Differential association of concurrent, baseline, and average depressive symptoms with cognitive decline in older adults
Differential association of concurrent, baseline, and average depressive symptoms with cognitive decline in older adults
复制标题
DOI：
10.1097/jgp.0b013e3181662a9c
复制
发表时间：
2008-04-01
影响因子：
7.2
通讯作者：
Zonderman, Alan B.
中科院分区：
文献类型：
--
作者：
Dotson, Vonetta M.;Resnick, Susan M.;Zonderman, Alan B.
目的：抑郁症状对老年人认知能力下降的影响尚不清楚，因为文献中的研究结果不一致。目前还不清楚抑郁症状对认知能力下降的影响是否随年龄而变化。本研究调查了并发，基线和平均抑郁症状对认知功能和下降的影响，并检查了年龄和抑郁症状对认知的交互作用。设计图：前瞻性观察设计，每隔1- 2年检查一次认知能力和抑郁症状，最长持续26年。地点：巴尔的摩老龄化纵向研究，国家老龄化研究所。参与者：1586名50岁及以上的无痴呆症成年人。测量值：随着时间的推移，流行病学研究中心抑郁量表的评分以及学习和记忆、注意力和执行功能、言语和语言能力、视觉空间功能和一般认知状态的测量。结果：抑郁症状的增加与认知功能差和多个领域的认知下降有关。同时，基线和平均抑郁症状与认知有不同的关联。平均抑郁症状，一种慢性症状的衡量标准，似乎对认知能力的影响最广泛。随着年龄的增长，抑郁症状对某些额叶功能的影响更大。结论：抑郁症状与认知功能低下和认知能力下降有关，尤其是随着年龄的增长。平均抑郁症状对认知的广泛影响表明，临床医生在评估老年人的认知功能时应考虑抑郁症状的慢性化。
Objectives: The impact of depressive symptoms on cognitive decline in older adults remains unclear due to inconsistent findings in the literature. It is also unclear whether effects of depressive symptoms on cognitive decline vary with age. This study investigated the effect of concurrent, baseline, and average depressive symptoms on cognitive functioning and decline, and examined the interactive effect of age and depressive symptoms on cognition. Design: Prospective observational design with examination of cognitive performance and depressive symptoms at 1- to 2-year intervals for up to 26 years. Setting: Baltimore Longitudinal Study of Aging, National Institute on Aging. Participants: One thousand five hundred eighty-six dementia-free adults 50 years of age and older. Measurements: Scores over time on the Center for Epidemiologic Studies Depression Scale and measures of learning and memory, attention and executive functions, verbal and language abilities, visuospatial functioning, and general cognitive status. Results: Increased depressive symptoms were associated with poor cognitive functioning and cognitive decline in multiple domains. Concurrent, baseline, and average depressive symptoms had differential associations with cognition. Average depressive symptoms, a measure of chronic symptoms, seemed to show the most widespread effects on cognitive abilities. Effects of depressive symptoms on some frontal functions were greater with advancing age. Conclusion: Depressive symptoms are associated with poor cognitive functioning and cognitive decline, particularly with advancing age. The widespread impact of average depressive symptoms on cognition suggests that clinicians should consider the chronicity of depressive symptoms when evaluating cognitive functioning in older adults.