Trajectories of depressive symptoms and subsequent cognitive decline in older adults: a pooled analysis of two longitudinal cohorts

Zhu, Yidan; Li, Chenglong; Xie, Wuxiang; Zhong, Baoliang; Wu, Yangfeng; Blumenthal, James A

doi:10.1093/ageing/afab191

Cited by 112Dementia and Cognitive Impairment ResearchAging, Health, and DisabilityAging and Gerontology Research

Trajectories of depressive symptoms and subsequent cognitive decline in older adults: a pooled analysis of two longitudinal cohorts

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Zhu, Yidan, Li, Chenglong, Xie, Wuxiang, Zhong, Baoliang, Wu, Yangfeng, Blumenthal, James A·2022·Age and Ageing

DOI 10.1093/ageing/afab191

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Abstract

Background: the course of depression is variable, but it is unknown how this variability over time affects long-term cognitive decline. Objective: to examine the relationship of different trajectories of depressive symptoms on rates of subsequent cognitive decline in older adults. Design: population-based cohort study. Setting: communities in the USA and England. Subjects: 17,556 older adults from the Health and Retirement Study and the English Longitudinal Study of Ageing. Methods: depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, and trajectories were calculated using group-based trajectory modelling. Global cognitive function and three cognitive domains of memory, executive function and temporal orientation were assessed for up to 18 years. Results: five trajectories of depressive symptoms were identified. Compared with the ‘non-depressed’ trajectory, the ‘worsening depressive symptoms’ trajectory (pooled β = −0.016 standard deviation (SD)/year, 95% confidence interval (CI): −0.021 to −0.010), ‘persistent depressive symptoms’ trajectory (pooled β = −0.016 SD/year, 95% CI: −0.024 to −0.008), and ‘mild depressive symptoms’ trajectory (pooled β = −0.008 SD/year, 95% CI: −0.014 to −0.003) were associated with faster rates of cognitive decline, while no such association was found for the ‘improving depressive symptoms’ trajectory (pooled β = 0.001 SD/year, 95% CI: −0.010 to 0.012). Conclusions: subthreshold depressive symptoms are associated with an increased rate of cognitive decline, while individuals who show improving depressive symptoms do not exhibit accelerated cognitive decline. These findings raise the possibility that maintaining depressive symptoms as low as possible and ignoring the clinical threshold, might mitigate cognitive decline in older adults.

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ML and AI techniques, such as deep learning and longitudinal modeling, can analyze large, complex datasets spanning multiple life stages to identify patterns and trajectories of health and disease over time.
“ML and AI techniques, such as deep learning and longitudinal modeling, can analyze large, complex datasets spanning multiple life stages to identify patterns and trajectories of health and disease over time [30, 31].”
From Integrating machine learning and artificial intelligence in life-course epidemiology: pathways to innovative public health solutions (2024) · cites this paper as [30]
Unsupervised learning techniques, such as clustering and latent class analysis, can uncover distinct subgroups of individuals with similar developmental trajectories, which may inform the timing of interventions.
“Unsupervised learning techniques, such as clustering and latent class analysis, can uncover distinct subgroups of individuals with similar developmental trajectories, which may inform the timing of interventions [30, 31].”
From Integrating machine learning and artificial intelligence in life-course epidemiology: pathways to innovative public health solutions (2024) · cites this paper as [30]

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Longitudinal associations between late-life depression, cerebrovascular disease and cognition
Loyal, M. S., Numbers, K. T., Reppermund, S., Brodaty, H., Sachdev, P. S., Mewton, L. R., Jiang, J., & Lam, B. C. P. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.01.147 · Cited by 9 · see citing works
Association between multimorbidity trajectories and subsequent cognitive decline: evidence from two nationwide longitudinal cohorts
Wang, L., Lou, Y., Jiang, Q., Wang, H., Huang, S., Xie, Y., Wang, F., & Cao, S. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119958 · Cited by 9 · see citing works
Association between internal migration experience and depressive symptoms: analysis of PSID data
Liao, Z.-X., Tan, X.-M., Zhao, Y., Sun, X.-C., & Yi, F. (2023) · BMC Public Health · doi:10.1186/s12889-023-16073-0 · Cited by 9 · see citing works
“Control variables Previous studies have found that sex [1, 25, 26], age [25– 27], marital status [26–28], developmental environment [29], and health-related quality of life [30–32], among others, are influencing factors of depressive symptoms.”
