Zhang Na, Yao Yisong, Li Limin, Sun Mingjun, Zhou Baihe, Fu Hong, Guo Binjin, Li Qing, Jinfu Wang, Jiang Wenhui
School of Nursing, Health Science Center, Xian Jiaotong University, Xi'an, China.
The Fourth Clinical Medical College, Qingdao University, Yantai, China.
Child Abuse Negl. 2024 Dec;158:107088. doi: 10.1016/j.chiabu.2024.107088. Epub 2024 Oct 15.
Cognitive dysfunction imposes a heavy economic burden on families and society. Depression and deprivation-related adverse childhood experiences (ACEs) are important factors that contribute to cognitive dysfunction. However, few studies have explored these complex interactions.
This study aimed to elucidate the mediating effect of depression on the relationship between deprivation-related ACEs and cognitive function in older adults.
This national, cross-sectional study used data from the 2020 Chinese Longitudinal Aging Social Survey. Information regarding depression, ACEs, and cognitive function was collected from individuals aged 60 years and older. A structural equation model was used to examine the mediating effect of depression on the relationship between deprivation-related ACEs and cognitive function.
A total of 9828 participants were included in this study. Their mean total cognitive function score was 13.488 ± 3.006. The results showed that sex, age, educational level, marital status, body mass index, registered residence, chronic disease situation, health, smoking, living alone, life satisfaction, social security, and internet use were all related to cognitive function (P < 0.05). Deprivation-related ACEs were negatively correlated with cognitive function (r = -0.132, P < 0.01). And depression symptoms were negatively correlated with cognitive function (r = -0.158, P < 0.01). The mediating effect analysis indicated that depression symptoms had a significant mediating effect between the 3 dimensions of deprivation-related ACEs and cognitive function.
This study highlighted that improvement of deprivation-related ACEs was indirectly related to a reduced likelihood of cognitive dysfunction through depression in older adults. With the limitations of cross-sectional studies, validation through longitudinal design studies is deemed necessary. Future interventions should focus on alleviating depression symptoms to prevent cognitive decline and impairment in this population.
认知功能障碍给家庭和社会带来了沉重的经济负担。抑郁和与贫困相关的童年不良经历（ACEs）是导致认知功能障碍的重要因素。然而，很少有研究探讨这些复杂的相互作用。
本研究旨在阐明抑郁在老年人与贫困相关的ACEs和认知功能之间关系中的中介作用。
这项全国性横断面研究使用了2020年中国老年社会追踪调查的数据。收集了60岁及以上人群关于抑郁、ACEs和认知功能的信息。采用结构方程模型来检验抑郁在与贫困相关的ACEs和认知功能之间关系中的中介作用。
本研究共纳入9828名参与者。他们的平均总认知功能得分为13.488±3.006。结果表明，性别、年龄、教育水平、婚姻状况、体重指数、户籍、慢性病情况、健康状况、吸烟、独居、生活满意度、社会保障和互联网使用均与认知功能相关（P<0.05）。与贫困相关的ACEs与认知功能呈负相关（r=-0.132，P<0.01）。抑郁症状与认知功能呈负相关（r=-0.158，P<0.01）。中介效应分析表明，抑郁症状在与贫困相关的ACEs的3个维度和认知功能之间具有显著的中介作用。
本研究强调，改善与贫困相关的ACEs与通过减轻老年人抑郁来降低认知功能障碍的可能性间接相关。鉴于横断面研究的局限性，认为有必要通过纵向设计研究进行验证。未来的干预措施应侧重于减轻抑郁症状，以预防该人群的认知衰退和损害。
