文献类型：期刊文献

英文题名：Combined Associations of Diabetes and Depressive Symptoms on Cognitive Impairment Risk in the Population Aged 60 or Older: Cross-Cohort Comparisons From NHANES and CHARLS

作者：Ma, Siheng[1];Wang, Qilong[2];Zhao, Dongrong[2];Wang, Huaning[1];Cai, Min[1]

第一作者：Ma, Siheng

通信作者：Cai, M[1]

机构：[1]Fourth Mil Med Univ, Xijing Hosp, Dept Psychiat, 127 Changle West Rd, Xian, Shaanxi, Peoples R China;[2]Gansu Univ Chinese Med, Lanzhou, Gansu, Peoples R China

第一机构：Fourth Mil Med Univ, Xijing Hosp, Dept Psychiat, 127 Changle West Rd, Xian, Shaanxi, Peoples R China

通信机构：[1]corresponding author), Fourth Mil Med Univ, Xijing Hosp, Dept Psychiat, 127 Changle West Rd, Xian, Shaanxi, Peoples R China.

年份：2026

卷号：23

期号：9

起止页码：1183

外文期刊名：PSYCHIATRY INVESTIGATION

收录：;Scopus(收录号：2-s2.0-105049463210);WOS:【SSCI(收录号:WOS:001865115200008)，SCI-EXPANDED(收录号:WOS:001865115200008)】；

基金：This research was funded by the Clinical Research Program of the Xijing Hospital (XJZT24LY35) and the Fourth Military Medical University (No. 2023LC2306) , Shaanxi Province Science and Technology New Star Project (No. 2023KJXX-024) .

语种：英文

外文关键词：Diabetic cognitive impairment; Depressive symptoms; Synergistic effects; Cohort studies; Cross-cultural comparison

摘要：Objective Diabetes mellitus (DM) and cognitive impairment (CoI) are correlated, but the combined impact of depressive symptoms on CoI risk in older adults remains unclear. Methods This study included 1,200 U.S. adults aged >= 60 years (National Health and Nutrition Examination Survey, NHANES) and 1,500 Chinese adults (China Health and Retirement Longitudinal Study, CHARLS). DM was defined by laboratory measures or self-report; depressive symptoms were assessed via the Patient Health Questionnaire-9 (PHQ-9) (NHANES) and CES-D-10 (CHARLS); CoI was measured using the CERAD battery (NHANES) and situational memory/mental integrity scores (CHARLS). Multivariate logistic regression estimated associations of DM and depressive symptoms with CoI. Additive interaction was evaluated by the relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S). Restricted cubic spline (RCS) analyses examined Results Both DM and depressive symptoms were independently and significantly associated with CoI. After multivariate adjustment, diabetic patients exhibited significantly increased CoI risk; depressive symptoms similarly elevated CoI risk. Interaction analysis revealed an additive effect when DM co-occurred with depressive symptoms in CHARLS but not in NHANES. Mediation analyses further suggest bidirectional associations: in CHARLS, diabetes and depressive symptoms appear to mediate each other's effects on CoI. Additionally, RCS analysis in NHANES indicated a nonlinear interaction between depressive symptom severity (PHQ-9) and DM on CoI (p<0.05). Conclusion The observed associations varied across cohorts, with a significant additive interaction between diabetes and depressive symptoms found only in the CHARLS cohort. Integrating metabolic and mental health screening and interventions may optimize cognitive outcomes in high-risk older adult populations. Psychiatry Investig 2026;23(9):1183-1195