Background
Core Symptoms and Dynamic Interactions of Depressive Symptoms in Older Chinese Adults: A Longitudinal Network Analysis
Feng, Y., Chen, L., Yuan, Q., Ma, L., Zhao, W., Bai, L., & Chen, J. (2025) · Depression and Anxiety · doi:10.1155/da/8078557 · Cited by 8 · see citing works
The association between subjective cognitive decline and trajectories of objective cognitive decline: Do social relationships matter?
Pai, M., Lu, W., Chen, M., & Xue, B. (2023) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2023.104992 · Cited by 9 · see citing works
Depression Trajectories, Genetic Risk, and Cognitive Performance in Older Adults: Multilevel Model with a 10-Year Longitudinal Cohort
Liu, Z., Su, Y., Huang, R., Li, R., Wei, Z., He, L., Pei, Y., Yu, M., Hu, X., & Peng, X. (2023) · Gerontology · doi:10.1159/000530200 · Cited by 7 · see citing works
Folate Deficiency Increased Microglial Amyloid-β Phagocytosis via the RAGE Receptor in Chronic Unpredictable Mild-Stress Rat and BV2 Cells
Fan, J., Ma, Z., Zheng, Y., Zhang, M., Huang, L., & Liu, H. (2023) · Nutrients · doi:10.3390/nu15163501 · Cited by 7 · see citing works
“These symptoms may serve as early indicators of the dementing process [5,7].”
Background
Trajectories of depressive symptom and its association with air pollution: evidence from the Mr. OS and Ms. OS Hong Kong cohort study
Zhao, Y., Liu, Q., Chen, Y., Kwok, T. C. Y., Leung, J. C. S., Feng, H., & Wong, S. Y. S. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-04731-w · Cited by 7 · see citing works
“The concentration of PM approximately 10% of individuals falling into the persistent high-risk group [7, 60–62].”
Background
Mechanistic exploration of the shenlian formula in the suppression of atherosclerosis progression via network pharmacology and in vivo experimental validation
Xing-xing, C., Ri-jin, H., Wang, X., Cai-ying, Y., Qing, Y., Chen, Y., Li, Q., Zhu, X., Lihong, Y., Cheng, L., et al. (2024) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2024.118347 · Cited by 7 · see citing works
Does the coexistence of pain and depressive symptoms accelerate cognitive decline?
Tofani, P. S., Máximo, R. D. O., Cochar-Soares, N., Ramírez, P. C., Luiz, M. M., Lima, S. S., da Silva, T. B. P., de Souza, T. B., Silveira, L. C., Guandalini, V. R., et al. (2024) · Aging & Mental Health · doi:10.1080/13607863.2024.2392737 · Cited by 7 · see citing works
“…also improve over time; (2) evidence that individuals who experience improvement in depressive symptoms also show significant cognitive improvement (Zhu et al., 2022); and (3) the presence of moderate/intense pain exacer-bating depressive symptoms, reinforcing the dual mechanism of brain injury…”
Depressive intensity, duration, and their associations with cognitive decline: a population-based study in Korea
Lu, K., Wang, W., Wang, J., Du, Q., Li, C., Wei, Y., Yao, M., Zhang, T., Yin, F., & Ma, Y. (2025) · GeroScience · doi:10.1007/s11357-025-01518-8 · Cited by 7 · see citing works
“Several studies have explored the associations between trajectories of depression and cognitive decline and have shown that worsening or persistent severe depressive symptoms contribute to greater cognitive decline [45, 50].”
