Dai Xiangwei, Liu Sihan, Li Xin, Chen Kewei, Gao Shudan, Wang Jun, Aarsland Dag, Han Zhuo Rachel, Zhang Zhanjun
State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China.
Psychol Med. 2024 Oct 14;54(13):1-10. doi: 10.1017/S0033291724001612.
The neural correlates underlying late-life depressive symptoms and cognitive deterioration are largely unclear, and little is known about the role of chronic physical conditions in such association. This research explores both concurrent and longitudinal associations between late-life depressive symptoms and cognitive functions, with examining the neural substrate and chronic vascular diseases (CVDs) in these associations.
A total of 4109 participants (mean age = 65.4, 63.0% females) were evaluated for cognitive functions through various neuropsychological assessments. Depressive symptoms were assessed by the Geriatric Depression Scale and CVDs were self-reported. T1-weighted magnetic resonance imaging (MRI), diffusion tensor imaging, and functional MRI (fMRI) data were acquired in a subsample ( = 791).
Cognitively, higher depressive symptoms were correlated with poor performance across all cognitive domains, with the strongest association with episodic memory ( = ‒0.138, < 0.001). Regarding brain structure, depressive symptoms were negatively correlated with thalamic volume and white matter integrity. Further, white matter integrity was found to mediate the longitudinal association between depressive symptoms and episodic memory ( = -0.017, 95% CI -0.045 to -0.002) and this mediation was only significant for those with severe CVDs ( = -0.177, = 0.008).
This study is one of the first to provide neural evidence elucidating the longitudinal associations between late-life depressive symptoms and cognitive dysfunction. Additionally, the severity of CVDs strengthened these associations, which enlightens the potential of managing CVDs as an intervention target for preventing depressive symptoms-related cognitive decline.
晚年抑郁症状和认知衰退背后的神经关联在很大程度上尚不清楚，而且对于慢性身体状况在这种关联中的作用知之甚少。本研究探讨晚年抑郁症状与认知功能之间的并发和纵向关联，并研究这些关联中的神经基质和慢性血管疾病（CVD）。
通过各种神经心理学评估对总共4109名参与者（平均年龄 = 65.4岁，63.0%为女性）的认知功能进行评估。抑郁症状通过老年抑郁量表进行评估，CVD通过自我报告。在一个子样本（n = 791）中获取了T1加权磁共振成像（MRI）、扩散张量成像和功能MRI（fMRI）数据。
在认知方面，较高的抑郁症状与所有认知领域的较差表现相关，与情景记忆的关联最强（r = -0.138，p < 0.001）。在脑结构方面，抑郁症状与丘脑体积和白质完整性呈负相关。此外，发现白质完整性介导了抑郁症状与情景记忆之间的纵向关联（β = -0.017，95%CI -0.045至-0.002），并且这种中介作用仅在患有严重CVD的人群中显著（β = -0.177，p = 0.008）。
本研究是首批提供神经证据阐明晚年抑郁症状与认知功能障碍之间纵向关联的研究之一。此外，CVD的严重程度加强了这些关联，这为将管理CVD作为预防与抑郁症状相关的认知衰退的干预靶点的潜力提供了启示。
