Wang Xinru, Zhu Baoqi, Li JunPeng, Li Xiaoyan, Zhang Lane, Wu Yibo, Ji Lili
Spine Surgery, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong Province, China; School of Nursing, Shandong Second Medical University, Weifang, Shandong Province, China.
Spine Surgery, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong Province, China.
J Affect Disord. 2025 Apr 15;375:508-516. doi: 10.1016/j.jad.2025.01.118. Epub 2025 Jan 23.
Comorbidities of depression, anxiety and loneliness may be more prevalent in frail older adults, which may lead to an accelerated deterioration of psychological symptoms. This study was aimed to assess the moderating effect of frailty on the network of depression, anxiety, and loneliness symptoms in community-dwelling older adults.
A sample of 4253 older adults were recruited from the Psychology and Behavior Investigation of Chinese Residents (PBICR). Frailty, depression, anxiety, and loneliness were assessed using the FRAIL scale, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder 7-item scale, and the Three-Item Loneliness Scale, respectively. Covariates of age, gender, education level, living status, marital status, and monthly family income were also collected.
The prevalence of combined depression, anxiety and loneliness was 36.49 % in (pre)frail (i.e., frail or prefrail) older adults. Using the moderated network model, we found that (pre)frail older adults were more likely to experience "sad mood", "appetite changes", and "feel left out" than non-frail older adults. In addition, (pre)frail older adults had stronger correlations between "feel left out" and "feel isolated from others", "feel isolated from others" and "lack companionship", "nervousness or anxiety" and "feel left out", "nervousness or anxiety" and "feel isolated from others", and "sleep difficulties" and "feel left out" than non-frail older adults, while non-frail older adults had stronger correlations between "feel worthlessness" and "psychomotor agitation/retardation" than (pre)frail older adults.
(Pre)frail older adults may experience more comorbidities of depression, anxiety and loneliness due to more symptoms and stronger correlations between specific symptoms in the network. Future studies should target these symptoms to eliminate comorbidities of depression, anxiety and loneliness in (pre)frail older adults.
抑郁症、焦虑症和孤独感的共病情况在体弱的老年人中可能更为普遍，这可能导致心理症状加速恶化。本研究旨在评估虚弱对社区居住老年人抑郁、焦虑和孤独症状网络的调节作用。
从中国居民心理与行为调查（PBICR）中招募了4253名老年人作为样本。分别使用衰弱量表、患者健康问卷-9、广泛性焦虑障碍7项量表和三项孤独量表对衰弱、抑郁、焦虑和孤独进行评估。还收集了年龄、性别、教育水平、生活状况、婚姻状况和家庭月收入等协变量。
（前）衰弱（即衰弱或衰弱前期）老年人中抑郁、焦虑和孤独合并症的患病率为36.49%。使用调节网络模型，我们发现（前）衰弱老年人比非衰弱老年人更有可能经历“情绪低落”、“食欲改变”和“感到被冷落”。此外，与非衰弱老年人相比，（前）衰弱老年人在“感到被冷落”与“感到与他人隔绝”、“感到与他人隔绝”与“缺乏陪伴”、“紧张或焦虑”与“感到被冷落”、“紧张或焦虑”与“感到与他人隔绝”以及“睡眠困难”与“感到被冷落”之间的相关性更强，而非衰弱老年人在“感到无价值”与“精神运动性激越/迟缓”之间的相关性比（前）衰弱老年人更强。
（前）衰弱老年人可能由于网络中特定症状更多且相关性更强而经历更多的抑郁、焦虑和孤独共病情况。未来的研究应针对这些症状，以消除（前）衰弱老年人的抑郁、焦虑和孤独共病情况。
