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日常生活活动在患有多种疾病的老年人抑郁症状与多维衰弱关系中的中介作用

The Mediating Role of Activities of Daily Living in the Relationship Between Depressive Symptoms and Multidimensional Frailty in the Elderly with Multimorbidity.

作者信息

Mei Dongmei, Yang Yan, Meng Defang, Hu Yaoyao, Wang Xiaoyan

机构信息

Department of Cardiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China.

出版信息

Clin Interv Aging. 2025 Jul 26;20:1109-1123. doi: 10.2147/CIA.S518492. eCollection 2025.

Abstract

PURPOSE

Previous studies have shown an association between depression and frailty in older adults, but the psychological and social dimensions of frailty are often overlooked, especially in the context of multimorbidity. This study aims to explore the association of depressive symptoms with multidimensional frailty and the mediating role of ADL.

PATIENTS AND METHODS

Data were collected using a general information questionnaire, Tilburg Frailty Indicator (TFI), ADL was assessed with Barthel index, and Elderly Depression Rating Scale.

RESULTS

Depressive symptoms were significantly correlated with multidimensional frailty (including each dimension) and ADL ( <0.05). Regression analysis showed that depressive symptoms were directly associated with multidimensional frailty (β = 0.484, < 0.001) and indirectly through ADL (β = 0.442, < 0.001). Dimensions showed that depressive symptoms directly associated with physical frailty and mental frailty (β = 0.454, 0.542, 0.118, < 0.001) indirectly through ADLs (β = 0.250, 0.492, < 0.001). Bootstrap tests confirmed the robustness of these findings.

CONCLUSION

The findings confirm the importance of interventions targeting mental health and restoration of physical function to prevent multidimensional frailty in older adults with multimorbidity.

摘要

目的

以往研究表明老年人抑郁与衰弱之间存在关联,但衰弱的心理和社会维度常被忽视,尤其是在患有多种疾病的情况下。本研究旨在探讨抑郁症状与多维衰弱的关联以及日常生活活动(ADL)的中介作用。

患者与方法

使用一般信息问卷、蒂尔堡衰弱指标(TFI)收集数据,用巴氏指数评估ADL,并采用老年抑郁评定量表。

结果

抑郁症状与多维衰弱(包括各维度)及ADL显著相关(<0.05)。回归分析表明,抑郁症状与多维衰弱直接相关(β = 0.484,<0.001),并通过ADL间接相关(β = 0.442,<0.001)。各维度显示,抑郁症状通过ADL与身体衰弱和精神衰弱直接相关(β = 0.454、0.542、0.118,<0.001),间接相关(β = 0.250、0.492,<0.001)。自助法检验证实了这些发现的稳健性。

结论

研究结果证实了针对心理健康和身体功能恢复的干预措施对于预防患有多种疾病的老年人出现多维衰弱的重要性。

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