中国中老年人抑郁症状、身体功能与心血管疾病风险的关联
Association of depressive symptoms, physical function, and cardiovascular disease risk in middle-aged and elderly Chinese.
作者信息
Li Miao, Zhuang Shuo, Gao Yan
机构信息
Department of General Medicine, The 960th Hospital of People's Liberation Army Joint Logistics Support Force, Jinan, China.
First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China.
出版信息
Front Med (Lausanne). 2025 May 14;12:1513614. doi: 10.3389/fmed.2025.1513614. eCollection 2025.
OBJECTIVE
Current research suggests that depressive symptoms and physical function increase the risk of developing cardiovascular disease (CVD), but how these factors interact to increase the risk of CVD remains unclear. Therefore, we used data from Chinese middle-aged and older adults to investigate the relationship between depressive symptoms and physical function and CVD risk.
METHODS
Using information from the China Health and Retirement Longitudinal Study (CHARLS), we examined the relationship between depressive symptoms, physical functioning, and CVD risk in middle-aged and older Chinese adults. The subsequent seven-year endeavor, which ran from 2011 to 2018, enrolled Chinese adults who were middle-aged and older (≥45 years). The exposures of interest were symptoms of depression and physical impairment. To measure depression symptoms, the Center for Epidemiological Studies Depression Scale (CESD-10) was used. The physical disability was ascertained using the physical mobility function. Its principal endpoint was the incidence of CVD. Cox proportional hazards regression methods has been applied to ascertain 95% of the hazard ratios (HRs) and confidence intervals (CIs). Cox multivariate regression and stratified interaction analysis analyses were employed to investigate the association between depressive symptoms, physical functioning, and CVD.
RESULTS
A total of 1980 people were included, of whom the mean age of the participants was 56.4 ± 7.7 years, of whom 1,013 (51.2%) were women. During the maximum follow-up period of 7 years, 303 (15.3%) suffered from cardiovascular disease, of whom 246 (12.4%) had heart disease and 72 (3.6%) suffered from stroke. Compared with those with NDS (no depressive symptoms) (CESD <10) and NPD (no physical dysfunction), those with both DS (depressive symptoms) (CESD ≥10) and PD (physical dysfunction) had the highest risk of overall CVD (adjusted hazard ratio [HR], 1.88; 95% CI 1.18 to 3), coronary heart disease (HR, 2.45; 95% CI 1.44 to 4.18) and stroke (HR, 0.45; 95% CI 0.15 to 1.31), which were most common in people aged 60 years or younger.
CONCLUSION
This study found that older adults with DS and PD were strongly associated with an increased risk of CVD.
目的
当前研究表明，抑郁症状和身体功能会增加患心血管疾病（CVD）的风险，但这些因素如何相互作用以增加CVD风险仍不清楚。因此，我们使用来自中国中老年人的数据来研究抑郁症状、身体功能与CVD风险之间的关系。
方法
利用中国健康与养老追踪调查（CHARLS）的信息，我们研究了中国中老年人抑郁症状、身体功能与CVD风险之间的关系。随后从2011年至2018年进行了为期七年的研究，纳入了年龄在中年及以上（≥45岁）的中国成年人。感兴趣的暴露因素为抑郁症状和身体损伤。使用流行病学研究中心抑郁量表（CESD-10）来测量抑郁症状。通过身体活动功能确定身体残疾情况。其主要终点是CVD的发病率。采用Cox比例风险回归方法确定95%的风险比（HRs）和置信区间（CIs）。采用Cox多变量回归和分层交互分析来研究抑郁症状、身体功能与CVD之间的关联。
结果
共纳入1980人，参与者的平均年龄为56.4±7.7岁，其中1013人（51.2%）为女性。在最长7年的随访期内，303人（15.3%）患心血管疾病，其中246人（12.4%）患心脏病，72人（3.6%）患中风。与无抑郁症状（NDS）（CESD<10）和无身体功能障碍（NPD）的人相比，同时有抑郁症状（DS）（CESD≥10）和身体功能障碍（PD）的人患总体CVD（调整后风险比[HR]，1.88；95%CI 1.18至3）、冠心病（HR，2.45；95%CI 1.44至4.18）和中风（HR，0.45；95%CI 0.15至1.31）的风险最高，这些情况在60岁及以下人群中最为常见。
结论
本研究发现，患有DS和PD的老年人与CVD风险增加密切相关。
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