Sad Mood Bridges Depressive Symptoms and Cognitive Performance in Community-dwelling Older Adults: A Network Approach

IF 4.9 3区医学 Q1 GERIATRICS & GERONTOLOGY

Innovation in Aging Pub Date : 2023-12-29 DOI:10.1093/geroni/igad139

Wen Zhang, Tianyin Liu, D. Leung, Stephen Chan, Gloria Wong, Terry Lum

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引用次数: 0

Abstract

Depression and cognitive impairment are common and often coexist in older adults. The network theory of mental disorders provides a novel approach to understanding the pathways between depressive symptoms and cognitive domains and the potential “bridge” that links and perpetuates both conditions. This study aimed to identify pathways and bridge symptoms between depressive symptoms and cognitive domains in older adults. Data were derived from 2792 older adults aged 60 years and older with mild and more severe depressive symptoms from the community in Hong Kong. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9) and cognition using the Montreal Cognitive Assessment 5-min protocol (MoCA-5min). Summary descriptive statistics were calculated, followed by network estimation using graphical LASSO, community detection, centrality analysis using bridge expected influence (BEI), and network stability analyses to assess the structure of the PHQ-9 and MoCA-5min items network, the pathways and the bridge symptoms. Participants (mean age=77.3 years, SD=8.5) scored 8.2 (SD=3.4) on PHQ-9 and 20.3 (SD=5.4) on MoCA-5min. Three independent communities were identified in PHQ-9 and MoCA-5min items, suggesting that depression is not a uniform entity (two communities) and has differential connections with cognition. The network estimation results suggested that the two most prominent connections between depressive symptoms and cognitive domains were: (1) anhedonia with executive functions/language and (2) sad mood with memory. Among all depressive symptoms, sad mood had the highest BEI, bridging depressive symptoms and cognitive domains. Sad mood seems to be the pathway between depression and cognition in this sample of older Chinese. This finding highlights the importance of sad mood as a potential mechanism for the co-occurrence of depression and cognitive impairment, implying that intervention targeting sad mood might have rippling effects on cognitive health.

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悲伤情绪为社区老年人的抑郁症状和认知能力搭建了桥梁：网络方法

抑郁症和认知障碍在老年人中很常见，而且常常同时存在。精神障碍的网络理论提供了一种新的方法来理解抑郁症状和认知领域之间的路径，以及连接和延续这两种症状的潜在 "桥梁"。本研究旨在确定老年人抑郁症状与认知领域之间的路径和桥梁症状。数据来自香港社区中 2792 名 60 岁及以上、有轻度和较严重抑郁症状的老年人。抑郁症状采用患者健康问卷（PHQ-9）进行评估，认知能力则采用蒙特利尔认知评估 5 分钟方案（MoCA-5min）进行评估。研究人员首先计算了描述性统计摘要，然后利用图形化 LASSO 进行了网络估算、社区检测、利用桥接预期影响（BEI）进行了中心性分析，并利用网络稳定性分析评估了 PHQ-9 和 MoCA-5min 项目网络、路径和桥接症状的结构。参与者（平均年龄=77.3岁，SD=8.5）的PHQ-9得分为8.2（SD=3.4），MoCA-5min得分为20.3（SD=5.4）。在PHQ-9和MoCA-5min项目中发现了三个独立的群落，这表明抑郁症并不是一个统一的实体（两个群落），它与认知有着不同的联系。网络估算结果表明，抑郁症状与认知领域之间最突出的两个联系是(1) 快感缺失与执行功能/语言；(2) 悲伤情绪与记忆。在所有抑郁症状中，悲伤情绪的 BEI 最高，是抑郁症状与认知领域之间的桥梁。在这一中国老年人样本中，悲伤情绪似乎是连接抑郁和认知的途径。这一发现强调了悲伤情绪作为抑郁和认知障碍并存的潜在机制的重要性，意味着针对悲伤情绪的干预可能会对认知健康产生连锁反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Innovation in Aging GERIATRICS & GERONTOLOGY-

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

15 weeks

期刊介绍： Innovation in Aging, an interdisciplinary Open Access journal of the Gerontological Society of America (GSA), is dedicated to publishing innovative, conceptually robust, and methodologically rigorous research focused on aging and the life course. The journal aims to present studies with the potential to significantly enhance the health, functionality, and overall well-being of older adults by translating scientific insights into practical applications. Research published in the journal spans a variety of settings, including community, clinical, and laboratory contexts, with a clear emphasis on issues that are directly pertinent to aging and the dynamics of life over time. The content of the journal mirrors the diverse research interests of GSA members and encompasses a range of study types. These include the validation of new conceptual or theoretical models, assessments of factors impacting the health and well-being of older adults, evaluations of interventions and policies, the implementation of groundbreaking research methodologies, interdisciplinary research that adapts concepts and methods from other fields to aging studies, and the use of modeling and simulations to understand factors and processes influencing aging outcomes. The journal welcomes contributions from scholars across various disciplines, such as technology, engineering, architecture, economics, business, law, political science, public policy, education, public health, social and psychological sciences, biomedical and health sciences, and the humanities and arts, reflecting a holistic approach to advancing knowledge in gerontology.