美国老年人的累积孤独和记忆功能:抑郁症状的作用

Xuexin Yu, Adina Zeki Al Hazzouri, Tsai-Chin Cho, Laura B Zahodne, Alden L Gross, Belinda L Needham, Kenneth M Langa, Lindsay C Kobayashi
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摘要

背景:本研究旨在探讨抑郁症状是否介导衰老过程中累积孤独与记忆功能的关系。方法:数据来自美国健康与退休研究中2006-2018年(队列A)和2008-2020年(队列B)两个随机亚队列的4779名50岁以上成年人。根据加州大学洛杉矶分校的孤独量表,参与者在8年的暴露期内分别在0、1、2或3个时间点经历孤独。使用流行病学研究中心抑郁量表测量抑郁症状。情景记忆功能在随访时通过即时和延迟单词回忆分数进行评估。在合并队列中进行因果中介分析。结果:平均基线年龄(SD)为65岁(7.6岁),62%的样本为女性(2941 / 4779)。在8年的暴露期内,累积的孤独感越大,随后的记忆功能越低,并呈剂量-反应关系。观察到的孤独感在1、2和3个时间点上的估计值分别与额外的0.26、0.84和2.56年的衰老相关记忆衰退相当。随着孤独感持续时间的增加,抑郁症状介导的关联比例从70%下降到21%。讨论:抑郁症状可能是一种心理机制,通过这种机制,累积的孤独感会对美国中老年人的记忆功能产生负面影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cumulative loneliness and memory function among US older adults: the role of depressive symptoms.

Background: This study aimed to investigate whether depressive symptoms mediate the association between cumulative loneliness and memory function during aging.

Methods: Data were from 4,779 adults aged over 50 in the US Health and Retirement Study in two random sub-cohorts from 2006-2018 (Cohort A) and 2008-2020 (Cohort B). Participants were categorized as experiencing loneliness at 0, 1, 2, or 3 time points over an 8-year exposure period according to the UCLA Loneliness Scale. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Episodic memory function was assessed at the follow-up by immediate and delayed word recall scores. Causal mediation analysis was performed in the pooled cohorts.

Results: Mean baseline age (SD) was 65 (7.6), and 62% of the sample was female (2,941/4,779). Greater cumulative loneliness over the 8-year exposure period was associated with lower subsequent memory function in a dose-response relationship. Observed estimates for loneliness at each of 1, 2, and 3 time points were comparable in magnitude to an additional 0.26, 0.84, and 2.56 years of aging-related memory decline, respectively. The proportion of the association mediated by depressive symptoms decreased from 70% to 21% as the duration of loneliness increased.

Discussion: Depressive symptoms may be a psychological mechanism through which cumulative loneliness negatively affects memory function among middle-aged and older adults in the United States.

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