Article(id=1241025208711181173, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241025201983508979, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202412556, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1735315200000, receivedDateStr=2024-12-28, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773813066890, onlineDateStr=2026-03-18, pubDate=1744214400000, pubDateStr=2025-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773813066890, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773813066890, creator=13701087609, updateTime=1773813066890, updator=13701087609, issue=Issue{id=1241025201983508979, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='7', pageStart='1153', pageEnd='1344', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773813065285, creator=13701087609, updateTime=1773815493878, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241035388320543403, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241025201983508979, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241035388320543404, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241025201983508979, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1306, endPage=1310, ext={EN=ArticleExt(id=1241025210141438867, articleId=1241025208711181173, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Cognitive function and depression symptom trajectories in middle-aged and older adults and their influencing factors, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective To explore the trends in cognitive function and depression symptoms over time among middle-aged and older adults in China, and to identify populations with differing trajectories of cognitive function and depression symptoms, thereby providing a scientific basis for formulating targeted prevention and control measures.
Methods A total of 11 863 individuals aged 45 and above from the China Health and Retirement Longitudinal Study (CHARLS) were included. The Group-based Dual Trajectory Model (GBDTM) was employed to identify the developmental trajectories of cognitive function and depression symptoms, and multinomial logistic regression analysis was utilized to examine the influencing factors of different trajectories.
Results The GBDTM identified four trajectory groups: “Poor cognitive function but mild depression symptoms” (Group 1, 32.9%),“Poor cognitive function and severe depression symptoms” (Group 2, 10.8%), “Good cognitive function and mild depression symptoms” (Group 3, 40.5%), and “Moderate cognitive function and moderate depression symptoms” (Group 4, 15.7%). Factors associated with a higher likelihood of being classified in the“Poor cognitive function and severe depression symptoms” group included being female (OR=4.70, 95%CI: 3.82-5.78), unmarried (OR=2.09, 95%CI: 1.67-2.60), residing in rural areas (OR=4.26,95%CI: 3.59-5.07), smoking (OR=1.26, 95%CI: 1.02-1.56), having activities of daily living (ADL) disabilities (OR=1.92, 95%CI:1.39-2.65), and having instrumental activities of daily living (IADL) disabilities (OR=7.43, 95%CI: 5.90-9.35).
