Department of Health Policy and Management, School of Public Health, Peking University, Beijing, 100191, China.
Department of Public Health Sciences, Biological Sciences Division, University of Chicago, Chicago, Illinois 60637.
J Affect Disord. 2021 Dec 1;295:703-710. doi: 10.1016/j.jad.2021.08.072. Epub 2021 Aug 31.
Given that multimorbidity is strongly associated with disability in activities of daily living (ADL) and the mechanism still remains unclear, this study sought to investigate the mediating effect of depressive symptoms on such association.
A longitudinal dataset was drawn from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2015), including 3951 adults aged 45 years and above. By sex, logistic regression and mediation analysis (the Karlson, Holm, and Breen Method) were employed.
The presence of multimorbidity was associated with increased odds of having depressive symptoms and developing ADL disability, and depressive symptoms was significantly associated with ADL disability among middle-aged and older women. Mediation analysis illustrated that depressive symptoms accounted for 6.36% of the effect of multimorbidity on ADL disability in women.
Results might not generalize to all middle-aged and older Chinese due to missing data on depressive symptoms and ADL.
Multimorbidity increased the likelihood of ADL disability onset partially through depressive symptoms in middle-aged and older women, suggesting that emphasizing mental wellness of females with multimorbidity are necessary to prevent impairments in physical function.
由于多病共存与日常生活活动（ADL）残疾密切相关，其机制仍不清楚，本研究旨在探讨抑郁症状在此相关性中的中介作用。
从中国健康与养老追踪调查（CHARLS，2011-2015 年）中抽取一个纵向数据集，包括 3951 名 45 岁及以上成年人。按性别进行逻辑回归和中介分析（Karlson、Holm 和 Breen 方法）。
多病共存与抑郁症状和 ADL 残疾的发生几率增加有关，抑郁症状与中年及以上女性的 ADL 残疾显著相关。中介分析表明，抑郁症状占女性多病共存对 ADL 残疾影响的 6.36%。
由于抑郁症状和 ADL 数据缺失，结果可能不适用于所有中年及以上的中国人。
在中年及以上女性中，多病共存部分通过抑郁症状增加了 ADL 残疾的发病几率，这表明强调多病共存女性的精神健康对于预防身体功能受损是必要的。
