Shandong Provincial Mental Health Center, Jinan City, Shandong, China.
National Institute of Health Data Science of China, Shandong University, Jinan, Shandong, China; Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
J Affect Disord. 2022 Oct 15;315:7-12. doi: 10.1016/j.jad.2022.07.050. Epub 2022 Jul 25.
In the context of rapid aging, "empty nest syndrome" is becoming a major public health concern. The causal effects of empty nest on depressive symptoms have been studied in developed countries, but the mediating mechanism of depressive symptoms in the association between empty nest and cognitive impairments has not been studied. This study estimated the causal association of empty nest with depressive symptoms and cognitive impairments in China, and then estimated how depression mediates the association between empty nest and cognitive impairments.
Using data of 23,614 urban older adults (65+) obtained from the Shandong Province Aging and Mental Health Survey in 2020, a weighted linear regression model combined with instrumental variable was applied to explore the causal effects of empty nest, and a four-step mediation model was run to test the mediator of depressive symptoms. The Ascertain Dementia 8-item Questionnaire and Patient Health Questionnaire-9 were used to measure cognitive impairments and depressive symptoms.
Empty nest was associated with 0.13 (95%CI: 0.04-0.23) and 0.23 (95%CI: 0.14-0.33) increases in the Ascertain Dementia 8-item Questionnaire and the Patient Health Questionnaire-9 scores, respectively. The association between empty nest and the Ascertain Dementia 8-item Questionnaire scores was mediated by the Patient Health Questionnaire-9 scores.
Empty nest affected depression in adulthood with cognitive impairments. A focus on integrative intervention for empty nesters is recommended, taking depression and cognition into account.
It is a cross-sectional study and the data is not nationally representative.
在快速老龄化的背景下，“空巢综合征”正成为一个主要的公共卫生问题。空巢对抑郁症状的因果效应已在发达国家得到研究，但空巢与认知障碍之间关联中抑郁症状的中介机制尚未得到研究。本研究估计了中国空巢与抑郁症状和认知障碍之间的因果关联，然后估计了抑郁如何在空巢与认知障碍之间的关联中起中介作用。
使用 2020 年山东省老龄化与心理健康调查中 23614 名城市老年人（65 岁以上）的数据，应用加权线性回归模型结合工具变量来探讨空巢的因果效应，并运行四步中介模型来检验抑郁症状的中介作用。采用确定痴呆症 8 项问卷和患者健康问卷-9 来衡量认知障碍和抑郁症状。
空巢与确定痴呆症 8 项问卷和患者健康问卷-9 评分分别增加 0.13（95%CI：0.04-0.23）和 0.23（95%CI：0.14-0.33）有关。空巢与确定痴呆症 8 项问卷评分之间的关联由患者健康问卷-9 评分中介。
空巢影响成年人的抑郁和认知障碍。建议关注对空巢者的综合干预，同时考虑抑郁和认知因素。
这是一项横断面研究，数据不具有全国代表性。
