老年人群中视听障碍对主观幸福感的影响:抑郁倾向的中介作用  

The impact of audio-visual impairments on subjective well-being status in the elderly:mediation by depressive tendency

作　　者：刘叶 高广峰 周亦凡 凯维萨·阿布杜许库尔 汪楚楚 罗剑锋 LIU Ye;GAO Guang-feng;ZHOU Yi-fan;Kaiweisa Abuduxukuer;WANG Chu-chu;LUO Jian-feng(Department of Biostatistics,School of Public Health,Fudan University,Shanghai 200032,China;NHC Key Laboratory of Health Technology Assessment(Fudan University),Shanghai 200032,China;Key Laboratory of Public Health Safety of Ministry of Education(Fudan University),Shanghai 200032,China;Dean’s Office,Shanghai Jiading District Hospital of Traditional Chinese Medicine,Shanghai 201800,China;Department of Ophthalmology,Shanghai Tenth People’s Hospital,Shanghai 200072,China)

机构地区：[1]复旦大学公共卫生学院生物统计学教研室,上海200032 [2]国家卫生健康委员会卫生技术评估重点实验室(复旦大学),上海200032 [3]公共卫生安全教育部重点实验室(复旦大学),上海200032 [4]上海市嘉定区中医院院长室,上海201800 [5]上海市第十人民医院眼科,上海200072

出　　处：《复旦学报（医学版）》2024年第4期558-565,共8页Fudan University Journal of Medical Sciences

摘　　要：目的探讨视听障碍(audio-visual impairments)对主观幸福感(subjective well-being,SWB)的影响,以及抑郁倾向是否中介了视听障碍与主观幸福感之间的关联。方法中国健康与退休纵向调查(The China Health and Retirement Longitudinal Survey,CHARLS)对45岁及以上的中老年人进行问卷调查,在全国30个省级行政单位中采用多阶段抽样,分别在县(区)-村(居)-家户-个人层面上进行抽样,并在县(区)-村(居)两级抽样中,采用按人口规模成比例的概率(proportional probability sampling,PPS)抽样,最终纳入了28个省份150个县(区)的450个村/社区。本研究基于2018年的CHARLS数据展开研究,纳入标准为:(1)年龄≥60岁;(2)有完整的自我报告的视力和听力状况;(3)至少含有生活满意度、主观期望寿命、自评健康状况3项主观幸福感指标中的一个。CHARLS使用Likert五分量表测定老年人的主观幸福感,使用10项流调中心抑郁自评量表(the Center for Epidemiology Studies Depression Scale-10,CESD-10)测定老年人的抑郁倾向。本研究采用多元回归分析视听障碍与抑郁倾向、主观幸福感之间的关联,并通过中介模型分析抑郁倾向的中介作用。双侧P值<0.05被认为有统计学意义。结果最终纳入符合标准的研究对象7620人。其中有视听障碍的患者抑郁倾向水平明显更高,主观幸福感的三项指标均较低(P值均小于0.05)。视觉障碍、听觉障碍和视听双重障碍与更高的抑郁倾向水平和更低的自评健康、主观期望寿命有关;视觉障碍和视听双重障碍与较低的生活满意度有关。抑郁倾向在视听双重障碍与生活满意度间及视觉障碍、听觉障碍、视听双重障碍与自评健康和主观期望寿命间起部分中介作用。结论在中国老年人群中,视听障碍与较低的主观幸福感状态有关,抑郁倾向在其中起着中介作用。Objective To investigate the impact of audio-visual impairments on subjective well-being(SWB),and whether the depressive tendency mediate the association between them.Methods The China Health and Retirement Longitudinal Survey(CHARLS)conducted a questionnaire survey on people aged 45 and above,using multi-stage sampling at the county(district)-village(residential)-household-individual level.In the county(district)-village(residential)level sampling,proportional probability sampling(PPS)was used according to population scale.This study was based on CHARLS data from 2018,and the inclusion criteria were(1)age≥60 years old;(2)having a complete self-reported visual and hearing condition;(3)at least one of the three subjective well-being indicators of life satisfaction,subjective life expectancy,and self-rated health status should be included.Likert five-component scale was used in CHARLS to measure the subjective well-being of the elderly,and the Center for Epidemiology Studies Depression Scale-10(CESD-10)was used to measure the depressive mood of the elderly.We used multiple regression to explore the association between vision and hearing impairment with depressive tendency and subjective well-being;and explored possible mediating effects through a mediation model.Two-side P values<0.05 were considered statistically significant.Results Finally,7620 people who met the standards were included.Individuals with audio-visual impairments had significantly higher levels of depression and lower levels of all three SWB measurements(all P values<0.05).Single vision impairment(SVI),single hearing impairment(SHI)and double sensory impairment(DSI)were associated with more depression tendencies,lower self-rated health(SRH),and subjective life expectancy(SLE).SVI and DSI were associated with lower life satisfaction.Depressive tendency partially mediated the association of DSI with LS and the associations of SVI,SHI,and DSI with SLE and SRH.Conclusion Audio-visual impairments are independently associated with lower SWB status amon

关 键 词：中国健康与退休纵向调查(CHARLS) 生活满意度 主观期望寿命 自评健康 抑郁倾向 视听障碍 老年人 

分 类 号：R749.2[医药卫生—神经病学与精神病学]