Yu Xuexin, Zeki Al Hazzouri Adina, Cho Tsai-Chin, Zahodne Laura B, Gross Alden L, Needham Belinda L, Langa Kenneth M, Kobayashi Lindsay C
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States.
Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, Michigan, United States.
J Gerontol A Biol Sci Med Sci. 2025 Jul 24;80(8). doi: 10.1093/gerona/glaf143.
This study aimed to investigate whether depressive symptoms mediate the association between cumulative loneliness and memory function during aging.
Data were from 4779 adults aged over 50 in the U.S. Health and Retirement Study in two random sub-cohorts from 2006 to 2018 (Cohort A) and 2008 to 2020 (Cohort B). Participants were categorized as experiencing loneliness at 0, 1, 2, or 3 time points over an 8-year exposure period according to the UCLA Loneliness Scale. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Episodic memory function was assessed at the follow-up by immediate and delayed word recall scores. Causal mediation analysis was performed in the pooled cohorts.
Mean baseline age (SD) was 65 (7.6), and 62% of the sample was female (2941/4779). Greater cumulative loneliness over the 8-year exposure period was associated with lower subsequent memory function in a dose-response relationship. Observed estimates for loneliness at each of 1, 2, and 3 time points were comparable in magnitude to an additional 0.26, 0.84, and 2.56 years of aging-related memory decline, respectively. The proportion of the association mediated by depressive symptoms decreased from 70% to 21% as the duration of loneliness increased.
Depressive symptoms may be a psychological mechanism through which cumulative loneliness negatively affects memory function among middle-aged and older adults in the USA.
本研究旨在调查抑郁症状是否介导了衰老过程中累积孤独感与记忆功能之间的关联。
数据来自美国健康与退休研究中4779名50岁以上的成年人，分为2006年至2018年的两个随机子队列（队列A）和2008年至2020年的（队列B）。根据加州大学洛杉矶分校孤独量表，参与者在8年的暴露期内被分类为在0、1、2或3个时间点经历孤独。使用流行病学研究中心抑郁量表测量抑郁症状。在随访时通过即时和延迟单词回忆分数评估情景记忆功能。在合并队列中进行因果中介分析。
平均基线年龄（标准差）为65岁（7.6），样本中62%为女性（2941/4779）。在8年暴露期内累积孤独感越强，随后的记忆功能越低，呈剂量反应关系。在1、2和3个时间点观察到的孤独估计值分别相当于与衰老相关的记忆衰退额外增加0.26、0.84和2.56年。随着孤独持续时间的增加，由抑郁症状介导的关联比例从70%降至21%。
抑郁症状可能是一种心理机制，通过这种机制，累积孤独感对美国中年和老年人的记忆功能产生负面影响。
