关节炎对老年人认知功能的影响路径分析:日常活动能力的中介作用和社会参与的调节作用  

Pathway analysis of the effect of arthritis on cognitive functioning status in the elderly:the mediating effect of activities of daily living and the moderating role of social engagement

作　　者：牟艺帆 孙嘉颖 罗金萍 张宝轩 耿铭慧 尹文强 陈钟鸣 马东平 MOU Yi-fan;SUN Jia-ying;LUO Jin-ping;ZHANG Bao-xuan;GENG Ming-hui;YIN Wen-qiang;CHEN Zhong-ming;MA Dong-ping(School of Management,Shandong Second Medical University,Weifang,Shandong 261053,China;不详)

机构地区：[1]山东第二医科大学管理学院,山东潍坊261053 [2]“健康山东”重大社会风险预测与治理协同创新中心 [3]健康风险预警治理协同创新中心

出　　处：《现代预防医学》2025年第4期690-696,共7页Modern Preventive Medicine

基　　金：国家自然科学基金青年项目(72004164)。

摘　　要：目的探讨老年人关节炎患病与认知功能的关系,并验证日常活动能力的中介作用和社会参与的调节作用,为促进积极老龄化提供参考依据。方法本研究基于2020年中国健康与养老追踪调查(CHARLS)数据,采用PROCESS 4.1程序构建有调节的中介效应模型,分析日常活动能力及社会参与在老年人关节炎对认知功能影响中的作用机制。结果共有5882名老年人纳入本研究。关节炎对老年人认知功能具有显著的负向影响(β=-1.050,P<0.001);日常活动能力在两者之间起部分中介作用,中介效应显著(95%CI:-0.430~-0.194),效应值为-0.306,效应占比为29.1%;社会参与显著调节日常活动能力对认知功能的影响(β=1.594,P<0.001),对于低社会参与的老年人,日常活动能力对认知功能的预测作用更显著。结论日常活动能力在老年人关节炎患病与认知功能之间起中介作用;社会参与在日常活动能力和认知功能之间起调节作用;老年人应提高防范意识,减少该疾病的发生;家庭医生服务团队应加强对老年人关节炎的健康管理和早期干预,提供科学用药指导;加强老年人日常活动能力的提升;鼓励老年人多参与社会活动,增强其认知功能,实现积极老龄化。Objective To explore the relationship between the prevalence of arthritis and cognitive function in the elderly and to verify the mediating effect of activities of daily living(ADL)and the moderating effect of social engagement to provide a reference point for promoting active aging.Methods This study based on the data of China Health and Retirement Longitudinal Study(CHARLS)in 2020,a moderated mediated-effects model was constructed using the PROCESS 4.1 program to analyze the mechanisms of ADL and social engagement in the effects of arthritis on cognitive function in the elderly.Results A total of 5882 elderly were enrolled in this study.The prevalence of arthritis in the elderly had a significant negative effect on cognitive function(β=-1.050,P<0.001);ADL partially mediated between the two,with a significant mediating effect(95%CI:-0.430--0.194),and an effect value of-0.306,with an effect percentage of 29.1%;social engagement significantly moderated the effect of ADL on cognitive function(β=1.594,P<0.001),and the predictive effect of ADL on cognitive function was more significant for the elderly with low social engagement.Conclusion ADL mediates the relationship between arthritis prevalence and cognitive function in the elderly;social engagement moderates the relationship between ADL and cognitive function;the elderly should be more aware of precautions to reduce the incidence of the disease;family doctor service teams should strengthen the health management and early intervention of arthritis in the elderly and provide scientific guidance on the use of medication;enhance the ADL of the elderly;and encourage the social engagement of the elderly to strengthen their cognitive function and achieve active ageing.

关 键 词：关节炎 老年人 认知功能 日常活动能力 社会参与 

分 类 号：R165[医药卫生—公共卫生与预防医学]