患者,并同时设立非便秘的对照组,观察两组患者的焦虑抑郁状态和睡眠障碍的情况,并对CC患者根据结肠传输功能试验区分为慢传输型和正常传输型便秘调查抑郁、焦虑状态、睡眠障碍的情况。结果老年CC患者焦虑状态、抑郁状态和焦虑抑郁状态共存者分别为55例(52.387%)、61例(58.10%)和48例(45.71%),而对照组分别为9例(9.28%)、11例(11.34%)和9例(9.28%),两组之间差异显著(P0.05)。在CC患者中,正常传输型便秘焦虑状态(67.44%)及抑郁状态(83.72%)比例明显高于慢传输型(38.71.09%和51.62%),且焦虑与抑郁状态共存的比例(44.19%)也明显高于慢常传输型患者(20.97%)(P0.05)。睡眠障碍在老年CC的患病率为41.90%,慢传输型占43.55%,正常传输型中占39.53%,非便秘患者为7.22%,三组比较差异有统计学意义(P0.05)。结论老年CC患者中,焦虑状态、抑郁状态和睡眠障碍发病率高,结肠传输功能正常型便秘患者与抑郁或焦虑相关,慢传输型便秘患者睡眠障碍发病率高。     

住院军队离退休干部老年综合征调查分析

目的调查住院军队离退休干部老年综合征(CGA)的发病情况,为提高军队干部保健质量提供理论依据。方法选择火箭军总医院干部病房于2010年1月~2016年6月收治的65岁以上老年离退休干部进行老年综合征评估。内容包括一般情况、慢性疾病及老年综合征。结果接受调查的87例患者中,其中男性62例(71.3%),女性25例(28.7%);年龄65~90岁,平均年龄(83.08±7.3)岁。最常见的前3种慢性疾病患病率依次为高血压病62例(71.3%)、冠心病49例(56.3%)和糖尿病43例(49.4%)。老年综合征为焦虑抑郁状态(59例,67.8%)和自理能力下降(48例,55.2%)的患病率分别超过了入组病例的50%。慢性疼痛(43例,49.4%)、睡眠障碍(42例,48.3%)、尿失禁(42例,48.3%)和衰弱(38例,43.7%)四类症状占较高比例。营养风险(13例,19.4%)的发生比例最低。结论军队离退休干部是一类特殊的老年人群,其老年综合征的发病情况与地方老年人存在异同点,有必要建立与军队特色相匹配的军队离退休干部老年综合征评估模式和疾病管理体系。     

老年脑卒中急性期情感障碍的临床观察

目的 探讨老年脑卒中急性期情感障碍患者的临床特点.方法 根据诊断标准和入选条件收集急性脑卒中患者216例,采用相关量表进行临床指标评定,并据量表结果和年龄分为老年组(126例)和青年组(90例).结果 卒中后情感障碍共95例,总发病率为43.98%,老年组卒中后情感障碍发病率为48.41%,其中抑郁发病率较高36.51%、焦虑发病率11.90%,青年组卒中后情感障碍发病率为37.78%,其中焦虑发病率为17.78%、抑郁发病率为20.00%.老年情感障碍组与青年情感障碍组在神经功能缺损评分、日常生活能力指数、伴发疾病评分及智能状况评分等方面比较均有统计学意义(P<0.01).结论 老年卒中患者更易合并情感障碍,且以抑郁为主.     

老年脑卒中患者不同抑郁程度睡眠障碍和认知障碍的关系

<正>脑卒中后抑郁发生率为20%~60%〔1〕,而脑卒中后抑郁则是诱发或加重脑卒中患者并发症的重要因素〔2,3〕。睡眠障碍及认知障碍同样是脑卒中后常见的并发症,脑卒中后睡眠障碍及认知障碍的发生与抑郁存在密切的联系〔4〕。本文分析老年脑卒中患者不同抑郁程度的睡眠障碍和认知障碍的关系。1资料与方法1.1一般资料我院2011年3月至2013年3月老年初发脑卒中患者212例,均符合全国第4次脑血管病会议制定的有关     

