老年憂鬱症患者緩解期之認知功能與其影響因素

Nature and Determinants of Cognitive Functions in Late-life Major depressive disorders in Remitted phase

葉怡君(Yi-Chun Yeh)

指導教授 ： 陳正宗

高雄醫學大學/醫學院/神經學科研究所/碩士(2008年)

https://doi.org/10.6832/KMU.2008.00021

摘要

老年憂鬱症為常見老年精神疾病且常合併失能、自殺、認知功能障礙。老年憂鬱症合併認知功能障礙可能增加日後發展為失智症的危險性，因此了解老年憂鬱症憂鬱期到緩解期的認知功能變化有其相當重要性。
本研究主要目的在了解老年憂鬱症緩解期是否存在認知功能障礙、以何種認知功能障礙為核心問題表現、並探討其相關影響因子。收案對象包括處於重鬱症緩解期之個案組74人及對照組74人。我們進行臨床評估與完整認知功能測驗，比較兩組的認知功能差異，並探討個案組臨床變項和核心認知功能障礙之間的相關性。
研究結果發現老年憂鬱症緩解期仍存在廣泛性認知功能障礙，其中又以執行功能及記憶力障礙為核心問題，且越晚發病者有越明顯的執行功能障礙。結果顯示執行功能及記憶功能障礙可能是老年憂鬱症之獨立性特質（trait）而非伴隨憂鬱的短暫症狀。
臨床工作者應注意，在老年憂鬱症患者憂鬱症狀緩解後應持續追蹤注意是否存在認知功能障礙。此外，未來仍須致力於持續認知功能障礙相關影響因子及病因的研究，期望能找出治療或預防持續性認知功能障礙的方法，進一步預防及降低失智症的發生。

關鍵字

老年憂鬱症 ； 緩解期 ； 神經心理學測驗 ； 認知功能障礙 ； 發病年齡 ； 發作次數

並列摘要

Depression in late life is a common elderly psychiatric disorder with significant morbidity, including cognitive impairment. Cognitive impairment in late-life depression (LLD) would increase the risk of dementia so it is important to investigate the cognitive function of LLD.
The purpose of this study is to investigate the cognitive impairment in remitted LLD and the related clinical variables.
Study group was composed of seventy four elders with major depressive disorder in remission and seventy four normal controls were administered a comprehensive neuropsychological batteries. Patients with remitted LLD had core cognitive impairment in the memory and executive function. Later age at onset of first depressive episode is the risk factor of executive dysfunction.
The results of this study show that the memory and executive impairments seem to be trait characteristics of late-life depression. Therefore, the clinicians are advised to closely monitor the cognitive function in LLD even in remitted state. Further studies examining the mechanisms of the cognitive impairment in remitted LLD are suggested to develop early intervention to avoid progression to dementia.

並列關鍵字

late life depression ； remission ； neuropsychological test ； cognitive impairment ； age of onset ； episode number

參考文獻

http://www.doh.gov.tw/statistic/index.htm

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