老年轻度认知损害患者抑郁情绪与认知功能相关性分析

目的 探讨轻度认知损害(MCI)患者抑郁情绪与认知功能之间的相关性.方法 纳入2020年12月至2021年12月浙江大学医学院附属第一医院收治的106例轻度认知损害患者,根据老年抑郁量表(GDS)评分分为伴抑郁MCI组(53例)和无抑郁MCI组(53例),以及同期就诊的53例认知功能正常的抑郁患者(抑郁组)和53例无认知功能障碍且无抑郁的对照者(对照组).采用简易智能状态检查量表(MMSE)和蒙特利尔认知评价量表(MoCA)评价整体认知功能,Rey-Osterrieth复杂图形测验(ROCFT)和画钟测验(CDT)评价视空间能力,逻辑记忆测验(LMT)和听觉词汇学习测验(AVLT)评价记忆力,Stroop色词测验(SCWT)和连线测验(TMT)评价注意力和执行功能,词语流畅性测验(VFT)和Boston命名测验(BNT)评价语言功能,日常生活活动能力量表(ADL)评价日常生活活动能力.Pearson相关分析和偏相关分析探讨抑郁情绪与认知功能之间的相关性.结果 4组受试者各项神经心理学测验差异具有统计学意义(均P＜0.05),其中,伴抑郁MCI组MMSE和MoCA评分低于对照组(均P=0.000)、抑郁组(均P=0.000)和无抑郁MCI组(均P=0.000);伴抑郁MCI组ROCFT-临摹和回忆、CDT评分低于对照组(均P=0.000)、抑郁组(均P=0.000)和无抑郁MCI组(均P=0.000);伴抑郁MCI组和无抑郁MCI组LMT-即刻回忆和延迟回忆评分低于对照组(P=0.000,0.000,0.002,0.001)和抑郁组(P=0.000,0.000,0.040,0.043),伴抑郁MCI组LMT-延迟回忆评分低于无抑郁MCI组(P=0.030);伴抑郁MCI组AVLT-即刻回忆、短延迟回忆、长延迟回忆和再认评分低于对照组(均P=0.000)、抑郁组(均P=0.000)和无抑郁 MCI 组(P=0.009,0.003,0.017,0.001);伴抑郁 MCI 组 SCWT-A、SCWT-B 和 SCWT-C、TMT-A 和TMT-B 完成时间长于对照组(P=0.001,0.000,0.000,0.000,0.000)、抑郁组(P=0.008,0.001,0.001,0.001,0.001)和无抑郁 MCI组(P=0.001,0.000,0.000,0.000,0.004),SCWT-A、SCWT-B和SCWT-C正确个数少于对照组(P=0.003,0.008,0.001)和抑郁组(P=0.016,0.031,0.002),而 SCWT-A 和 SCWT-C 正确个数少于无抑郁MCI组(P=0.003,0.008);伴抑郁MCI组VFT-动物和蔬菜、BNT正确个数少于对照组(均P=0.000)、抑郁组(P=0.016,0.003,0.000)和无抑郁 MCI组(P=0.010,0.005,0.000);伴抑郁 MCI组ADL评分高于对照组(P=0.000)、抑郁组(P=0.001)和无抑郁MCI组(P=0.000),抑郁组ADL评分高于对照组(P=0.014)和无抑郁MCI组(P=0.001);对照组和无抑郁MCI组的GDS评分低于抑郁组(均P=0.000)伴抑郁 MCI组(均P=0.000).相关分析显示,GDS评分与 MMSE(r=-0.300,P=0.000),MoCA(r=-0.357,P=0.000),ROCFT-临摹(r=-0.192,P=0.006)和回忆(r=-0.142,P=0.044),CDT(r=-0.171,P=0.015),LMT-即刻回忆(r=-0.213,P=0.002)和延迟回忆(r=-0.193,P=0.005),AVLT-即刻回忆(r=-0.159,P=0.021)、短延迟回忆(r=-0.161,P=0.020)和长延迟回忆(r=-0.137,P=0.047),以及SCWT-A(r=-0.156,P=0.025)、VFT-动物(r=-0.271,P=0.000)和蔬菜(r=-0.145,P=0.038)、BNT(r=-0.194,P=0.005)正确个数呈负相关;与 SCWT-A(r=0.162,P=0.020)、SCWT-B(r=0.189,P=0.007)、SCWT-C(r=0.184,P=0.009)、TMT-A(r=0.189,P=0.006)完成时间和 ADL评分(r=0.367,P=0.000)呈正相关.结论 轻度认知损害伴抑郁情绪患者存在更广泛、更严重的认知域损害,临床照料轻度认知损害患者时应关注其情绪问题.