You Ruijia, Li Wenjie, Ni Linghao, Peng Bin
School of Public Health, Chongqing Medical University, Chongqing, 400016, China.
SSM Popul Health. 2023 Sep 13;24:101510. doi: 10.1016/j.ssmph.2023.101510. eCollection 2023 Dec.
Previous studies have shown that middle-aged and elderly adults with disabilities are at higher risk for depressive symptoms. However, there are few studies on the long-term trajectories of depressive symptoms in the Chinese middle-aged and elderly disabled population.
This study aimed to identify the different development trajectories of depressive symptoms and their influencing factors in middle-aged and elderly people with disabilities in China.
Using data from the China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013, 2015, and 2018, a longitudinal cohort was formed for the study. A total of 2053 participants underwent at least two measures of depressive symptoms, assessed using the Center for Epidemiological Studies Depression Scale (CES-D10), a depression symptom assessment scale. We constructed a Group-Based Trajectory Model (GBTM) to identify the development trajectory of depressive symptoms in 2053 middle-aged and elderly disabled individuals, screened the potential predictors using lasso regression, and analyzed the factors affecting the development trajectory of depression through multivariate logistic regression.
We identified four depression symptom trajectories throughout the follow-up process: "low depressive symptom group", "worsening depressive symptom group", "relieved depressive symptom group", and "high depressive symptom group". We found that there were differences in basic characteristics among different subgroups of depression trajectory. However, middle-aged and elderly disabled women living in rural areas, with limited ADL or IADL, physical pain, poor self-reported health and self-reported memory, short sleep time, and no relatives and friends to take care of them were the key groups for the prevention and treatment of depressive symptoms.
There is heterogeneity in the trajectories of depressive symptoms in the Chinese middle-aged and elderly disabled population, it is necessary to focus on the characteristics of the trajectories of different subgroups.
以往研究表明，残疾的中老年人出现抑郁症状的风险更高。然而，针对中国中老年残疾人群抑郁症状的长期轨迹研究较少。
本研究旨在识别中国中老年残疾人抑郁症状的不同发展轨迹及其影响因素。
利用2011年、2013年、2015年和2018年中国健康与养老追踪调查（CHARLS）的数据，形成一个纵向队列进行研究。共有2053名参与者接受了至少两次抑郁症状测量，采用流行病学研究中心抑郁量表（CES-D10）这一抑郁症状评估量表进行评估。我们构建了基于群体的轨迹模型（GBTM）来识别2053名中老年残疾人抑郁症状的发展轨迹，使用套索回归筛选潜在预测因素，并通过多变量逻辑回归分析影响抑郁发展轨迹的因素。
在整个随访过程中，我们识别出四条抑郁症状轨迹：“低抑郁症状组”、“抑郁症状恶化组”、“抑郁症状缓解组”和“高抑郁症状组”。我们发现抑郁轨迹不同亚组之间的基本特征存在差异。然而，居住在农村地区、日常生活活动能力或工具性日常生活活动能力有限、有身体疼痛、自我报告健康状况和自我报告记忆力较差、睡眠时间短且没有亲戚朋友照顾的中老年残疾女性是抑郁症状防治的重点人群。
中国中老年残疾人群抑郁症状轨迹存在异质性，有必要关注不同亚组轨迹的特征。
