重鬱症合併認知功能障礙及亞臨床甲狀腺亢進症病例之周全性老年評估

Comprehensive Geriatric Assessment: A Case of Major Depressive Disorder, Impaired Cognitive Function and Subclinical Hyperthyroidism

林玟玓(Wen-Ti Lin) ； 顏啓華(Chi-Hua Yen) ； 李孟智(Meng-Chih Lee)

《醫學與健康期刊》 7卷1期 (2018/03) Pp. 53-63

摘要

憂鬱症是21世紀的三大疾病之一，社區研究發現約有百分之四的老年人罹患重度憂鬱症症。老年憂鬱症不僅常合併認知功能障礙，亦與甲狀腺功能異常密切相關。本文以一位罹患憂鬱症、認知功能障礙及亞臨床甲狀腺亢進症的六十七歲老年女性患者為例，透過周全性老年評估以及全人照護的方式介入，經跨領域的多醫療團隊討論，針對憂鬱症及認知功能障礙的關聯性、亞臨床甲狀腺亢進症的追蹤及治療及病患的疾病議題，提供個人化建議，期望能增進診斷的精確性、建立後續照護及追蹤方向。

關鍵字

重鬱症 ； 認知功能障礙 ； 亞臨床甲狀腺功能亢進症 ； 周全性老年評估

並列摘要

Depressive disorders were ranked as the third leading cause of the global burden of disease in the 21st century. According to community studies, prevalence of major depressive disorder in the geriatric population is 4%. Depression in the elderly population is not only closely related to cognitive function impairment but also thyroid function abnormalities. In this article, we present a case involving a 67-year-old woman with major depressive disorder, cognitive function impairment and subclinical hyperthyroidism. We conducted a comprehensive review of geriatric assessment and discuss the clinical presentation and management of major depressive disorder, cognitive function impairment and subclinical hyperthyroidism in the elderly patients. With these findings and recommendations, we aim to help the patient establish her own follow-up plans and subsequent health management.

並列關鍵字

Major depressive disorder ； Impaired cognitive function ； Subclinical hyperthyroidism ； Comprehensive geriatric assessment

參考文獻

Ferrari, AJ,Charlson, FJ,Norman, RE(2013).Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010.PLoS medicine.10,e1001547.

Chen, H,Cohen, P,Kasen, S,Johnson, JG,Berenson, K,Gordon, K(2006).Impact of adolescent mental disorders and physical illnesses on quality of life 17 years later.Arch Pediatr Adolesc Med.160,93-9.

Diniz, BS,Butters, MA,Albert, SM,Dew, MA,Reynolds, CF(2013).Late-life depression and risk of vascular dementia and Alzheimer's disease: systematic review and meta-analysis of community-based cohort studies.Br J Psychiatry.202,329-35.

Allen, N,Burns, A(1995).The noncognitive features of dementia.Reviews in clinical gerontology.5,57-75.

Blum, MR,Wijsman, LW,Virgini, VS(2016).Subclinical thyroid dysfunction and depressive symptoms among the elderly: a prospective cohort study.Neuroendocrinology.103,291-9.