Conclusion There is a partially “joint development” trajectory relationship between cognitive function and depression symptoms in middle-aged and older adults. Early intervention targeting the influencing factors of different trajectory groups is crucial.
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目的 探索我国中老年人认知功能和抑郁症状随时间变化的趋势，识别出具有不同认知功能和抑郁症状变化趋势的人群，为其制定精准化的防控措施提供科学依据。
方法 纳入中国健康与养老追踪调查（CHARLS）中11 863名45岁及以上中老年人，采用组基双轨迹模型（GBDTM）识别认知功能和抑郁症状的发展轨迹，采用多分类logistic回归分析不同轨迹的影响因素。
结果 GBDTM共确定四组双轨迹，认知功能较差但抑郁症状较轻（G1组，32.9%）、认知功能较差且抑郁症状较严重（G2组，10.8%）、认知功能较好且抑郁症状较轻（G3组，40.5%）、认知功能中等且抑郁症状中等（G4组，15.7%）。女性（OR=4.70，95%CI：3.82～5.78）、未婚（OR=2.09，95%CI：1.67～2.60）、居住在农村（OR=4.26，95%CI：3.59～5.07）、吸烟（OR=1.26，95%CI：1.02～1.56）、存在日常生活活动能力失能（OR=1.92，95%CI：1.39～2.65）、存在工具性日常生活活动能力失能（OR=7.43，95%CI：5.90～9.35）的人群更容易被分到认知功能较差且抑郁症状较严重组。
结论 中老年人认知功能和抑郁症状间存在部分“共同发展”的轨迹关系，针对不同轨迹人群的影响因素进行早期干预十分重要。
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本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=jJyaM05cuSWKAIUwppCF8Q==, magXml=4+jzO/ut8TBPWpYn210Biw==, pdfUrl=null, pdf=Wr5Sv8huk5BKiw4buc/DVA==, pdfFileSize=581757, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=nYjMBxr5vjeY8EESMUe0KQ==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=/sOF4ZZS/5sejejgo2SI9Q==, mapNumber=null, authorCompany=null, fund=null, authors=
王珂瑞（1999—），女，硕士在读，研究方向：慢性病流行病学
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Dual trajectories of cognitive function and depressive symptoms, figureFileSmall=yZ1hb59xf6GShWcDUnzJ9w==, figureFileBig=nYjMBxr5vjeY8EESMUe0KQ==, tableContent=null), ArticleFig(id=1241025216646803846, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241025208711181173, language=CN, label=图1, caption=
认知功能与抑郁症状的双轨迹注：图A为G1组认知功能发展轨迹；图B为G2组认知功能发展轨迹；图C为G3组认知功能发展轨迹；图D为G4组认知功能发展轨迹；图E为G1组抑郁症状发展轨迹；图F为G2组抑郁症状发展轨迹；图G为G3组抑郁症状发展轨迹；图H为G4组抑郁症状发展轨迹。
, figureFileSmall=yZ1hb59xf6GShWcDUnzJ9w==, figureFileBig=nYjMBxr5vjeY8EESMUe0KQ==, tableContent=null), ArticleFig(id=1241025216915239323, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241025208711181173, language=EN, label=Table 1, caption=
Characteristics distribution of participants (n=11 863)［（
），n（%）］
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | | 人数/均值 |
|---|
| 年龄（岁） | | 58.96±8.68 |
| 性别 | 女 | 6 302（53.12） |
| 男 | 5 561（46.88） |
| 受教育程度 | 高中以下 | 10 442（88.02） |
| 高中及以上 | 1 421（11.98） |
| 婚姻状况 | 已婚 | 10 581（89.19） |
| 未婚 | 1 282（10.81） |
| 居住地 | 城镇 | 4 225（35.61） |
| 农村 | 7 638（64.39） |
| 吸烟 | 是 | 3 564（30.32） |
| 否 | 8 189（69.68） |
| 饮酒 | 是 | 4 233（35.68） |
| 否 | 7 630（64.32） |
| 慢性病数量 | 无 | 5 172（43.60） |
| 有一种 | 3 049（25.70） |
| 有两种及以上 | 3 642（30.70） |
| ADL失能 | 无 | 9 792（95.12） |
| 有 | 502（4.88） |
| IADL失能 | 无 | 10 601（89.36） |
| 有 | 1 262（10.64） |
), ArticleFig(id=1241025217015902624, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241025208711181173, language=CN, label=表1, caption=
研究对象的一般特征（n=11 863）［（
），n（%）］
