Relationship Between Cognitive Impairment And Metabolic Disorders In Middle-aged And Elderly Patients With MDD

Objective:To explore the relationship between cognitive impairment and metabolic disorders in middle-aged and elderly patients with MDD,and to explore which metabolic components have an impact on cognitive function in middle-aged and elderly patients with MDD.Methods:There were 72 patients with MDD,including 19 patients in simple MDD group,34 patients in comorbidity of MDD and metabolic disorder group and 19 patients in comorbidity of MDD and MetS group,42 cases in control group were included.The blood lipid and blood glucose levels were measured after fasting 8 hours.The waist and hip circumference of participants were measured with tape measure.MocA are uesd assess the cognitive function of MDD group and control group;RBANS and Trail Making Test are uesd assess the cognitive function of Subgroup on MDD.Finally,Analysis of the influencing factors of cognitive function in middle-aged and elderly patients with MDD.Results:1.The comparison of cognitive function between MDD group and control group:The MocA score of MDD group was lower than that of control group(P<0.001).2.The comparison of cognitive function among with Subgroup on MDD:1)There is statistical difference in MocA scores among with the three groups(P=0.035).The MocA score(P=0.042)of comorbidity of MDD and MetS group group is lower than simple MDD.2)The total score of RBANS(P=0.001),the scores of Immediate Memory(P=0.023),Visuospatial/Constructional(P=0.010),Language(P=0.038),Attention(P<0.001)among the three groups are statistically different.The total score of RBANS(P<0.001),Immediate Memory(P=0.021),Visuospatial/Constructional(P=0.007),Language(P=0.043)and Attention(P<0.001)of comorbidity of MDD and MetS group are lower than simple MDD group.The total score of RBANS(P=0.018),Attention(P=0.003)of comorbidity of MDD and metabolic disorder group are lower than simple MDD group.The Attention score(P=0.035)of comorbidity of MDD and metabolic disorder group is lower than comorbidity of MDD and MetS.3)The comparison of TMT among with Subgroup on MDD:TMT-A time-consuming(P=0.004),TMT-B time-consuming(P=0.002)and Disturbance(P=0.010)are statistically different among the three groups.TMT-A time-consuming(P=0.001),TMT-B time-consuming(P<0.001),Disturbance(P=0.004)of comorbidity of MDD and MetS are higher than simple MDD group.TMT-B time-consuming(P=0.007),Disturbance(P=0.010)of comorbidity of MDD and MetS are higher than comorbidity of MDD and metabolic disorder group.TMT-A time-consuming(P=0.013)of comorbidity of MDD and MetS is higher than simple MDD group.4)After controlling for age,sex,education,smoking,course of depressive disorder,recurrence,HAMD,HAMA score,The RBANS score(P=0.003),Immediate memory(P=0.025),Attention score(P=0.002)of comorbidity of MDD and MetS are lower than simple MDD group.TMT-B time-consuming(P=0.023),Disturbance(P=0.038)of comorbidity of MDD and MetS are higher than simple MDD group.Attention score(P=0.022)of comorbidity of MDD and metabolic disorder group is lower than simple MDD group.3.Analysis on the Influencing Factors of Cognitive Function of MDD in Middle and Old Age:①The RBANS score was related to education(P=0.001),HAMD(P=0.042),abdominal obesity(P=0.018),hyperglycemia(P=0.027),R2=0.409;②Immediate Memory was associated with education(P=0.001),HAMD(P=0.013),and hyperglycemia(P=0.009),R2=0.312;③Visuospatial/Constructional is related only to educational level(P<0.001),R2=0.294;④Language was associated with education(P=0.001),HAMA(P=0.012),R2=0.256;⑤The Attention was related to education(P=0.003),abdominal obesity(P=0.001),R2=0.369.⑥Delayed Memory was associated with HAMD(P=0.031),abdominal obesity(P=0.044),and hyperglycemia(P=0.007),R2=0.196.⑦TMT-A time-consuming was associated with education(P<0.001),abdominal obesity(P=0.008)and HAMA(P=0.011),R2=0.493.⑧TMT-B time-consuming was associated with education(P=0.007),age(P=0.006),abdominal obesity(P=0.015),course of MDD(P=0.013)and HAMA(P=0.032),R2=0.518.⑨Disturbancewas associated with education(P=0.006),age(P=0.015),abdominal obesity(P=0.015),course of MDD(P=0.021)and smoking(P=0.046),R2=0.362Conclusions:There are obvious cognitive impairment in middle-aged and elderly patients with MDD,among which MetS may aggravate the cognitive impairment in middle-aged and elderly patients with MDD,especially in attention and executive function.Age,course of MDD,education level,levels of anxiety and depression during testing,hyperglycemia and abdominal obesity were all associated with cognitive impairment in middle-aged and elderly patients with depressive disorders.