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中国中老年人群抑郁症状与肌肉减少症的关系:日常生活活动(ADL)残疾的中介作用。

Association between depressive symptoms and sarcopenia among middle-aged and elderly individuals in China: the mediation effect of activities of daily living (ADL) disability.

机构信息

School of Nursing, Jinan University, Guangzhou, Guangdong, China.

Department of Neurosurgery, the First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.

出版信息

BMC Psychiatry. 2024 Jun 10;24(1):432. doi: 10.1186/s12888-024-05885-y.


DOI:10.1186/s12888-024-05885-y
PMID:38858698
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11165901/
Abstract

BACKGROUND: Depressive symptoms and sarcopenia, often observed among middle-aged and elderly individuals, are significant health concerns in China, particularly given the country's rapidly aging population. Depressive symptoms, characterized by persistent feelings of sadness and loss of interest, can significantly impact quality of life. Little is known about the underlying pathway connecting these two conditions. METHODS: The data for this study were derived from the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were evaluated using the Centre for Epidemiological Studies Depression (CSED) scale. Logistic regression analyses were employed to investigate the association between depressive symptoms, activities of daily living (ADL) disability, and sarcopenia, while adjusting for potential confounding factors. The selection of predictor variables, including social activity, chronic diseases, demographic factors, and lifestyle habits, was based on their known associations with mental health, physical functioning and sarcopenia. These variables were included to ensure a comprehensive adjustment for potential confounding factors and to provide a more accurate estimation of the relationship between depressive symptoms and sarcopenia. Additionally, mediation analysis was conducted to assess the mediating role of ADL disability in the relationship between depressive symptoms and sarcopenia. RESULTS: A comprehensive study was conducted on a total of 8,238 participants aged 45 years and older, comprising 3,358 men and 4,880 women. Logistic regression analyses were conducted to identify significant associations between depressive symptoms (OR = 1.30, P = 0.0269,95%CI = 1.03-1.63), ADL disability (OR = 1.94, P < 0.001,95%CI = 1.37-2.75) and sarcopenia. The results revealed significant relationships among these variables. Furthermore, mediation effect analyses demonstrated that ADL disability partially mediated the association between depressive symptoms and sarcopenia (estimated indirect effect: 0.006, 95% CI: 0.003, 0.008, proportion of mediation effect: 20.00%). CONCLUSIONS: The study underscores a significant association between depressive symptoms and sarcopenia among middle-aged and elderly individuals in China, with ADL disability acting as a mediator. These findings offer novel insights for targeted health interventions. Future interventions should effectively combat sarcopenia by integrating psychological support with muscle-strengthening exercise programs. By addressing both depressive symptoms and ADL disability, clinicians and public health professionals can enhance outcomes for this demographic. Collaborative efforts across disciplines are essential for providing comprehensive health management tailored to the needs of middle-aged and elderly individuals. Future research should longitudinally assess the impact of such integrated interventions on sarcopenia prevention and depressive symptom alleviation. Additionally, investigating the role of social and environmental factors in mediating this relationship is crucial for developing more effective health strategies for this vulnerable population.

摘要

背景:抑郁症状和肌肉减少症在中老年人群中很常见,是中国的重大健康问题,尤其是考虑到该国人口老龄化迅速。抑郁症状表现为持续的悲伤和兴趣丧失,会显著影响生活质量。目前还不清楚将这两种情况联系起来的潜在途径。

方法:本研究的数据来自中国健康与退休纵向研究(CHARLS)。抑郁症状使用流行病学研究中心抑郁量表(CSED)进行评估。使用逻辑回归分析调查了抑郁症状、日常生活活动(ADL)残疾和肌肉减少症之间的关联,同时调整了潜在的混杂因素。选择社会活动、慢性疾病、人口统计学因素和生活方式习惯等预测变量,是基于它们与心理健康、身体功能和肌肉减少症的已知关联。这些变量的纳入是为了确保对潜在混杂因素进行全面调整,并更准确地估计抑郁症状和肌肉减少症之间的关系。此外,还进行了中介分析,以评估 ADL 残疾在抑郁症状和肌肉减少症之间关系中的中介作用。

结果:对总共 8238 名年龄在 45 岁及以上的参与者进行了综合研究,其中包括 3358 名男性和 4880 名女性。逻辑回归分析用于确定抑郁症状(比值比(OR)=1.30,P=0.0269,95%置信区间(CI)=1.03-1.63)、ADL 残疾(OR=1.94,P<0.001,95%CI=1.37-2.75)和肌肉减少症之间的显著关联。结果表明这些变量之间存在显著关系。此外,中介效应分析表明 ADL 残疾部分介导了抑郁症状和肌肉减少症之间的关联(估计间接效应:0.006,95%CI:0.003,0.008,中介效应的比例:20.00%)。

结论:本研究强调了中国中老年人群中抑郁症状和肌肉减少症之间存在显著关联,ADL 残疾起中介作用。这些发现为有针对性的健康干预措施提供了新的见解。未来的干预措施应通过将心理支持与肌肉强化运动相结合来有效防治肌肉减少症。通过解决抑郁症状和 ADL 残疾问题,临床医生和公共卫生专业人员可以改善这一年龄段人群的健康状况。跨学科的合作对于为中老年人群提供量身定制的综合健康管理至关重要。未来的研究应纵向评估这种综合干预措施对肌肉减少症预防和抑郁症状缓解的影响。此外,研究社会和环境因素在介导这种关系中的作用对于为这一弱势群体制定更有效的健康策略至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/978d/11165901/063ce68c3357/12888_2024_5885_Figb_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/978d/11165901/95f3c3004824/12888_2024_5885_Figa_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/978d/11165901/063ce68c3357/12888_2024_5885_Figb_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/978d/11165901/95f3c3004824/12888_2024_5885_Figa_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/978d/11165901/063ce68c3357/12888_2024_5885_Figb_HTML.jpg

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本文引用的文献

[1]
The impact of the Mediterranean diet on alleviating depressive symptoms in adults: a systematic review and meta-analysis of randomized controlled trials.

Nutr Rev. 2025-1-1

[2]
Association between activities of daily living and depressive symptoms among older adults in China: evidence from the CHARLS.

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Exploring the reciprocal relationship between activities of daily living disability and depressive symptoms among middle-aged and older Chinese people: a four-wave, cross-lagged model.

BMC Public Health. 2023-6-20

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Physical function, ADL, and depressive symptoms in Chinese elderly: Evidence from the CHARLS.

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