Faculty of Humanities, Charles University Prague, Czechia.
Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
J Affect Disord. 2023 Jun 15;331:380-385. doi: 10.1016/j.jad.2023.03.057. Epub 2023 Mar 23.
We aimed to disentangle within-person and between-person effects in the temporal relationship between depressive symptoms and cognitive function.
We performed a prospective population-based cohort study on participants of the Survey of Health, Ageing and Retirement in Europe. Cognitive function was assessed by tests on verbal fluency, immediate recall and delayed recall. Depressive symptoms were measured with EURO-D scale. To determine the temporal order of the association between cognitive function and depressive symptoms, we employed the fully saturated cross-lagged panel model (between-person effects), and random intercept cross-lagged panel model (within-person effects).
In 59,311 participants (mean age 65, ranging 46-100), between-person effects showed a bi-directional relationship that could be seen in three stages: First, the effect of cognitive function on depressive symptoms was initially slightly stronger than vice versa. Second, the effect of depressive symptoms on cognitive function became stronger during the follow-up. Third, all effects were small and no direction dominated. Within-person effects, however, revealed a dominant effect from depressive symptoms on cognitive function. Some effects from cognitive function on depressive symptoms were apparent only in older adults, in particular men. All effects were small and strongest for individuals aged 65 years and above.
The sample is healthier than general population and thus not fully representative. A comprehensive cognitive battery was not available.
Long-term relationship between depressive symptoms and cognitive function is bi-directional. However, to achieve improvement in an individual in the short-term, the focus should be on decreasing depressive symptoms to improve cognitive function.
我们旨在厘清个体内和个体间效应在抑郁症状和认知功能之间的时间关系。
我们对欧洲健康、老龄化和退休调查的参与者进行了一项前瞻性的基于人群的队列研究。认知功能通过词语流畅性、即刻回忆和延迟回忆测试进行评估。抑郁症状用 EURO-D 量表进行测量。为了确定认知功能和抑郁症状之间关联的时间顺序，我们采用了完全饱和的交叉滞后面板模型（个体间效应）和随机截距交叉滞后面板模型（个体内效应）。
在 59311 名参与者（平均年龄 65 岁，年龄范围为 46-100 岁）中，个体间效应显示出一种双向关系，可以分为三个阶段：首先，认知功能对抑郁症状的影响最初略强于反之。其次，抑郁症状对认知功能的影响在随访期间变得更强。第三，所有效应都很小，没有主导方向。然而，个体内效应显示出抑郁症状对认知功能的主导效应。认知功能对抑郁症状的一些影响仅在老年人中出现，特别是男性。所有效应都很小，在 65 岁及以上的个体中最强。
该样本比一般人群更健康，因此不完全具有代表性。没有全面的认知测试包。
抑郁症状和认知功能之间的长期关系是双向的。然而，要在短期内改善个体，重点应放在降低抑郁症状以改善认知功能上。
