Department of Health Promotion, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Wuxi 214023, China.
Department of Nursing, Nanjing Drum Tower Hospital, Nanjing 210008, China.
Arch Psychiatr Nurs. 2024 Oct;52:69-75. doi: 10.1016/j.apnu.2024.07.012. Epub 2024 Jul 8.
Many studies have focused on the relationship between depressive symptoms and cognitive impairment, but gender differences in this relationship are unclear, especially among Chinese older adults. Therefore, this study explores whether there are gender differences between depressive symptoms and risk of cognitive impairment based on a survey of a Chinese older adult population.
This is a cross-sectional study.
We screened 9678 older adults aged 65 to 105 from the 2018 CLHLS database. The 10-item Center for Epidemiological Studies Depression Scale (CESD-10) and Mini-Mental State Examination (MMSE) were utilized for measuring depressive symptoms and cognitive performance, respectively. Logistic regressions and restricted cubic spline were applied to investigate the relationship between depressive symptoms and cognitive impairment.
Of the 9678 participants, 4719 (48.8 %) were men. The association between severe depressive symptoms and cognitive impairment was more pronounced in older men (male × severe depressive symptoms: OR = 2.71, 95%CI = 1.07-6.92, p = 0.037). Compared with no depressive symptoms, severe depressive symptoms were associated with an almost five times greater risk of cognitive impairment in men (OR = 4.84, 95 % CI = 2.26-10.40, p < 0.001, compared to OR = 2.25, 95 % CI = 1.27-3.96, p = 0.005 in women). Gender differences were demonstrated in the association of individual ten depressive symptoms with cognitive impairment: men who felt lonely were more likely to have cognitive impairment (OR = 1.24, 95 % CI = 1.06-1.47, p = 0.010), while women who slept poorly were more likely to have cognitive impairment (OR = 1.42, 95 % CI = 1.16-1.74, p = 0.001).
Results indicate a stronger association between severe depressive symptoms and cognitive impairment among older Chinese males. Our study suggests that reducing loneliness can help prevent cognitive impairment in older men, and improving sleep quality can help improve cognitive function in older women.
许多研究都集中在抑郁症状与认知障碍之间的关系上，但这种关系在性别上的差异尚不清楚，尤其是在中国的老年人群体中。因此，本研究基于对中国老年人群体的调查，探讨了抑郁症状与认知障碍风险之间是否存在性别差异。
这是一项横断面研究。
我们从 2018 年 CLHLS 数据库中筛选出 9678 名 65-105 岁的老年人。使用 10 项流行病学研究中心抑郁量表（CESD-10）和简易精神状态检查（MMSE）分别测量抑郁症状和认知表现。应用逻辑回归和限制立方样条分析抑郁症状与认知障碍之间的关系。
在 9678 名参与者中，4719 名（48.8%）为男性。在老年男性中，严重抑郁症状与认知障碍之间的关联更为明显（男性×严重抑郁症状：OR=2.71，95%CI=1.07-6.92，p=0.037）。与无抑郁症状相比，严重抑郁症状使男性患认知障碍的风险几乎增加了五倍（OR=4.84，95%CI=2.26-10.40，p<0.001，而女性为 OR=2.25，95%CI=1.27-3.96，p=0.005）。在个体十种抑郁症状与认知障碍的关联方面，也显示出了性别差异：感到孤独的男性更有可能出现认知障碍（OR=1.24，95%CI=1.06-1.47，p=0.010），而睡眠不佳的女性更有可能出现认知障碍（OR=1.42，95%CI=1.16-1.74，p=0.001）。
结果表明，在中国老年男性中，严重抑郁症状与认知障碍之间的关联更强。本研究提示，减少孤独感有助于预防老年男性认知障碍，改善睡眠质量有助于改善老年女性的认知功能。
