| Part 1:Study on the Relationship between Cognitive Function and Homocysteine Level in Late-onset Depression Objective: To explore the relationship between homocysteine(Hcy)levels and cognitive function in patients with late-onset depression.To provide a research basis for further exploring whether homocysteine is effective as an intervention factor in the process of cognitive dysfunction.Methods: There were 92 patients with late-onset depression(LOD),including 27 males and 65 females,aged 60-79 years(65.51±5.02).There were 86 normal elderly people,including 27 males and 59 females,aged 60-79 years(65.43±4.65).Enzyme method was used to measure blood homocysteine levels in all subjects,and field interviews were used to assess the cognitive function of all subjects.Result:(1)There was no significant difference in gender and age between the patient group and the control group.There was a significant difference in education years between the patient group and the control group(P?0.05).The HAMD score of the patient group(32.3±4.44)was higher than that of the control group(3.86±1.48),and the difference was significant(P?0.05).Hcy(13.53±6.92)was higher in the patient group than in the control group(11.69±3.68),and the difference was significant(P?0.05).(2)The MMSE,TMT-A and TMT-B scores of the patient group were higher thanthose of the control group,and the difference was significant(P?0.05).The SDMT,VFT-animal,VFT-action,DST-forward,and DST-backward scores of the patient group were lower than those of the control group,and the difference between the two groups was significant(P?0.05).(3)There was no correlation between Hcy level and HAMD score(r=-0.006,P=0.956).After adjusting for age and years of education,Hcy levels were negatively correlated with MMSE total scores(r=-0.231,P=0.028).Conclusion:(1)Patients with late onset depression have high levels of Hcy.Higher levels of Hcy may be one of the important factors leading to cognitive impairment in patients with late onset depression.(2)Compared with the normal elderly population,patients with late-onset depression have significant cognitive deficits in attention,short-term memory,speech,and executive function.Part 2:Study on the Characteristics of Cognitive Function and Psychosocial Factors of Early-onset and Late-onset DepressionObjective: To study the influence of cognitive function characteristics,personality traits,social support and other psychosocial factors on cognitive function among different types of late life depression(LLD).It provides a theoretical basis for the early identification of elderly depression,especially the treatment and prognosis of cognitive function.Methods: There were 39 patients with late onset depression(LOD),including 5males and 24 females,aged 60-77 years(66.97±4.99).There were 39 patients with early onset depression(EOD),including 7 males and 32 females,aged 60-77 years(66.31±5.19).There were 40 normal control group(NC),13 males and 27 females,aged 60-77 years(65.93 ± 4.89).On-site interview assessment was used to assess depression,social support,personality traits,and cognitive function of all subjects.Result:(1)There were no significant differences in gender,age,and years of education between the LOD group,the EOD group,and the NC group.There were significant differences in marital status among LOD group,EOD group and NC group(P ?0.05).There were significant differences in vascular risk factors between LOD group,EOD group and NC group(P?0.05).Vascular risk factors in the LOD group(14.69±2.02)were higher than those in the EOD group(13.62±2.03),and the difference was significant(P?0.05).The total course of disease in the LOD group(7.55±13.26)was lower than the total course of disease in the EOD group(195.10±110.26),and the difference was significant(P ? 0.05).The depression score of the LOD group(36.95±4.68)and the depression score of the EOD group(38.36±2.91)were higher than the depression score of the NC group(2.18 ± 17.20),and the difference was significant(P?0.05).(2)In terms of cognitive function,the MMSE,SDMT,VFT,DST,TMT scores of the LOD group and the EOD group were lower than those of the NC group(P?0.05).The MMSE score of the LOD group(24.92±1.11)was lower than that of the EOD group(26.28±1.32),and the difference was significant(P?0.05).The TMT-A score of the LOD group(153.49±43.48)was higher than that of the EOD group(129.82±39.04),and the difference was significant(P?0.05).(3)The total social support score in the LOD group(33.64±2.84)and the total social support score in the NC group(31.72 ± 3.09)were higher than those in the EOD group(35.48±2.86),with significant differences(P?0.05).The subjective support score and support utilization score of the EOD group were lower than those of the NC group,and the differences were significant(P?0.05).(4)The score of introversion and extroversion in LOD group(40.51 ± 3.77)was lower than that in EOD group(45.39±3.87),and the differences were significant(P?0.05).The scores of neuroticism in the LOD group(56.67 ± 4.78)and the neurotic score in the NC group(55.13±4.76)were lower than those in the EOD group(65.26±5.37),and the difference was significant(P?0.05).The scores of psychoticism in LOD group(47.82±3.40)and EOD group(65.26±5.37)were lower than those in NC group(55.13±4.76),and the difference was significant(P?0.05).(5)Vascular risk factors in the LOD group were negatively correlated with DST-forward(r=-0.418,P?0.05).The total social support score of the LOD group was positively correlated with the DST-forward score(r=0.366,P?0.05),and the objective support score was positively correlated with the DST-forward score(r=0.393,P?0.05).Introversion and extroversion scores were negatively correlated with SDMT scores(r=-0.845,P ? 0.01),neuroticism scores were negatively correlated with SDMT scores(r=-0.816,P ? 0.01),and psychoticism scores were negatively correlated with SDMT scores(r =-0.718,P?0.05).(6)The incidence of EOD group was negatively correlated with VFT-action score(r=-0.368,P ? 0.05).HAMD score was negatively correlated with MMSE score(r=-0.353,P?0.05),and negatively correlated with SDMT score(r=-0.361,P?0.05).The psychoticism score was negatively correlated with TMT-A score(r=-0.515,P?0.01),and negatively correlated with TMT-B score(r=-0.324,P?0.05).Conclusion:(1)Cognitive impairment exists in patients with early-onset and late-onset depression.In patients with late-onset depression,executive function impairment is more pronounced than in patients with early-onset depression.(2)Compared with patients with LOD,EOD is more neurotic and social support is worse.(3)Cognitive function of patients with late-onset depression is closely related to individual psychosocial factors. |
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