Abstract：
BACKGROUND: Depression has been found to be associated with cognitive decline, but whether longer depressive durations lead to more severe cognitive declines has not been investigated. We aimed to estimate the association between depressive duration and cognitive decline in middle-aged and older Americans based on a large-scale representative population study.
METHODS: We included 27,886 participants from the Health and Retirement Study (HRS) in 2010-2018. Four datasets with 2-, 4-, 6-, and 8-year consecutive interviews were further derived which involving persistent depressed and persistent depression-free individuals. Multiple linear regressions were constructed to estimate the effects of each depressive duration on the decline in global cognition, memory and mental status. Meta-regressions were performed to test the linear trends and to explore the heterogeneity between sex, age and baseline cognitive function along with subgroup analyses.
RESULTS: Depressive durations of 2, 4, 6, and 8 years were associated with reductions in global cognitive scores of 0.62 points (95% CI: 0.51-0.73), 0.77 points (95% CI: 0.60-0.94), 0.83 points (95% CI: 0.55-1.10), and 1.09 points (95% CI: 0.63-1.55), respectively, indicating a linear trend (P = 0.016). More pronounced associations were observed in middle-aged adults and females. Similar patterns were found in the associations between depressive duration and two subdomains, i.e., memory and mental health.
CONCLUSIONS: This study is essentially a cross-sectional study and therefore cannot provide causal associations.
CONCLUSIONS: Longer depressive durations were linearly related to more severe cognitive declines. Timely intervention for depression targeted middle-aged adults can more effectively alleviate cognition-related burdens.
METHODS: We included 27,886 participants from the Health and Retirement Study (HRS) in 2010-2018. Four datasets with 2-, 4-, 6-, and 8-year consecutive interviews were further derived which involving persistent depressed and persistent depression-free individuals. Multiple linear regressions were constructed to estimate the effects of each depressive duration on the decline in global cognition, memory and mental status. Meta-regressions were performed to test the linear trends and to explore the heterogeneity between sex, age and baseline cognitive function along with subgroup analyses.
RESULTS: Depressive durations of 2, 4, 6, and 8 years were associated with reductions in global cognitive scores of 0.62 points (95% CI: 0.51-0.73), 0.77 points (95% CI: 0.60-0.94), 0.83 points (95% CI: 0.55-1.10), and 1.09 points (95% CI: 0.63-1.55), respectively, indicating a linear trend (P = 0.016). More pronounced associations were observed in middle-aged adults and females. Similar patterns were found in the associations between depressive duration and two subdomains, i.e., memory and mental health.
CONCLUSIONS: This study is essentially a cross-sectional study and therefore cannot provide causal associations.
CONCLUSIONS: Longer depressive durations were linearly related to more severe cognitive declines. Timely intervention for depression targeted middle-aged adults can more effectively alleviate cognition-related burdens.
摘要：
背景：已发现抑郁症与认知能力下降有关，但长期抑郁是否会导致更严重的认知功能下降尚未得到研究.我们旨在基于大规模代表性人群研究，估计中年和老年美国人抑郁持续时间和认知能力下降之间的关联。
方法：我们纳入了2010-2018年健康与退休研究（HRS）的27,886名参与者。四个数据集，其中2-，4-,6-，并进一步得出连续8年的访谈,这些访谈涉及持续性抑郁和持续性无抑郁个体.构建多元线性回归来估计每个抑郁持续时间对全球认知下降的影响，记忆和精神状态。进行元回归以检验线性趋势并探索性别之间的异质性。年龄和基线认知功能以及亚组分析。
结果：2、4、6和8年的抑郁持续时间与全球认知评分降低0.62分相关（95％CI：0.51-0.73），0.77点（95%CI：0.60-0.94），0.83点（95%CI：0.55-1.10），和1.09点（95%CI：0.63-1.55），分别,表明呈线性趋势(P=0.016)。在中年人和女性中观察到更明显的关联。在抑郁持续时间和两个子域之间的关联中发现了类似的模式，即，记忆和心理健康
结论：这项研究本质上是一项横断面研究，因此不能提供因果关系。
结论：更长的抑郁持续时间与更严重的认知能力下降呈线性关系。对中年人进行针对性的抑郁症及时干预可以更有效地减轻认知相关负担。
方法：我们纳入了2010-2018年健康与退休研究（HRS）的27,886名参与者。四个数据集，其中2-，4-,6-，并进一步得出连续8年的访谈,这些访谈涉及持续性抑郁和持续性无抑郁个体.构建多元线性回归来估计每个抑郁持续时间对全球认知下降的影响，记忆和精神状态。进行元回归以检验线性趋势并探索性别之间的异质性。年龄和基线认知功能以及亚组分析。
结果：2、4、6和8年的抑郁持续时间与全球认知评分降低0.62分相关（95％CI：0.51-0.73），0.77点（95%CI：0.60-0.94），0.83点（95%CI：0.55-1.10），和1.09点（95%CI：0.63-1.55），分别,表明呈线性趋势(P=0.016)。在中年人和女性中观察到更明显的关联。在抑郁持续时间和两个子域之间的关联中发现了类似的模式，即，记忆和心理健康
结论：这项研究本质上是一项横断面研究，因此不能提供因果关系。
结论：更长的抑郁持续时间与更严重的认知能力下降呈线性关系。对中年人进行针对性的抑郁症及时干预可以更有效地减轻认知相关负担。
