Department of Epidemiology, Biostatistics, and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel.
The Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat-Gan, Israel.
Int Psychogeriatr. 2024 Feb;36(2):119-129. doi: 10.1017/S1041610222000357. Epub 2022 May 11.
People with posttraumatic stress disorder (PTSD) may have cognitive decline, a risk which can be particularly threatening at old age. However, it is yet unclear whether initial cognitive decline renders one more susceptible to subsequent PTSD following exposure to traumatic events, whether initial PTSD precedes cognitive decline or whether the effects are reciprocal.
This study examined the bidirectional longitudinal associations between cognitive function and PTSD symptoms and whether this association is mediated by depressive symptoms.
The study used data from two waves of the Israeli component of the Survey of Health, Ageing, and Retirement in Europe (SHARE), collected in 2013 and 2015. This study focused on adults aged 50 years and above (N = 567, mean age = 65.9 years). Each wave used three measures of cognition (recall, fluency, and numeracy) and PTSD symptoms following exposure to war-related events. Data were analyzed using mediation analysis with path analysis.
Initial PTSD symptoms predicted cognitive decline in recall and fluency two years later, while baseline cognitive function did not impact subsequent PTSD symptoms. Partial mediation showed that older adults with more PTSD symptoms had higher depressive symptoms, which in turn were linked to subsequent cognitive decline across all three measures.
This study reveals that PTSD symptoms are linked with subsequent cognitive decline, supporting approaches addressing this direction. It further indicates that part of this effect can be explained by increased depressive symptoms. Thus, treatment for depressive symptoms may help reduce cognitive decline due to PTSD.
患有创伤后应激障碍（PTSD）的人可能会出现认知能力下降，这种风险在老年时尤其具有威胁性。然而，目前尚不清楚最初的认知能力下降是否会使人在经历创伤性事件后更容易患上随后的 PTSD，是最初的 PTSD 先于认知能力下降，还是两者之间存在相互影响。
本研究旨在探讨认知功能和 PTSD 症状之间的双向纵向关联，以及这种关联是否受抑郁症状的影响。
本研究使用了来自以色列参与欧洲健康、衰老和退休调查（SHARE）的两个波次的数据，收集时间分别为 2013 年和 2015 年。本研究关注的是年龄在 50 岁及以上的成年人（N=567，平均年龄为 65.9 岁）。每个波次都使用了三种认知测试（回忆、流畅性和计算能力）和 PTSD 症状来评估个体在经历战争相关事件后的表现。采用中介分析中的路径分析来分析数据。
最初的 PTSD 症状预测了两年后回忆和流畅性方面的认知能力下降，而基线认知功能并未影响随后的 PTSD 症状。部分中介分析表明，PTSD 症状更严重的老年人抑郁症状更高，而抑郁症状又与所有三种认知测试的后续认知能力下降有关。
本研究表明，PTSD 症状与随后的认知能力下降有关，支持针对这一方向的干预措施。此外，这表明这种影响的一部分可以通过增加的抑郁症状来解释。因此，针对抑郁症状的治疗可能有助于减轻 PTSD 引起的认知能力下降。
