Posttraumatic stress disorder, depressive symptoms, and cognitive function among middle-aged urban adults: Healthy Aging in Neighborhoods of Diversity across the Life Span study

Authors

• MF Georgescu
• MA Beydoun
• RH Pietrzak
• HA Beydoun
• NN Hooten
• S Banerjee
• MK Evans
• AB Zonderman

Abstract

Post-traumatic stress disorder (PTSD) and depressive symptoms have been linked to cognitive functioning. However, PTSD and depression impact on cognitive functioning, especially among middle-aged urban adults is not well understood. Cross-sectional data were analyzed from 1,434 participants from the Healthy Aging in Neighborhoods of Diversity across the Life Span study. We used multivariable adjusted linear regression and structural equations models (SM) testing association between PTSD, CES-D and cognitive test scores. We found PTSD strongly associated with depressive symptoms despite adjustment for potential confounders. SM cognitive test scores found delayed free recall and List A immediate recall inversely associated with PTSD score, with TEs of β±SE:-0.08398±0.02654, P=0.002 and β±SE:-0.10734±0.02571, P<0.001, respectively and IEs of β±SE:-0.06786±0.02202, P=0.002 and β±SE:-0.07625±0.02140, P<0.001, indicating depressive symptoms significantly mediated the potential association of PTSD with poorer verbal memory. Other cognitive test scores showed total or direct effects suggesting different pathways not including depressive symptoms as a mediator. At higher intima media thickness (IMT) tertiles, PTSD score strongly associated with total CES-D score. This study provides evidence of an association between PTSD and cognitive functioning among middle-aged urban adults, partially mediated through depressive symptoms in verbal memory, with IMT enhancing the association between PTSD and depressive symptoms.

Scientific Focus Area: Epidemiology

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