行动能力、认知功能和抑郁症状是否介导了老年男性和女性社交活动与死亡风险之间的关联？
Do mobility, cognitive functioning, and depressive symptoms mediate the association between social activity and mortality risk among older men and women?
作者信息
Katja Pynnönen, Timo Törmäkangas, Taina Rantanen, Tiina-Mari Lyyra
机构信息
Department of Health Sciences and Gerontology Research Center, University of Jyväskylä, PO. Box 35, 40014 Jyväskylä, Finland.
出版信息
Eur J Ageing. 2013 Oct 1;11(2):121-130. doi: 10.1007/s10433-013-0295-3. eCollection 2014 Jun.
Social activity and health correlate in old age, but less is known about what explains this association. The aim of this study was to investigate whether mobility, cognitive functioning, and depressive symptoms mediate the association between social activity and mortality risk, or whether they alternatively should be considered as prerequisites for social activity in older Finnish men and women. In 1988, 406 men and 775 women aged 65-84 years took part in face-to-face interviews about their health, socioeconomic status, and social activities. Confirmatory factor analyses were used to form latent variables describing collective and productive social activity. Latent variable models were used to investigate the possible pathways among social activity, mobility, cognitive functioning, depressive symptoms, and mortality risk. In the 21-year follow-up, 89 % of men and 81 % of women had died. Collective and productive social activity correlated with a lower risk for mortality among men and women. Part of the association between social activity and mortality was mediated by mobility. Cognitive functioning and depressive symptoms were not mediators in the association. Instead, good cognitive functioning and having less depressive symptoms were prerequisites for participating in collective social activity among men and women. Among men, good cognitive functioning, and among women, good cognitive functioning and having less depressive symptoms were prerequisites for productive social activity. The health-enhancing influences of social activity may be partly explained by better mobility among persons who are socially active. Moreover, social activity may maintain mobility and thus decreases mortality risk, as many social activities also include physical activity. Better cognitive functioning and having less depressive symptoms should be considered as prerequisites for participating in social activities.
社交活动与老年人的健康状况相关，但对于造成这种关联的原因却知之甚少。本研究旨在调查身体活动能力、认知功能和抑郁症状是否介导了社交活动与死亡风险之间的关联，或者是否应将它们视为芬兰老年男性和女性参与社交活动的先决条件。1988年，406名65至84岁的男性和775名同龄女性参加了关于其健康状况、社会经济地位和社交活动的面对面访谈。验证性因素分析用于形成描述集体社交活动和生产性社交活动的潜在变量。潜在变量模型用于研究社交活动、身体活动能力、认知功能、抑郁症状和死亡风险之间可能的路径。在21年的随访中，89%的男性和81%的女性已经死亡。集体社交活动和生产性社交活动与男性和女性较低的死亡风险相关。社交活动与死亡之间的部分关联是由身体活动能力介导的。认知功能和抑郁症状并非该关联的中介因素。相反，良好的认知功能和较少的抑郁症状是男性和女性参与集体社交活动的先决条件。对于男性而言，良好的认知功能是参与生产性社交活动的先决条件；对于女性而言，良好的认知功能和较少的抑郁症状是参与生产性社交活动的先决条件。社交活动对健康的促进作用可能部分归因于社交活跃人群更好的身体活动能力。此外，社交活动可能维持身体活动能力，从而降低死亡风险，因为许多社交活动也包括体育活动。应将更好的认知功能和较少的抑郁症状视为参与社交活动的先决条件。
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