People with posttraumatic stress disorder (PTSD) may have cognitive decline, a risk which can be particularly threatening at old age. However, it is yet unclear whether initial cognitive decline renders one more susceptible to subsequent PTSD following exposure to traumatic events, whether initial PTSD precedes cognitive decline or whether the effects are reciprocal.

This study examined the bidirectional longitudinal associations between cognitive function and PTSD symptoms and whether this association is mediated by depressive symptoms.

The study used data from two waves of the Israeli component of the Survey of Health, Ageing, and Retirement in Europe (SHARE), collected in 2013 and 2015. This study focused on adults aged 50 years and above (N = 567, mean age = 65.9 years). Each wave used three measures of cognition (recall, fluency, and numeracy) and PTSD symptoms following exposure to war-related events. Data were analyzed using mediation analysis with path analysis.

Initial PTSD symptoms predicted cognitive decline in recall and fluency two years later, while baseline cognitive function did not impact subsequent PTSD symptoms. Partial mediation showed that older adults with more PTSD symptoms had higher depressive symptoms, which in turn were linked to subsequent cognitive decline across all three measures.

This study reveals that PTSD symptoms are linked with subsequent cognitive decline, supporting approaches addressing this direction. It further indicates that part of this effect can be explained by increased depressive symptoms. Thus, treatment for depressive symptoms may help reduce cognitive decline due to PTSD.

患有创伤后应激障碍（PTSD）的人可能会出现认知能力下降，这种风险在老年时尤其具有威胁。然而，目前尚不清楚最初的认知能力下降是否会使人在经历创伤事件后更容易患上后续的 PTSD，最初的 PTSD 是否先于认知能力下降，或者这种影响是否是相互的。

这项研究检查了认知功能和创伤后应激障碍症状之间的双向纵向关联，以及这种关联是否是由抑郁症状介导的。

该研究使用了 2013 年和 2015 年收集的欧洲健康、老龄化和退休调查 (SHARE) 以色列部分的两波数据。这项研究重点关注 50 岁及以上的成年人（N = 567，平均年龄= 65.9 年）。每波都使用了三种认知衡量标准（回忆能力、流利程度和计算能力）以及接触战争相关事件后的创伤后应激障碍（PTSD）症状。使用中介分析和路径分析来分析数据。

最初的 PTSD 症状预示着两年后记忆力和流畅性的认知能力下降，而基线认知功能并不影响随后的 PTSD 症状。部分中介显示，患有更多 PTSD 症状的老年人有更高的抑郁症状，这反过来又与所有三项指标随后的认知能力下降有关。

这项研究表明，创伤后应激障碍症状与随后的认知能力下降有关，支持解决这一方向的方法。它进一步表明这种效应的部分原因可以通过抑郁症状的增加来解释。因此，治疗抑郁症状可能有助于减少创伤后应激障碍（PTSD）引起的认知能力下降。