Nagaoka Maiko, Nagaoka Katsuya, Kajitani Naoto, Yuki Seiji, Koyama Asuka, Yoshiura Kazuhiro, Honda Kazuki, Miyagawa Yusuke, Boku Shuken, Fujise Noboru, Takebayashi Minoru
Health Care Center, Kumamoto University, 2-40-1 Kurokami, Chuo-Ku, Kumamoto, Kumamoto, 860-8555, Japan.
Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, Kumamoto, 860-8556, Japan.
BMC Psychiatry. 2025 Jul 2;25(1):674. doi: 10.1186/s12888-025-07061-2.
AIM: The association between cognitive decline and late-life depression (LLD) is well-reported, but few studies have investigated the mediating factors. This study aimed to identify mediating factors between cognitive function and depressive symptoms (outcome), focusing on IADL, in adults aged 65 years and older. METHODS: This cross-sectional study included 1,401 community-dwelling Japanese individuals aged ≥ 65 years. LLD was defined using the Geriatric Depression Scale (GDS). Cognitive function was assessed using the Mini-Mental State Examination Test Form (MMSE), and IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). Multiple regression and mediation analyses were conducted by fully adjusted potential confounding factors. RESULTS: Among the 1,401 participants, the prevalence of late-life depression was 10.2%. In the adjusted multiple regression analysis, IADL demonstrated a significant correlation coefficient and was significantly associated with depressive symptoms (regression coefficient [β] = -0.33, 95% confidence interval [CI] = -0.39 to -0.26). Cognitive function was also significantly associated with depressive symptoms (β = -0.05, CI: -0.09 to -0.01). In the mediation analysis, IADL scores significantly mediated the relationship between cognitive function and depressive symptoms (estimated indirect effect = -0.1000, bootstrap standard error = 0.0142, bootstrap standard CI = -0.1290 to -0.0737). CONCLUSIONS: IADL was a mediating factor in the relationship between cognitive function and depressive symptoms, and cognitive function contributed to depressive symptoms through IADL. IADL might play an important role in the prevention and early diagnosis of late-life depression.
目的:认知功能衰退与老年期抑郁症(LLD)之间的关联已有充分报道,但很少有研究探讨其中介因素。本研究旨在确定65岁及以上成年人认知功能与抑郁症状(结果)之间的中介因素,重点关注日常生活活动能力(IADL)。 方法:这项横断面研究纳入了1401名年龄≥65岁的日本社区居民。使用老年抑郁量表(GDS)定义LLD。使用简易精神状态检查表(MMSE)评估认知功能,使用东京都老人综合研究所能力指数(TMIG-IC)评估IADL。通过对潜在混杂因素进行充分调整后进行多元回归和中介分析。 结果:在1401名参与者中,老年期抑郁症的患病率为10.2%。在调整后的多元回归分析中,IADL显示出显著的相关系数,且与抑郁症状显著相关(回归系数[β]= -0.33,95%置信区间[CI]= -0.39至-0.26)。认知功能也与抑郁症状显著相关(β= -0.05,CI:-0.09至-0.01)。在中介分析中,IADL得分显著介导了认知功能与抑郁症状之间的关系(估计间接效应= -0.1000,自抽样标准误= 0.0142,自抽样标准CI= -0.1290至-0.0737)。 结论:IADL是认知功能与抑郁症状之间关系的中介因素,认知功能通过IADL导致抑郁症状。IADL可能在老年期抑郁症的预防和早期诊断中发挥重要作用。
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