Yan Wenjing, Wang Lina, Li Chao, Meng Yihan, Guo Qi, Li Hongjuan
School of Physical Education, Shanxi Normal University, Taiyuan, Shanxi, China.
School of Sport Science and Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China.
Sci Rep. 2025 Feb 28;15(1):7125. doi: 10.1038/s41598-025-91680-y.
This study investigates the bidirectional relationship between Activities of Daily Living (ADL) disability and depressive symptoms (DS) among middle-aged and older adults in China, utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) from 2015 to 2018. A total of 8994 participants were analyzed to assess the impact of ADL on the risk of depressive symptoms, while 9673 participants were included to examine the influence of depressive symptoms on the risk of ADL disability. Cox proportional hazards regression models were employed to evaluate these relationships, adjusting for sociodemographic, lifestyle, and health-related covariates. Results revealed that ADL disability significantly increased the risk of depressive symptoms (HR = 1.090, 95% CI 1.058-1.123), and depressive symptoms were associated with a higher risk of ADL disability (HR = 1.033, 95% CI 1.025-1.042). Subgroup analyses demonstrated that factors such as education level, social activity, and disability significantly modified the relationship between ADL and depressive symptoms, while age, marital status, and pain influenced the association between depressive symptoms and ADL. Sensitivity analyses confirmed the robustness of these findings. This study highlights the complex interplay between ADL and depressive symptoms, emphasizing the need for targeted interventions to mitigate the risk of depression and improve functional independence in aging populations.
本研究利用中国健康与养老追踪调查（CHARLS）2015年至2018年的数据，调查了中国中老年人日常生活活动（ADL）残疾与抑郁症状（DS）之间的双向关系。共分析了8994名参与者，以评估ADL对抑郁症状风险的影响，同时纳入9673名参与者，以研究抑郁症状对ADL残疾风险的影响。采用Cox比例风险回归模型评估这些关系，并对社会人口学、生活方式和健康相关协变量进行了调整。结果显示，ADL残疾显著增加了抑郁症状的风险（HR = 1.090，95%CI 1.058 - 1.123），抑郁症状与ADL残疾风险较高相关（HR = 1.033，95%CI 1.025 - 1.042）。亚组分析表明，教育水平、社会活动和残疾等因素显著改变了ADL与抑郁症状之间的关系，而年龄、婚姻状况和疼痛则影响了抑郁症状与ADL之间的关联。敏感性分析证实了这些发现的稳健性。本研究强调了ADL与抑郁症状之间复杂的相互作用，强调需要采取有针对性的干预措施，以降低老年人群体中抑郁症的风险并提高功能独立性。
