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Abstract：
(1) Objectives: This study aims to investigate the bidirectional relationship between depressive symptoms and cognitive function among older adults in China, addressing a research gap in the context of developing nations. (2) Methods: A total of 3813 adults aged 60 and older participating in 2013, 2015, and 2018 waves of the China Health and Retirement Longitudinal Study (CHARLS) were included. A fixed-effects model and cross-lagged panel model (CLPM) was utilized. (3) Results: First, the results indicated that a significant negative correlation existed between depressive symptoms and cognitive function in older adults during the study period (β = -0.084, p < 0.001). Second, after controlling for unobserved confounding factors, the deterioration and improvement of depressive symptoms still significantly affected cognitive function (β = -0.055, p < 0.001). Third, using the cross-lagged panel model, we observed a reciprocal relationship between depressive symptoms (Dep) and cognitive function (Cog) among Chinese older adults (Dep2013 → Cog2015, β = -0.025, p < 0.01; Dep2015 → Cog2018, β = -0.028, p < 0.001; Cog2013 → Dep2015, β = -0.079, p < 0.01; Cog2015 → Dep2018, β = -0.085, p < 0.01). (4) Discussion: The reciprocal relationship between depressive symptoms and cognitive functioning in older adults emphasizes the need for integrated public health policies and clinical interventions, to develop comprehensive intervention strategies that simultaneously address depressive symptoms and cognitive decline.
摘要：
(1)目的:本研究旨在探讨中国老年人抑郁症状与认知功能的双向关系。解决发展中国家背景下的研究差距。(2)方法:纳入2013年、2015年和2018年中国健康与退休纵向研究(CHARLS)的3813名60岁及以上成年人。采用了固定效应模型和交叉滞后面板模型(CLPM)。（3）结果：第一，结果表明，在研究期间，老年人的抑郁症状与认知功能之间存在显着负相关（β=-0.084，p<0.001）。第二,在控制了未观察到的混杂因素后，抑郁症状的恶化和改善仍然显着影响认知功能（β=-0.055，p<0.001）。第三，使用交叉滞后面板模型，我们观察到中国老年人抑郁症状（Dep）与认知功能（Cog）之间存在相互关系（Dep2013→Cog2015，β=-0.025，p<0.01；Dep2015→Cog2018，β=-0.028，p<0.001；Cog2013→Dep2015，β=-0.079，p<0.01；Cog2015→Dep2018，β=-0.085，p<0.01）。（4）讨论：老年人抑郁症状和认知功能之间的相互关系强调需要综合的公共卫生政策和临床干预措施，制定同时解决抑郁症状和认知能力下降的综合干预策略。
