Department of Counseling Psychology, Yongmoon Graduate School of Counseling Psychology, Seoul, Republic of Korea.
Int Psychogeriatr. 2021 Aug;33(8):791-801. doi: 10.1017/S1041610220003622. Epub 2020 Nov 16.
Geriatric depression complicates cognitive health in older adults. This study aims to investigate the impact of depressive symptoms on cognitive impairment in community-dwelling older adults, depending on whether cognitive dysfunction accompanied.
A community-based longitudinal cohort study.
This study analyzed data from the Korean Longitudinal Study of Aging (KLoSA) from 2006 to 2018.
Among 10,254 individuals who were registered in the KLoSA study, a total of 9119 subjects met the criteria, and 4547 subjects were included in the final analysis. The subjects were grouped into 4 categories based on depressive symptoms and cognitive dysfunction at baseline assessment: "normal control" (NC, n = 3341), "depression only" (Dep-only, n = 652), "cognitive dysfunction only" (CD-only, n = 393), and "depression with cognitive dysfunction" (Dep-CD, n = 161).
Cognitive impairment 10 years later was defined as K-MMSE scores below two percentile on demographically adjusted norms.
Ten-year survival, that is, not experiencing cognitive impairment, was 80 $$ \pm ,$$1% in NC group, 72 $$ \pm $$ 2% in Dep-only group, 52 $$ \pm $$ 3% in CD-only group, and 44 $$ \pm $$ 5% in Dep-CD group. The hazard ratio (HR) of the Dep-only group (HR = 1.18, 95% CI, 0.97-1.43, n.s.) did not differ from that of the NC group, but the HR of the Dep-CD group was significantly higher (HR = 2.85, 95% CI, 2.23-3.66, p < 0.001) than the NC group. When the Dep-CD group was compared to the CD-only group, the HR was 1.13 (95% CI, 0.85-1.49, n.s.), which indicates that it did not significantly differ from the CD-only group.
Our findings suggest that depressive symptoms with cognitive dysfunction are associated with a higher risk of cognitive impairment. Furthermore, cognitive dysfunction occurring with depressive symptoms is as much a risk for cognitive impairment as is pure cognitive dysfunction. Thus, healthcare providers should pay close attention to the community-dwelling elderly when depressive symptoms occur with cognitive dysfunction.
老年抑郁症会使老年人的认知健康复杂化。本研究旨在探讨社区老年人抑郁症状对认知障碍的影响，同时考虑是否伴有认知功能障碍。
基于社区的纵向队列研究。
本研究分析了 2006 年至 2018 年韩国老龄化纵向研究（KLoSA）的数据。
在注册 KLoSA 研究的 10254 人中，共有 9119 人符合标准，其中 4547 人纳入最终分析。根据基线评估时的抑郁症状和认知功能障碍，将受试者分为 4 组：“正常对照组”（NC，n=3341）、“仅抑郁组”（Dep-only，n=652）、“仅认知功能障碍组”（CD-only，n=393）和“抑郁伴认知功能障碍组”（Dep-CD，n=161）。
10 年后认知障碍的定义为 K-MMSE 评分低于人口统计学调整后正常范围的两个百分位数。
NC 组 10 年生存率（即无认知障碍）为 80$$\pm$$1%，Dep-only 组为 72$$\pm$$2%，CD-only 组为 52$$\pm$$3%，Dep-CD 组为 44$$\pm$$5%。Dep-only 组的危险比（HR）与 NC 组无差异（HR=1.18，95%CI，0.97-1.43，n.s.），但 Dep-CD 组的 HR 明显更高（HR=2.85，95%CI，2.23-3.66，p<0.001）。与 CD-only 组相比，Dep-CD 组的 HR 为 1.13（95%CI，0.85-1.49，n.s.），差异无统计学意义。
本研究结果表明，伴认知功能障碍的抑郁症状与认知障碍风险增加相关。此外，伴抑郁症状的认知功能障碍与单纯认知功能障碍一样，是认知障碍的一个重要危险因素。因此，医护人员在社区老年人出现抑郁症状伴认知功能障碍时应密切关注。
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