上海市街道社区老年功能性消化不良伴抑郁、焦虑的现况研究

[目的]了解社区功能性消化不良(FD)老年患者伴随抑郁、焦虑症状患病率及既往诊治情况。[方法]采用现况研究方法,收集社区卫生服务中心就诊的FD老年患者305例。由经培训的调查员用统一的调查表进行面对面调查,同时使用综合医院焦虑抑郁(HAD)量表、Hamilton焦虑量表和Hamilton抑郁量表进行心理测评。[结果]被确定为抑郁、焦虑症状的FD老年患者的患病率约为24.6%。而经HAD量表确认具有抑郁、焦虑症状的患者中,抑郁和(或)焦虑障碍的患病率为68.1%;此外在非首诊患者中,经HAD量表确认具有抑郁、焦虑症状的患者病史显示,诊断其抑郁障碍并给予治疗的比例低于10.0%。[结论]在社区中,FD的老年患者具有较高的抑郁、焦虑症状和抑郁、焦虑障碍患病率,且既往诊治率较低,这一现状应引起社区医务人员的关注。     

住院冠心病患者1083例心理状况的调查与相关分析

目的 探讨住院冠心病患者焦虑和抑郁症状的发生情况及相关因素.方法 采用现况调查研究,自2007年6月至2009年5月连续入选经冠状动脉造影诊断的住院冠心病患者.选用Zung焦虑自评量表(SAS)和抑郁自评量表(SDS)对入选患者进行心理测评,同时对受试者的经济状况、家庭情况、生活及工作场所环境等因素进行流行病学调查.统计学处理采用Student's t检验、卡方检验和多元逐步logistic回归分析.结果 共入选住院冠心病患者1083例,年龄(64.8±10.2)岁,其中男性863例,女性220例.单纯焦虑、单纯抑郁、焦虑合并抑郁的症状患病率分别为7.9%、28.3%和14.3%.女性患者焦虑、抑郁的症状患病率明显高于男性(29.5%比20.3%,P=0.003;50.0%比40.7%,P=0.012);老年(≥65岁)患者焦虑症状的患病率明显高于非老年患者(25.9%比17.9%,P=0.001);老年人、受教育年限少于9年、睡眠质量差与焦虑症状的发生显著相关,相应OR值分别为1.63(95%CI:1.21～2.21,P=0.002)、1.54(95%CI:1.15～2.07,P=0.004)和1.62(95%CI:1.34～1.96,P=0.000);长期工作地噪音、合并慢性疾病及睡眠质量差与抑郁症状的发生显著相关,OR值分别为1.52(95%CI:1.18～1.98,P=0.002)、1.36(95%CI:1.06～1.75,P=0.016)和1.27(95%CI:1.08～1.50,P=0.005);女性、老年人、长期工作地噪音、合并慢性疾病、睡眠质量差与焦虑合并抑郁症状的发生显著相关,OR值分别为1.91(95%CI:1.22～2.98,P=0.005)、1. 84(95%CI:1.23～2.76,P=0.003)、1.61(95%CI:1.07～2.42,P=0.022)、1.84(95%CI:1.24～2.71,P=0.002)和1.73(95%CI:1.35～2.21,P=0.000).结论 在住院冠心病患者中,约50%患者并发不同程度的焦虑和(或)抑郁症状,女性和老年患者是高发人群.受教育年限少于9年、合并慢性疾病、睡眠质量差、工作地噪音等与焦虑、抑郁症状的发生相关.     

功能性消化不良与睡眠障碍的相关分析

目的研究功能性消化不良患者的睡眠障碍问题,并评估二者之间的关系。方法选取功能性消化不良及健康人群各90例,所选病例（FD组和对照组）均进行PSQI和HAD测试,FD组符合罗马Ⅲ诊断标准。结果 PSQI评分FD组高于对照组;FD组患者焦虑抑郁比例明显高于对照组,且年龄越大,患病率越高。结论睡眠障碍与功能性消化不良有关,伴有睡眠障碍的FD患者有很高的焦虑抑郁倾向。     

