社区老年人自我感知老化与认知功能间的关系:孤独感的中介作用和调节效应

Relationship between self-perceptions of aging and cognitive function in community elderly:the mediating and moderating effects of loneliness

目的探讨社区老年人自我感知老化和认知功能的关系及孤独感在两者间的中介作用和调节效应。方法2021年9—11月在锦州市进行多阶段分层抽样确定318例社区老年人为研究对象。采用一般资料调查表、简版自我感知老化量表(the brief ageing perceptions questionnaire,BAPQ)、孤独感量表(University of California,Los Angeles loneliness scale,UCLA Loneliness Scale,UCLA-LS)、简易精神状态量表(mini-mental state examination,MMSE)进行问卷调查。采用IBM SPSS 25.0软件对数据进行独立样本t检验、方差分析和Pearson相关分析,AMOS 22.0的Bootstrap程序进行中介效应分析和SPSSAU在线分析程序中模型进行调节作用检验。结果社区老年人自我感知老化得分(44.85±12.48)分,孤独感得分(41.70±8.73)分,认知功能得分(24.87±3.40)分。存在认知障碍的老年人65例,检出率为20.44%(65/318)。自我感知老化、孤独感和认知功能得分两两显著相关(均P<0.05)。社区老年人自我感知老化对认知功能有负向影响(β=-0.467,P<0.01),自我感知老化对孤独感有正向影响(β=0.585,P<0.01),孤独感对认知功能有负向影响(β=-0.234,P<0.01)。孤独感在自我感知老化与认知功能间的标准化间接效应为-0.137,中介效应占总效应的22.68%。孤独感在自我感知老化与认知功能间起到调节作用(β=-0.114,t=-2.26,P=0.025)。结论自我感知老化和孤独感对老年人认知功能有预测作用,孤独感在自我感知老化和认知功能间起部分中介作用和调节作用。尽早发现老年人的负面衰老情绪和孤独感,对预防认知功能障碍的发生有积极作用。

Objective To explore the relationship between self-perceptions of aging and cognitive function,and the mediating and moderating effect of loneliness among them.Methods A multi-stage stratified sampling was conducted in Jinzhou from September to November 2021,and 318 community-based elderly were included.General data questionnaire,the brief ageing perceptions questionnaire(BAPQ),UCLA loneliness scale(UCLA-LS)and mini-mental state examination(MMSE)were applied to all subjects.IBM SPSS 25.0 software was used to conduct independent sample t-test,analysis of variance and Pearson correlation analysis,and Bootstrap program of AMOS 22.0 was used to analyze the mediation effect.The model in SPSSAU on-line analysis program was used to test the moderating effect.Results The average scores of self-perceptions of aging,loneliness and cognitive function were(44.85±12.48),(41.70±8.73)and(24.87±3.40)respectively.And 65 of 318 subjects had cognitive impairment,and the detection rate was 20.44%(65/318).Self-perceptions of aging,loneliness and cognitive function scores were significantly correlated between each other(all P<0.05).Self-perceptions of aging had a negative effect on cognitive function(β=-0.467,P<0.01).Self-perceptions of aging had a positive effect on loneliness(β=0.585,P<0.01).Loneliness had a negative effect on cognitive function(β=-0.234,P<0.01).The indirect standardization effect of loneliness between self-perceptions of aging and cognitive function was-0.137,and the mediating effect accounted for 22.68%of the total effect.Loneliness played a moderating role between self-perceptions of aging and cognitive function(β=-0.114,t=-2.26,P=0.025).Conclusion Self-perceptions of aging and loneliness can predict the cognitive function in the elderly,and loneliness plays a mediating role between self-perceptions of aging and cognitive function.Early detection of negative senility emotion and loneliness of the elderly will play a positive role in preventing the occurrence of cognitive impairment.