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | | 人数/均值 |
|---|
| 年龄（岁） | | 58.96±8.68 |
| 性别 | 女 | 6 302（53.12） |
| 男 | 5 561（46.88） |
| 受教育程度 | 高中以下 | 10 442（88.02） |
| 高中及以上 | 1 421（11.98） |
| 婚姻状况 | 已婚 | 10 581（89.19） |
| 未婚 | 1 282（10.81） |
| 居住地 | 城镇 | 4 225（35.61） |
| 农村 | 7 638（64.39） |
| 吸烟 | 是 | 3 564（30.32） |
| 否 | 8 189（69.68） |
| 饮酒 | 是 | 4 233（35.68） |
| 否 | 7 630（64.32） |
| 慢性病数量 | 无 | 5 172（43.60） |
| 有一种 | 3 049（25.70） |
| 有两种及以上 | 3 642（30.70） |
| ADL失能 | 无 | 9 792（95.12） |
| 有 | 502（4.88） |
| IADL失能 | 无 | 10 601（89.36） |
| 有 | 1 262（10.64） |
), ArticleFig(id=1241025217141731753, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241025208711181173, language=EN, label=Table 2, caption=
Multinomial logistic regression results for cognitive function and depressive symptoms trajectories
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | | 认知功能与抑郁症状的轨迹OR（95%CI） |
|---|
| G1组 | G2组 | G4组 |
|---|
| 年龄（岁） | | 1.08***（1.07～1.09） | 1.06***（1.05～1.07） | 1.00（0.99～1.00） |
| 性别（参考组：男性） | | 2.20***（1.93～2.52） | 4.70***（3.82～5.78） | 1.73***（1.47～2.03） |
| 受教育程度（参考组：高中以下） | | 0.13***（0.10～0.16） | 0.07***（0.04～0.12） | 0.49***（0.40～0.59） |
| 婚姻状况（参考组：已婚） | | 1.42***（1.18～1.69） | 2.09***（1.67～2.60） | 1.54***（1.24～1.91） |
| 居住地（参考组：城镇） | | 2.57***（2.30～2.86） | 4.26***（3.59～5.07） | 1.70***（1.50～1.92） |
| 吸烟（参考组：否） | | 1.23**（1.08～1.41） | 1.26*（1.02～1.56） | 1.32***（1.13～1.56） |
| 饮酒（参考组：否） | | 0.93（0.83～1.05） | 0.89（0.74～1.06） | 0.87（0.76～1.01） |
| 慢性病数量（参考组：无慢性病) | 一种 | 0.96（0.85～1.09） | 1.31**（1.08～1.58） | 1.22*（1.05～1.42） |
| 两种及以上 | 0.90（0.80～1.02） | 1.77***（1.49～2.10） | 1.76***（1.53～2.03） |
| ADL残疾（参考组：无） | | 1.83**（1.61～2.12） | 1.92***（1.39～2.65） | 1.90***（1.40～2.58） |
| IADL残疾（参考组：无） | | 3.32***（2.70～4.09） | 7.43***（5.90～9.35） | 2.71***（2.14～3.42） |
), ArticleFig(id=1241025217254977967, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241025208711181173, language=CN, label=表2, caption=
认知功能与抑郁症状不同轨迹的多分类logistic回归分析结果
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | | 认知功能与抑郁症状的轨迹OR（95%CI） |
|---|
| G1组 | G2组 | G4组 |
|---|
| 年龄（岁） | | 1.08***（1.07～1.09） | 1.06***（1.05～1.07） | 1.00（0.99～1.00） |
| 性别（参考组：男性） | | 2.20***（1.93～2.52） | 4.70***（3.82～5.78） | 1.73***（1.47～2.03） |
| 受教育程度（参考组：高中以下） | | 0.13***（0.10～0.16） | 0.07***（0.04～0.12） | 0.49***（0.40～0.59） |
| 婚姻状况（参考组：已婚） | | 1.42***（1.18～1.69） | 2.09***（1.67～2.60） | 1.54***（1.24～1.91） |
| 居住地（参考组：城镇） | | 2.57***（2.30～2.86） | 4.26***（3.59～5.07） | 1.70***（1.50～1.92） |
| 吸烟（参考组：否） | | 1.23**（1.08～1.41） | 1.26*（1.02～1.56） | 1.32***（1.13～1.56） |
| 饮酒（参考组：否） | | 0.93（0.83～1.05） | 0.89（0.74～1.06） | 0.87（0.76～1.01） |
| 慢性病数量（参考组：无慢性病) | 一种 | 0.96（0.85～1.09） | 1.31**（1.08～1.58） | 1.22*（1.05～1.42） |
| 两种及以上 | 0.90（0.80～1.02） | 1.77***（1.49～2.10） | 1.76***（1.53～2.03） |
| ADL残疾（参考组：无） | | 1.83**（1.61～2.12） | 1.92***（1.39～2.65） | 1.90***（1.40～2.58） |
| IADL残疾（参考组：无） | | 3.32***（2.70～4.09） | 7.43***（5.90～9.35） | 2.71***（2.14～3.42） |
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