中文摘要：

【提要】目的探讨老年人群中认知损害与抑郁症之间的关系，为制定科学合理的认知损害与抑郁共病防治策略，提高老年人生存质量提供理论依据。同时，对重复测量资料的多水平模型在纵向资料研究中的优势进行探讨，为慢性病共病进展的影响因素及其变化规律分析提供方法学借鉴。方法利用太原市600名60岁及以上轻度认知损害老年人的3次随访资料，以反映认知功能的MoCA量表得分为应变量，探讨老年人认知功能随时间的变化趋势以及不同特征人群变化趋势的差异。结果多水平模型分析结果显示，年龄、婚姻、教育程度、目前生活居住情况、听力、看书读报、吸烟情况等个体背景变量对老年认知功能的影响有统计学意义。控制个体背景协变量之后抑郁与时间的交互项有统计学意义，与非抑郁组相比，抑郁组MoCA平均分值随时间下降的速率较快。结论老年认知功能与多种因素相关，老年抑郁会加剧老年人认知功能下降。重复测量多水平模型适用于慢性病纵向研究影响因素及其变化规律分析。

英文摘要：

Objective The aims of this study were：（ 1 ）to explore the relationship between cognitive impairment and depression among the elderly to provide scientific bases for formulating policies to improve their quality of life ; （ 2 ） to discuss the strength of multilevel model for longitudinal data analysis and to provide methodological reference for exploring influencing fac- tors and variation patterns for the progress of chronic diseases co - existing. Methods Our data came from three waves of re- peated measurement data of 600 older adults （ i〉 60 years old） in Taiyuan who suffered from mild cognitive impairment. With MoCA scores of the cognitive function as dependent variables, multilevel model of repeated measurement data was applied to find out the time trend and the trend differences among the elderly. Results Multilevel model analysis showed that individual background variables such as age, marriage, education, living situation, hearing, reading and smoking were the predictive factors for the elderly cognitive function. After controlling these individual background covariates,interaction of depression and time was statistically significant, and decline rate of MoCA scores for depression group was greater than non - depression group. Conclu- sion Various factors are related to cognition in older adults. The depression could promote the decline of cognition. Repeated measurement multilevel model is appropriate for the analysis of influencing factors and variation patterns in longitudinal study of chronic diseases.