BACKGROUND Depression comprises common psychological problems, and has been strongly related to neuroticism and perceived stress. While neuroticism has been shown to have a direct effect on depression, it also has an indirect effect via perceived stress. Among the elderly, cognitive function produces influences that should not be overlooked when investigating depression. This study aimed to determine the role of mediating effects of perceived stress as well as cognitive function on neuroticism and depression among elderly patients. METHODS This research constituted a secondary analysis, with data collected during the pre-operative period of 429 elderly individuals undergoing elective, noncardiac surgery. The evaluation included the Perceived Stress Scale, the Neuroticism Inventory, the Montreal Cognitive Assessment, and the Geriatric Depression Scale. Structural equation modeling was used to investigate the hypothesized model. RESULTS Neuroticism exhibited a significant indirect effect on perceived stress via depression and cognition (β = 0.162, 95% CI 0.026, 0.322, p = .002). Neuroticism initially had a direct effect on depression (β = 0.766, 95% CI 0.675, 0.843 p = 0.003); thereafter, it was reduced after covariates were added (β = 0.557, 95% CI 0.432, 0.668 p = 0.002). Based on this model, the total variance explained by this model was 67%, and the model showed an acceptable fit with the data. CONCLUSIONS Both perceived stress and cognitive function partially mediated the effect of neuroticism on depression, with perceived stress exhibiting a greater effect. TRIAL REGISTRATION The study protocol has been registered at Clinicaltrials.gov under registered number: NCT02131181.

中文翻译：

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感知压力和认知功能对老年人神经质和抑郁之间关系的作用：结构方程模型方法。

背景技术抑郁症包括常见的心理问题，并且与神经质和感觉到的压力密切相关。虽然神经质已被证明对抑郁症有直接影响，但它也通过感觉到的压力而具有间接影响。在老年人中，认知功能产生的影响在调查抑郁症时不容忽视。这项研究旨在确定老年患者感知压力以及认知功能对神经质和抑郁的中介作用。方法本研究构成了一项二级分析，收集了429例接受择期非心脏手术的老年患者的术前数据。评估包括感知压力量表，神经质量表，蒙特利尔认知评估，和老年抑郁量表。使用结构方程建模来研究假设的模型。结果神经质通过抑郁和认知对感知的压力表现出显着的间接影响（β= 0.162，95％CI 0.026，0.322，p = .002）。神经质最初对抑郁症有直接影响（β= 0.766，95％CI 0.675，0.843 p = 0.003）；此后，在添加协变量后将其降低（β= 0.557，95％CI 0.432，0.668 p = 0.002）。在此模型的基础上，该模型解释的总方差为67％，并且该模型显示出与数据可接受的拟合度。结论感知压力和认知功能均部分介导了神经质对抑郁的影响，感知压力表现出更大的作用。试验注册研究方案已在临床试验中注册。