Liu Yixuan, Li Wenjun, Chen Ziqiang, He Minfu, Zhang Wenjing, Wei Yachen, Chen Yibing, Li Ranran, Gao Xinyu, Liu Hongjian, Zhang Xiumin
Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China.
Int J Behav Med. 2025 Apr 30. doi: 10.1007/s12529-025-10366-x.
This study evaluated the relationship between sarcopenia and the trajectories of depressive symptoms among Chinese older adults and verified the mediating role of social participation.
The sample included 1832 participants aged ≥ 60 years from five waves of the China Health and Retirement Longitudinal Study (CHARLS). The optimal trajectory class of depressive symptoms was identified using the latent growth mixture model (LGMM). The association between sarcopenia and the trajectories of depressive symptoms was assessed by multinomial logistic regression. The potential mediating effect of social participation was evaluated through mediation analysis. Subgroup and interaction analyses were also carried out.
The results showed that the depressive symptom score trajectory of the sarcopenia group was higher than that of the normal group. The depressive symptoms of the general participants had three trajectories: "Anterior high level," "Posterior high level," and "Stable low level". Sarcopenia was related to the increased odds of adverse trajectory of depressive symptoms ("Anterior high level" trajectory) (adjusted OR = 1.53, 95% CI: 1.02-2.30). Social participation mediated 10.69% of the association between sarcopenia and adverse trajectory of depressive symptoms. Sex, education, marital status, chronic disease, self-rated health status, and self-rated standard of living were modifiable factors affecting the relationship of sarcopenia and adverse trajectory of depressive symptoms.
Comprehensive measures including early screening and treatment for sarcopenia, the strengthening of social participation levels, and formulating targeted intervention strategies are recommended to alleviate depressive symptoms and enhance mental health.
本研究评估了中国老年人肌肉减少症与抑郁症状轨迹之间的关系,并验证了社会参与的中介作用。
样本包括来自中国健康与养老追踪调查(CHARLS)五轮调查的1832名年龄≥60岁的参与者。使用潜在增长混合模型(LGMM)确定抑郁症状的最佳轨迹类别。通过多项逻辑回归评估肌肉减少症与抑郁症状轨迹之间的关联。通过中介分析评估社会参与的潜在中介作用。还进行了亚组分析和交互分析。
结果显示,肌肉减少症组的抑郁症状评分轨迹高于正常组。一般参与者的抑郁症状有三种轨迹:“前期高水平”、“后期高水平”和“稳定低水平”。肌肉减少症与抑郁症状不良轨迹(“前期高水平”轨迹)的几率增加有关(调整后的OR = 1.53,95% CI:1.02 - 2.30)。社会参与介导了肌肉减少症与抑郁症状不良轨迹之间10.69%的关联。性别、教育程度、婚姻状况、慢性病、自评健康状况和自评生活水平是影响肌肉减少症与抑郁症状不良轨迹关系的可改变因素。
建议采取综合措施,包括对肌肉减少症进行早期筛查和治疗、提高社会参与水平以及制定有针对性的干预策略,以减轻抑郁症状并增强心理健康。