老年人的抑郁轨迹、遗传风险与认知表现：具有 10 年纵向队列的多层次模型。

Depression Trajectories, Genetic Risk, and Cognitive Performance in Older Adults: Multilevel Model with a 10-Year Longitudinal Cohort.

机构信息

Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.

West China Hospital, Sichuan University, Chengdu, China.

出版信息

Gerontology. 2023;69(7):899-909. doi: 10.1159/000530200. Epub 2023 Mar 21.

DOI:10.1159/000530200

PMID:36944316

Abstract

INTRODUCTION

Cognitive performance in older ages is strongly affected by individuals' genetic predispositions. We investigated whether depression trajectories were associated with subsequent cognitive performance independent of participants' genetic predispositions.

METHODS

Participants from the Health and Retirement Study with European ancestry and aged over 50 were included in the analysis. Depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale, and the 6-year trajectories were fitted using latent class linear mixed models. Linear multilevel regression was applied to model the associations between depression trajectory and subsequent cognitive performance. Stratified analyses were performed to investigate these associations in participants with different genetic predispositions of cognitive performance and APOE ε4 allelic status.

RESULTS

A total of 5,942 eligible participants were included in the study. Four depression trajectories were identified. Compared with the nondepression trajectory, all other depression trajectories were associated with worse cognitive performance (β [95% CI]: mild-depression trajectory: -0.20 [-0.56, -0.06], p = 0.007; worsening-depression trajectory: -0.29 [-0.47, -0.12], p = 0.001; persistent-depression trajectory: -0.32 [-0.53, -0.13], p = 0.001). Although these associations were independent of participants' inherent genetic risk, the participants with a low polygenetic score for cognitive performance were more likely to have an enhanced association between depression trajectories and cognitive decline. Similar relationships were also found in APOE ε4 noncarriers.

CONCLUSION

Among older participants with European ancestry, even a mild-depression trajectory was associated with worse cognitive performance. Early intervention in participants with any degree of depression might benefit regarding preventing cognitive performance decline.

摘要

简介

老年人的认知表现受个体遗传倾向的影响很大。我们研究了抑郁轨迹是否与随后的认知表现相关，而不考虑参与者的遗传倾向。

方法

本研究纳入了具有欧洲血统且年龄在 50 岁以上的健康与退休研究参与者。使用中心流行病学研究抑郁量表评估抑郁症状，并使用潜在类别线性混合模型拟合 6 年轨迹。应用线性多层回归模型来模拟抑郁轨迹与随后认知表现之间的关联。进行分层分析，以研究具有不同认知表现和 APOE ε4 等位基因状态的参与者中这些关联。

结果

共纳入 5942 名符合条件的参与者。确定了四种抑郁轨迹。与非抑郁轨迹相比，所有其他抑郁轨迹都与较差的认知表现相关（β[95%CI]：轻度抑郁轨迹：-0.20[-0.56，-0.06]，p=0.007；抑郁恶化轨迹：-0.29[-0.47，-0.12]，p=0.001；持续抑郁轨迹：-0.32[-0.53，-0.13]，p=0.001）。尽管这些关联独立于参与者的固有遗传风险，但认知表现多基因评分较低的参与者中，抑郁轨迹与认知下降之间的关联更强。在 APOE ε4 非携带者中也发现了类似的关系。