Self-citation
Genetic similarities and differences among distinct definitions of depression
Wu, Y., Wang, L., Zhang, C., Li, M., & Li, Y. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114843 · Cited by 6 · see citing works
Self-citation
Cognitive decline among older adults with depressive symptoms before and during the COVID-19 pandemic
Zheng, F., Liang, J., Li, C., Gao, D., & Xie, W. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.10.051 · Cited by 6 · see citing works
Self-citation
Trajectories and influencing factors of cognitive function and physical disability in Chinese older people
Cheng, S., Yin, R., Wu, K., Wang, Q., Zhang, H., Ling, L., Chen, W., & Shi, L. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1380657 · Cited by 6 · see citing works
Causal relationship between dietary habits and Alzheimer's disease risk: a univariable and multivariable Mendelian randomization study
Huang, Y., Zhao, M., Shen, H., Chen, S., Zhang, E., Sun, J., & Gao, X. (2025) · Food & Function · doi:10.1039/d4fo03636k · Cited by 5 · see citing works
Temporal Dynamics of Depressive Symptoms, Apathy, Daily Activities, and Cognitive Decline in Older People From the General Population: A Network Analysis
van der Slot, A. J. C., Mooijaart, S. P., van Dalen, J. W., Hoevenaar‐Blom, M. P., Richard, E., & Giltay, E. J. (2025) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2025.02.011 · Cited by 5 · see citing works
Association between pain interference and motoric cognitive risk syndrome in older adults: a population-based cohort study
Li, G., He, Z., Hu, J., Xiao, C., Fan, W., Zhang, Z., Yao, Q., Zou, J., Huang, G., & Zeng, Q. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-04974-7 · Cited by 5 · see citing works
“Sociodemographic factors included sex, age, race and ethnicity, and educational level (defined as high-level if they had 12 years of education or more) [35].”
Background
Safety and tolerability of vortioxetine versus serotonin reuptake inhibitors in late life depression: A systematic review and meta-analysis
Alessi, M. R., Barroso, D. C., Barbosa, E. C., Sehgal, K., Vieira, G. H., Miozzo, I. A., Freitas, V. T. H., Larcipretti, A. L. L., Balogun, M., Miyashiro, L., et al. (2025) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2025.104409 · Cited by 5 · see citing works
Association between adiposity and emergent depressive symptoms in a 10-years prospective cohort of older adults: The EpiFloripa Aging study
Ceolin, G., Moreira, J. D., Breda, V., Mendes, B. C., Gomes, F. A., Mansur, R. B., d’Orsi, E., Rieger, D. K., & Brietzke, E. M. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.03.009 · Cited by 5 · see citing works
Identifying Physiological and Cognitive Indicators of Subthreshold Depression and Major Depressive Disorder Progression Risk
Shimizu, A., Yokoyama, S., Fermin, A. S. R., Mitsuyama, Y., Mizoi, K., Yoshimoto, J., Furukawa, T. A., Takagaki, K., Okamoto, Y., Okamoto, Y., et al. (2026) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s526034 · Cited by 4 · see citing works
“…approximately 12% of StD cases transition to MDD, 6 and that persistent depressive symptoms are associated with cognitive decline and adverse brain outcomes in both older adults 38 and younger cohorts, 39 underscoring the consistent clinical significance of symptom persistence across generations.”
Cognitive decline among older adults with heart diseases before and during the COVID-19 pandemic: A longitudinal cohort study
Hua, R., Li, C., Gao, D., Zheng, F., & Xie, W. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.1077800 · Cited by 4 · see citing works
Self-citation
The Grip Strength Loss Rate and the Subsequent Cognitive Decline Rate in Older Adults: The Moderating Role of Social Isolation
Li, Y., Zhu, L., Zhang, C., Zhao, H., Wang, W., Guo, L., & Lu, C. (2024) · Innovation in Aging · doi:10.1093/geroni/igae055 · Cited by 4 · see citing works
“The details of cognitive assessment have been previously reported (24–26).”
