认知衰弱与抑郁之间的关联：一项针对中国45岁及以上成年人的前瞻性队列研究。

Association Between Cognitive Frailty and Depression: A Prospective Cohort Study of Adults Aged 45 Years and Older in China.

作者信息

Wang Jiang, Zhu Aizhang, Chen Jie, Zeng Rui, Wang Siyi, Chen Lihuan, Chen Ying, Min Qianqian, Li Wei, Ye Dongmei, Wu Ruohan, Xie Fayi, Fan Tenghui, Zhu Ke, Zhu Wan, Hu Hongmei, Wang Conghua, Zhang Xiaoming

机构信息

School of Basic Medicine, Jinggangshan University, Ji'an, Jiangxi, People's Republic of China.

Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch, Ji'an, Jiangxi, People's Republic of China.

出版信息

Clin Interv Aging. 2024 Dec 28;19:2167-2178. doi: 10.2147/CIA.S484352. eCollection 2024.

DOI:10.2147/CIA.S484352

PMID:39749318

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11693858/

Abstract

BACKGROUND

The interplay between cognitive frailty and depression remains inadequately understood, with a paucity of evidence from prospective cohort studies. Our study aims to elucidate the relationship between cognitive frailty and the risk of incident depression.

METHODS

Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011, 2013, and 2015, subjects were classified according to cognitive frailty criteria established by an international consensus panel. Multiple logistic regression models were employed to examine the cross-sectional and longitudinal associations between frailty, cognitive impairment, cognitive frailty, and depression. Subgroup analyses and interaction tests were conducted to identify potential effect modifiers.

RESULTS

In 2011, the study encompassed 4514 participants, with 2330 individuals followed up through 2015. Cross-sectional analyses revealed that participants classified in frailty, cognitive impairment, and cognitive frailty exhibited multivariable-adjusted odds ratios (ORs) for depression of 1.87 (95% CI 1.60-2.18; P < 0.001), 1.97 (95% CI 1.58-2.47; P < 0.001), and 3.38 (95% CI 2.66-4.29; P < 0.001), respectively, compared to no diseased group. Longitudinal analyses from 2011 to 2015 indicated that participants in frailty, cognitive impairment, and cognitive frailty had multivariable-adjusted ORs of 1.28 (95% CI 1.05-1.58; P = 0.0165), 1.39 (95% CI 1.01-1.91; P = 0.0411), and 1.57 (95% CI 1.05-2.35; P = 0.0273), respectively, for new-onset depression relative to no diseased group.

LIMITATIONS

The definition of depression relied solely on self-reported data.

CONCLUSION

In the middle-aged and elderly Chinese population, patients with cognitive frailty have a higher risk of depression than those with only frailty and cognitive impairment. This may suggest that health care providers should pay more attention to the mental health of those patients with cognitive frailty.

摘要

背景

认知衰弱与抑郁症之间的相互作用仍未得到充分理解，前瞻性队列研究的证据匮乏。我们的研究旨在阐明认知衰弱与新发抑郁症风险之间的关系。

方法

利用中国健康与养老追踪调查（CHARLS）2011年、2013年和2015年的数据，根据国际共识小组制定的认知衰弱标准对受试者进行分类。采用多重逻辑回归模型来检验衰弱、认知障碍、认知衰弱与抑郁症之间的横断面和纵向关联。进行亚组分析和交互作用检验以识别潜在的效应修饰因素。

结果

2011年，该研究纳入了4514名参与者，其中2330人随访至2015年。横断面分析显示，与未患病组相比，被归类为衰弱、认知障碍和认知衰弱的参与者患抑郁症的多变量调整优势比（OR）分别为1.87（95%CI 1.60 - 2.18；P < 0.001）、1.97（95%CI 1.58 - 2.47；P < 0.001）和3.38（95%CI 2.66 - 4.29；P < 0.001）。2011年至2015年的纵向分析表明，相对于未患病组，衰弱、认知障碍和认知衰弱的参与者新发抑郁症的多变量调整OR分别为1.28（95%CI 1.05 - 1.58；P = 0.0165）、1.39（95%CI 1.01 - 1.91；P = 0.0411）和1.57（95%CI 1.05 - 2.35；P = 0.0273）。