Nanqiao Town Community Health Service Center, Shanghai, China.
Shanghai Fengxian District Center for Disease Control and Prevention, Shanghai, China.
Front Public Health. 2024 Sep 4;12:1387550. doi: 10.3389/fpubh.2024.1387550. eCollection 2024.
Anxiety and depression are serious psychological and public health issues among the older adults. Currently, there is a lack of understanding of the relationship between Body Mass Index (BMI) and anxiety or depression symptoms in the older adult population in China. Therefore, the purpose of this study is to investigate the impact of BMI on anxiety and depression through correlation analysis in different subgroups and to examine the potential chain mediating effects of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) between BMI and symptoms of anxiety and depression.
From the CLHLS database conducted in 2017-2018, data regarding height, weight, anxiety symptoms, depression symptoms, as well as demographic, socioeconomic, behavioral, and health-related characteristics were collected. Multivariate logistic regression analysis was used to explore the impact of BMI on anxiety and depression symptoms. Finally, the SPSS macro process was utilized to test the multiple mediating effects of ADL and IADL between BMI and anxiety or depression symptoms.
After screening, a final sample of 9,098 Chinese older adult individuals aged 65 and above was selected. Among them, 1,074 cases (11.8%) exhibited anxiety symptoms, 1,458 cases (16.0%) exhibited depressive symptoms. Compared to normal BMI, the adjusted analysis showed that underweight in Chinese older adult individuals was significantly associated with anxiety (OR = 1.316, = 0.004) and depression (OR = 1.232, = 0.013). This relationship was found to be more significant in males, individuals aged 80 and above, unmarried individuals, and those residing in town. ADL and IADL played a chain-mediated role between BMI and anxiety symptoms in the older adult. BMI not only had a direct effect on anxiety symptoms in the older adult (effect = -0.0159; SE = 0.0066; 95%CI: LL = -0.0288, UL = -0.0031), but also influenced them indirectly through two pathways: the independent mediating role of IADL (effect = -0.0010; SE = 0.0005; 95%CI: LL = -0.0018, UL = -0.0003) and the chain-mediated role of ADL and IADL (effect = -0.0012; SE = 0.0004; 95%CI: LL = -0.0020, UL = -0.0006).
In the older adult individuals in China, underweight is associated with an increased risk of anxiety and depression symptoms. Improving the underweight condition of Chinese older adult individuals can reduce their ADL and IADL limitations, thereby benefiting their mental health.
焦虑和抑郁是老年人中严重的心理和公共卫生问题。目前，人们对中国老年人群体中身体质量指数（BMI）与焦虑或抑郁症状之间的关系了解甚少。因此，本研究旨在通过相关性分析探讨 BMI 对不同亚组焦虑和抑郁的影响，并检验 BMI 与焦虑和抑郁症状之间日常生活活动（ADL）和工具性日常生活活动（IADL）的潜在链式中介作用。
本研究从 2017-2018 年进行的 CLHLS 数据库中收集了身高、体重、焦虑症状、抑郁症状以及人口统计学、社会经济、行为和健康相关特征等数据。采用多变量逻辑回归分析探讨 BMI 对焦虑和抑郁症状的影响。最后，使用 SPSS 宏程序检验 BMI 与焦虑或抑郁症状之间 ADL 和 IADL 的多重中介效应。
经过筛选，最终纳入了 9098 名年龄在 65 岁及以上的中国老年个体。其中，1074 例（11.8%）表现出焦虑症状，1458 例（16.0%）表现出抑郁症状。与正常 BMI 相比，调整分析显示，中国老年个体体重过轻与焦虑（OR=1.316，=0.004）和抑郁（OR=1.232，=0.013）显著相关。这种关系在男性、80 岁及以上的个体、未婚个体和居住在城镇的个体中更为显著。ADL 和 IADL 在 BMI 与老年个体焦虑症状之间发挥了链式中介作用。BMI 不仅对老年个体的焦虑症状有直接影响（效应=-0.0159；SE=0.0066；95%CI：LL=-0.0288，UL=-0.0031），而且还通过两条途径产生间接影响：IADL 的独立中介作用（效应=-0.0010；SE=0.0005；95%CI：LL=-0.0018，UL=-0.0003）和 ADL 和 IADL 的链式中介作用（效应=-0.0012；SE=0.0004；95%CI：LL=-0.0020，UL=-0.0006）。
在中国老年个体中，体重过轻与焦虑和抑郁症状的风险增加有关。改善中国老年个体的体重过轻状况，可以减少他们的日常生活活动和工具性日常生活活动限制，从而有益于他们的心理健康。