BackgroundMethod
Trajectories of stroke severity and functional outcomes after endovascular treatment in ischemic stroke: A post hoc analysis of a randomized controlled trial
Huo, S., Gao, J., Lv, Q., Xie, M., Wang, H., Zhang, X., Xie, Y., Wu, M. F., Liu, R., Liu, X., et al. (2024) · Clinical Neurology and Neurosurgery · doi:10.1016/j.clineuro.2024.108248 · Cited by 4 · see citing works
Editorial: Epidemiology and clinical researches in atherosclerosis and cardiovascular disease
Gao, D., Cai, Y. S., Pan, Y., Ma, Q., & Xie, W. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1212269 · Cited by 4 · see citing works
Self-citation
Supporting the Development of Contactless Mental Health Assessment: An Explorations of the Relationships Between Gaze Patterns, Depression, Anxiety, and Insomnia
Zhang, S., Zhang, Z., Xu, R., Wei, X., & Zhang, J. (2025) · Lecture notes in computer science · doi:10.1007/978-3-031-92707-2_27 · Cited by 3 · see citing works
Childhood Adversity and Cognitive Function Across Physical‐Mental‐Cognitive Health Trajectories: A 10‐Year Longitudinal Study of Chinese Older Adults
Wang, Y., Yu, J., Yang, Y. T., & Chen, S. (2025) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.70162 · Cited by 3 · see citing works
Persistent depressive symptom trajectory is associated with cognitive impairment: a population-based longitudinal study of aging in Taiwan
Lin, H.-C., Lao, W.-L., Tseng, T.-C., & Yeh, C. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-05706-1 · Cited by 3 · see citing works
One-Year Changes in Depressive Symptoms and Cognitive Function Among Brazilian Older Adults Attending Primary Care
Rivoli, F. M. S., Galhardo, A. P. G. M., Lucchetti, G., Ésper, L. A., Ribeiro, Y. L., Santos, G. D. S., JOSÉ, H. M. G., Sousa, L., Low, G., & Vitorino, L. M. (2025) · Healthcare · doi:10.3390/healthcare13070807 · Cited by 3 · see citing works
“Depression may impair cognitive processes, such as memory, attention, and executive function, while cognitive decline can exacerbate depressive symptoms by reducing independence and quality of life [47].”
Longitudinal Trajectories of Cognitive Function Among Chinese Middle-Aged and Older Adults: The Role of Sarcopenia and Depressive Symptoms
Jin, S., Chao, J., Jin, Q., Yang, B., Tan, G., Wang, L., & Wu, Y. (2025) · Brain Sciences · doi:10.3390/brainsci15040408 · Cited by 3 · see citing works
“This is inconsistent with previous research on the relationship between depression and cognitive decline [52,53].”
Self-citation
Associations of depressive symptoms and lifestyles with cognitive function: results from two cross-sectional studies among middle-age and older Chinese populations
Chen, S., Ke, W., Guan, X., Hong, S., Wu, S., Yu, Z., Lin, J., Wang, C., Fu, M., Xiao, Y., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119573 · Cited by 3 · see citing works
Effects of thematic art programs on cognitive function and depressive symptoms in older adults
Jia, L.-M., & Tung, F.-W. (2024) · Educational Gerontology · doi:10.1080/03601277.2024.2422335 · Cited by 3 · see citing works
“This observation underscores the importance of addressing depressive symptoms of any severity (Zhu et al., 2022).”
Editorial: Epidemiology and clinical researches on neuropsychiatric disorders in aging
Xie, W., Zhong, B., Liang, L., & Cai, Y. S. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1108474 · Cited by 3 · see citing works
Self-citation
Depressive Symptoms Affect Cognitive Functioning from Middle to Late Adulthood: Ethnoracial Minorities Experience Greater Repercussions
Persin, M. J., Payen, A., Bateman, J. R., Alessi, M. G., Price, B. C., & Bennett, J. M. (2024) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-024-02121-x · Cited by 3 · see citing works
“While prior longitudinal evidence suggests that depressive symptoms predict cognitive decline among primarily White populations [13–15], our findings suggest among middle to late midlife adulthood, depressive symptoms take a toll on the cognitive functioning among ethnoracial minority individuals…”
The impact of household solid fuel use on depression trajectories in middle-aged and older adults: Findings from a longitudinal study in China
Huang, Y., Jin, X., Yi, X., Cui, Z., Li, M., Zhang, Z., Kuang, L., Song, R., Yi, W., Pan, R., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120071 · Cited by 2 · see citing works
Depressive symptom trajectories and risk of CVD among rural older adults in China: a CHARLS-based cohort study
Ding, D., Sun, X., Cai, J., Liu, H., & Luo, R. (2026) · BMC Public Health · doi:10.1186/s12889-026-26305-8 · Cited by 2 · see citing works
“Participants in the Increasing or Decreasing groups were characterised by a score change of at least five points across the observed waves (2011– 2020), accompanied by a notable shift in the depression severity category [33].”
