Lai Li-Chong, Huang Dong-Mei, Peng Jie, Cao Xiao-Ying, Feng Xiao-Ling, Tao Pin-Yue, Pan Xiao, Pan Qi-Ni, Fan Deng-Jing, Lu Shu-Yu, Li Cai-Li, Pan Yan-Fei, Dong Peng-Xin, Chai Yi-Dan, Huang Ping-, Wu Hai-Chen, Huang Hui-Qiao
Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Rehabilitation Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Front Psychiatry. 2024 Jul 17;15:1404229. doi: 10.3389/fpsyt.2024.1404229. eCollection 2024.
The purpose of this study was to understand the relationship between the multiple chronic conditions (MCC), mental health and cognitive function of older adults in the community, and to propose a hypothesis that depressive symptom mediate the number of chronic diseases and cognitive impairment in older adults.
Participants aged 65 years and older from 35 communities in 14 cities in Guangxi, China were recruited. The residents' depressive symptom (PHQ-9) and cognitive status (AD-8) were evaluated, Chi-square test was used to explore the effects of different socio-demographic characteristics on depressive symptom and cognitive impairment. Pearson correlation analysis and the process model 4 were used to explore the relationship between the number of chronic diseases, depressive symptom and cognitive impairment.
A total of 11,582 older adults were included in our analysis. The rate of MCC reaching 26.53%. Hypertension combined with diabetes accounts for the highest proportion of two chronic diseases (13.2%). Among the combination of three chronic diseases, the highest incidence of coexisting hypertension combined with cervical/lumbar spondylosis, and rheumatoid arthritis (7.1%). In this study, depression symptoms accounted for 12.9% of older adults aged 65 and above, and cognitive impairment accounted for 27.4%. Female, older age, reside in urban areas, lower educational levels, no spouse, live alone, and MCC were risk factors for depressive symptom and cognitive impairment in older adults (<0.05). Depressive symptom had a mediating effect in the number of chronic diseases and cognitive impairment, and the mediating effect (1.109) accounted for 44.13% of the total effect (0.247).
The mental health of the older adult needs to be taken seriously, and improving depressive symptom can reduce the occurrence of cognitive impairment in older patients with MCC to a certain extent.
本研究旨在了解社区老年人多种慢性病（MCC）、心理健康与认知功能之间的关系，并提出抑郁症状介导老年人慢性病数量与认知障碍之间关系的假设。
招募了来自中国广西14个城市35个社区的65岁及以上参与者。评估了居民的抑郁症状（PHQ-9）和认知状态（AD-8），采用卡方检验探讨不同社会人口学特征对抑郁症状和认知障碍的影响。采用Pearson相关性分析和过程模型4探讨慢性病数量、抑郁症状与认知障碍之间的关系。
我们的分析共纳入11582名老年人。MCC发生率达到26.53%。高血压合并糖尿病在两种慢性病中所占比例最高（13.2%）。在三种慢性病的组合中，高血压合并颈椎/腰椎病和类风湿关节炎的共存发生率最高（7.1%）。在本研究中，65岁及以上老年人中抑郁症状占12.9%，认知障碍占27.4%。女性、年龄较大、居住在城市地区、教育水平较低、无配偶、独居和患有MCC是老年人抑郁症状和认知障碍的危险因素（<0.05）。抑郁症状在慢性病数量和认知障碍之间具有中介作用，中介效应（1.109）占总效应（0.247）的44.13%。
老年人的心理健康需要得到重视，改善抑郁症状可以在一定程度上降低患有MCC的老年患者认知障碍的发生。
