基于双轨迹模型的老年人抑郁症状与身体功能障碍的关联性研究  

A study on the correlation between depression symptoms and physical functional impairment in the elderly based on a dual trajectory model

作　　者：张洁 李佳男 黄妤洁 徐德民 ZHANG Jie;LI Jia-nan;HUANG Yu-jie;XU De-min(School of Public Health,Xiamen University,Xiamen,Fujian 361000,China;不详)

机构地区：[1]厦门大学公共卫生学院,福建厦门361000 [2]复旦大学附属中山医院厦门医院医务部,福建厦门361000 [3]复旦大学附属中山医院心脏外科,上海200000

出　　处：《现代预防医学》2025年第3期513-519,共7页Modern Preventive Medicine

基　　金：厦门市医疗卫生重点项目(3502Z20234018)。

摘　　要：目的探索中国老年人抑郁症状和身体功能障碍发展轨迹间的双向关系。方法使用2011、2013、2015和2018年中国健康与养老追踪调查(CHARLS)的4轮数据,利用组基轨迹模型识别老年人抑郁症状和身体功能障碍不同轨迹组,并利用双轨迹模型评估抑郁症状和身体功能障碍轨迹组关联程度。结果组基轨迹模型将抑郁症状分为持续低抑郁症状组、抑郁症状下降组、抑郁症状上升组、持续高抑郁症状组。身体功能障碍分为无身体功能障碍组、身体功能障碍加重组、身体功能障碍缓解组和高身体功能障碍组。双轨迹分析表明抑郁症状下降组中,44.86%的人遵循身体功能障碍缓解轨迹;抑郁症状上升组中,37.58%的人遵循身体功能障碍加重轨迹。身体功能障碍加重组中,47.8%的人遵循抑郁症状上升轨迹;身体功能障碍缓解组中,41.9%的人遵循抑郁症状下降。结论在大多数情况下,抑郁症状和身体功能障碍轨迹是正相关的,抑郁症状下降通常伴随身体功能障碍缓解,抑郁症状上升伴随身体功能障碍加重。反之亦然。Objective To explore the bidirectional relationship between depression symptoms and physical functional impairment trajectories in Chinese elderly individuals.Methods Utilizing data from four waves of the China Health and Retirement Longitudinal Study(CHARLS)conducted in 2011,2013,2015,and 2018,we employed group-based trajectory modeling to identify distinct trajectory groups for depression symptoms and physical functional impairment among the elderly.A dual trajectory model was then used to assess the degree of association between these trajectory groups.Results The group-based trajectory model categorized depression symptoms into four groups:consistently low depression symptoms,decreasing depression symptoms,increasing depression symptoms,and consistently high depression symptoms.Physical functional impairment was classified into four groups:no physical functional impairment,worsening physical functional impairment,improving physical functional impairment,and high physical functional impairment.Dual trajectory analysis revealed that 44.86% of individuals in the decreasing depression symptoms group followed the improving physical functional impairment trajectory;conversely,37.58% of individuals in the increasing depression symptoms group followed the worsening physical functional impairment trajectory.Among those in the worsening physical functional impairment group,47.8% followed the increasing depression symptoms trajectory,while 41.9% of individuals in the improving physical functional impairment group followed the decreasing depression symptoms trajectory.Conclusion In most cases,there is a positive correlation between the trajectories of depression symptoms and physical functional impairment.A decrease in depression symptoms is typically associated with an improvement in physical functional impairment,while an increase in depression symptoms corresponds with a worsening of physical functional impairment,and vice versa.

关 键 词：抑郁症状 身体功能障碍 老年人 双轨迹模型 

分 类 号：R749.4[医药卫生—神经病学与精神病学]