Frau Loredana, Jonaitis Erin, Langhough Rebecca E, Zuelsdorff Megan, Okonkwo Ozioma, Bruno Davide
School of Psychology, Liverpool, John Moores University, United Kingdom.
Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
Clin Neuropsychol. 2025 May;39(4):952-974. doi: 10.1080/13854046.2024.2388904. Epub 2024 Aug 23.
The current study examined the longitudinal relationship between cognitive reserve (CR), depression, and executive function (EF) in a cohort of older adults. : 416 participants were selected from the Wisconsin Registry for Alzheimer's Prevention. They were native English speakers, aged ≥50+, and cognitively unimpaired at baseline, with no history of neurological or other psychiatric disorders aside from depression. Depression was assessed with the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). A composite score, based on the premorbid IQ (WRAT-3 Reading subtest) and years of education was used to estimate CR. Another composite score from four cognitive tests was used to estimate EF. A moderation analysis was performed to evaluate the effects of CR and Depression on EF at follow-up after controlling for age, gender, and APOE risk score. Moreover, a multinomial logistic regression was used to predict conversion to Mild Cognitive Impairment (MCI) from the healthy baseline. : The negative relationship between depression and EF was stronger in individuals with higher CR levels, suggesting a possible floor effect at lower CR levels. In the multinomial regression, the interaction between CR and depression predicted conversion to MCI status, indicating that lower CR paired with more severe depression at baseline was associated with a higher risk of subsequent impairment. : This study sheds light on the intricate relationship between depression and EF over time, suggesting that the association may be influenced by varying levels of CR. Further studies may replicate these findings in clinical populations.
本研究调查了一组老年人认知储备（CR）、抑郁和执行功能（EF）之间的纵向关系。从威斯康星州阿尔茨海默病预防登记处选取了416名参与者。他们以英语为母语，年龄≥50岁，基线时认知功能未受损，除抑郁症外无神经或其他精神疾病史。使用20项流行病学研究中心抑郁量表（CES-D）评估抑郁情况。基于病前智商（WRAT-3阅读子测验）和受教育年限的综合得分用于估计CR。来自四项认知测试的另一个综合得分用于估计EF。在控制年龄、性别和APOE风险评分后，进行了调节分析以评估CR和抑郁对随访时EF的影响。此外，使用多项逻辑回归从健康基线预测向轻度认知障碍（MCI）的转化。抑郁与EF之间的负相关在CR水平较高的个体中更强，表明在较低CR水平可能存在下限效应。在多项回归中，CR与抑郁之间的相互作用预测了向MCI状态的转化，表明基线时较低的CR与更严重的抑郁与随后受损的较高风险相关。本研究揭示了抑郁与EF随时间的复杂关系，表明这种关联可能受不同CR水平的影响。进一步的研究可能在临床人群中重复这些发现。
