晚发型抑郁障碍与轻度认知功能损害患者的认知功能差异研究

目的 探讨晚发型抑郁障碍患者与轻度认知功能损害患者的认知功能损害的差异.方法 研究对象为2012年7月～2013年8月上海市精神卫生中心老年科住院与门诊就诊符合DSM—Ⅳ诊断标准且起病年龄≥60岁的抑郁障碍患者,共26例为晚发型抑郁障碍组（LOD组）,另选择26例轻度认知功能损害的患者（MCI组）与26例正常老年人（NC组）.认知功能评估采用简明精神状态量表（MMSE）、蒙特利尔量表（MoCA）.结果 MMSE总分、MMSE分测验中计算力与注意力及MoCA总分、MoCA分测验中连线、注意、持续注意、计算、复述、延迟回忆在LOD组与MCI组差比较异无统计学意义（P＞0.05）,两组与NC组比较差异有统计学意义（P＜0.05）.三组在MMSE分测验的时间定向、延迟回忆、三步指令、书写书面指令及MoCA分测验的复制图、画钟、命名比较,MCI组均值最低,与NC组比较差异有统计学意义（P＜0.05）,与LOD组比较差异无统计学意义（P＞0.05）.结论 LOD组认知功能在注意力、延迟回忆、连线测验方面与MCI组损害程度相当.MCI组认知功能受损范围较LOD组广泛.

Differences of cognitive impairment between late-onset depressive disorder and mild cognitive impairment

Objective To study the differences of cognitive impairment between late-onset depressive disorder and mild cognitive impairment.Methods Totals of 26 patients that were met the DSM -Ⅳ diagnostic criteria of depressive disorder and over 60 years old were collected in Shanghai mental health outpatient and inpatient from July 2012 to August 2013.26 participants with mild cognitive impairment （MCI） and 26 normal controls （NC） were collected from Shanghai community.MMSE and MoCA were used to evaluate the cognitive functions.Results There were no significant differences between the participants with late-onset depressive disorder （LOD） and MCI in the total score of MMSE,calculation and attention,the total score of MoCA,the Trail Making B task,attention,sustained attention,calculation,rehearsal and delayed recall （P＞0.05）.There were significant differences between the two groups and normal controls.The scores of MCI group were worse than the other two groups in time orientation,delayed recall,three-step instructions,and following command in written of MMSE and copy pattern,clock drawing test and naming of MoCA.There were significant differences between MCI group and normal controls （P＜0.05）.Conclusions The patients with late-onset depressive disorder impaired equally with the patients in mild cognitive impairment of attention,delayed recall and the Trail Making B task.MCI patients had wider impaired domains of cognitive function than LOD patients.