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中国东北老年人中抑郁症状在衰弱与认知障碍之间的中介作用

The Mediating Effect of Depressive Symptoms between Frailty and Cognitive Impairment in the Northeast Chinese Older Adults.

作者信息

Geng Xiaohan, Kou Changgui, Wu Songyu, Zhang Wangyi, Li Biao, Yu Ge, Shen Yuxuan, Gao Junling, Li Wenjun, Bai Wei

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China.

Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China.

出版信息

Dement Geriatr Cogn Disord. 2025;54(4):235-245. doi: 10.1159/000543830. Epub 2025 Jan 30.

Abstract

INTRODUCTION

Cognitive impairment among older adults is a significant public health concern worldwide. This study aimed to investigate the prevalence of cognitive impairment, its correlates, and the mediating role of depressive symptoms between frailty and cognitive impairment among older adults in northeast region of China.

METHODS

This was a cross-sectional study which used the intercept interview method to recruit participants. Social demographic characteristic, health-related behaviours, physical health, and functional status of the participants were collected. Univariate and multivariate analyses were conducted to correlates of cognitive impairment. Additionally, mediating effect analysis was performed using the Bootstrap tool.

RESULTS

Among the 2,859 older adults included in the study, 32.4% of participants screened positive for cognitive impairment. Higher educational attainment had negative association with cognitive impairment in older adults (p < 0.05). Living in rural areas, fair/poor self-rated health, pre-frailty, frailty, having depressive symptoms, impaired activities of daily living, poor sleep quality, and inactive physical activity had positive association with cognitive impairment in older adults (p < 0.05). Furthermore, depressive symptoms exhibited a partial mediating role between frailty and cognitive impairment, with a mediating effect of 58.0%.

CONCLUSIONS

Preventive measures should be implemented to address the associated factors with cognitive impairment. Promoting higher education levels, advocating for a positive and healthy lifestyle, and ensuring their physical and mental well-being among older adults are essential. Early diagnosis and proactive prevention of frailty and depressive symptoms in older adults may effectively decelerate cognitive decline.

摘要

引言

老年人认知障碍是全球重大的公共卫生问题。本研究旨在调查中国东北地区老年人认知障碍的患病率、相关因素以及衰弱与认知障碍之间抑郁症状的中介作用。

方法

这是一项横断面研究,采用拦截访谈法招募参与者。收集了参与者的社会人口学特征、健康相关行为、身体健康和功能状态。对认知障碍的相关因素进行了单因素和多因素分析。此外,使用Bootstrap工具进行中介效应分析。

结果

在纳入研究的2859名老年人中,32.4%的参与者认知障碍筛查呈阳性。较高的教育程度与老年人认知障碍呈负相关(p<0.05)。居住在农村地区、自我评定健康状况一般/较差、衰弱前期、衰弱、有抑郁症状、日常生活活动能力受损、睡眠质量差和身体活动不活跃与老年人认知障碍呈正相关(p<0.05)。此外,抑郁症状在衰弱和认知障碍之间发挥了部分中介作用,中介效应为58.0%。

结论

应采取预防措施来应对认知障碍的相关因素。提高老年人的教育水平、倡导积极健康的生活方式并确保其身心健康至关重要。早期诊断和积极预防老年人的衰弱和抑郁症状可能有效减缓认知衰退。

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