He Juan, Hu Yinghong, Wu Xinyi, Yin Jiazhen, Cai Jingjia, Jin Zhi
Nanshan School, Guangzhou Medical University, Jingxiu Road, Panyu District, Guangzhou, 511436, China.
Nanshan School, Guangzhou Medical University, Jingxiu Road, Panyu District, Guangzhou, 511436, China.
J Affect Disord. 2026 Mar 1;396:120863. doi: 10.1016/j.jad.2025.120863. Epub 2025 Dec 7.
This study investigates the relationship between life satisfaction and chronic disease development in older adults, with depressive symptoms and frailty serving as mediating factors.
This study utilized data from the 2011 and 2018 China Health and Retirement Longitudinal Study (CHARLS), comprising 7809 middle-aged and older Chinese adults. Life satisfaction (including health, marriage, children relationship satisfaction, and air quality satisfaction) and chronic disease diagnosis were assessed, using self-reported questionnaires. Depressive symptoms were measured using the CES-D-10 scale, while frailty was evaluated by the FFP criterion. Negative binomial regression and logistic regression models were used to investigate associations among life satisfaction and chronic diseases, calculating incidence rate ratios (IRR) and odds ratios (OR). Additionally, mediation analysis was performed to examine whether depression and frailty mediated the relationship between life satisfaction and chronic diseases. Sensitivity and subgroup analyses confirmed the robustness of our findings.
Our results showed that life satisfaction was significantly associated with a reduced prevalence of chronic diseases in middle-aged and older adults (IRR = 0.87; 95 % CI: 0.85-0.88; p < 0.001). Significant associations were observed from four types of satisfaction, including satisfactions of health (IRR = 0.77; 95 % CI: 0.75-0.78; p < 0.001), marriage (IRR = 0.95; 95 % CI: 0.94-0.97; p < 0.001), children relationship (IRR = 0.93; 95 % CI: 0.91-0.95; p < 0.001) and air quality (IRR = 0.94; 95 % CI: 0.92-0.96; p < 0.001). Mediation analysis further revealed that depression and frailty partially mediated the relationship between life satisfaction and chronic diseases, accounting for 19.4 % and 7.3 %.
These findings indicate that higher life satisfaction is associated with a lower burden of chronic diseases among middle-aged and older adults. Depressive symptoms and frailty statistically accounted for part of this association, emphasizing the need to address both psychological and physical factors to reduce burden of chronic disease burden in aging populations.
本研究调查老年人生活满意度与慢性病发展之间的关系，将抑郁症状和虚弱作为中介因素。
本研究使用了2011年和2018年中国健康与养老追踪调查（CHARLS）的数据，该数据包含7809名中国中老年成年人。使用自我报告问卷评估生活满意度（包括健康、婚姻、子女关系满意度和空气质量满意度）和慢性病诊断情况。使用CES-D-10量表测量抑郁症状，同时通过FFP标准评估虚弱状况。使用负二项回归和逻辑回归模型研究生活满意度与慢性病之间的关联，计算发病率比（IRR）和优势比（OR）。此外，进行中介分析以检验抑郁和虚弱是否介导了生活满意度与慢性病之间的关系。敏感性和亚组分析证实了我们研究结果的稳健性。
我们的结果表明，生活满意度与中老年成年人慢性病患病率降低显著相关（IRR = 0.87；95% CI：0.85 - 0.88；p < 0.001）。从四种类型的满意度中观察到显著关联，包括健康满意度（IRR = 0.77；95% CI：0.75 - 0.78；p < 0.001）、婚姻满意度（IRR = 0.95；95% CI：0.94 - 0.97；p < 0.001）、子女关系满意度（IRR = 0.93；95% CI：0.91 - 0.95；p < 0.001）和空气质量满意度（IRR = 0.94；95% CI：0.92 - 0.96；p < 0.001）。中介分析进一步表明，抑郁和虚弱部分介导了生活满意度与慢性病之间的关系，占比分别为19.4%和7.3%。
这些发现表明，较高的生活满意度与中老年成年人较低的慢性病负担相关。抑郁症状和虚弱在统计学上解释了这种关联的一部分，强调需要同时解决心理和生理因素，以减轻老年人群体的慢性病负担。
