Wang Xiwu, Ye Teng, Zhou Wenjun, Zhang Jie
Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China.
Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Alzheimers Dement. 2025 Aug;21(8):e70548. doi: 10.1002/alz.70548.
Sex differences in the association between depressive symptoms and cognitive decline or dementia risk among older adults remain controversial. Reliance on single time point assessments of depressive symptoms, which fail to capture their dynamic course, may contribute to the inconsistencies.
We investigated the sex-specific associations of longitudinal trajectories of depressive symptoms with cognitive decline and progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD) dementia among 811 individuals with MCI.
In men, increasing depressive symptoms were associated with significantly steeper rates of cognitive decline, as measured by global cognitive and functional outcomes, and with an increased risk of dementia compared to consistently low depressive symptoms. In women, however, these associations were absent. Exploratory analyses using multiple specific cognitive domains as outcomes were also generally consistent with our main findings.
These findings have critical implications for developing sex-specific, depression-targeted dementia prevention strategies.
We examined the sex-specific effects of depressive symptom trajectories on cognition and dementia risk in the Alzheimer's Disease Neuroimaging Initiative cohort. Increasing depressive symptoms were associated with cognitive and functional decline in men. Increasing depressive symptoms contributed to conversion to dementia in men. These associations were absent in women.
老年人抑郁症状与认知衰退或痴呆风险之间的性别差异仍存在争议。依赖抑郁症状的单一时点评估无法捕捉其动态过程，这可能导致结果不一致。
我们调查了811名轻度认知障碍（MCI）患者中，抑郁症状纵向轨迹与认知衰退以及从MCI进展为阿尔茨海默病（AD）痴呆之间的性别特异性关联。
在男性中，与持续低水平抑郁症状相比，抑郁症状增加与认知衰退速度显著加快相关，这通过整体认知和功能结果来衡量，并且痴呆风险增加。然而，在女性中不存在这些关联。使用多个特定认知领域作为结果的探索性分析也总体上与我们的主要发现一致。
这些发现对于制定针对性别、以抑郁为目标的痴呆预防策略具有关键意义。
我们在阿尔茨海默病神经影像倡议队列中研究了抑郁症状轨迹对认知和痴呆风险的性别特异性影响。抑郁症状增加与男性的认知和功能衰退相关。抑郁症状增加导致男性转化为痴呆。这些关联在女性中不存在。
