Late-life depression symptom dimensions and cognitive functioning in the Longitudinal Aging Study Amsterdam (LASA).
Late-life depression symptom dimensions and cognitive functioning in the Longitudinal Aging Study Amsterdam (LASA).
复制标题
DOI：
10.1016/j.jad.2016.05.027
复制
发表时间：
2016-09-01
影响因子：
6.6
通讯作者：
Huisman M
中科院分区：
文献类型：
--
作者：
Brailean A;Comijs HC;Aartsen MJ;Prince M;Prina AM;Beekman A;Huisman M
抑郁症通常在认知功能下降的老年背景下同时发生，但目前尚不清楚特定的抑郁症状维度是否与认知能力有差异相关。研究样本包括来自阿姆斯特丹纵向老龄化研究（LASA）的3107名社区居住的老年人。我们采用多指标多原因（MIMIC）模型来检验认知能力与流行病学研究中心抑郁量表（CES-D）潜在维度之间的关系，同时考虑到年龄、性别和认知功能水平导致的差异项目功能（DIF）。由躯体症状、积极情绪、抑郁情绪和人际关系困难组成的因素结构与数据拟合良好。较高水平的归纳推理与较低水平的抑郁情绪和躯体症状显著相关，而较快的处理速度与较低水平的躯体症状显著相关。发现了由年龄和性别引起的DIF，但影响的幅度很小，并没有改变实质性结论。由于本研究的横断面背景，尚不能确定抑郁症状水平与认知功能水平之间的影响方向。此外，研究结果与非临床人群相关，它们并没有阐明某些DIF效应是否仅在高水平或低水平抑郁中发现。我们的研究结果表明，晚年抑郁维度与老年认知能力之间存在不同的关联，并指出了可能强调这些关联的潜在病因机制。这些发现对老年抑郁症患者的认知预后具有启示意义。较好的归纳推理能力与较低的抑郁程度有关。更好的归纳推理与较低的躯体症状严重程度相关。处理速度越快，躯体症状的严重程度越低。由年龄和性别引起的DIF有统计学意义，但幅度较小。未发现因认知功能水平引起的DIF。
Depression often co-occurs in late-life in the context of declining cognitive functions, but it is not clear whether specific depression symptom dimensions are differentially associated with cognitive abilities. The study sample comprised 3107 community-dwelling older adults from the Longitudinal Aging Study Amsterdam (LASA). We applied a Multiple Indicators Multiple Causes (MIMIC) model to examine the association between cognitive abilities and latent dimensions of the Center for Epidemiologic Studies Depression Scale (CES-D), while accounting for differential item functioning (DIF) due to age, gender and cognitive function levels. A factor structure consisting of somatic symptoms, positive affect, depressed affect, and interpersonal difficulties fitted the data well. Higher levels of inductive reasoning were significantly associated with lower levels of depressed affect and somatic symptoms, whereas faster processing speed was significantly associated with lower levels of somatic symptoms. DIF due to age and gender was found, but the magnitude of the effects was small and did not alter substantive conclusions. Due to the cross-sectional context of this investigation, the direction of influence between depression symptom levels and cognitive function levels cannot be established. Furthermore, findings are relevant to non-clinical populations, and they do not clarify whether certain DIF effects may be found only at high or low levels of depression. Our findings suggest differential associations between late-life depression dimensions and cognitive abilities in old age, and point towards potential etiological mechanisms that may underline these associations. These findings carry implications for the prognosis of cognitive outcomes in depressed older adults. Better inductive reasoning was associated with lower severity of depressed affect. Better inductive reasoning was associated with lower severity of somatic symptoms. Faster processing speed was associated with lower severity of somatic symptoms. DIF due to age and gender was statistically significant but of small magnitude. No DIF due to level of cognitive functioning was found.