社会支持在老年人抑郁与衰弱间的中介作用

The mediation of social support in the association between depression and frailty in the elderly

目的分析老年人抑郁与衰弱的关系,探讨社会支持在两者间的中介作用。方法选取中国健康与养老追踪调查数据库(CHARLS)中2018年的11448名≥60岁的老年人为研究对象,采用χ^(2)检验分析老年人人口学特征、抑郁情况、社会支持情况对老年人不同程度衰弱的影响;采用多元无序logistic回归模型分别分析老年人抑郁情况、社会支持情况对衰弱的影响;采用多元线性逐步回归分析对社会支持的中介效应进行检验。结果Logistic回归分析结果显示,相比于无抑郁的老年人,患有抑郁的老年人衰弱(OR=9.67,P<0.01)和衰弱前期(OR=3.98,P<0.01)风险较高;高水平正式社会支持的老年人从无衰弱转变为衰弱前期(OR=0.73,P<0.05)或衰弱期(OR=0.62,P<0.05)的风险均较小;高水平非正式社会支持老年人从无衰弱转变为衰弱的风险同样较小(OR=0.81,P<0.05)。多元线性逐步回归检验显示,抑郁与衰弱呈显著正相关(β=0.532,P<0.01),抑郁与正式社会支持呈显著负相关(β=-0.119,P<0.01),同时纳入正式社会支持与抑郁后,抑郁对衰弱的作用降低但仍呈显著正相关(β=0.527,P<0.01)。结论老年人抑郁对衰弱有显著影响,且正式社会支持在其中发挥一定的中介作用。

Objective To explore the relationship between depression and frailty in the elderly,and analyze the mediating role of social support.Methods A total of 11448 elderly people(≥60 years old)from the China Health and Retirement Longitudinal Study Database(CHARLS)in 2018 were selected as the research objects.χ^(2) test was used to analyze the effects of demographic characteristics,depression and social support on different degrees of frailty in the elderly.Multivariate Logistic regression model was used to analyze the effects of depression and social support on frailty in the elderly.Multiple linear stepwise regression analysis was used to test the mediating effect of social support in depression and frailty.Results Logistic regression analysis showed that the elderly with depression,had a higher risk of frailty than(OR=9.67,P<0.01)and pre-frailty(OR=3.98,P<0.01)those without depression.Elderly with high levels of formal social support had a lower risk of transition from non-frailties to pre-frailties(OR=0.73,P<0.05)or frailties(OR=0.62,P<0.05).Elderly with high levels of informal social support also had a lower risk of transition from non-frailty to frailty(OR=0.81,P<0.05).Multiple linear regression test showed that depression was positively correlated with frailty(β=0.532,P<0.01),and negatively correlated with formal social support(β=-0.119,P<0.01).The effect of depression on frailty was decreased when formal social support was included,but remained positively correlated(β=0.527,P<0.01).Conclusion Depression in the elderly has a significant impact on frailty,and formal social support plays a mediating role.