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The role of persistent and incident major depression on rate of cognitive deterioration in newly diagnosed Alzheimer's disease patients

机译：持续和突发性重大抑郁症对新诊断的阿尔茨海默氏病患者认知能力下降的作用

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摘要

Depression may potentially impair the clinical course of Alzheimer's disease (AD). Thus, the aim of this study was to investigate cognitive progression of AD patients with or without major depressive episode (MDE). In this 1-year longitudinal follow-up study conducted in three Italian memory clinics, 119 newly diagnosed probable AD patients of mild severity, who were not undergoing treatment with an acetyl-cholinesterase inhibitor (AChEI), and had not been treated with psychotropic drugs in the last 2. years, were included. Patients were assessed to investigate the effect of baseline and 1-year follow-up MDE (using modified DSM-IV diagnostic criteria for MDE in AD) on progression of global cognitive deterioration (using Mini-Mental State Examination (MMSE)), adjusted for confounding factors. Never being depressed was associated with a 3.1 (95%CI 1.0-10.1) increased risk of MMSE decline compared to recovered depression. Six times more patients with persistent depression had MMSE decline compared to patients with recovered depression. However, the largest odds (7.3; 95%CI 1.4-38.1) of cognitive decline was observed in patients who developed incident depression over follow-up. In conclusion, persistent or incident depression worsens cognitive outcome while no or recovered depression does not affect it in early AD patients.
机译：抑郁症可能会损害阿尔茨海默氏病（AD）的临床过程。因此，本研究的目的是调查患有或不患有严重抑郁发作（MDE）的AD患者的认知进展。在这家为期三年的纵向随访研究中，这家公司在意大利的三家记忆诊所进行了研究，其中有119名新诊断的轻度AD患者，他们没有接受乙酰胆碱酯酶抑制剂（AChEI）的治疗，也没有接受过精神药物的治疗在过去的2年中，都包括在内。评估患者以调查基线和1年随访MDE（使用针对MDE的改良DSM-IV诊断标准）对总体认知能力恶化进展的影响（使用最小精神状态检查（MMSE）），混杂因素。与恢复的抑郁症相比，从未抑郁症与MMSE下降风险增加3.1（95％CI 1.0-10.1）有关。与持续抑郁症患者相比，持续抑郁症患者的MMSE下降多六倍。然而，在随访期间发生抑郁事件的患者中，认知能力下降的最大几率（7.3; 95％CI 1.4-38.1）。总之，持续性或偶发性抑郁症会使认知结果恶化，而在早期AD患者中，没有或恢复的抑郁症不会对其产生影响。

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