患慢性病对老年人抑郁症状的影响

Influence of chronic diseases on depressive symptoms among older adults

目的分析患慢性病与老年人抑郁症状的关系及其作用机制,旨在帮助老年人管理慢性病,保护其心理健康,进而为实现健康老龄化提供科学依据。方法基于2018年中国老年社会追踪调查(China Longitudinal Aging Social Survey,CLASS)数据,采用多元线性回归模型对患慢性病与老年人抑郁症状的关系进行分析,采用Bootstrap方法对其中介机制进行分析。结果2018年我国老年人慢性病患病率为69.84%,患慢性病和未患慢性病老年群体的抑郁量表得分分别为(18.54±2.64)分和(19.22±2.42)分。多元线性回归分析结果显示,患慢性病(β=-0.394)是影响老年人抑郁症状水平的主要因素(P<0.05),且该关系在倾向值匹配后仍然成立。Bootstrap检验结果显示,睡眠状况、主观年龄、孤独感均在患慢性病与老年人抑郁症状的关系间起中介作用,效应值分别为-0.202(95%CI:-0.273~-0.131)、-0.013(95%CI:-0.023~-0.005)、-0.090(95%CI:-0.140~-0.040),分别占总效应的50.50%、3.25%、22.50%。结论患慢性病与老年人抑郁症状呈正相关,睡眠状况、主观年龄、孤独感是患慢性病作用于老年人心理健康的中介路径。未来相关部门应采取针对性措施帮助老年群体管理和应对慢性病,以保护其心理健康。

Objective To analyze the relationship between chronic diseases and depression symtoms of elder adults in China and its mechanism of action,to help elder adults manage chronic diseases and mental health,and to provide scien-tific basis for achieving healthy aging.Methods sBased on the data from 2018 China Longitudinal Aging Social Survey(CLASS),multiple linear regression model was used to analyze the relationship between chronic disease and depression symtoms in elder adults,and Bootstrap methods was used to analyze the mediating mechanisms.Results In 2018,69.84 percent of older adults in China suffered from chronic diseases.The depression scale scores of the elder adults with chronic diseases and without chronic diseases were(18.54±2.64)and(19.22±2.42),respectively.Multiple linear regression analyses showed that having chronic disease(β=-0.394)was the main influence on the level of depression symtoms in the elderly(P<0.05),and this relationship still held after using propensity score matching.Bootstrap test results showed that sleep status,subjective age,and loneliness mediate the relationship between chronic illness and depression symtoms in elder adults,with effect values of-0.202(95%Cl:-0.273--0.131),-0.013(95%CI:-0.023--0.005),and-0.090(95%Cl:-0.140--0.040),which were 50.50%,3.25%,22.5%of the total effect,respective-ly.Conclusion Chronic diseases are positively associated with depression in elder adults.Sleep status,subjective age,and loneliness are mediating pathways for chronic diseases influencing on mental health.In future,the relevant departments should take targeted measures to help elder people manage and cope with chronic diseases and protect their mental health.