老年人日常生活活动能力与抑郁症状和焦虑症状共存的关系研究  

The comorbid relationship between activities of daily living and symptoms of depression and anxiety in the elderly

作　　者：刘建康 李书[1] 蔺婧 徐富升 张愿 孙俐 徐晨婕[1] 杨洪喜 王耀刚 LIU Jian-kang;LI Shu;LIN Jing;XU Fu-sheng;ZHANG Yuan;SUN li;XU Chen-jie;YANG Hong-xi;WANG Yao-gang(School of Public Health,Tianjin Medical University,Tianjin 300070,China;不详)

机构地区：[1]天津医科大学公共卫生学院,天津300070 [2]天津医科大学护理学院

出　　处：《中国慢性病预防与控制》2022年第4期251-255,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：国家自然科学基金项目(91746205,72004160)。

摘　　要：目的 了解我国老年人日常生活活动能力(ADL)与抑郁症状和焦虑症状共存的关系,为提高老年人心理生活质量提供参考。方法 数据来源于2017—2018年中国老年健康影响因素追踪调查(CLHLS)。本研究共选取其中6 463份65岁及以上的有效样本进行分析。研究使用Katz日常生活功能指数量表和Lawton’s量表对老年人ADL状况进行测量。采用10项流调中心抑郁量表测量抑郁症状,采用广泛性焦虑量表测量焦虑症状。采用Stata 15.0和R 4.0.4进行多因素二分类logistic回归、无序多分类logistic回归,采用两步回归法进行中介作用分析。结果 3 858名65岁及以上老年人ADL受损,ADL受损率为59.7%。多因素二分类logistic回归调整多种混杂因素后结果显示,ADL受损者抑郁症状、焦虑症状发生风险的OR值分别为1.60(95%CI:1.41~1.82)、1.37(95%CI:1.12~1.68),均有统计学意义(P<0.01)。多分类logistic回归分析结果显示,调整混杂因素后,ADL受损与抑郁症状和焦虑症状共存的高发生风险相关,有统计学意义(OR=1.78,95%CI:1.42~2.25,P<0.01)。中介作用分析结果显示,睡眠不足(<6 h)是ADL受损与抑郁症状与焦虑症状共存之间的重要中介因素,中介效应占比为42.0%。结论 老年人ADL受损与抑郁症状和焦虑症状的发生密切相关,并且睡眠不足在这种关系中具有中介作用,对老年人ADL和睡眠状况的评估与筛查可以有效预防抑郁症状和焦虑症状的发生。Objective To understand the comorbid relationship between activities of daily living(ADL) and symptoms of depression and anxiety in the elderly,and provide the reference for improving the quality of mental life in the elderly. Methods The data were from the Chinese Longitudinal Healthy Longevity Survey(CLHLS) in 2017-2018. In present study,6 463 effective samples (≥65years old) were analyzed. The Katz scale and Lawton’s scale were used to measure the ADL in elderly;10 items of Center for Epidemiological Studies Depression Scale(CES-D) were used to measure depression symptom,Generalized Anxiety Disorder-7was used to measure the anxiety symptom. Binary multi-factor logistic regression analysis and unordered multi-factor logistic regression analysis were used to analyze the data;two-stage regression method was used to analyze the mediating role. The used softwares were Stata 15.0 and R 4.0.4. Results It was found that the number of subjects (≥65 years old) with impaired ADL was3 858 cases(59.7%). The binary multinomial logistic regression analysis showed that after adjusting the confounding factors,the risk OR values of depression symptoms and anxiety symptoms in the subjects with impaired ADL were 1.60(95%CI:1.41-1.82)and 1.37(95%CI:1.12-1.68),P<0.01. The unordered multinomial logistic regression analysis showed that after adjusting the confounding factors,the impaired ADL was related to the high risk for comorbid depression symptoms and anxiety symptoms(OR=1.78,95%CI:1.42-2.25,P<0.01). The mediating effect analysis showed that the short sleep duration(<6 h) was the important mediating factor between the impaired ADL and comorbid symptoms of depression and anxiety,the ratio of mediating effect was42.0%. Conclusion The impaired ADL is associate with higher risk of comorbid depression symptoms and anxiety symptoms,and the short sleep duration have mediating role in this association. The assessment and screening of ADL and sleep status in the elderly can effectively prevent the occurrence of depression symptoms

关 键 词：老年人 日常生活活动能力 抑郁症状 焦虑症状 睡眠时长 

分 类 号：R749[医药卫生—神经病学与精神病学]