Longitudinal associations between late-life depression dimensions and cognitive functioning: a cross-domain latent growth curve analysis.
Longitudinal associations between late-life depression dimensions and cognitive functioning: a cross-domain latent growth curve analysis.
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DOI：
10.1017/s003329171600297x
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发表时间：
2017-03
影响因子：
6.9
通讯作者：
Beekman A
中科院分区：
文献类型：
--
作者：
Brailean A;Aartsen MJ;Muniz-Terrera G;Prince M;Prina AM;Comijs HC;Huisman M;Beekman A
认知障碍和抑郁症经常在老年人中同时发生，但尚不清楚抑郁症是否是认知能力下降的危险因素、认知能力下降的心理反应，或者抑郁症状的变化是否与认知能力随时间的变化相关。抑郁症和认知障碍的共病表现可能反映因果效应或共同原因，具体取决于所经历的具体症状和受影响的认知功能。研究样本包括来自阿姆斯特丹纵向老龄化研究 (LASA) 的 1506 名 65 岁以上社区居民老年人。我们进行了跨领域潜在生长曲线分析，以检查晚年抑郁维度（即抑郁情感、积极情感和躯体症状）与特定认知功能领域（即处理速度、归纳推理、即时回忆和延迟回忆）之间的纵向关联。基线时的延迟回忆表现较差，预示着随着时间的推移，抑郁情绪会急剧增加。随着时间的推移，处理速度的急剧下降与抑郁症躯体症状的急剧增加相关。我们的研究结果表明，记忆功能与抑郁情绪之间存在前瞻性关联，即老年人对记忆功能不佳的反应可能会增加抑郁情绪。抑郁症的躯体症状随着处理速度的下降而增加，这可能反映了常见的神经退行性过程。我们的研究结果并不支持抑郁症状可能是普通人群认知能力下降的危险因素的假设。这些发现对晚年抑郁症的治疗和认知结果的预后具有潜在影响。
Cognitive impairment and depression often co-occur in older adults, but it is not clear whether depression is a risk factor for cognitive decline, a psychological reaction to cognitive decline, or whether changes in depressive symptoms correlate with changes in cognitive performance over time. The co-morbid manifestation of depression and cognitive impairment may reflect either a causal effect or a common cause, depending on the specific symptoms experienced and the cognitive functions affected. The study sample comprised 1506 community-dwelling older adults aged ⩾65 years from the Longitudinal Aging Study Amsterdam (LASA). We conducted cross-domain latent growth curve analyses to examine longitudinal associations between late-life depression dimensions (i.e. depressed affect, positive affect, and somatic symptoms) and specific domains of cognitive functioning (i.e. processing speed, inductive reasoning, immediate recall, and delayed recall). Poorer delayed recall performance at baseline predicted a steeper increase in depressed affect over time. Steeper decline in processing speed correlated with a steeper increase in somatic symptoms of depression over time. Our findings suggest a prospective association between memory function and depressed affect, whereby older adults may experience an increase in depressed affect in reaction to poor memory function. Somatic symptoms of depression increased concurrently with declining processing speed, which may reflect common neurodegenerative processes. Our findings do not support the hypothesis that depression symptoms may be a risk factor for cognitive decline in the general population. These findings have potential implications for the treatment of late-life depression and for the prognosis of cognitive outcomes.