Zhang Na, Chao Jianqian, Cai Ruixue, Bao Min, Chen Hongling
Department of Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of public health, Southeast University, Nanjing 210009, China.
Department of Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of public health, Southeast University, Nanjing 210009, China.
Arch Gerontol Geriatr. 2023 Jun;109:104960. doi: 10.1016/j.archger.2023.104960. Epub 2023 Feb 11.
Depression is associated with cognitive impairment and dementia, but few studies have been done on Chinese adults. This study evaluates the relationship between depressive symptoms status and cognitive function in middle-aged and elderly Chinese adults.
We included 7,968 participants from the Chinese Health and Retirement Longitudinal Survey (CHRALS) with a follow-up of 4 years. Using the Center for Epidemiological Studies Depression Scale to measure depressive symptoms, with a score of 12 or more indicating elevated depressive symptoms. Adjust covariance analysis and generalized linear analysis were used to investigate the relationship between depressive symptoms status (never, new-onset, remission and persistence) and cognitive decline. Restricted cubic spline regression was used to performed the potential nonlinear associations between depressive symptoms and the change scores of cognitive functions.
During the 4-year follow-up, 1148 participants (14.41%) reported persistent depressive symptoms. The participants who have persistent depressive symptoms with more declines in total cognitive scores (least-square mean = -1.99, 95% CI: -3.70 to -0.27). Compared with never depressive symptoms, participants with persistent depressive symptoms experienced a faster decline in cognitive scores (β = -0.68, 95%CI: -0.98 to -0.38), and small difference (d=0.29) at follow-up. But females with new-onset depression had more cognitive decline than those with persistent depression (least-square mean - least-square mean =-0.10), its differences in males (least-square mean - least-square mean =0.03).
Participants with persistent depressive symptoms experienced a faster decline in cognitive function, but differently in men and women.
抑郁症与认知障碍和痴呆有关，但针对中国成年人的研究较少。本研究评估中国中老年成年人抑郁症状状态与认知功能之间的关系。
我们纳入了来自中国健康与养老追踪调查（CHARLS）的7968名参与者，随访4年。使用流行病学研究中心抑郁量表测量抑郁症状，得分12分及以上表明抑郁症状升高。采用调整协方差分析和广义线性分析来研究抑郁症状状态（从未有过、新发、缓解和持续存在）与认知衰退之间的关系。使用受限立方样条回归来分析抑郁症状与认知功能变化分数之间的潜在非线性关联。
在4年的随访期间，1148名参与者（14.41%）报告有持续的抑郁症状。有持续抑郁症状的参与者在总体认知得分上下降更多（最小二乘均值=-1.99，95%CI：-3.70至-0.27）。与从未有过抑郁症状的参与者相比，有持续抑郁症状的参与者认知得分下降更快（β=-0.68，95%CI：-0.98至-0.38），随访时差异较小（d=0.29）。但新发抑郁症的女性比持续抑郁的女性认知衰退更多（最小二乘均值-最小二乘均值=-0.10），男性差异为（最小二乘均值-最小二乘均值=0.03）。
有持续抑郁症状的参与者认知功能下降更快，但在男性和女性中情况不同。
