社区老年人认知功能和抑郁情绪的纵向研究  

Cognitive function and depression in community-dwelling elderly:a longitudinal study

作　　者：李峥[1] 邹海欧[1] 王凌云[2] 姚秀钰[1] 李树亚 李小雪[1] 周滢[1] 谷嘉宁 张海宇 赵禹 尹敏 LI Zheng;ZOU Haiou;WANG Lingyun;YAO Xiuyu;LI Shuya;LI Xiaoxue;ZHOU Ying;GU Jianing;ZHANG Haiyu;ZHAO Yu;YIN Min

机构地区：[1]北京协和医学院护理学院,北京市100144 [2]北京市西城区德胜社区卫生服务中心 [3]中国医学科学院北京协和医院急诊科 [4]北京大学第一医院肾内科

出　　处：《中华护理杂志》2020年第9期1394-1398,共5页Chinese Journal of Nursing

基　　金：北京协和医学院2017年协和青年科研基金课题(2017330027)。

摘　　要：目的探究社区老年人认知功能和抑郁情绪间是否存在交叉延宕效应。方法基于纵向研究,分析2013年(基线)、2017年(随访)2个时间点社区老年人认知功能水平和抑郁情绪,通过构建结构方程模型分析认知功能与抑郁情绪之间是否存在交叉延宕效应。结果①方差分析结果显示,随时间的推移,社区老年人认知功能下降、抑郁情绪加重,且女性的下降程度更严重;②相关分析结果显示,基线认知功能得分与随访认知功能得分呈正相关(r=0.632,P<0.001),基线抑郁情绪得分与随访抑郁情绪得分呈正相关(r=0.485,P<0.001),随访认知功能得分与随访抑郁情绪得分呈负相关(r=-0.166,P=0.002),基线认知功能得分与基线、随访2个时间点的抑郁情绪得分不存在相关性(P>0.05);③交叉延宕分析结果显示,基线认知功能得分对随访认知功能得分(β=0.718,P<0.001)和随访抑郁情绪得分(β=-0.133,P=0.004)的预测作用有统计学意义,基线抑郁情绪得分与随访抑郁情绪得分的预测作用有统计学意义(β=0.518,P<0.001),基线认知功能得分与基线抑郁情绪得分间的预测作用有统计学意义(β=-0.155,P=0.006)。结论社区老年人认知功能和抑郁情绪均随时间发展而有下降趋势,老年男性的认知功能和抑郁情绪优于老年女性。2个时间点认知功能与抑郁情绪间互相预测的交叉延宕模型不成立,但社区老年人的基线认知功能水平对随访抑郁情绪有预测作用,二者间关系需进一步探究。Objective To explore the cross-lagged effect between cognitive function and depression in the elderly in communities. Methods Based on the longitudinal study,the cross-lagged panel model was used to analyze the cognitive function and depression performance of elderly people in 2013 and 2017. The cross-lagged effect was analyzed by the structural equation model. Results ①The results of ANOVA showed that the cognitive function and the depressive behavior have a decreasing trend with time,and the decline level of women is more severe;②The correlation analysis showed that the baseline cognitive function score was positively correlated with the follow-up cognitive function score(r=0.632,P<0.001);the baseline depression score was positively correlated with the follow-up depression score(r=0.485,P<0.001);the follow-up cognitive function score was negatively correlated with the followup depression score(r =-0.166,P =0.002);the baseline cognitive function score did not have correlation with the baseline and follow-up depression scores(P>0.05);③The results of cross-lagged regression analysis showed that the cognition at baseline positively predicted cognition at follow-up (β=0.718,P<0.001) and depressive symptoms at followup (β=-0.133,P=0.004);the depressive symptoms at baseline positively predicted those at follow-up (β=0.518,P<0.001).But there was no significant predicted effect between cognition at baseline and depressive symptoms at baseline (β=-0.155,P=0.006). Conclusion The baseline cognitive function level of the elderly in the community have a predictive effect on the follow-up of depression,while the baseline depression level have no predictive effect on the follow-up of cognitive function,and the relationship between the cognition and depression should be further explored.

关 键 词：老年人 认知 抑郁 交叉延宕 社区保健护理 

分 类 号：R473.2[医药卫生—护理学]