社会参与、抑郁及领悟社会支持对社区老年人认知功能的影响

Effect of Social Participation,Depression and Perceived Social Support on Cognitive Function of Community-dwelling Older Adults

目的了解社区老年人认知功能现状及影响因素,分析抑郁在社会参与对认知功能影响中的中介作用,探索领悟社会支持在中介模型中的调节作用,为保护社区老年人认知功能、预防认知功能障碍提供新思路。方法2019年6—12月对海口市580名社区老年人进行问卷调查,问卷内容包括一般人口学特征、认知功能现状、社会参与、领悟社会支持及抑郁状况。结果580名老年人认知功能得分为(26.95±3.96)分,认知功能障碍现患率为19.14%(111/580)。社会参与得分可通过直接效应正向预测认知功能得分,也可通过抑郁的中介效应对社区老年人认知功能得分产生影响(β=0.121,95%CI:0.273~0.370);中介效应占总效应的比例为37.79%。社会参与对社区老年人认知功能的直接效应受到领悟社会支持的调节作用(β=-0.006,P<0.05),且社会参与对认知功能的直接效应针对平均水平、低水平领悟社会支持的个体更显著。结论在社会参与对社区老年人认知功能作用路径中,抑郁具有中介作用,领悟社会支持起到调节社会参与对认知功能直接效应的作用。

Objective To understand the status quo and influencing factors of cognitive function of community-dwelling older adults,analyze the mediating role of depression in the effect of social participation on cognitive function,and explore the regulatory role of social support in the mediation model,so as to provide new ideas for the protection of cognitive function and the prevention and intervention of cognitive dysfunction of community-dwelling older adults.Methods From June to December 2019,a total of 580 community-dwelling older adults in Haikou city were surveyed by a questionnaire,which included general demographic characteristics and status of cognitive function,social participation,perceived social support and depression.Results The cognitive function score of the 580 elderly people was 26.95±3.96,and the current incidence of cognitive dysfunction was 19.14%(111/580).The score of social participation could positively predict the score of cognitive function through direct effect,and could also affect the score of cognitive function through the mediating effect of depression(β=0.121,95%CI:0.273-0.370).The mediating effect accounted for 37.79%of the total effect.The direct effect of social participation on the cognitive function of community-dwelling older adults was moderated by perceived social support(β=-0.006,P<0.05),and was more significant for individuals with average level and low level of perceived social support.Conclusion Depression plays a mediating role in the effect of social participation on the cognitive function of community-dwelling older adults,and perceived social support plays a moderating role in the direct effect of social participation on the cognitive function.