The Relationship Between Serum Sex Hormone Concentration And Cognitive Function In Male Patients With Late-Life First-Episode Depression

BackgroundLate-life depression refers to depression occurring for the first time in an older person(usually over 60 years of age).While depression is not a normal part of the aging process,it does occur and should be treated or it can lead to disability and increased mortality.Testosterone as the most important sex hormone of the men,with the increase of age,the level will be significantly reduced,the elderly men is also the high incidence of depression.We speculate that depression is related to the hypothalamic pituitary gonadal axis.A large number of domestic and foreign studies have found that the elderly patients with depression in addition to the mood disorders,often accompanied by cognitive dysfunction.Therefore,the aim of this study is to explore the relationship between cognitive function and serum sex hormone levels in the first-episode male depressive patients,which may provide the basis for clinical diagnosis and treatment.Objectives1.To explore the changes of the level of sex hormone in elderly men with first-episode depression,to understand the etiology of depression;2.To explore the changes of the level of cognitive function and the activities of daily living in elderly men with first-episode depression,to provide evidence for clinical treatment of depression and intervention;3.To explore the relationship between of cognitive function and serum sex hormone levels in the first-episode male depressive disorder.MethodsForty first-episode male depressive patients were selected as the experimental group.Forty normal healthy elderly men were matched with age and educational level as the control group.The levels of serum testosterone(T),estradiol(E2),luteinizing hormone(LH),prolactin(PRL),follicle stimulating hormone(FSH)and progesterone(PROG)were measured by chemiluminescence immunoassay method,depressive symptoms were evaluated with the total score of Hamilton Depression Scale-17(HAMD-17);The cognitive functions were evaluated with the Mini-Mental State Examination(MMSE),the Trail Making Test A(TMTA),the Trail Making Test B(TMTB),the Digit Span Backwards(DSB)and the Digit Span Forwards(DSF)tests;The activities of daily living was evaluated with the Activities of Daily Living Scale(ADL).Pearson correlation analysis was used to study the relationship between of cognitive function and serum sex hormone levels.Results1.Compared with healthy elderly men,the levels of serum T,E2 and PROG of in the elderly men with first-episode depression were significantly decreased(P<0.05);However,there was no significant difference in levels of serum FSH,LH and PRL(P>0.05).2.Compared with healthy elderly men,the cognitive functions and ADL scores of the elderly men with first-episode depression were significantly decreased(P<0.05).3.Correlation analysis showed that the serum level of T was negatively correlated with the TMTA scores(r=-0.445,P=0.004),the serum level of E2 was negatively correlated with the TMTB scores(r=-0.361,P=0.022).Conclusions1.There were sex hormone metabolic abnormalities in elderly men with first-episode depression.It was characterized by the decline of serum T and E2 levels.2.The Elderly male patients with first-episode depression showed impaired cognitive functions such as attention,memory and executive functions,reduced abilities of daily living.3.The lower levels of serum E2 and T may be the risk factors for the cognitive impairment of the elderly men with first-episode depression.