Effects of multidomain intervention on cognitive function in older adults with cognitive impairment: A multicenter, four‐arm, cluster randomized trial
Yin, Z. D., Gao, X., Yang, H., Jie, W., Wang, A., & Wu, J. (2026) · Alzheimer s & Dementia Translational Research & Clinical Interventions · doi:10.1002/trc2.70221 · Cited by 2 · see citing works
The effects of sensorial and mobility frailty on the overall and domain-specific cognition performance of Chinese community-dwelling older adults
Ruan, J., Hu, X., Zhang, W., Zhang, M., Liu, Y., Han, Z., Ruan, Q., Bao, Z., & Yu, Z. (2024) · Medicine · doi:10.1097/md.0000000000038500 · Cited by 2 · see citing works
Risk Factors and Predictive Nomogram for Survival in Elderly Patients with Brain Glioma
Fan, Z., Zhao, W., Jiao, Y., Guo, S., Kou, Y., Chao, M., Wang, N., Zhou, C., Wang, Y., Liu, J.-H., et al. (2024) · Current Medical Science · doi:10.1007/s11596-024-2880-4 · Cited by 2 · see citing works
Clinical characteristics of schizophrenia, depression, and Alzheimer’s diseases among older adults: a retrospective study of 271 consecutive admissions
Wang, W., Ye, J., Wei, Y., Huang, J., Wang, H., Liu, F., Wu, S., Wu, J., Li, Z., Guo, J., et al. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1486626 · Cited by 3 · see citing works
“” The ﬁ ve answers to items 1, 4, 7, 9, and 12 were scored as 3 points, the 10 answers to items 2, 3, 5, 6, 8, 10, 11, 13, 14, and 15 received 1 point, and all answers to items “ no ” were scored as 0 points.”
Bidirectional relationships between television viewing and loneliness in middle-aged and older men and women
Liu, Z., Werneck, A. O., Herold, F., Lowe, C. J., Hallgren, M. Å., Cheval, B., Tari, B., Stubbs, B., Gerber, M., Falck, R. S., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119737 · Cited by 2 · see citing works
Comparison of the 10-, 14- and 20-Item CES-D Scores as Predictors of Cognitive Decline
Zinkunegi, A. J., Langhough, R. E., Johnson, S. C., Mueller, K. D., & Bruno, D. (2023) · Brain Sciences · doi:10.3390/brainsci13111530 · Cited by 2 · see citing works
“Moreover, a study of two longitudinal cohorts reported that the presence of persistent or deteriorating depressive symptoms were related to faster cognitive decline, even among individuals with mild symptoms [15].”
Background
Harmonization of Later-Life Cognitive Function Across National Contexts: Results from the Harmonized Cognitive Assessment Protocols (HCAPs)Preprint
Gross, A. L., Li, C., Briceño, E. M., Rentería, M. A., Jones, R. N., Langa, K. M., Manly, J. J., Nichols, E. L., Weir, D. R., Wong, R., et al. (2023) · medRxiv · doi:10.1101/2023.06.09.23291217 · Cited by 2 · see citing works
Self-citation
Late Life Cognitive Function Trajectory Among the Chinese Oldest-Old Population—A Machine Learning Approach
Hu, J., Ye, M., & Xi, J. (2024) · Journal of Gerontological Social Work · doi:10.1080/01634372.2024.2339982 · Cited by 1 · see citing works
“However, most studies, with only a few exceptions (Jia, Du, et al., 2020; Mukadam et al., 2019), have mainly focused on antecedents of one or two life domains (Mao et al., 2020; Yin et al., 2017; C.-E. Zhu et al., 2022).”
