目的 分析老年抑郁症(late life depression,LLD)患者认知功能对自杀观念的影响.方法 入组2021年1月至2022年12月在首都医科大学附属北京安定医院门诊和住院的LLD患者共103例,按照近2周有无自杀观念(包括自杀观念和自杀未遂),将其分为无自杀倾向组(n=37例)和自杀倾向组(n=66例).收集患者的一般人口学资料,采用重复成套神经心理状态测量表(Repeatable Battery for the Assessment of Neuropsychological Status,RBANS)评定患者认知功能.采用 Logistic 回归对各相关因素进行分析.结果自杀倾向组[RBANS总分(137.26±28.78)、即刻记忆(22.39±7.47)、词汇学习(16.02±4.59)]和无自杀倾向组[RBANS总分(150.00±25.53)、即刻记忆(26.41±6.74)、词汇学习(18.43±4.18)]的RBANS总分、即刻记忆、词汇学习差异具有统计学意义(P<0.05);Logistics回归分析结果显示,词汇学习(OR=0.012,P=0.012)、首次发病年龄(OR=1.036,P=0.024)均是LLD患者自杀倾向的危险因素.结论 词汇学习能力越差、首次发病年龄越大提示患者自杀风险越高,可能为自杀风险的早期识别指标.
Factors associated with risk of suicide in late life depression
Objective To examine the influence of cognitive function on suicidal ideation among patients with late life depression(LLD).Methods Between January 2021 and December 2022,we enrolled 103 LLD patients from Beijing Anding Hospital,Capital Medical University.These patients were divided into two groups based on the presence of suicidal ideation(encompassing suicidal thoughts and attempted suicidality)in the past two weeks:those without suicidal ideation(n=37)and those with suicidal ideation(n=66).We collected general demographic data and assessed cognitive functions using the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS).The study employed Logistic regression to determine significant factors.Results There were statistically significant differences in RBANS total score,immediate memory,and vocabulary learning between suicidal ideation and without suicidal ideation groups[RBANS total score(137.26±28.78)vs(150.00±25.53),immediate memory(22.39±7.47)vs(26.41± 6.74),vocabulary learning(16.02±4.59)vs(18.43±4.18),all P<0.05];The logistic regression analysis indicated that the score of vocabulary learning(OR=0.012,P=0.012)and the first onset age(OR=1.036,P=0.024)served as a risk factors against suicidal ideation among LLD patients.Conclusion The lower the vocabulary learning score and the older the age of the first onset suggested that the LLD patient may be at higher risk of suicide,which may be used as an early indicator to identify suicide risk.