Lu Kai, Wang Wei, Wang Junyu, Du Qianqian, Li Chen, Wei Yuxin, Yao Menghan, Zhang Tao, Yin Fei, Ma Yue
West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, No. 17, Section 3, Renmin South Road, Chengdu, 610036, China.
Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Geroscience. 2025 Jan 23. doi: 10.1007/s11357-025-01518-8.
Existing epidemiological studies have ignored the effect of depressive duration on cognitive decline despite the presence of biological cues and understudied the depression-cognition association in Asian countries in the context of increasing cognitive burden worldwide. We aimed to comprehensively characterize the effects of depressive duration and intensity on cognitive decline at the population level. A total of 6406 individuals from the Korean Longitudinal Study of Aging (KLoSA) from 2010 to 2018 were included to generate four datasets with durations of 2, 4, 6, and 8 years. Depressive intensity was categorized as no, mild, and major depression according to the Center for Epidemiological Studies Depression scale (CES-D10), and duration was measured by the span of consecutive interviews. Cognitive function was assessed using the Korean Mini-Mental Status Examination (K-MMSE). Multiple linear regressions and meta-regressions were used to estimate the effects of depressive intensity and duration on global cognition and seven cognitive subdomains. Stratified analyses were performed to explore effect differences between subpopulations of different sexes and ages. The potential bias in the effect of depressive intensity on cognitive decline when ignoring duration was also explored. On average, a 1-year longer duration decreased the global cognitive scores by 0.44 (95% CI 0.36, 0.51) across intensities and major depression decreased the scores by an additional 0.82 (95% CI 0.59, 1.04) points than mild depression across durations. Similar trends held for seven cognitive subdomains except for visual construction. Older adults suffered more cognitive decline from major depression than middle-aged adults did. More severe and longer-duration depression lead to greater cognitive decline. Ignoring depressive duration can lead to an overestimated effect of depressive intensity on cognitive decline. The depressive effects and susceptible populations clarified in our study have important implications for the preservation of cognitive health in Asian region.
尽管存在生物学线索，但现有的流行病学研究忽视了抑郁持续时间对认知衰退的影响，并且在全球认知负担不断增加的背景下，对亚洲国家抑郁与认知之间的关联研究不足。我们旨在全面描述抑郁持续时间和严重程度在人群层面上对认知衰退的影响。纳入了2010年至2018年韩国老年纵向研究（KLoSA）中的6406名个体，以生成持续时间分别为2年、4年、6年和8年的四个数据集。根据流行病学研究中心抑郁量表（CES-D10），将抑郁严重程度分为无抑郁、轻度抑郁和重度抑郁，持续时间通过连续访谈的时长来衡量。使用韩国简易精神状态检查表（K-MMSE）评估认知功能。采用多元线性回归和meta回归来估计抑郁严重程度和持续时间对整体认知及七个认知子领域的影响。进行分层分析以探讨不同性别和年龄亚组之间的效应差异。还探讨了忽略持续时间时抑郁严重程度对认知衰退影响的潜在偏差。平均而言，在不同严重程度下，持续时间每延长1年，整体认知得分下降0.44（95%CI 0.36，0.51），在不同持续时间下，重度抑郁比轻度抑郁使得分额外下降0.82（95%CI 0.59，1.04）分。除视觉构建外，七个认知子领域也呈现类似趋势。老年人因重度抑郁导致的认知衰退比中年人更严重。更严重且持续时间更长的抑郁会导致更严重的认知衰退。忽略抑郁持续时间会导致高估抑郁严重程度对认知衰退的影响。我们研究中明确的抑郁效应和易感人群对亚洲地区认知健康的维护具有重要意义。
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