Trajectories of depressive symptoms and subsequent cognitive decline in older adults: a pooled analysis of two longitudinal cohorts

医学 认知功能衰退 认知 置信区间 人口 纵向研究 队列 萧条(经济学) 抑郁症状 队列研究 流行病学研究中心抑郁量表 人口学 痴呆 老年学 精神科 内科学 社会学 经济 病理 宏观经济学 疾病 环境卫生
作者
Yidan Zhu,Chenglong Li,Wuxiang Xie,Bao‐Liang Zhong,Yangfeng Wu,James A. Blumenthal
出处
期刊:Age and Ageing [Oxford University Press]
卷期号:51 (1) 被引量:60
标识
DOI:10.1093/ageing/afab191
摘要

Abstract Background the course of depression is variable, but it is unknown how this variability over time affects long-term cognitive decline. Objective to examine the relationship of different trajectories of depressive symptoms on rates of subsequent cognitive decline in older adults. Design population-based cohort study. Setting communities in the USA and England. Subjects 17,556 older adults from the Health and Retirement Study and the English Longitudinal Study of Ageing. Methods depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, and trajectories were calculated using group-based trajectory modelling. Global cognitive function and three cognitive domains of memory, executive function and temporal orientation were assessed for up to 18 years. Results five trajectories of depressive symptoms were identified. Compared with the ‘non-depressed’ trajectory, the ‘worsening depressive symptoms’ trajectory (pooled β = −0.016 standard deviation (SD)/year, 95% confidence interval (CI): −0.021 to −0.010), ‘persistent depressive symptoms’ trajectory (pooled β = −0.016 SD/year, 95% CI: −0.024 to −0.008), and ‘mild depressive symptoms’ trajectory (pooled β = −0.008 SD/year, 95% CI: −0.014 to −0.003) were associated with faster rates of cognitive decline, while no such association was found for the ‘improving depressive symptoms’ trajectory (pooled β = 0.001 SD/year, 95% CI: −0.010 to 0.012). Conclusions subthreshold depressive symptoms are associated with an increased rate of cognitive decline, while individuals who show improving depressive symptoms do not exhibit accelerated cognitive decline. These findings raise the possibility that maintaining depressive symptoms as low as possible and ignoring the clinical threshold, might mitigate cognitive decline in older adults.
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