Song Wei, Liu Manyu, Ye Ting, Wang Dong, Yuan Quan, Li Fen, Wang Qiushi, Ma Yana
School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China.
Suzhou Xiangcheng Second People's Hospital, Suzhou, Jiangsu, China.
Front Med (Lausanne). 2024 Jun 26;11:1416173. doi: 10.3389/fmed.2024.1416173. eCollection 2024.
Previous studies have demonstrated that frailty is associated with depressive symptoms among older people and significantly increase the risk of difficulty in activities of daily living (ADL). However, uncertainties remain regarding the mechanisms behind such relationship. The aim of this study was to investigate the mediating effect of ADL in the relationship between frailty and depressive symptoms among older adults in China, and to explore to what extend sleep duration moderated the association between ADL and depressive symptoms.
In this study, we carried out cross-sectional descriptive analysis and 1,429 participants were included in the analysis. A survey was conducted using questionnaires and instruments measuring frailty, depressive symptoms, ADL and sleep duration. Bootstrap analyses served to explore the impact of ADL in mediating frailty and depressed symptoms, as well as the effect of sleep duration in moderating ADL and depressive symptoms.
Compared to the robust group, the mediating effects of ADL between frailty and depressive symptoms were significant in the prefrail group and the frail group. The interaction term between sleep duration and ADL was significantly presented in the regression on depressive symptoms. Specifically, the Johnson-Neyman technique determined a range from 8.31 to 10.19 h for sleep duration, within which the detrimental effect of frailty on depressive symptoms was offset.
Sleep duration moderated the indirect effect of ADL on the association between frailty and depressive symptoms. This provides support for unraveling the underlying mechanism of the association between frailty and depressive symptoms. Encouraging older adults to enhance ADL and obtain appropriate sleep duration might improve depressive symptoms for older adults with frailty and prefrailty.
先前的研究表明，衰弱与老年人的抑郁症状相关，并显著增加日常生活活动（ADL）困难的风险。然而，这种关系背后的机制仍存在不确定性。本研究的目的是调查ADL在中国老年人衰弱与抑郁症状关系中的中介作用，并探讨睡眠时间在多大程度上调节了ADL与抑郁症状之间的关联。
在本研究中，我们进行了横断面描述性分析，纳入1429名参与者进行分析。使用问卷和测量衰弱、抑郁症状、ADL和睡眠时间的工具进行调查。Bootstrap分析用于探讨ADL在中介衰弱和抑郁症状方面的影响，以及睡眠时间在调节ADL和抑郁症状方面的作用。
与强壮组相比，ADL在衰弱前期组和衰弱组中对衰弱与抑郁症状之间的中介作用显著。睡眠时间与ADL的交互项在抑郁症状的回归中显著呈现。具体而言，约翰逊-奈曼技术确定睡眠时间范围为8.31至10.19小时，在此范围内，衰弱对抑郁症状的有害影响得到抵消。
睡眠时间调节了ADL对衰弱与抑郁症状之间关联的间接影响。这为揭示衰弱与抑郁症状之间关联的潜在机制提供了支持。鼓励老年人增强ADL并获得适当的睡眠时间可能会改善衰弱和衰弱前期老年人的抑郁症状。