Influential
Effects of Persistent Depression on Recall Memory are Moderated by Subjective Age Levels: Evidence From Community‐Dwelling Older Adults
Hoffman, Y. S. G. (2025) · Stress and Health · doi:10.1002/smi.70023 · Cited by 1 · see citing works
Tracking symptom dynamics in people living with HIV on different treatment: a longitudinal cross-lagged panel network analysis
Xie, M., Liu, X., Yu, Y., Zhang, Z., Zhang, L., Zhang, J., & Wu, D. (2025) · Annals of Medicine · doi:10.1080/07853890.2025.2541090 · Cited by 1 · see citing works
“Such results resonate with the recent research that Zhu Y [31] presented, which showed that depressive symptoms’ trajectory was associated with faster rates of cognitive decline.”
The delta/alpha ratio in sleep EEG increases with the severity of depression in patients over 50 years old
Yang, L., Kong, X., Geng, H., Xie, P., Sun, Y., Lv, S., Guo, Y., Gao, X., Zhu, N., Li, J. J., et al. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07367-1 · Cited by 1 · see citing works
“Additionally, the risk of serious consequences such as cognitive decline, social isolation, and an increased risk of suicide is higher in middle-aged and elderly stages than other stages among patients with depression [2–4].”
The ten-year evolution of factors predicting depressive symptoms among the Chinese elderly: an analysis based on the random forest model
Wang, J., Chen, S., Wang, Y., & Sun, G. (2026) · Current Psychology · doi:10.1007/s12144-025-08701-2 · Cited by 1 · see citing works
Association between vitamin D supplement use and cognitive functioning: a longitudinal cohort study
Hua, R., Lam, C. S., Mok, V., & Cheung, Y. T. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-106050 · Cited by 1 · see citing works
Trajectories of depressive symptoms in older adults: Correlates and consequences for mortality
Harber-Aschan, L., Sjöberg, L., Triolo, F., & Dekhtyar, S. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.121409 · Cited by 1 · see citing works
Cognitive impairments among older adults in Bahir Dar City, Northwest Ethiopia: A community-based cross-sectional study
Anteneh, Y. E., Fentanew, M., Mekuria, B. A., Zinabu, F. S., Shiferaw, K. B., Takele, M. D., Chanie, S. T., Kassa, T., Eriku, G. A., Cherkos, K., et al. (2026) · Aging and Health Research · doi:10.1016/j.ahr.2026.100279 · Cited by 1 · see citing works
Effects of particulate matter exposures on depressive symptom trajectories: Evidence from a national longitudinal survey in China
Wang, H., Lou, Y., Xie, Y., Guo, Y., Wang, L., Chen, C., (王芙蓉), F. W., Jiang, Q., & Cao, S. (2026) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.70058 · Cited by 1 · see citing works
“First, our study constitutes one of the largest and most comprehensive analyses to date on PM pollution exposures and depressive symptoms in middle-aged 62 Third, this study used a WQS regression model to assess the effect of PM pollutant mixture on depressive symptom trajectories.”
Trajectories of Cognitive Function and Predictors Among Older Adults in Korea for 8 Years: A National Panel Data Analysis
Lee, D., & Tak, S. H. (2025) · Journal of Applied Gerontology · doi:10.1177/07334648251314281 · Cited by 1 · see citing works
“However, the relationship between depression and cognitive function in this study was inconsistent with previous research, which reported that more depressed participants experienced a signi ﬁ cantly steeper decline in cognitive function (Form´anek et al., 2020; Zhu et al., 2022).”
