School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China.
The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China.
J Affect Disord. 2023 Nov 15;341:211-218. doi: 10.1016/j.jad.2023.08.060. Epub 2023 Aug 12.
There is a greater likelihood of anxiety and depression among older adults who suffer falls. This study examined the relationships of falls and severe falls with anxiety and depressive symptoms, and the moderating role of psychological resilience on these associations.
Our study recruited participants from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), a nationally representative cohort study. A total of 11,857 participants included in the analysis. We used a linear regression model to investigate the relationship between falls/severe falls and anxiety/depressive symptoms, adjusting for a range of potential covariates and a bootstrapping sample test to examine the potential moderating role of psychological resilience in these relationships.
Older adults who suffered the falls have higher anxiety/depressive symptoms (β = 0.28 [0.23, 0.32] for anxiety symptoms, p < 0.001; β = 0.21 [0.16, 0.25] for depressive symptoms, p < 0.001), and those who suffered the severe falls have higher anxiety/depressive symptoms (β = 0.30 [0.24, 0.37] for anxiety symptoms, p < 0.001; β = 0.21 [0.15, 0.27] for depressive symptoms, p < 0.001), in the fully adjusted model. The relationship between falls/severe falls and anxiety/depressive symptoms was mitigated in participants with higher levels of psychological resilience.
The present study is based on cross-sectional data, which limits the ability to infer causal relationships.
Falls/severe falls were positively associated with anxiety and depression, and that psychological resilience could moderate this association. Our findings suggest that psychological resilience may be an effective target for intervention and prevention of fall-related symptoms of anxiety and depression.
老年人跌倒后更容易出现焦虑和抑郁。本研究调查了跌倒和严重跌倒与焦虑和抑郁症状的关系，并检验了心理弹性在这些关联中的调节作用。
我们的研究从 2018 年中国长寿纵向研究（CLHLS）中招募了参与者，该研究是一项具有全国代表性的队列研究。共纳入 11857 名参与者进行分析。我们使用线性回归模型来研究跌倒/严重跌倒与焦虑/抑郁症状之间的关系，同时调整了一系列潜在的混杂因素，并通过 bootstrap 样本检验来检验心理弹性在这些关系中的潜在调节作用。
跌倒的老年人有更高的焦虑/抑郁症状（焦虑症状的β=0.28[0.23,0.32]，p<0.001；抑郁症状的β=0.21[0.16,0.25]，p<0.001），严重跌倒的老年人有更高的焦虑/抑郁症状（焦虑症状的β=0.30[0.24,0.37]，p<0.001；抑郁症状的β=0.21[0.15,0.27]，p<0.001），在完全调整的模型中。在心理弹性水平较高的参与者中，跌倒/严重跌倒与焦虑/抑郁症状之间的关系有所缓解。
本研究基于横断面数据，这限制了推断因果关系的能力。
跌倒/严重跌倒与焦虑和抑郁呈正相关，而心理弹性可以调节这种关联。我们的研究结果表明，心理弹性可能是干预和预防与跌倒相关的焦虑和抑郁症状的有效靶点。
