中国中老年人躯体功能、自理能力障碍与抑郁症状的纵向关联及健康自评的中介作用
The longitudinal relationship between physical function,activities of daily living impairment,and depressive symptoms in middle-aged and older adults in China:the mediating role of self-rated health
李佩谦 1陈茂森 1张晗 1戴雅伊 1黄莹1
作者信息
- 1. 昆明医科大学公共卫生学院,云南 昆明 650500
- 折叠
摘要
目的 研究中国中老年人躯体功能、自理能力障碍和抑郁症状之间的纵向联系,并探索健康自评的中介作用.方法 采用中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)2013-2020年四期全国队列研究数据,共纳入7 899名≥45岁的研究对象.Cox比例风险回归模型用以分析障碍情况与抑郁症状的纵向关联,采用Process插件model 4构建模型,分析健康自评在两者之间的中介作用,并采用bootstrap法检验中介效应的显著性.结果 调整混杂因素后Cox比例风险回归结果显示,仅躯体功能障碍、仅自理能力障碍及双重障碍的中老年人出现抑郁症状的风险分别为无障碍的 1.408(95％CI:1.284～1.543)、1.447(95％CI:1.166～1.795)和 1.825(95％CI:1.636～2.034)倍(P＜0.001).健康自评在两者的关系中发挥了显著的部分中介效应,仅躯体功能障碍组中健康自评的效应占比最大,为24.29％,其次是双重障碍组和仅自理能力障碍组,分别为17.02％和12.15％.结论 中老年人躯体功能、自理能力障碍与抑郁症状之间存在纵向联系,且健康自评在两者间发挥部分中介作用.采取针对性干预措施,延缓中老年人身体机能老龄化,提高其健康自评水平,能有效控制中老年人抑郁的发生发展,实现预防关口前移.
Abstract
Objective To investigate the longitudinal relationship between physical function,impairment in activities of daily living,and depressive symptoms among middle-aged and older adults in China,as well as to explore the mediating role of self-rated health.Methods Data from the China Health and Retirement Longitudinal Study(CHARLS)national cohort from 2013 to 2020 were analyzed,including 7 899 participants aged 45 and older.The Cox proportional hazards regression model was employed to analyze the longitudinal association between impairment and depressive symptoms.The Process macro model 4 was used to construct the model,examining the mediating effect of self-rated health,with the Bootstrap method applied to test the significance of the mediation effect.Results After adjusting for confounding factors,the Cox proportional hazards re-gression results indicated that the risk of depressive symptoms for individuals with only physical function impairment,only activities of daily living impairment,and dual impairment was 1.408 times(95％CI:1.284-1.543),1.447 times(95％CI:1.166-1.795),and 1.825 times(95％CI:1.636-2.034)higher,respectively,compared to those without impairment(P＜0.001).Self-rated health played a significant partial mediating role in the relationship between the two,with the effect size being the largest in the group with only physical function impairment at 24.29％,followed by the dual impairment group at 17.02％,and the group with only activities of daily living impairment at 12.15％.Conclusion There is a longitudinal relationship be-tween physical function,activities of daily living impairment,and depressive symptoms among middle-aged and older adults.Additionally,self-rated health serves as a partial mediator in this relationship.Implementing targeted interventions to delay the aging of physical functions and improve self-rated health can effectively control the occurrence and progression of depres-sion in this population,facilitating a shift towards preventive measures.
关键词
抑郁症状/中老年人/中介效应/CHARLSKey words
Depressive symptoms/Middle-aged and older adults/Mediating effect/CHARLS引用本文复制引用
出版年
2024
NETL
NSTL
万方数据