老年人认知表现与抑郁症状之间的相互关系及其与生活质量的关联：基于 2017-2018 年中国健康长寿纵向研究（CLHLS）的网络分析。
Inter-relationship between cognitive performance and depressive symptoms and their association with quality of life in older adults: A network analysis based on the 2017-2018 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS).
机构信息
Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
Faculty of Education, University of Macau, Macao SAR, China.
出版信息
J Affect Disord. 2023 Jan 1;320:621-627. doi: 10.1016/j.jad.2022.09.159. Epub 2022 Oct 5.
BACKGROUND
Depressive symptoms and cognitive impairment are common psychiatric conditions and often co-occur in older adults. Network analysis has been widely used in exploring the inter-connections between psychiatric symptoms. The aim of this study was to explore the network model of depressive symptoms and cognitive performance, and their association with quality of life in people aged 65 years or above based on the 2017-2018 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS).
METHOD
Global cognitive performance, depressive symptoms, and global quality of life (QoL) were measured using the validated Chinese version of the Mini Mental State Examination (MMSE), the 10-item Center for Epidemiologic Studies Short Depression Scale (CES-D), and the World Health Organization Quality of Life-brief version (WHOQOL-BREF), respectively. Central symptoms and bridge symptoms were identified via strength and bridge strength, respectively. The flow network was used to identify symptoms directly related to QoL. Network stability was examined using the case dropping bootstrap method.
RESULTS
A total of 9023 participants were included in the network analysis. CESD3 "Feeling blue/depressed", CESD4 "Everything was an effort", and At_C "Attention and Calculation" were the central (influential) symptoms that had the highest strength value. Three bridge symptoms (i.e., Nam "Naming", CESD2 "Difficulty with concentrating", and Lan "Language") were also identified. CESD10 "Sleep disturbances" had the strongest direct connection to QoL.
CONCLUSIONS
This exploratory study highlights the inter-relationships between cognitive performance and depressive symptoms in older adults in the general population. Interventions targeting bridge symptoms have the potential to alleviate depressive and cognitive symptoms in this population. Furthermore, improving sleep quality in older adults may reduce the negative impact of depression and cognition decline on QoL.
背景
抑郁症状和认知障碍是常见的精神疾病，老年人常同时患有这两种疾病。网络分析已广泛应用于探索精神症状之间的相互关系。本研究旨在基于 2017-2018 年中国长寿纵向研究（CLHLS）的调查数据，探索老年人抑郁症状和认知表现的网络模型，以及它们与生活质量的关系。
方法
使用经过验证的中文版简易智力状态检查（MMSE）、10 项中心流行病学研究短抑郁量表（CES-D）和世界卫生组织生活质量简表（WHOQOL-BREF）分别测量总体认知表现、抑郁症状和总体生活质量（QoL）。通过强度和桥梁强度分别识别核心症状和桥梁症状。使用流网络识别与 QoL 直接相关的症状。使用病例剔除 bootstrap 方法检查网络稳定性。
结果
共纳入 9023 名参与者进行网络分析。CESD3“感到忧郁/沮丧”、CESD4“做任何事都很吃力”和 At_C“注意力和计算”是强度值最高的核心（有影响力）症状。还确定了三个桥梁症状（即 Nam“命名”、CESD2“注意力集中困难”和 Lan“语言”）。CESD10“睡眠障碍”与 QoL 有最强的直接联系。
结论
这项探索性研究强调了普通人群中老年人群认知表现和抑郁症状之间的相互关系。针对桥梁症状的干预措施有可能减轻该人群的抑郁和认知症状。此外，改善老年人的睡眠质量可能会降低抑郁和认知能力下降对 QoL 的负面影响。
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