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Repetitive negative thinking associated with cognitive decline in older adults

Background Psychological problems such as depression and anxiety increase the risk of cognitive impairment in older adults. But mechanisms on the effect of psychological disorder on cognitive function is inconclusive. Repetitive negative thinking (RNT) is a core symptom of a number of common psychological disorders and may be a modifiable process shared by many psychological risk factors that contribute to the development of cognitive impairment. RNT may increase the risk of cognitive impairment. However, there are fewer studies related to RNT and cognitive function, and there is a lack of epidemiological studies to explore the relationship between RNT and cognitive function. Methods A cross-sectional study of 424 older adults aged 60 years or over was performed form May to November 2023 in hospital. To investigate the RNT level by using the Perseverative Thinking Questionnaire (PTQ), and investigate the cognitive function level by using the Montreal Cognitive Assessment Scale (MoCA). Multivariable linear regression and subgroup analyses were used to explore the relationship between RNT and cognitive function. Results We categorized the total RNT scores into quartiles. The multivariable linear regression analysis showed that after adjusting for all covariates, the participants in the Q3 and Q4 groups exhibited lower cognition scores (Q3:β = -0.180, 95%CI -2.849~-0.860; Q4:β = -0.164, 95% -2.611~-0.666) compared to the Q1 group. The results of the subgroup analyses showed that individuals aged 60 ~ 79 years, junior high school and above are more prone to suffer from cognitive impairment with a high RNT score. Conclusion The study reveals a negative association between RNT and cognitive function in community-dwelling older adults. However, multi-center and a longer time span cohort studies on the relationship between RNT and cognitive function should be carried out to further explore the mechanisms involved.

The association remained statistically significant across all multivariate linear regression models, even after controlling for various covariates such as age, occupation, marital status, living arrangement, education level, monthly income, and number of hobbies. The present study suggested that the risk of cognitive impairment increased with higher RNT scores among older adults, and the robustness of the finding was confirmed through adjustment for various potential confounding variables. Firstly, in examining the association between RNT and cognitive function, the study eliminated as many bias-inducing factors as possible to ensure more reliable results through previous research and by conducting in-depth analyses that took into account a variety of possible potential confounders.

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