晚年抑郁症的认知缺陷:从症状和评估到治疗方法
Antonio L Teixeira1, Allison Gregg1, Melanie T Gentry1
1Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center, San Antonio (Teixeira); McLean Hospital, Harvard Medical School, Belmont, Massachusetts (Gregg, Weisenbach, Patrick); Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Gentry); Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Rapp, Gujral); Department of Neuroscience, AdventHealth Research Institute, Orlando, Florida, and Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, White Plains, New York (Oberlin); Department of Psychiatry, University of Illinois Chicago, Chicago (Ajilore).
晚年抑郁症 (LLD) 通常涉及认知问题,影响治疗. 本综述为诊断和治疗认知障碍的LLD提供了一个框架,将其与阿尔茨海默病 (AD) 区分开来.
科学领域:
- 老年精神病学是一门精神病学专业.
- 神经心理学 神经心理学
- 认知神经学 认知神经学
背景情况:
- 认知症状是晚年抑郁症 (LLD) 的核心,影响20-50%的轻度认知障碍 (MCI) 患者.
- 认知缺陷,特别是执行功能障碍,与较差的LLD治疗结果相关.
- 从早期阿尔茨海默氏症 (AD) 区分与认知障碍的LLD,由于症状重叠和自我意识不同,这带来了诊断挑战.
研究的目的:
- 为临床医生评估和治疗LLD提供最新的概念和实践框架.
- 澄清认知障碍LLD与早期AD之间的差异诊断.
- 审查与认知症状,MCI或痴呆症同时发生的LLD的治疗方法.
主要方法:
- 关于LLD,认知障碍和阿尔茨海默病的现有文献的审查.
- 强调神经心理评估用于差异诊断.
- 对治疗策略的分析,包括非药物和药物干预措施.
主要成果:
- 通常,LLD表现为皮下认知模式 (精神运动减慢,注意力缺陷,执行功能障碍).
- 对于LLD和认知症状,建议使用非药物治疗策略 (有氧运动,认知补救,神经调节).
- 与非药物方法相比,证据证明抗抑郁药在改善痴呆症LLD患者的认知能力方面的有效性不那么强大.
结论:
- 系统的方法对于诊断和管理认知缺陷的LLD至关重要.
- 神经心理测试对于区分LLD和AD至关重要.
- 专注于抑郁症和认知功能的综合治疗策略对于改善LLD的结果至关重要.
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