Subsyndromal (“Mixed”) anxiety-depression in primary care

Objective: To determine in primary care settings the prevalence, clinical characteristics, and functional status of patients who have anxious and depressive symptoms who did not meet diagnostic criteria for major mood and anxiety diagnoses. Design: Patients were screened with the General Health Questionnaire and interviewed if they exceeded the cutoff score of 5. Also, one patient whose score was below the cutoff was interviewed for every two patients whose scores were above the cutoff. Setting: Five primary care sites in the United States, France, and Australia. Patient: Two hundred sixty-seven patients presenting to their primary care physicians for general medical care and follow-up. Methods: Structured diagnostic interviews were conducted and ratings of anxiety, depression, and functional impairment were obtained by trained interviewers. Results: After adjustments for sampling, 5% of the patients had symptoms of anxiety, depression, and functional impairment, without meeting formal criteria for a major DSM-III-R mood or anxiety disorder. This was comparable to the prevalence of diagnosable DSM-III-R mood disorders but only one-fourth the prevalence of diagnosable anxiety disorders. These patients who had subsyndromal symptoms had rates of lifetime psychiatric disorders and prior psychiatric treatment comparable to those of patients meeting criteria for major mood and anxiety disorders. Conclusion: The comparable rates of symptomatic distress, functional impairment, and prior psychiatric illness and treatment suggest that patients with subsyndromal anxiety and depressive symptoms warrant clinical recognition and possibly specific treatment. Supported in part by a grant from the American Psychiatric Association.     

Anxiety, depression, and 1-year incident cognitive impairment in community-dwelling older adults

OBJECTIVES: To examine in men and women the independent associations between anxiety and depression and 1‐year incident cognitive impairment and to examine the association of cognitive impairment, no dementia (CIND) and incident cognitive impairment with 1‐year incident anxiety or depression. DESIGN: Prospective cohort study. SETTING: General community. PARTICIPANTS: Population‐based sample of 1,942 individuals aged 65 to 96. MEASUREMENTS: Two structured interviews 12 months apart evaluated anxiety and mood symptoms and disorders according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. Incident cognitive impairment was defined as no CIND at baseline and a follow‐up Mini‐Mental State Examination score at least 2 points below baseline and below the 15th percentile according to normative data. The associations between cognitive impairment and anxiety or depression were assessed using logistic regression adjusted for potential confounders. RESULTS: Incident cognitive impairment was, independently of depression, associated with baseline anxiety disorders in men (odds ratio (OR)=6.27, 95% confidence interval (CI)=1.39–28.29) and anxiety symptoms in women (OR=2.14, 95%=1.06–4.34). Moreover, the results indicated that depression disorders in men (OR=8.87, 95%=2.13–36.96) and anxiety symptoms in women (OR=4.31, 95%=1.74–10.67) were particularly linked to incident amnestic cognitive impairment, whereas anxiety disorders in men (OR=12.01, 95%=1.73–83.26) were especially associated with incident nonamnestic cognitive impairment. CIND at baseline and incident cognitive impairment were not associated with incident anxiety or depression. CONCLUSION: Anxiety and depression appear to have different relationships with incident cognitive impairment according to sex and the nature of cognitive impairment. Clinicians should pay particular attention to anxiety in older adults because it may shortly be followed by incident cognitive treatment.     

运动神经元病患者认知功能筛查

目的 调查中国运动神经元病患者认知功能异常及额颞叶功能异常的发生情况.方法 对100例运动神经元病的患者行简易智能状态量表(MMSE),神经精神科问卷,汉密尔顿抑郁量表及汉密尔顿焦虑量表检查.并调查患者一般资料及功能等级评分(FRS)等情况.结果 MMSE结果示轻度认知障碍者占24.2%,MMSE正常与异常之间比较FRS总分及抑郁情况,两者差异有统计学意义.抗抑郁治疗3个月后随访,发现2例患者可能存在额颞叶功能受损.结论 运动神经元病患者认知功能可能轻度受损,部分存在精神行为表现异常,2例患者可能有额颞叶功能受损.     

Cognitive and behavioral assessment in the early stages of neurodegenerative extrapyramidal syndromes

Parkinson's disease (PD), Dementia with Lewy Bodies (DLB), Progressive Supranuclear Palsy (PSP) and Corticobasal Degeneration Syndrome (CBDS) are the most common neurodegenerative extrapyramidal syndromes. Beyond motor symptoms, cognitive dysfunctions and behavioral disturbances are reported. Neuropsychological and neuropsychiatry features in the early stages, however, are under-investigated, and few comparison studies are available yet. The aim of the present study was to evaluate the cognitive and behavioral profile in the early stages of neurodegenerative extrapyramidal syndromes. Thirty-nine PD, 27 DLB, 16 CBDS, and 24 PSP were recruited. Groups were matched for global cognitive and motor impairment. The overall sample showed a common neuropsychological core characterized by visuospatial deficits. Although in the early stage of the disease, a high presence of behavioral disturbances was detected, depression and anxiety were the most common disorders, followed by apathy and sleep disturbances. The observation of overlapping clinical entities points the attention on the need of adjunctive diagnostic markers for early differential diagnosis.     

