老年人日常生活活动能力、自评健康状况在慢性病影响抑郁症状中的效应研究  

Mediating role of activities of daily living and self-rated health in chronic disease-caused depressive symptoms among the elderly

作　　者：王怀昭 乔婷婷[2] 范艳存[2] WANG Huaizhao;QIAO Tingting;FAN Yancun(School of Public Health,Inner Mongolia Medical University,Hohhot,Inner Mongolia 010110,China;Inner Mongolia Medical University,Hohhot,Inner Mongolia 010110,China)

机构地区：[1]内蒙古医科大学公共卫生学院,内蒙古呼和浩特010110 [2]内蒙古医科大学,内蒙古呼和浩特010110

出　　处：《预防医学》2023年第7期574-577,共4页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：内蒙古自治区哲学社会科学规划项目(2022ZZA073);内蒙古自治区高等学校人文社会科学重点研究基地项目(JD20200101);内蒙古自治区高等学校科学技术研究项目(NJSY20144)。

摘　　要：目的探讨老年人日常生活活动能力(ADL)和自评健康状况在慢性病影响抑郁症状中的中介效应,为老年人抑郁防制提供依据。方法通过2018年中国健康与养老追踪调查数据库,收集年龄≥60岁老年人的基本情况、抑郁症状、慢性病、ADL和自评健康状况资料。采用HAYES等编译的Process程序构建多重线性回归模型,分析ADL和自评健康状况在慢性病患病数量影响抑郁症状中的中介效应,并采用Bootstrap法检验中介效应的显著性。结果纳入5892名老年人资料进行分析,年龄为(68.42±6.23)岁;男性2744人,占46.57%。抑郁症状得分M(QR)为8(10)分;慢性病患病数量M(QR)为1(1)种;ADL得分M(QR)为12(3)分;自评健康得分M(QR)为3(1)分。中介效应分析结果显示,老年人慢性病患病数量通过ADL和自评健康状况的独立中介效应影响抑郁症状(β=0.163,95%CI:0.120~0.206;β=0.303,95%CI:0.259~0.351),也通过ADL和自评健康状况的链式中介效应影响抑郁症状(β=0.057,95%CI:0.043~0.074);总中介效应占总效应的58.44%。结论老年人慢性病患病数量通过增加ADL受损和降低自评健康水平增加抑郁症状发生风险。Objective To investigate the mediating role of activities of daily living(ADL)and self-rated health in chronic disease-caused depressive symptoms among the elderly,so as to provide insights into depression control among the elderly.Methods Basic features,depressive symptoms,number of chronic diseases,ADL and self-rated health of the elderly at ages of 60 years and older were collected from the China Health and Retirement Longitudinal Study 2018.Multiple linear regression model was created using the Process program to examine the mediating role of ADL and self rated health in number of chronic disease-caused depressive symptoms,and the significance of the mediating role was tested using the Bootstrap test.Results A total of 5892 elderly participants were enrolled,with a mean age of(68.42±6.23)years and including 2744 men(46.57%).The participants had a median depressive symptom score of 8(interquartile range,10)points,a median number of chronic diseases of 1(interquartile range,1),a median ADL score of 12(interquartile range,3)points,and a median self-rated health score of 3(interquartile range,1)points.Mediation analysis showed that number of chronic diseases affected depressive symptoms via the independent mediating role of ADL(β=0.163,95%CI:0.120-0.206)and self-rated health(β=0.303,95%CI:0.259-0.351),and affected depressive symptoms via the chain mediating role of ADL and self-rated health(β=0.057,95%CI:0.043-0.074)among the elderly,and the gross mediating role consisted of 58.44%of total effects.Conclusions The number of chronic diseases may incease the risk of depressive symptoms through aggravating the impairment of ADL and decreasing self-rated health levels among the elderly.

关 键 词：抑郁 慢性病 日常生活活动能力 自评健康状况 

分 类 号：R749.4[医药卫生—神经病学与精神病学]