A Follow-up Study Of Persistent Cognitive Impairment Of Senile Depression

Objective: This study attempted to explore the relationship betweendepressive symptom and cognitive impairment,and neuropsychologicalcharacteristics of elderly first-episode patients with depressive disorder.Methods:30elderly patients(aged over60) with cognitive impairmentand34elderly patients without cognitive impairment with the first episode ofdepression diagnosed according to DSM-I V,31elderly patients with mildcognitive impairment,and31elderly healthy people were investigated.Allsubjects were interviewed with GDS,MMSE,The digit span tasks and Trailmaking test on the baseline and12months later.All subjects were measuredApolipoprotein E genotype.Results:1.Older patients with depression of two groups were treated by selectiveserotonin reuptake inhibitor (SSRI).In elderly depressed patients withcognitive impairment,the score of MMSE,12months later, increased than thebaseline,and was lower than that of depressed patients without cognitiveimpairment,and the score of GDS was higher than that of depressed patientswithout cognitive impairment.2.The score of MMSE in12th month,in elderly depressed patientswith cognitive impairment, negative related to the score of GDS in12thmonth.While that of MMSE related to age,in elderly depressed patients without cognitive impairment.3.Gene ApoE epsilon4was no statistical difference in four groups (P>0.05). The score of MMSE in12th month,in elderly depressed patients withcognitive impairment and elderly patients with mild cognitive impairment,were related to ApoE epsilon4.4. After12months, the numbers of the digit span task in elderlydepressed patients with cognitive impairment, were higher than that ofbaseline,and were lower than that of elderly depressed patients withoutcognitive impairment and elderly healthy people.5. After12months,TMT-A and TMT-B were higher than the baseline inall elderly depressed patient（sP<0.01）.There were no significant differencebetween elderly depressed patients with cognitive impairment and withoutcognitive impairment in TMT-A. While the time of elderly depressed patientswith cognitive impairment in TMT-B, was worse than that of elderlydepressed patients without cognitive impairment.Conclusions:1.After antidepression, elderly depressed patients with cognitiveimpairment had the worse response, related to elderly depressed patientswithout cognitive impairment.The cognitive function in elderly depressedpatients could be improved by antidepressive treat.2.Depression may be a risk factor for cognitive impairment.3.ApoE epsilon4gene is a risk factor for AD.Persistent cognitiveimpairment in elderly depressed patients related to genes ApoE epsilon4.4.The cognitive impairment between elderly depressed patients and MCIwas distinguished. Digit span task,TMT-A,TMT-B can help identify patients’ cognitive impairment with depression and MCI.