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中国中老年人不良经历与纵向应激负荷随抑郁症状轨迹的变化之间的关联:一项纵向研究

The association between adverse experiences and longitudinal allostatic load changes with the depression symptoms trajectories in middle-aged and older adults in China: A longitudinal study.

作者信息

Li Xiujuan, Dong Mingyi, Xia Wenjing, Huang Can, Zheng Taoyun, Zhu Xinhong

机构信息

School of Nursing, Hubei University of Chinese Medicine, 430065 Wuhan, China.

School of Nursing, Hubei University of Chinese Medicine, 430065 Wuhan, China; Hubei Shizhen Laboratory, China.

出版信息

J Affect Disord. 2025 Mar 1;372:377-385. doi: 10.1016/j.jad.2024.11.082. Epub 2024 Dec 7.

Abstract

BACKGROUND

This study investigated the associations between adverse childhood experiences (ACEs), adverse adulthood experiences (AAEs), allostatic load (AL) changes, and later depression symptoms trajectories in middle-aged and older Chinese longitudinally.

METHODS

1921 individuals aged ≥45 years at baseline were included from the China Health and Retirement Longitudinal Study (CHARLS). Measures included ACEs, AAEs, depression symptoms scores, health-related factors, and demographic characteristics. AL changes were assessed by the difference in AL scores between wave 3 (2015) and wave 1(2011).

RESULTS

Compared to consistently low trajectory, 2 or more ACEs (OR 1.78, 95 % CI 1.28-2.46), 2 or more AAEs (OR 1.82, 95 % CI 1.26-2.64), decreasing metabolic AL over time (OR 0.63, 95 % CI 0.46-0.86), increasing inflammatory AL over time (OR 1.60, 95 % CI 1.07-2.37), and decreasing renal AL over time (OR 1.38, 95 % CI 1.01-1.87) were associated with the low-moderate depression symptoms trajectory. Furthermore, 2 or more ACEs (OR 1.48, 95 % CI 1.10-2.00), 2 or more AAEs (OR 1.85, 95 % CI 1.32-2.60), decreasing metabolic AL over time (OR 0.75, 95 % CI 0.57-1.00), increasing inflammatory AL over time (OR 1.69, 95 % CI 1.19-2.42) were associated with the high-moderate depression symptoms trajectory.

CONCLUSION

Experiencing more ACEs and AAEs was associated with higher depression symptoms trajectories. Moreover, participants with decreasing metabolic AL over time showed a low depression symptoms trajectory, while those with increasing inflammatory AL over time and decreasing renal AL over time showed a worse depression symptoms trajectory. These findings highlighted the physiological damage caused by stress on mental health outcomes.

摘要

背景

本研究纵向调查了中国中老年人童年不良经历(ACEs)、成年不良经历(AAEs)、应激负荷(AL)变化与后期抑郁症状轨迹之间的关联。

方法

从中国健康与养老追踪调查(CHARLS)中纳入了1921名基线年龄≥45岁的个体。测量指标包括ACEs、AAEs、抑郁症状评分、健康相关因素和人口统计学特征。通过第3波(2015年)和第1波(2011年)之间AL评分的差异来评估AL变化。

结果

与始终处于低轨迹相比,2次或更多次ACEs(比值比[OR]1.78,95%置信区间[CI]1.28 - 2.46)、2次或更多次AAEs(OR 1.82,95% CI 1.26 - 2.64)、随时间代谢性AL降低(OR 0.63,95% CI 0.46 - 0.86)、随时间炎症性AL升高(OR 1.60,95% CI 1.07 - 2.37)以及随时间肾脏AL降低(OR 1.38,95% CI 1.01 - 1.87)与低 - 中度抑郁症状轨迹相关。此外,2次或更多次ACEs(OR 1.48,95% CI 1.10 - 2.00)、2次或更多次AAEs(OR 1.85,95% CI 1.32 - 2.60)、随时间代谢性AL降低(OR 0.75,95% CI 0.57 - 1.00)、随时间炎症性AL升高(OR 1.69,95% CI 1.19 - 2.42)与高 - 中度抑郁症状轨迹相关。

结论

经历更多的ACEs和AAEs与更高的抑郁症状轨迹相关。此外,随时间代谢性AL降低的参与者表现出低抑郁症状轨迹,而随时间炎症性AL升高和肾脏AL降低的参与者表现出更差的抑郁症状轨迹。这些发现突出了应激对心理健康结果造成的生理损害。

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