摘要
目的探究老年人社交活跃度与抑郁症状之间的因果时序关系,为预防及干预老年人抑郁症状提供参考依据。方法资料来源于中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)项目,收集3164名年龄≥60岁的老年人在2015年(T1)和2018年(T2)2次测量中关于抑郁症状和社交活跃度的数据资料,其中男1240名,女1924名,平均年龄(71±7)岁。通过CHARLS问卷中包含的11项社交活动及其活动频率构建社交活跃度指数评估社交活跃度。采用简版流行病学调查中心抑郁量表(10-item Center for Epidemiological Studies Depression Scale,CESD-10)评估老年人抑郁症状的严重程度。采用双因素混合设计方差分析探讨老年人社交活跃度与抑郁症状随时间和性别变化的趋势。采用Pearson相关分析探究老年人社交活跃度与抑郁症状是否满足同时性与继时性相关,进而采用交叉滞后模型分析老年人间隔3年的社交活跃度与抑郁症状间的因果时序关系或相互预测关系。结果男性老年人T2社交活跃度显著低于T1社交活跃度(F=21.00,P<0.001),女性老年人T1、T2社交活跃度差异无统计学意义(F=0.31,P=0.581)。男性老年人T1、T2社交活跃度得分均高于女性老年人[T1:(2.93±2.98)分比(2.55±2.65)分;T2:(2.28±2.49)分比(2.24±2.43)分;F=43.60、11.24,均P<0.01]。男性和女性老年人的T2抑郁症状得分均高于T1[男性:(21.90±6.10)比(21.52±6.08)分,女性:(23.84±6.54)比(23.07±6.44)分;F=5.20、32.77,均P<0.05]。男性老年人T1、T2抑郁症状得分均低于女性老年人(T1:F=45.74,P<0.001;T2:F=69.96,P<0.001)。Pearson相关分析显示,间隔3年2次测量的老年人社交活跃度与抑郁症状均呈负相关(T1:r=-0.329,P<0.01;T2:r=-0.343,P<0.01),T1、T2社交活跃度和抑郁症状均呈正相关(r=0.391、0.573,均P<0.01),满足同时性与继时性相关,符合交叉滞后设计的基本假设。交叉滞后分析显示,T1社交活跃度对T2抑郁症状具有负向预测作用(β=-0.128,P<0.001);T1抑郁症状对T2社交活跃度具有负向预测作用(β=-0.202,P<0.001)。结论老年人社交活跃度与抑郁症状之间存在双向预测关系。抑郁症状导致老年人社交活跃度下降,社交活跃度下降可预测老年人抑郁症状加重。
Objective To explore the causal relationship between social activity and depressive symptoms in the elderly,and to provide a reference for preventing and interventing depressive symptoms in the elderly.Methods Data were sourced from the China Health and Retirement Longitudinal Study(CHARLS)program,involving 3164 elderly individuals aged≥60 years with data collected in two measurements,in 2015(T1)and 2018(T2).The sample included 1240 males and 1924 females aged(71±7)years.Social activities were assessed by constructing a social activity index from the 11 social activities included in the CHARLS questionnaire and the frequency of their activities.The depressive symptoms were assessed using the short version of the Center for Epidemiological Studies Depression Scale(the 10-item Center for Epidemiological Studies Depression Scale,CESD-10).A mixed-design ANOVA was used to explore the trends in social activity and depressive symptoms over time and across genders in the elderly adults.Pearson correlation analysis was used to investigate whether social activity and depressive symptoms in the elderly met the criteria for simultaneous and sequential correlations,followed by a cross-lagged model to analyze the causal temporal or mutual prediction between social activeness and depressive symptoms over a 3-year intervals.Results The social activity of elderly men at T2 was significantly lower than at T1(F=21.00,P<0.001),while no significant difference observed in elderly women(F=0.31,P<0.001).At both T1 and T2,elderly men scored higher in social activity than elderly women[T1:2.93±2.98 vs 2.55±2.65,T2:2.28±2.49 vs 2.24±2.43;F=43.60,11.24,both P<0.01].Depressive symptoms at T2 were higher than at T1 for both elderly men and elderly women((male:1.90±6.10 vs 21.52±6.08,female:23.84±6.54 vs 23.07±6.44);F=5.20,32.77,both P<0.05).Elderly men scored lower than elderly women on depression symptoms at both T1 and T2(T1:F=45.74,P<0.001;T2:F=69.96,P<0.001).Pearson correlation analysis showed a negative correlation between social activity and depressive symptoms at both measurement points(T1:r=-0.329,P<0.01;T2:r=-0.343,P<0.01),and a positive correlation across T1 and T2(r=0.391,0.573;both P<0.01),meeting the criteria for simultaneous and sequential correlations,and supporting the basic assumptions of cross-lagged design.Cross-lagged analysis revealed that T1 social activity negatively predicted T2 depressive symptoms(β=-0.128,P<0.001),and T1 depressive symptoms negatively predicted T2 social activity(β=-0.202,P<0.001).Conclusion There is a bidirectional predictive relationship between social activity and depression symptoms in the elderly.Depression symptoms lead to a decrease in social activity,and a decrease in social activity predicts an exacerbation of depression in the elderly.
作者
侯雅婷
江李梅
孙振杰
孙俊伟
姚付新
杨甫德
王斌红
那龙
Hou Yating;Jiang Limei;Sun Zhenjie;Sun Junwei;Yao Fuxin;Yang Fude;Wang Binhong;Na Long(Medical Department,Taiyuan Psychiatric Hospital,Taiyuan 030045,China;Psychological Counseling Center of Suzhou City Second People′s Hospital,Suzhou 234000,China;School of Mental Health,Shanxi Medical University,Taiyuan 030001,China;Department of Early intervention,Taiyuan Psychiatric Hospital,Taiyuan 030045,China;Performance Office,Beijing Huilongguan Hospital,Huilongguan Clinical Medical School of Peking University,Beijing 100096,China;Hospital Office,Beijing Huilongguan Hospital,Huilongguan Clinical Medical School of Peking University,Beijing 100096,China;Hospital Office,Taiyuan Psychiatric Hospital,Taiyuan 030045,China)
出处
《中华精神科杂志》
CAS
CSCD
北大核心
2024年第10期646-652,共7页
Chinese Journal of Psychiatry
关键词
老年人
社交活跃度
抑郁症状
纵向研究
交叉滞后分析
The elderly
Social activity
Depressive
Longitudinal study
Cross-lagged analysis