Intertwined depressive and cognitive trajectories and the risk of dementia and death in older adults:a competing risk analysis  

作　　者：Ziyang Ren Lirong Nie Yushan Du Jufen Liu 

机构地区：[1]Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health,Peking University,Beijing,China [2]Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing,China

出　　处：《General Psychiatry》2024年第2期207-215,共9页综合精神医学（英文）

基　　金：This study is funded by the Major Project of the National Social Science Fund of China(21&ZD187).

摘　　要：Background Depressive symptoms and cognitive impairment often interact,rendering their associations controversial.To date,their joint trajectories and associations with dementia and death remain underexplored.Aims To explore the interactions between depressive symptoms and cognitive function,their developmental trajectories and the associations with all-cause dementia,Alzheimer’s disease(AD)and all-cause death in older adults.Methods Data were from the Health and Retirement Study.Depressive symptoms and cognitive function were measured using the 8-item Centre for Epidemiologic Studies Depression Scale and the Telephone Interview of Cognitive Status,respectively.All-cause dementia and AD were defined by self-reported or proxy-reported physician diagnoses.All-cause death was determined by interviews.The restricted cubic spline,group-based trajectory modelling and subdistribution hazard regression were used.Results Significant interactions between depressive symptoms and cognitive function in 2010 in their association with new-onset all-cause dementia and AD from 2010 to 2020 were found,especially in women(p for interaction<0.05).Independent trajectory analysis showed that emerging or high(vs no)depressive trajectories and poor or rapidly decreased cognitive trajectories(vs very good)from 1996 to 2010 were at significantly higher risk of subsequent all-cause dementia,AD and all-cause death.15 joint trajectories of depressive symptoms and cognitive function from 1996 to 2010 were determined,where rapidly decreased cognitive function was more common in those with no depressive symptoms.Compared with older adults with the trajectory of no depressive symptoms and very good cognitive function,those with the trajectory of no depressive symptoms but rapidly decreased cognitive function were much more likely to develop new-onset all-cause dementia and death,with subdistribution hazard ratios(95%confidence intervals)of 4.47(2.99 to 6.67)and 1.84(1.43 to 2.36),especially in women.Conclusions To effectively mitigate the risk

关 键 词：DEATH analysis RENDERING 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R749.16[医药卫生—临床医学]