中老年人肺功能与认知障碍的关系：抑郁症状的中介作用

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2025-05-09 DOI:10.1016/j.jpsychores.2025.112148

Yubin Wang, Jifeng Huang, Yuhan Tao, Yuling Zhang, Xiaojie Zhou, Hui Mao

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引用次数: 0

摘要

迄今为止，肺功能和认知能力下降之间关系的潜在机制仍然知之甚少。本研究旨在探讨抑郁在肺功能与后续认知功能障碍（CI）的纵向关联中的中介作用。方法中国健康与退休纵向研究（CHARLS）共纳入7275名受试者进行最终分析。肺功能评价采用呼气峰流量（PEF）测量的峰值流量计。使用复合认知评分来评估认知功能。采用线性和逻辑回归模型，结合自举分析，探讨抑郁症状对肺功能与认知能力下降关系的中介作用。结果在调整潜在协变量后，整体认知及其四个维度的得分显示，从四分位数1 （Q1）到四分位数4 (Q4)， PEF和PEF%预测(p <；0.001)。较高的PEF值（Q4 vs Q1: OR = 0.93, 95% CI 0.90 ~ 0.97, p = 0.001）以及较高的PEF%预测值（Q4 vs Q1: OR = 0.94, 95% CI 0.90 ~ 0.97, p = 0.001）与发生CI发作的风险降低相关。在肺功能对认知能力下降的影响中，抑郁的中介效应约占总效应的8.2%。结论较高的PEF与中老年人纵向认知能力下降的速度较慢有关。尽管抑郁症状是CI发展相关的中介，但大多数方差仍无法解释。

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The relationship between lung function and cognitive impairment among middle-aged and older adults: The mediating role of depressive symptoms

Background

To date, the mechanisms underlying the relationship between lung function and cognitive decline remain poorly understood. This study aims to investigate the mediating effect of depression in the longitudinal association between lung function and subsequent cognitive impairment (CI).

Methods

In the China Health and Retirement Longitudinal Study (CHARLS), a total of 7275 participants were included in the final analysis. Lung function was evaluated using peak expiratory flow (PEF) measured by a peak flow meter. A composite cognitive score was used to assess cognitive function. Linear and logistic regression models, along with bootstrap analyses, were used to investigate the mediating effect of depressive symptoms on the relationship between lung function and cognitive decline.

Results

After adjusting for potential covariates, scores on both overall cognition and its four dimensions demonstrated an increasing trend from quartile 1 (Q1) to quartile 4 (Q4) of PEF and PEF% predicted (p < 0.001). Higher PEF values (Q4 vs Q1: OR = 0.93, 95 % CI 0.90 to 0.97, p = 0.001) as well as elevated PEF% predicted (Q4 vs Q1: OR = 0.94, 95 % CI 0.90 to 0.97, p = 0.001) were associated with a reduced risk of developing CI onset. The mediation effect of depression accounted for approximately 8.2 % of the total effect concerning lung function's impact on cognitive decline.

Conclusion

Higher PEF was associated with a slower rate of longitudinal cognitive decline in middle-aged and older adults. Although depressive symptoms acted as a mediator associated with the development of CI, the majority of variance remained unexplained.

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.