Associations of cognitive function and depression with future cancer risk in middle-aged and older adults: Findings from a National China Survey

Background While links between depression and cancer risk are well documented, specific depressive symptoms involved remain unclear, as does the presence of associations between cognitive function and cancer risk. To address these gaps, we assessed associations of cognitive function levels and depressive symptoms with cancer occurrence among middle-aged and older Chinese adults. Methods This prospective cohort study utilized 2011 to 2020 data from the CHARLS, a population-based nationwide survey from China. Adults aged 45 years or older with cognitive function and depressive symptom data and no baseline cancer diagnosis were included for analysis. Global cognitive function scores were calculated for executive function and episodic memory performance using an adapted version of the Telephone Interview for Cognitive Status. Depressive symptoms were assessed using the CESD-10. Risk of events was reported based on adjusted HRs and 95 % CIs for cancer incidence, using a Cox proportional hazards regression model. Results Of 16,518 cancer-free adults (mean [SD] age: 56.5 [8.9] years) assessed at baseline, 244 new cancer cases were diagnosed (mean [SD] age: 57.6 [8.9] years) during a median follow-up period of 9 years (IQR, 7–9 years). A lower level of executive function (adjusted HR [95 %CI], 0.69 [0.52–0.92]) and higher somatic retardation levels (adjusted HR [95 %CI], 1.34 [1.00–1.79]) were associated with higher subsequent risk of cancer incidence, after controlling for the impact of demographic characteristics, health-related lifestyle factors and medical conditions. Conclusion In this longitudinal cohort study, lower initial levels of executive function and higher somatic retardation depressive symptom levels predicted higher subsequent cancer incidence.