Zhang Fan, Xiong Yu-Jun, Meng Xiang-Da, Lv Tian, Yang Du-Juan
Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Department of Hernia and Abdominal Wall Surgery, Peking University Peoples' Hospital, Beijing, China.
Front Nutr. 2025 Jul 28;12:1590194. doi: 10.3389/fnut.2025.1590194. eCollection 2025.
Digestive diseases impose a substantial global health burden, yet the joint impact of frailty and depression on their incidence remains underexplored.
This cohort study analyzed 5,506 adults aged ≥ 65 years from the China Health and Retirement Longitudinal Study (2011-2018). Participants with baseline digestive diseases or missing data were excluded. Cox proportional hazards models assessed associations, while mediation analysis evaluated bidirectional roles of the frailty index (FI) and 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) in new-onset digestive diseases.
Over 7 years, 988 participants developed digestive diseases. Frailty (HR = 1.66, < 0.001) and depression (HR = 1.62, < 0.001) independently increased risk, with the highest hazard in comorbid cases (HR = 2.16, < 0.001). Frailty mediated 30.5% of depression's effect, while depression mediated 45.2% of frailty's impact ( < 0.05). No multiplicative or additive interaction was observed.
Frailty and depression synergistically elevate digestive disease risk in aging populations, with bidirectional mediation underscoring their interdependence. Integrated interventions targeting mental health and geriatric vulnerability may mitigate disease burden.
消化系统疾病给全球健康带来了沉重负担，但虚弱和抑郁对其发病率的联合影响仍未得到充分研究。
这项队列研究分析了来自中国健康与养老追踪调查（2011 - 2018年）的5506名年龄≥65岁的成年人。排除有基线消化系统疾病或数据缺失的参与者。Cox比例风险模型评估关联，而中介分析评估虚弱指数（FI）和10项流行病学研究中心抑郁量表（CESD - 10）在新发消化系统疾病中的双向作用。
在7年多的时间里，988名参与者患上了消化系统疾病。虚弱（HR = 1.66，<0.001）和抑郁（HR = 1.62，<0.001）独立增加患病风险，合并病例中的风险最高（HR = 2.16，<0.001）。虚弱介导了抑郁影响的30.5%，而抑郁介导了虚弱影响的45.2%（<0.05）。未观察到相乘或相加的相互作用。
虚弱和抑郁协同增加老年人群患消化系统疾病的风险，双向中介作用凸显了它们的相互依存关系。针对心理健康和老年脆弱性的综合干预措施可能减轻疾病负担。
