衰弱、抑郁与认知功能的多轨迹：来自健康与退休纵向研究的发现

Multitrajectories of Frailty and Depression With Cognitive Function: Findings From the Health and Retirement Longitudinal Study.

作者信息

Hu Chengxiang, Sun Xiaoyue, Li Zhirong, He Yue, Han Beibei, Wu Zibo, Liu Siyu, Jin Lina

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China.

State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Changchun, Jilin Province, China.

出版信息

J Cachexia Sarcopenia Muscle. 2025 Apr;16(2):e13795. doi: 10.1002/jcsm.13795.

DOI:10.1002/jcsm.13795

PMID:40189221

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11972689/

Abstract

BACKGROUND

Little is known about the joint associations between trajectories of frailty and depression with cognitive function. This study aims to explore the multitrajectories of frailty and depression and their joint impact on cognition.

METHODS

A total of 8600 participants from the Health and Retirement Study (HRS) (1996-2018) were analysed using a group-based trajectory model for 10-year multitrajectories. Participants were classified into five groups based on their trajectories. Multivariable linear mixed models and Cox proportional hazards models were utilized.

RESULTS

Compared with Group 1 (stable robust and nondepressed), Groups 2 ('worsening prefrailty without depression,' β = -0.022 SD/year), 3 ('stable prefrailty with escalating depressive symptoms,' β = -0.016 SD/year), 4 ('increasing frailty alongside worsening depressive symptoms,' β = -0.034 SD/year) and 5 ('high and escalating frailty with persistent depression,' β = -0.055 SD/year) exhibited accelerated cognitive decline. Dementia risk was significantly higher in G2 (HR = 1.26, 95% CI: 1.08-1.48), G3 (HR = 1.54, 95% CI: 1.31-1.80), G4 (HR = 1.81, 95% CI: 1.54-2.14) and G5 (HR = 1.86, 95% CI: 1.48-2.33) compared with G1.

CONCLUSIONS

Worsening frailty and depression accelerate cognitive decline and risk of dementia, underscoring the need to address both conditions to mitigate cognition.

摘要

背景

关于衰弱轨迹和抑郁与认知功能之间的联合关联，人们了解甚少。本研究旨在探讨衰弱和抑郁的多轨迹及其对认知的联合影响。

方法

使用基于群体的轨迹模型对来自健康与退休研究（HRS）（1996 - 2018年）的8600名参与者进行了为期10年的多轨迹分析。参与者根据其轨迹被分为五组。采用多变量线性混合模型和Cox比例风险模型。

结果

与第1组（稳定强健且无抑郁）相比，第2组（“衰弱前期恶化但无抑郁”，β = -0.022标准差/年）、第3组（“衰弱前期稳定但抑郁症状逐渐加重”，β = -0.016标准差/年）、第4组（“衰弱加剧且抑郁症状恶化”，β = -0.034标准差/年）和第5组（“衰弱严重且持续抑郁”，β = -0.055标准差/年）的认知衰退加速。与第1组相比，第2组（HR = 1.26，95%CI：1.08 - 1.48）、第3组（HR = 1.54，95%CI：1.31 - 1.80）、第4组（HR = 1.81，95%CI：1.54 - 2.14）和第5组（HR = 1.86，95%CI：1.48 - 2.33）的痴呆风险显著更高。