宁夏≥55岁人群抑郁症状在信仰和认知功能关系中的效应研究

A study of depressive symptoms on relationship between beliefs and cognitive function in people aged ≥55 years old of Ningxia

目的分析宁夏≥55岁社区老年人群抑郁症状在信仰和认知功能水平关系中的效应,为深入研究社会因素影响认知功能的社会心理机制提供参考依据。方法采用典型抽样的方法,于2015—2017年选取宁夏银川市和吴忠市老年人口相对集中的5个社区,对所有符合纳入标准的3 311例,年龄≥55岁的社区居民进行日常生活能力量表(ADL)、简易智力状况检查量表(MMSE)、老年抑郁量表(GDS)和杜克信仰量表(DUREL)等量表的调查与评估。构建结构方程模型,分析抑郁症状在信仰与认知功能中的中介效应。结果 3 311例调查对象中,共有2 867例完成了全部测评,有效率为86.59%。男女比为1∶1.17;年龄55~<65岁1 760例(61.4%)、65~<75岁1 012例(35.3%)、≥75岁95例(3.3%);汉族与回族比例1∶3;文化程度中,文盲1 303例(45.4%),小学722例(25.5%),初中及以上942(29.4%)例;抑郁阳性592例(20.7%),认知功能障碍阳性466例(16.3%);高信仰人群抑郁阳性率(14.2%)低于非高信仰人群(20.2%),差异有统计学意义(P<0.05);高信仰人群在定向力、记忆力和语言能力优于无信仰的抑郁人群,差异有统计学意义(t=3.534、2.248、4.712,均P<0.05);老年抑郁与语言能力呈正相关(r_s=0.132);有组织的信仰与老年抑郁、定向力间存在负相关(r_s=-0.101,-0.053);个人信仰与老年抑郁、定向力、注意力及计算力、回忆力、语言能力间存在负相关(r_s=-0.116、-0.131、-0.109、-0.055和-0.180);内在信仰与定向力、回忆力和语言能力间均呈负相关关系(r_s=-0.070、-0.038、-0.070),差异均有统计学意义(均P<0.05);老年抑郁症在信仰和轻度认知功能障碍(MCI)间起部分中介效应,效应比为4.57%。结论宁夏地区老年人抑郁症和MCI患病率均较高,而信仰可以帮助改善认知功能障碍,老年抑郁在信仰和轻度认知功能障碍之间起部分中介效应。

Objective To analyze the mediating effect of depression symptoms between the beliefs and cognitive function level in community population aged≥55 years old of Ningxia,provide references for further study of the psychosocial mechanism of social factors affecting cognitive function.Methods Using a typical sampling method,five communities with relatively concentrated elderly population in Yinchuan City and Wuzhong City of Ningxia were selected from 2015-2017,to collect 3 311 community residents aged≥55 years old,who were compliance with inclusion criteria.All respondents were investigated with the the Activity of Daily Life Scale(ADL),the Simple Mental State Examination Scale(MMSE),the Geriatric Depression Scale(GDS)and the Duke Belief Scale(DUREL).The structural equation model was built to analyze the mediating effect of depressive symptoms on belief and cognitive function.Results Of the 3311 respondents,2 867 completed evaluations,with the effective rate of 86.59%.The ratio of male to female was 1∶1.17.There were 1 760(61.4%)people aged 55-<65 years old,1 012(35.3%)people aged 65-<75 years old and 95(3.3%)people aged≥75 years old.The ratio of Han to Hui was 1:3.As for the education level,1 303 people(45.4%)were illiterate,722(25.5%)were primary school students,and 942(29.4%)were junior middle school students or above.There were 592(20.7%)positive cases for depressive symptoms and 466(16.3%)positive cases for mild cognitive impairment(MCI).The positive rate of depression in the high-belief population(14.2%)was significantly lower than that in the non-belief population(14.2%),and the difference was statistically significant(P<0.05).The high-belief population was better than the non-belief population in the orientation,memory and language ability,and the difference was statistically significant(t=3.534,2.248,4.712,all P<0.05).The depression in the elderly was positively correlated with the language ability(r_s=0.132).The organized belief was negatively correlated with depression and orientation in the elderly(r_s=-0.101,-0.053).Personal belief was negatively correlated with depression,orientation,attention,computational ability,recall and language ability in the elderly(r_s=-0.116,-0.131,-0.109,-0.055,-0.180).There was a negative correlation between internal belief and orientation,recall and language ability(r_s=-0.070,-0.038,-0.070).All differences were statistically significant(all P<0.05).The senile depression had a partial mediating effect between belief and MCI,the regulating ratio was 4.57%.Conclusion In the elderly in Ningxia,the incidence of depression and mild cognitive dysfunction is high,and belief can help improve cognitive impairment.The senile depression has a partial mediating effect between belief and mild cognitive dysfunction.