慢性病共病对中老年抑郁的影响:生活满意度、日常生活活动能力和社交活动的多重中介效应-东南大学学报医学版

慢性病共病对中老年抑郁的影响:生活满意度、日常生活活动能力和社交活动的多重中介效应

单位：1. 南京中医药大学附属医院科技处, 江苏南京 210029;
2. 南京江北新区公共卫生服务中心疾病预防控制所, 江苏南京 210044;
3. 南京中医药大学附属医院临床研究院, 江苏南京 210029;
4. 南京中医药大学附属医院 GCP中心, 江苏南京 210029

关键词：多重中介效应慢病共病抑郁生活满意度日常生活活动

分类号：R749.4

出版年·卷·期（页码）：2025·44·第一期（53-59）

摘要：

目的:探讨生活满意度、日常生活活动能力和社交活动在慢性病共病(multiple chronic conditions, MCCs)与抑郁关联中的多重平行中介作用。方法:数据来源于2020年中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS)数据库,选取45~99岁调查对象进行横断面研究。结果: 共纳入17 318例研究对象,中老年人MCCs患病率为58.10%,抑郁患病率为37.56%,88.88%的中老年人对生活满意,日常生活活动能力(activities of daily living, ADL)评分为(6.53±1.50)分,社交活动评分的中位数为0(0, 2.00)分。多重平行中介效应分析显示,在全部研究对象和各亚组中MCCs与抑郁症状关联的直接效应均有统计学意义(P<0.05),生活满意度和ADL评分在该关联中的中介效应也均有统计学意义(P<0.05),而社交活动的中介效应仅在老年人中有统计学意义(P<0.05)。结论: MCCs在直接影响抑郁症状的同时,还可通过生活满意度和ADL间接影响抑郁症状。因此,应关注中老年慢性病群体,预防与延缓慢性病进展的同时要增强日常生活自理能力,提高生活满意度,鼓励和帮助慢性病较多的老年人积极参与社交活动,以减少抑郁症状的发生。

Objective: To explore the multiple parallel mediating effects of life satisfaction, activities of daily living(ADL) ability, and social activity on the association between Multiple Chronic Conditions(MCCs) and depression. Methods: The data was obtained from the 2020 China Health and Retirement Longitudinal Study(CHARLS) database, and a cross-sectional study was conducted on survey participants aged 45 to 99. Results: A total of 17318 participants were included, with a prevalence rate of 58.10% for MCCs and 37.56% for depression among middle-aged and elderly people. 88.88% of middle-aged and elderly people were satisfied with their lives, with an average ADL score of 6.53±1.50 points and a median social activity score of 0(0, 2.00) points. Multiple parallel mediation analysis showed that MCCs had a significant direct effect on depressive symptoms(P<0.05), and mediating effects of life satisfaction and ADL score on depressive symptoms was significant among all participants and subgroups(P<0.05), while mediating effect of social activities was only significant in elderly people(P<0.05). Conclusion: Not only do MCCs directly affect depressive symptoms, but also indirectly affect depressive symptoms through life satisfaction and ADL ability. Therefore, we should pay attention to the middle-aged and elderly population with chronic diseases, while preventing chronic diseases and delaying disease progression, enhancing daily self-care ability, improving life satisfaction, encouraging and helping elderly people with more chronic diseases to actively participate in social activities, in order to reduce the occurrence of depressive symptoms.

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