The Correlation Between Clinical Characteristics And Thyroid Hormone Levels With Cognitive Function In Early And Late Onset Late-Life Depressed Patients

Objective:The clinical features、thyroid hormone level and cognitive function of early-onset depression(EOD)and late-onset depression(LOD)were studied,and to explore the correlation between the clinical features、thyroid hormone level with cognitive function of different types of late-life depression(LLD),so as to provide a theoretical basis for improving their cognitive function and prognosis.Methods:Select the patients who went to the psychiatric department of a hospital from October 2020 to November 2022,the 176 elderly patients with depression who met the ICD-10 diagnostic criteria were in the study group(91 early onset and 85 late onset),and 100 healthy controls were randomly selected.The subject’s thyroid hormone levels were measured by electrochemiluminescence immunoassay,and assessed for clinical characteristics of depressive symptoms and intelligence status using the Hamilton Depression Scale(HAMD-24)、Hamilton Anxiety Scale(HAMA)、Minimum Mental State Examination(MMSE)、and vascular risk factors.Cognitive functions were assessed using Auditory Verbal Learning Test(AVMT),Verbal Fluency Test(VFT),Digital Span Test(DST),Digital Span Test(SDMT),and Trail Making Test A and B(TMT-A,B).Collated and analyzed the data,and the general conditions and clinical symptoms of early、late onset and healthy control group were analyzed by ANOVA or non-parametric test,then compare the thyroid hormone levels and cognitive function between the patient group with the healthy control group and the early onset group with the late onset group;Finally,the correlation between thyroid hormone and cognitive function in the early and late onset groups.Results:1.The differences in some general conditions and clinical characteristics of the three groups were statistically significant(P<0.05),the various thyroid hormone levels in the patient group were statistically significantly different from the control group(P<0.05),the cognitive function scores in the patient group were significantly different from the healthy controls(P<0.001),some social support items in the EOD group were statistically significant compared with the LOD group(P<0.05).2.The EOD group was significantly higher at the FT3 level than in the LOD group(P<0.05),T4 on the EOD group was significantly higher than the the EOD group had a statistically significant difference in the LOD group,the EOD group was significantly higher than the LOD group in the AVMT and DST-order,as well as in the TMT-A and B measurements(P<0.01,P<0.05,P<0.01),that in EOD group was significantly lower in VFT,DST-reverse order and SDMT measurements than in LOD group(P<0.05,P<0.001,P<0.001).3.Some clinical features and thyroid hormone levels in the EOD and LOD groups correlated with some cognitive function assessments(P<0.05),the number of episodes was positively associated with AVMT and HAMD and TMT(P<0.05),TSH was positively associated with SDMT(P<0.01),negative correlation with TMT-B results(P<0.05);FT3 was negatively associated with AVMT and VFT(P<0.01～P<0.05),positive correlation with TMT-A and B(P<0.05,P<0.01);FT4 and T3 were negatively correlated with AVMT(P<0.01～P<0.05)and a strong negative correlation between FT4 and instantaneous recall-1(P<0.01),T4 was negatively associated with AVMT,VFT,and SDMT(P<0.01～P<0.05);The number of episodes was positively associated with AVMT in the LOD group(P<0.05),HAMD was negatively associated with AVMT(P<0.05),TSH was positively associated with instantaneous AVMT(P<0.05);FT3 was negatively correlated with AVMT(P<0.01～P<0.05),positive correlation with TMT-B(P<0.01);FT4 showed negative correlation with AVMT、VFT、DST and SDMT(P<0.01～P<0.05)and strong negative correlation with some AVMT(r<-0.7),positive correlation with TMT-A(P<0.05);T3 was negatively associated with VFT-movement and DST-inverted back(P<0.05),and was a positive correlation with TMT(P<0.05,P<0.01);T4 was negatively associated with AVMT(P<0.01～P<0.05).Correlation analysis was obtained after multifactor linear regression analysis,in the EOD group,FT4 significantly affected the AVMT(P<0.001),FT3 significantly affected VFT-action(P<0.05),TSH and T4 significantly affected the SDMT(P<0.05),FT3 significantly affected the TMT(P<0.01～P<0.05);In the LOD group,FT3 and FT4 significantly affected the AVMT(P<0.001～P<0.05),FT4 and T4 significantly affected the VFT and DST-reverse order(P<0.05),FT4 significantly affected SDMT and TMT-A(P<0.05),T3 and FT3 significantly affected TMT-B(P<0.05).Conclusion:Elderly patients with depression have lower thyroid hormone levels compared to healthy elderly people and have impaired cognitive function.There are certain differences in clinical characteristics、thyroid hormone levels and cognitive function levels in elderly patients with depression at different first onset ages;Early onset geriatric depression with late onset has high thyroid hormone levels and more pronounced impairment of cognitive function.The cognitive function of elderly patients with depression at different first onset ages is negatively affected by the thyroid hormone level,and the influence of late onset is more obvious;Improving and stabilizing thyroid hormone in the lower levels within the normal range may play a positive role in relieving and improving their cognitive impairment.