Additive effects of depression and abdominal obesity on cognitive function in middle-aged and older population: evidence from multinational cohorts
Bibliographic record
Abstract
BACKGROUND: This study aimed to investigate the joint trajectories of obesity/abdominal obesity and depression, and their association with cognitive function among four nationally representative cohorts. METHODS: We used data from four nationally representative cohorts (China, UK, USA, and Mexico) in adults over the age of 45, which included a total of 114,633 participants. Kml3D clustering algorithm was conducted to identify the potential joint trajectories of obesity/abdominal obesity and depression of homogeneous groups. Generalized Estimating Equations (GEE) were performed to examine the joint trajectory of obesity/abdominal obesity and depression in relation to cognitive function. RESULTS: In all cohorts, the baseline "Comorbidity" (with both depression and obesity/abdominal obesity) exhibited significantly poorer performance on subsequent cognitive assessments compared to the "Neither condition" group (neither depression nor obesity). Cluster analysis and GEE revealed that when Body Mass Index (BMI) was used as an obesity indicator, individuals in the joint trajectory groups with depression trajectories (regardless of obesity trajectories) across four cohorts exhibited poorer cognitive performance compared to the Normal weight and No depressed group (CHARLS: β = - 0.35, 95% CI - 0.42 to - 0.28; ELSA: β = - 0.32, 95% CI - 0.44 to - 0.20; HRS: β = - 0.20, 95% CI - 0.27 to - 0.13, MHAS: β = - 0.15, 95% CI - 0.19 to - 0.10; all P < 0.001). Conversely, associations between the joint trajectory groups with obesity trajectories (regardless of depression trajectories) and cognitive function demonstrated significant heterogeneity across cohorts. Abdominal obesity measures indicated that the abdominal obesity or higher waist-to-height ratio (WHtR) and Depression group significantly contributed to cognitive decline compared to those in the No abdominal obesity and No depression group (CHARLS: β = - 0.31, 95% CI - 0.39 to - 0.23; ELSA: β = - 0.20, 95% CI 0.29 to - 0.12; HRS: β = - 0.20, 95% CI - 0.27 to - 0.14, all P < 0.001). CONCLUSIONS: Abdominal obesity and depression exert independent additive and fluctuating effects on measures of cognition in middle-aged and older persons. Strategies that broadly aim to decrease excess fat, notably abdominal obesity, represent near-term interventions that may beneficially influence aspects of cognition in depression.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".