自评健康与生活满意度在老年人日常生活能力受损和抑郁症状的中介效应及潜在剖面分析

Mediating effect and potential profile analysis of self-rated health and life satisfaction on impaired ability of daily living and depressive symptoms in the elderly

目的探讨我国老年人自评健康、生活满意度、日常生活能力受损和抑郁症状的中介效应关系,分析我国日常活动能力受损老年人抑郁症状的潜在类别,为制订有针对性的干预措施降低老年人抑郁提供参考。方法利用2018年中国老年健康调查项目数据,按照抑郁评分将被调查者分为抑郁症状组和非抑郁症状组。自评健康、生活满意度、日常生活能力受损和抑郁症状之间的相关性采用Spearman相关性分析;采用Bootstrap法检验自评健康与生活满意度在老年人日常生活能力受损和抑郁症状的中介效应;潜在类别法识别我国日常活动能力受损老年人抑郁症状的类别。结果两组年龄、受教育年限、性别、婚姻状况、居住地、吸烟、饮酒、锻炼、社交活动、经济状况、通风频率、自评健康、生活满意度、日常生活能力受损比较,差异有统计学意义(P<0.05)。日常生活能力受损与自评健康、生活满意度呈负相关(r<0、P<0.01),与抑郁症状呈正相关(r>0、P<0.01);自评健康与生活满意度呈正相关(r>0、P<0.01),与抑郁症状呈负相关(r<0、P<0.01);生活满意度和抑郁症状呈负相关(r<0、P<0.01)。日常生活能力受损正向预测抑郁症状(β=0.212,P<0.01),自评健康和生活满意度负向预测抑郁症状(β=-0.274、-0.198,P<0.01)。自评健康与生活满意度在老年人日常生活能力受损和抑郁症状中起部分,占比为46.02%。日常活动能力受损老年人抑郁症状分为3类,即低抑郁组(24.5%),中抑郁组(56.9%)和高抑郁组(18.6%)。结论我国日常活动能力受损老年人抑郁症状具有异质性,自评健康与生活满意度在老年人日常生活能力受损和抑郁症状间起部分中介作用。本研究有助于了解日常活动能力影响抑郁症状的内在机制,为改善缓解抑郁症状提供理论参考依据。

Objective To explore the relationship between the mediating effect of self-rated health,life satisfaction,impaired ability of daily living,and depressive symptoms among the elderly in China,and to analyze the potential categories of depressive symptoms among the elderly with impaired ability of daily living in China,so as to provide reference for formulating targeted intervention measures to reduce depression in the elderly.Methods Based on the data of the 2018 China Elderly Health Survey Project,participants were divided into the depressive symptoms group and the non-depressive symptoms group according to the depression score.The correlation among self-rated health,life satisfaction,impaired ability of daily living,and depressive symptoms were analyzed by Spearman correlation analysis;Bootstrap method was used to examine the mediating effect of self-rated health and life satisfaction on impaired ability of daily living and depressive symptoms in the elderly;potential categories method identifies depressive symptoms categories in the elderly with impaired ability of daily living in China.Results There were statistically significant differences in age,years of education,gender,marital status,place of residence,smoking,drinking,exercise,social events,economic status,ventilation frequency,self-rated health,life satisfaction,and impaired ability of daily living between the two groups(P<0.05).The impaired ability of daily living was negatively correlated with self-rated health and life satisfaction(r<0,P<0.01),and positively correlated with depressive symptoms(r>0,P<0.01).Self-rated health was positively correlated with life satisfaction(r>0,P<0.01),and negatively correlated with depressive symptoms(r<0,P<0.01).Life satisfaction was negatively correlated with depressive symptoms(r<0,P<0.01).Impaired ability of daily living positively predicted depressive symptoms(β=0.212,P<0.01),and self-rated health and life satisfaction negatively predicted depressive symptoms(β=-0.274,-0.198,P<0.01).Self-rated health and life satisfaction accounted for 46.02%of impaired ability of daily living and depressive symptoms in the elderly.The depression symptoms of the elderly with impaired ability of daily activity were divided into three categories,namely,low depression group(24.5%),medium depression group(56.9%),and high depression group(18.6%).Conclusion The depressive symptoms of the elderly people with impaired ability of daily living in China are heterogeneous,and self-rate health and life satisfaction play a partial mediating role between impaired ability of daily living and depressive symptoms in the elderly.This study helps to understand the internal mechanism of the ability of daily living affecting depressive symptoms,and provides a theoretical reference basis for improving and alleviating depressive symptoms.