Department of Graduate School, Wannan Medical College, Wuhu, An Hui, P.R. China.
Department of Gerontology, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Zheshan West Road, Yijishan District, Wuhu City, Anhui Province, P.R. China.
BMC Public Health. 2024 Aug 13;24(1):2201. doi: 10.1186/s12889-024-19627-y.
To investigate the cross-sectional and longitudinal associations between depressive symptoms and the prevalence of frailty and its components in a nationally representative sample of middle-aged and older Chinese adults.
The China Health and Retirement Longitudinal Study (CHARLS) provided data on 2581 (after inclusion and exclusion criteria) adults aged ≥ 45 years. Every two years, face-to-face, computer-aided personal interviews (CAPI), and structured questionnaires were used to follow up with the respondents. The Chinese version of the Center for Epidemiologic Studies-Depression Scale (CES-D) was used to evaluate depressive symptoms, and the Fried criteria were used to measure frailty. The odds ratio (OR) and 95% confidence interval (CI) for the association of exposure (depressive symptoms at baseline) with the onset of the outcome (frailty and its components) in the individuals at baseline were analyzed by binary logistic regression.
At baseline, 11.62% of participants had frailty, and 57.92% had depressive symptoms. In the cross-sectional analysis, depressive symptoms (OR = 5.222, 95%CI 3.665-7.442) were associated with frailty. In the longitudinal analysis, after adjusting for the full set of covariates among participants free of baseline frailty, depressive symptoms were significantly associated with incident frailty during the short term (OR = 2.193, 95%CI 1.324-3.631) and the long term (OR = 1.926, 95%CI 1.021-3.632). Meanwhile, depressive symptoms were associated with an increased risk of weakness (OR = 1.990, 95%CI 1.250-3.166), slowness (OR = 1.395, 95%CI 1.044-1.865), and exhaustion (OR = 2.827, 95%CI 2.150-3.719) onset during the short-term. Depressive symptoms were associated with an increased risk of exhaustion (OR = 2.869, 95%CI 2.004-4.109) onset during the long-term.
Among middle-aged and older adults, depressive symptoms could predict frailty during 2 years of follow-up and 4 years of follow-up. When considering potential confounding factors, depressive symptoms were considered a predictor of weakness, slowness, and exhaustion. Interventions aimed at preventing depressive symptoms may be beneficial in reducing frailty and its components.
本研究旨在通过全国代表性的中老年成年人样本，调查抑郁症状与衰弱及其各组分的横断面和纵向关联。
中国健康与养老追踪调查（CHARLS）提供了 2581 名（经过纳入和排除标准）年龄≥45 岁的成年人的数据。每两年通过面对面的、计算机辅助的个人访谈（CAPI）和结构化问卷对受访者进行随访。采用中文版流行病学研究中心抑郁量表（CES-D）评估抑郁症状，采用 Fried 标准衡量衰弱。采用二元逻辑回归分析基线时的暴露（抑郁症状）与基线时个体的结局（衰弱及其各组分）的发病比值比（OR）和 95%置信区间（CI）。
基线时，11.62%的参与者存在衰弱，57.92%存在抑郁症状。在横断面分析中，抑郁症状（OR=5.222，95%CI 3.665-7.442）与衰弱相关。在纵向分析中，在对无基线衰弱的参与者进行全变量调整后，抑郁症状与短期（OR=2.193，95%CI 1.324-3.631）和长期（OR=1.926，95%CI 1.021-3.632）衰弱的发病显著相关。同时，抑郁症状与虚弱（OR=1.990，95%CI 1.250-3.166）、行动缓慢（OR=1.395，95%CI 1.044-1.865）和疲惫（OR=2.827，95%CI 2.150-3.719）的短期发病风险增加相关。抑郁症状与长期疲惫（OR=2.869，95%CI 2.004-4.109）的发病风险增加相关。
在中老年人群中，抑郁症状可预测 2 年和 4 年随访期间的衰弱。考虑到潜在的混杂因素，抑郁症状被认为是虚弱、行动缓慢和疲惫的预测因素。预防抑郁症状的干预措施可能有助于减少衰弱及其各组分的发生。
