Department of Neurobiology,Care Sciences, and Society (NVS),Aging Research Center,Karolinska Institutet and Stockholm University,Stockholm,Sweden.
Centre for Cognitive Ageing and Cognitive Epidemiology,University of Edinburgh,Edinburgh,UK.
Psychol Med. 2018 Jun;48(8):1350-1358. doi: 10.1017/S0033291717002896. Epub 2017 Oct 17.
Anxiety and depression are both important correlates of cognitive function. However, longitudinal studies investigating how they covary with cognition within the same individual are scarce. We aimed to simultaneously estimate associations of between-person differences and within-person variability in anxiety and depression with cognitive performance in a sample of non-demented older people.
Participants in the Lothian Birth Cohort 1921 study, a population-based narrow-age sample (mean age at wave 1 = 79 years, n = 535), were examined on five occasions across 13 years. Anxiety and depression were measured with the Hospital Anxiety and Depression Scale (HADS) and cognitive performance was assessed with tests of reasoning, logical memory, and letter fluency. Data were analyzed using two-level linear mixed-effects models with within-person centering.
Divergent patterns were observed for anxiety and depression. For anxiety, between-person differences were more influential; people who scored higher on HADS anxiety relative to other same-aged individuals demonstrated poorer cognitive performance on average. For depression, on the other hand, time-varying within-person differences were more important; scoring higher than usual on HADS depression was associated with poorer cognitive performance relative to the average level for that participant. Adjusting for gender, childhood mental ability, emotional stability, and disease burden attenuated these associations.
The results from this study highlight the importance of addressing both between- and within-person effects of negative mood and suggest that anxiety and depression affect cognitive function in different ways. The current findings have implications for assessment and treatment of older age cognitive deficits.
焦虑和抑郁都是认知功能的重要相关因素。然而，关于它们在同一个体中如何随时间变化与认知相关的纵向研究却很少。我们旨在对无痴呆的老年人样本中个体间差异和个体内变异性的焦虑和抑郁与认知表现的相关性进行同时估计。
洛锡安出生队列 1921 研究的参与者是一个基于人群的窄年龄样本（第 1 波时的平均年龄为 79 岁，n=535），在 13 年内进行了 5 次检查。焦虑和抑郁使用医院焦虑和抑郁量表（HADS）进行测量，认知表现使用推理、逻辑记忆和字母流畅性测试进行评估。使用具有个体内中心化的两层线性混合效应模型对数据进行分析。
焦虑和抑郁表现出不同的模式。对于焦虑，个体间差异的影响更大；与同龄个体相比，HADS 焦虑得分较高的人平均认知表现较差。对于抑郁，另一方面，随时间变化的个体内差异更为重要；与该参与者的平均水平相比，HADS 抑郁得分高于平时与认知表现较差相关。调整性别、儿童期智力、情绪稳定性和疾病负担后，这些关联减弱。
本研究结果强调了关注负面情绪的个体间和个体内效应的重要性，并表明焦虑和抑郁以不同的方式影响认知功能。目前的研究结果对评估和治疗老年人认知缺陷具有重要意义。
