The Study Of Plasma Cortisol,DHEAS Levels And The Ratio Of Cortisol/DHEAS In Middle-aged Patients With Depression And Cognitive Impairment

Objective:This study which explores the correlation between cortisol,DHEAS,their ratio and Middle-aged patients with depression and Cognitive impairment is aim to find the Mechanism and to provide theoretical basis for the diagnosis and treatment of depression with Cognitive impairment.Methods:Serum cortisol,DHEAS level were measured both in patient group included 40 Middle-aged patients with depression before and after four weeks treatment by using ELISA and in control group included 40 health Middle-aged people. Both patient group (before and after four weeks treatment) and control group Cognitive function were evaluated by using WAIS-RC (Wechsler Intelligence Scale for Adut-Chinese Revised),STROOP,M-WCST,ADL (Activity of Daily Living Scale), and depressie symptoms were evaluated by using HAMD.Results:Serum cortisol levels, the ratio of cortisol/DHEAS were significantly higher in patient group than in control group (P<0.05), and which declined in patient group after four weeks treatment (P<0.05). Serum DHEAS levels were significantly lower in patient group than in control group(P<0.05), and which rised in patient group after four weeks treatment(P<0.05). Single factor analysis of variance shows serum cortisol,DHEAS levels and the ratio of cortisol/DHEAS is different in light,severe paitents group and control group(P<0.05).But serum DHEAS levels is not different btween light paitents group and control group (P=0.169).The linear relations were found between the serum DHEAS levels,the ratio of cortisol/DHEAS and value of HAMD(r=-0.784,P=0.000; r=-0.855,P=0.000) and between the ratio of cortisol/DHEAS and the reduced value of HAMD (r=0.421, P=0.007). Middle-aged patients with depression were significantly worse in cognitive tests than normal control on M-WCST,WAIS-RC,stroopc,stroopc-w,ADL(P<0.1或P<0.05), and were better after four weeks treatment P<0.1或P<0.05). The linear relations were found between the serum cortisol,DHEAS levels,the ratio of cortisol/DHEAS and cognitive tests on M-WCST,WAIS-RC,stroopc,stroopc-w,ADL (P<0.1或P<0.05)Conclusions 1.Compared to health people, Serum cortisol,DHEAS levels, the ratio of cortisol/DHEAS in elderly patients with depression are unusual, and the phenomenon is associated with the degree of depression. But the change of the rate of cortisol/DHEAS is more associated with the improvements in depressive symptoms.2.There are some cognitive damnification in elderly patients with depression, and we can find that State and trait can be shown at the same time. Higher cortisol,lower DHEAS levels, higher the ratio have some negative correlation with cognitive function.