Longitudinal studies of older couples as a promising approach to understanding mechanisms of changes in cognition and mental health
Haley, W. E., & Elayoubi, J. (2023) · International Psychogeriatrics · doi:10.1017/s1041610222001260
Health, lifestyle, and contextual factors in healthy and pathological neurocognitive aging
Anderson, N. D., Gatto, H., & Myftaraj, E. (2024) · Elsevier eBooks · doi:10.1016/b978-0-12-820480-1.00129-7
Can working in agriculture have a favorable effect on depressive symptoms? Life satisfaction as a mediator
He, F., Li, X., Xu, X., Bao, S., Chen, Y., Liu, H., & Chen, Y. Y. (2025) · PLoS ONE · doi:10.1371/journal.pone.0325912
“Based on previous studies, we selected a series of covariates, including demographic characteristics such as age [23–25], gender [26,27], type of residential address [28], and marital states [29,30], as well as factors that have been validated by research to be highly correlated with depressive…”
Exploring depressive symptoms in Peruvian older adults living in extreme poverty: A network analysis study
Travezaño-Cabrera, A., Garófalo, C. S., & Vilca, L. W. (2025) · Mental Health & Prevention · doi:10.1016/j.mhp.2025.200446
Identification of factors associated with depression chronicity: An analysis of the Canadian Study on Aging (CLSA)
Spiegler, G., Su, Y., Li, M., Meng, X., & Schmitz, N. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120079
Effect of Early‐Onset Dementia on Job Loss in Japan: A Matched Cohort Database Study Using Health Insurance Claims Data
Sumitomo, K., Higashibeppu, Y., Tajima, M., Sato, H., & Sugiyama, E. (2025) · Psychogeriatrics · doi:10.1111/psyg.70117
“The selected major comorbidities included hypertension [14–17], hyperlipidaemia [18, 19], diabetes [15, 20–22], cerebral infarction [23, 24] and depression [25–27], all of which have been reported to be potentially associated with cognitive decline and the development of dementia.”
Additional file 5 of Trajectories of depressive symptom and its association with air pollution: evidence from the Mr. OS and Ms. OS Hong Kong cohort study
Zhao, Y., Liu, Q., Chen, Y., Kwok, T. C. Y., Leung, J. C. S., Feng, H., & Wong, S. Y. S. (2024) · Figshare · doi:10.6084/m9.figshare.26702695
Additional file 6 of Trajectories of depressive symptom and its association with air pollution: evidence from the Mr. OS and Ms. OS Hong Kong cohort study
Zhao, Y., Liu, Q., Chen, Y., Kwok, T. C. Y., Leung, J. C. S., Feng, H., & Wong, S. Y. S. (2024) · Figshare · doi:10.6084/m9.figshare.26702698
Additional file 1 of Trajectories of depressive symptom and its association with air pollution: evidence from the Mr. OS and Ms. OS Hong Kong cohort study
Zhao, Y., Liu, Q., Chen, Y., Kwok, T. C. Y., Leung, J. C. S., Feng, H., & Wong, S. Y. S. (2024) · Figshare · doi:10.6084/m9.figshare.26702683
Additional file 1 of Sex differences in changes of depressive symptoms among older adults before and during the COVID-19 pandemic: evidence from two longitudinal cohorts
Zheng, F., Li, C., Hua, R., Liang, J., Gao, D., & Xie, W. (2023) · Figshare · doi:10.6084/m9.figshare.22601650
Self-citation
Additional file 3 of Trajectories of depressive symptom and its association with air pollution: evidence from the Mr. OS and Ms. OS Hong Kong cohort study
Zhao, Y., Liu, Q., Chen, Y., Kwok, T. C. Y., Leung, J. C. S., Feng, H., & Wong, S. Y. S. (2024) · Figshare · doi:10.6084/m9.figshare.26702689
Additional file 2 of Trajectories of depressive symptom and its association with air pollution: evidence from the Mr. OS and Ms. OS Hong Kong cohort study
Zhao, Y., Liu, Q., Chen, Y., Kwok, T. C. Y., Leung, J. C. S., Feng, H., & Wong, S. Y. S. (2024) · Figshare · doi:10.6084/m9.figshare.26702686
Additional file 4 of Trajectories of depressive symptom and its association with air pollution: evidence from the Mr. OS and Ms. OS Hong Kong cohort study
Zhao, Y., Liu, Q., Chen, Y., Kwok, T. C. Y., Leung, J. C. S., Feng, H., & Wong, S. Y. S. (2024) · Figshare · doi:10.6084/m9.figshare.26702692
