Objectives:

Depression both affects physical activity (PA) and cognition in older persons, yet its impact on the association between PA and cognitive decline is to be determined. We aimed to investigate the association between baseline PA and cognitive functioning over time, stratified for depression.

Methods:

We used data of the Netherlands Study of Depression in Older persons (NESDO), a multi-site cohort study with 6-years follow-up. Patients with complete data on PA and cognitive functioning at baseline were included, yielding 394 participants for the analyses of whom 297 were depressed and 97 non-depressed. PA (continuous) was measured with the International Physical Activity Questionnaire. Linear mixed models were used to determine differential effects of baseline PA on the rate of decline of 5 standardized outcomes of cognitive functioning over 6-year follow-up. For this purpose, we examined the significance of the interaction-term (PA*time) in both basic and adjusted models. We also assessed the association between time and cognitive functioning. All analyses were stratified for depression.

Results:

In both groups, no robust significant interactions of PA with time were found. Furthermore, only decline in working memory was significantly worse in the depressed compared to the non-depressed.

Conclusion:

At older age, the impact of a more inactive lifestyle on cognitive decline was shown to be limited, irrespective of depression that appeared to worsen age-related decline of working memory only. As a higher PA-level at older age has a positive effect on a multitude of other health outcomes, PA should still be encouraged in this population.

中文翻译：

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晚年抑郁会抵消身体活动对认知衰退的有益影响吗？NESDO 研究的结果

目标：

抑郁症会影响老年人的身体活动 (PA) 和认知能力，但其对 PA 与认知能力下降之间关联的影响尚待确定。我们旨在调查基线 PA 与认知功能之间的关联，并针对抑郁症进行分层。

方法：

我们使用了荷兰老年人抑郁症研究 (NESDO) 的数据，这是一项为期 6 年的多中心队列研究。包括在基线时具有完整的 PA 和认知功能数据的患者，产生 394 名参与者进行分析，其中 297 名抑郁症和 97 名非抑郁症。PA（连续）是用国际体力活动问卷测量的。线性混合模型用于确定基线 PA 对 6 年随访期间认知功能 5 项标准化结果下降率的不同影响。为此，我们检查了交互项（PA*time）在基本模型和调整模型中的重要性。我们还评估了时间和认知功能之间的关联。所有分析都针对抑郁症进行了分层。

结果：

在两组中，没有发现 PA 与时间的显着相互作用。此外，与非抑郁症患者相比，抑郁症患者的工作记忆下降明显更差。

结论：

在年龄较大时，较不活跃的生活方式对认知能力下降的影响被证明是有限的，无论抑郁症似乎只会恶化与年龄相关的工作记忆下降。由于较高年龄的 PA 水平对许多其他健康结果具有积极影响，因此仍应在该人群中鼓励 PA。