急性脑梗死老年患者认知功能障碍与焦虑、抑郁情绪的相关性

Correlation between cognitive dysfunction, anxiety and depression in elderly patients with acute cerebral infarction

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2020, 47(4)
作者
作者单位

洛阳市第一人民医院 ;

摘要
【摘要】探究急性脑梗死(ACI)老年患者认知功能障碍与焦虑、抑郁情绪的相关性。方法 回顾性分析2018年2月至2020年2月本院神经内科诊治的ACI老年患者112例临床资料。根据蒙特利尔认知量表(MoCA)评分结果将112例老年患者分为有认知功能障碍组(43例),无认知功能障碍组(69例)。比较两组临床资料及焦虑评分(HAMA)、抑郁评分(HAMD)、MoCA评分情况;分析焦虑、抑郁程度对老年ACI患者认知功能障碍的影响,评估HAMA、HAMD评分对认知功能障碍的预警作用;分析MoCA与HAMA、HAMD评分相关性。结果 两组年龄、受教育程度、焦虑程度、抑郁程度比较,差异有统计学意义(P<0.05),且有认知功能障碍组患者HAMA评分、HAMD评分高于无认知功能障碍组(P<0.05)。Logistic回归结果显示:重度焦虑(OR=10.696,95%CI=2.416~47.365)、重度抑郁(OR=6.870,95%CI=1.772~26.643)、年龄>80岁(OR=4.973,95%CI=1.141~21.663)是老年ACI患者认知功能障碍的危险因素(P<0.05)。有认知功能障碍组(18.49±3.33)分,显著高于无认知功能障碍组[(28.19±1.05)分],差异有统计学意义(t=18.557,P<0.05)。Pearson相关性显示:MoCA评分与HAMA、HAMD评分均呈负相关(r=-0.334、-0.314,P=0.000、0.001,均P<0.05)。ROC曲线显示:HAMA及HAMD评分预警老年ACI患者认知功能障碍的AUC为0.726(95% CI=0.630~0.821)、0.709(0.611~0.807),有一定准确性;最佳临界值依次为16.5、25.5;灵敏度、特异度:HAMA评分为53.5%、81.2%,HAMD评分为51.2%、84.1%。结论 老年ACI患者认知功能障碍与焦虑、抑郁情绪存在相关性,重度焦虑、重度抑郁的老年ACI患者更易产生认知功能障碍,且HAMA、HAMD评分对该类患者认知功能障碍具有一定预警作用。
Abstract
【Abstract】 Objective To explore the correlation between cognitive dysfunction and anxiety and depression in elderly patients with acute cerebral infarction (ACI).Methods The clinical data of 112 elderly patients with ACI diagnosed and treated in our department of neurology from February 2018 to February 2020 were retrospectively analyzed.According to the Montreal Cognitive Scale (MoCA) score, 112 elderly patients were divided into groups with cognitive dysfunction (43 cases) and those without cognitive dysfunction (69 cases).Compare the clinical data, anxiety score (HAMA), depression score (HAMD) and MoCA scores of the two groups; analyze the impact of anxiety and depression on cognitive dysfunction in elderly ACI patients, and evaluate the early warning of HAMA and HAMD scores for cognitive dysfunction Effect; analyze the correlation between MoCA and HAMA and HAMD scores.Results There were significant differences in age, education, anxiety and depression between the two groups (P <0.05), and the HAMA score and HAMD score of patients with cognitive impairment were higher than those without cognitive impairment (P <0.05).Logistic regression results showed: severe anxiety (OR = 10.696, 95% CI = 2.416 ~ 47.365), severe depression (OR = 6.870, 95% CI = 1.772 ~ 26.643), age> 80 years (OR = 4.973, 95% CI = 1.141 ~ 21.663) is a risk factor for cognitive dysfunction in elderly ACI patients (P <0.05).The score in the group with cognitive dysfunction (18.49 ± 3.33)score was significantly higher than that in the group without cognitive dysfunction [(28.19 ± 1.05)score], the difference was statistically significant (t = 18.557, P <0.05).Pearson correlation showed that MoCA score was negatively correlated with HAMA and HAMD scores (r = -0.334, -0.314, P = 0.000, 0.001, both P <0.05).The ROC curve shows that the AUC of HAMA and HAMD scores for early warning of cognitive dysfunction in elderly ACI patients is 0.726 (95% CI = 0.630 ~ 0.821), 0.709 (0.611 ~ 0.807), with certain accuracy; the optimal cutoff values are 16.5, 25.5; sensitivity, specificity: HAMA scores are 53.5% and 81.2%, and HAMD scores are 51.2% and 84.1%.Conclusion There is a correlation between cognitive dysfunction and anxiety and depression in elderly ACI patients. Elderly ACI patients with severe anxiety and severe depression are more likely to develop cognitive dysfunction, and HAMA and HAMD scores have a certain early warning effect on cognitive dysfunction in these patients .
关键词
【关键词】 急性脑梗死;认知功能障碍;老年;焦虑;抑郁
KeyWord
【Keywords】 Acute cerebral infarction; Cognitive dysfunction; Old age; Anxiety; Depression
基金项目
页码 749-753
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马明娟*. 急性脑梗死老年患者认知功能障碍与焦虑、抑郁情绪的相关性 [J]. 国际精神病学杂志. 2020; 47; (4). 749 - 753.

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