抑郁在老年人慢性病共病和睡眠时长之间的中介效应研究  

Mediating effect of depression between comorbidity of chronic diseases and sleep duration in elderly individuals

作　　者：于晴 李雪莹 官为民 苏文钰 葛怀举 董士红 马桂峰 刘建明 YU Qing;LI Xue-ying;GUAN Wei-min;SU Wen-yu;GE Huai-ju;DONG Shi-hong;MA Gui-feng;LIU Jian-ming(School of Public Health,Shandong Second Medical University,Weifang,Shandong 261053,China;不详)

机构地区：[1]山东第二医科大学公共卫生学院,山东潍坊261053 [2]山东第二医科大学基础医学院,山东潍坊261053

出　　处：《现代预防医学》2024年第19期3583-3587,3593,共6页Modern Preventive Medicine

基　　金：食品安全风险监测预警体系的评价与优化路径研究(LH2022GG06);山东省研究生教育教学改革研究项目(SDYJSJGC2023068);山东省本科教学改革研究项目(M2023344);山东省研究生优质教育教学资源项目(SDYKC2023146)。

摘　　要：目的 探讨抑郁在老年人慢性病共病和睡眠时长间的中介作用。方法 采用2018年中国健康与养老追踪调查追访数据,选取60岁及以上老年人样本共8 187例,采用流调中心抑郁水平评定量表(CES-D 10)测量抑郁状况,PROCESS 4.0程序检验抑郁在慢性病共病与睡眠时长间的中介效应,bootstrap法进行中介变量验证。结果 老年人抑郁症状检出3 109例,检出率为37.97%,慢性病共病患者5 270例,占64.37%,睡眠时长小于6 h者3 045例,占37.19%。老年人慢性病共病与抑郁间呈正相关关系(r=0.21,P<0.01),慢性病共病和抑郁均与睡眠时长呈负相关关系(r=-0.13、-0.27,P<0.01)。回归结果表示,慢性病共病情况和抑郁得分均对睡眠时长有影响(β=-0.31、-0.08,P<0.001)。慢性病共病对睡眠时长的总效应值为-0.52,直接效应值为-0.31,抑郁对睡眠时长的中介效应值为-0.21,占总效应的40.38%。结论 老年人睡眠时长不足问题不容忽视,慢性病共病、抑郁均是影响老年人睡眠时长的重要因素,抑郁在老年人慢性病共病与睡眠时长间起部分中介作用。Objective To explore the mediating role of depression in the relationship between comorbidity of chronic diseases and sleep duration in elderly individuals.Methods Utilizing data from the 2018 China Health and Retirement Longitudinal Study,8187 individuals aged 60 and above was selected.The Center for Epidemiologic Studies Depression Scale(CES-D 10)was employed to assess depression status.The PROCESS 4.0 macro was used to test the mediating effect of depression between chronic disease comorbidity and sleep duration,with Bootstrap methods applied for verification of the mediating variable.Results A total of 3109 cases of depressive symptoms were identified among the elderly,yielding a detection rate of 37.97%.Among the participants,5270 had chronic disease comorbidities,accounting for 64.37%,while 3045 individuals reported sleep duration of less than 6 hours,accounting for 37.19%.A positive correlation was found between chronic disease comorbidity and depression(r=0.21,P<0.01),while both chronic disease comorbidity and depression were negatively corre-lated with sleep duration(r=-0.13,-0.27,P<0.01).Regression results indicated that both chronic disease comorbidity and depression scores significantly affected sleep duration(β=-0.31,-0.08,P<0.001).The total effect of chronic disease comor-bidity on sleep duration was-0.52,with a direct effect of-0.31,and the mediating effect of depression on sleep duration was-0.21,accounting for 40.38%of the total effect.Conclusion The issue of insufficient sleep duration among the elderly war-rants attention,as both chronic disease comorbidity and depression are significant factors influencing sleep duration.Depres-sion plays a partial mediating role between chronic disease comorbidity and sleep duration in elderly individuals.

关 键 词：老年人 睡眠时长 慢性病共病 抑郁症状 中介效应 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R161.7[医药卫生—临床医学]