Accelerated Cognitive Decline in Pain-Insomnia-Depression Syndrome: Longitudinal Evidence and Protective Effects of Healthy Lifestyles
Zeng, Y., Song, Z., Zhang, L., Fang, S., Xie, J., Zhao, W., Zhang, D., & Li, S. (2026) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2025.106069
The effect of eHealth interventions on mental health and quality of life in older adults with subthreshold depression: A systematic review and meta-analysis
Wang, M., Xu, B., Zhang, C., Cui, N., & Sun, G. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.121379
20-year trajectories of depressive symptoms and subsequent functional limitation among middle-aged and elderly population: an analysis of longitudinal cohort
Li, Z. Y., & Qin, G. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.121492
A Dyadic Study of Depressive Symptom Trajectories and Health Lifestyle and Health Outcomes Among Middle-Aged and Older Couples: Evidence From the China Family Panel Studies
Yang, L., & Wang, L. (2026) · Research on Aging · doi:10.1177/01640275261452697

Trajectories of depressive symptoms and associated patterns of cognitive decline
Formánek, T., Csajbók, Z., Wolfová, K., Kučera, M., Tom, S. E., Aarsland, D., & Čermáková, P. (2020) · Scientific Reports · doi:10.1038/s41598-020-77866-6 · Cited by 98 · see citing works
Associations between trajectories of depressive symptoms and rate of cognitive decline among Chinese middle-aged and older adults: An 8-year longitudinal study
Zhang, B., Lin, Y., Hu, M., Sun, Y., Xu, M., Hao, J., & Zhu, C. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.110986 · Cited by 32 · see citing works
Persistent depressive symptom trajectory is associated with cognitive impairment: a population-based longitudinal study of aging in Taiwan
Lin, H.-C., Lao, W.-L., Tseng, T.-C., & Yeh, C. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-05706-1 · Cited by 3 · see citing works
Depressive symptoms and cognitive decline in older adults
Forbes, M., Lotfaliany, M., Mohebbi, M., Reynolds, C. F., Woods, R. L., Orchard, S. G., Chong, T. T. ‐., Agustini, B., O'Neil, A. E., Ryan, J. L., et al. (2024) · International Psychogeriatrics · doi:10.1017/s1041610224000541 · Cited by 35 · see citing works
Persistent depressive symptoms and cognitive decline in older adults
Zheng, F., Zhong, B., Song, X., & Xie, W. (2018) · The British Journal of Psychiatry · doi:10.1192/bjp.2018.155 · Cited by 107 · see citing works
Self-citation

Authors: Zhu, Y., Li, C., Xie, W., Zhong, B., Wu, Y., & Blumenthal, J. A.
Affiliations: Peking University (CN)
Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
Duke Medical Center (US)
Corresponding author: Xie, Wuxiang
ORCID: Zhu, Yidan
Li, Chenglong
Xie, Wuxiang
Wu, Yangfeng
Blumenthal, James A
Venue: Age and Ageing
Publisher: Oxford University Press (OUP)
Published: 2021-10-16
Volume: 51
Issue: 1
ISSN: 0002-0729 (ISSN-L)
1468-2834
DOI: 10.1093/ageing/afab191
OpenAlex: W3206498095
Cited by: 112
References: 37
Citations by year: 2026: 24 · 2025: 28 · 2024: 31 · 2023: 23 · 2022: 6
FWCI: 10.76
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: Age and Ageing (publishedVersion)
PubMed (publishedVersion)
Funders: Health Research and Educational Trust
Academy of Medical Sciences (NIF001-1005-P56804)
National Natural Science Foundation of China (81974489, 81974490)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
Keywords: depressive symptoms, cognitive decline, older adults, subthreshold depression, mild depressive symptoms, persistent depressive symptoms, memory, executive function, time orientation, global cognitive function
MeSH terms: Aged, Cognition, Depression, Humans, Longitudinal Studies, Cohort Studies, Cognitive Dysfunction

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Trajectories of depressive symptoms and subsequent cognitive decline in older adults: a pooled analysis of two longitudinal cohorts

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