缺血性卒中后认知功能障碍的患病率和危险因素

目的 明确卒中后认知功能障碍(PSCI)的患病率和危险因素.方法 526例缺血性卒中患者被分为无认知障碍、认知障碍非痴呆(CIND)和血管性痴呆(VaD),根据影像学表现,患者分为皮质下缺血性血管病、皮质型缺血性血管病和其他类型,登记患者人口学、血管危险凶素和卒中病情等.结果 PSCI患病率36.7%.与无认知障碍相比,PSCI患者年龄大、女性比例高、教育程度低、彳T侧瘫痪多、抑郁评分高,但血管危险因素无差别.与无认知障碍者相比,VaD者经济水平低、配偶照料少、失语多、尿失禁多、皮质型缺血性血管病多;CIND者则有较多的皮质下缺血性血管病.VaD者较CIND者皮质型缺血性血管病多、抑郁评分低.高龄、女性、低社会经济水平、失语、皮质下缺血性血管病、皮质型缺血性血管病和抑郁评分高为PSCI的独立危险因素.结论 PSCI常见于缺血性卒中患者,与人口学因素、卒中类型及抑郁有关.     

Neuropsychological performance in patients with asymptomatic HIV-1 infection

Human immunodeficiency virus (HIV-1) infection and acquired immunodeficiency syndrome (AIDS) lead to neurocognitive disorders; however, there is still much knowledge to be gained regarding HIV-associated neurocognitive disorders. The purpose of this study was to assess the cognitive performance, instrumental activities of daily living, depression, and anxiety in patients with asymptomatic HIV-1 infections compared with seronegative participants without neurocognitive impairment. We studied a sample consisted of 60 patients with asymptomatic HIV-1 infections and 60 seronegative participants without neurocognitive impairment from the city of Barranquilla, Colombia, with a mean age of 36.07 years. A protocol of neuropsychological and psychopathological tests was applied to the participants. The group of patients with asymptomatic HIV infections significantly underperformed on tasks that assessed global cognitive screening, attention span, learning, phonemic verbal fluency, auditory-verbal comprehension, information processing speed, cognitive flexibility, and motor skills compared to the group of seronegative participants. No significant differences were found in memory, visual confrontation naming, vocabulary, inhibition, and instrumental activities of daily living. Additionally, the patients with asymptomatic HIV-1 infection had a higher anxiety index than the seronegative participants, but no significant difference was found in depression. A correlation was found between depression and anxiety. In conclusion, the patients with asymptomatic HIV-1 infection had lower cognitive performances than the seronegative participants in the cognitive functions mentioned above and more anxiety but still performed the instrumental activities of daily living.     

Assessment of comorbid mild cognitive impairment and depression in patients with type 2 diabetes mellitus

ContextDepression, mild cognitive impairment, and dementia are highly prevalent chronic conditions associated with social, medical, and economic burdens. Although there are several epidemiological studies that have reported the prevalence of mild cognitive impairment or depressive syndrome in elderly diabetic population little is known about the comorbidity of these conditions. We aimed to study the prevalence of comorbid mild cognitive impairment (MCI) and depression in patients with Type 2 diabetes mellitus and its relation to glycemic control.Materials and methodsthe present work was carried on 400 patients with T2DM. History taking, physical examination, laboratory investigations (with special emphasis on glycemic profile and lipid profile parameters) were done for every patient. Assessment of anxiety and depression using the HADS score and assessment of mild cognitive impairment using MoCA score were done.Results76% of studied patients had depression of varying degrees while 56.8% of studied patients had MCI. Decreased level of HDL-cholesterol and increased HADS anxiety score were significant predictors of depression. On the other hand, increased level of total cholesterol, decreased level of HDL-cholesterol, increased HADS depression score and decreased MoCA score were significant predictors of anxiety. HDL-cholesterol HADS anxiety score, FBG, and duration of DM were the significant predictors of MCI.ConclusionIncreased level of total cholesterol, decreased level of HDL-cholesterol, increased HADS depression score and decreased MoCA score were significant predictors of anxiety. HDL-cholesterol, HADS anxiety score, FBG, and duration of DM were the significant predictors of MCI.