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首页> 外文期刊>The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry >Dimensions of Poststroke Depression and Neuropsychological Deficits in Older Adults
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Dimensions of Poststroke Depression and Neuropsychological Deficits in Older Adults

机译：女失败抑郁尺寸和老年人神经心理学赤字的尺寸

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摘要

Objective: Poststroke depression (PSD) has a heterogeneous presentation and is often accompanied by cognitive impairment. This study aimed to identify distinct dimensions of depressive symptoms in older adults with PSD and to evaluate their relationship to cognitive functioning. Design: Cross-sectional factor and correlational analyses of patients with poststroke depression. Setting: Patients were recruited from the community and from acute inpatient stroke rehabilitation hospitals. Participants: Participants had suffered a stroke and met DSM-IV criteria for major depression (>= 18 Montgomery Asberg Depression Scale; MADRS). Intervention: None. Measurements: MADRS was used to quantify depression severity at study entry. Neuropsychological assessment at the time of study entry consisted of measures of Global Cognition, Attention, Executive Function, Processing Speed, Immediate Memory, Delayed Memory, and Language. Results: There were 135 (age >= 50) older adult participants with PSD and varying degrees of cognitive impairment (MMSE Total >= 20). Factor analysis of the MADRS identified three factors, that is sadness, distress, and apathy. Items comprising each factor were totaled and correlated with neuropsychological domain z-score averages. Symptoms of the apathy factor (lassitude, inability to feel) were significantly associated with greater impairment in executive function, memory, and global cognition. Symptoms of the sadness and distress factors had no relationship to cognitive impairment. Conclusion: PSD consists of three correlated dimensions of depressive symptoms. Apathy symptoms are associated with cognitive impairment across several neuropsychological domains. PSD patients with prominent apathy may benefit from careful attention to cognitive functions and by interventions that address both psychopathology and behavioral deficits resulting from cognitive impairment.
机译：目的：卒中后抑郁（PSD）具有异质性表现，常伴有认知障碍。本研究旨在确定患有PSD的老年人抑郁症状的不同维度，并评估其与认知功能的关系。设计：脑卒中后抑郁患者的横断面因素和相关分析。背景：从社区和急性住院中风康复医院招募患者。参与者：参与者患有中风，并符合DSM-IV重度抑郁症标准（>=18蒙哥马利-阿斯伯格抑郁量表；MADRS）。干预：无。测量：MADRS用于量化研究开始时的抑郁严重程度。研究开始时的神经心理学评估包括整体认知、注意力、执行功能、处理速度、即时记忆、延迟记忆和语言的测量。结果：135名（年龄>=50）老年参与者患有PSD和不同程度的认知障碍（MMSE总数>=20）。对MADR的因素分析确定了三个因素，即悲伤、痛苦和冷漠。将包含每个因素的项目相加，并与神经心理学领域的z评分平均值相关联。冷漠因子的症状（倦怠、感觉无力）与执行功能、记忆和整体认知的更严重损害显著相关。悲伤和痛苦因素的症状和认知障碍无关。结论：PSD由抑郁症状的三个相关维度组成。冷漠症状与多个神经心理学领域的认知障碍有关。对认知功能的仔细关注，以及针对认知障碍导致的精神病理学和行为缺陷的干预措施，可能会使具有显著冷漠的PSD患者受益。

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