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中国中老年人群抑郁症状与认知功能关系

Correlation between depressive symptoms and cognitive function in middle-aged and elderly population in China: an analysis of CHARLS baseline data

  • 摘要:
    目的 探讨中国中老年人群抑郁症状与认知功能的关联,分析抑郁症状对不同性别、省份和居住地区的中老年人认知功能的影响。
    方法 选取2011、2013和2015年中国健康与养老全国追踪调查(CHARLS) ≥ 45岁的中老年人,采用多重线性逐步回归分析认知功能的影响因素,比较抑郁症状对认知功能影响在不同性别、省份和居住地区的差异。
    结果 共纳入14979名受访者,平均年龄为(58.05 ± 9.35)岁,男性7661人(51.18%),中老年人群抑郁症状的患病率为33.3%(4985例),认知功能的平均得分为(12.09 ± 3.54)分。多重线性逐步回归结果显示,女性(B = – 0.31)、高龄(B60 ~ 69岁 = – 0.19; B70 ~ 79岁 = – 1.18; B80 ~ 89岁 = – 2.12; B ≥ 90岁 = – 3.66)、中西部省份(B = – 0.36;B西 = – 0.57)、吸烟(B = – 0.15)和抑郁症状(B轻度至中度 = – 0.90;B重度 = – 1.51)是认知功能的危险因素。分层分析发现,抑郁症状对中老年人群认知功能在不同性别、居住地区、省份间均存在显著的负向影响,且抑郁程度越高,认知功能越差。
    结论 我国中老年人群抑郁症状患病率高,认知功能状况差;抑郁症状对认知功能存在负向预测作用,且抑郁症状对认知功能的影响在不同性别、省份和居住地区间无明显差异。

     

    Abstract:
    Objective To examine the association between depressive symptoms and cognitive function and the influences of gender, region of life, and residential area on the association in middle-aged and elderly people in China.
    Methods Data on 17 705, 2 834, and 574 individuals aged ≥ 45 years were extracted from the 2011, 2013, and 2015 China Health and Retirement Longitudinal Study (CHARLS) enrollment surveys, which used the 10-item Center for the Epidemiological Studies of Depression Short Form (CES-D-10) to identify participants′ depression symptoms. Multiple linear stepwise regression was used to analyze the factors influencing cognitive function and to compare the differences in the influence of depressive symptoms on cognitive function across gender, regions of life, and residential areas.
    Results The final analysis included 14 979 participants with a mean age of 58.05 ± 9.35 years and 51.18% (7 661) males. For all participants, the mean cognitive function score was 12.09 ± 3.54, and 33.3% (4 985) were classified as having depressive symptoms. The results of multiple linear stepwise regression showed that being female (B = – 0.31), being older (B60 – 69 years = – 0.19; B70 – 79 years = – 1.18; B80 – 89 years = – 2.12; B ≥ 90 years = – 3.66), living in central and western regions (Bcentral = – 0.36; Bwestern = – 0.57), smoking (B = – 0.15), and having depressive symptoms (Bmild to moderate = – 0.90; Bsevere = – 1.51) were risk factors for cognitive decline; further stratified analysis revealed that depressive symptoms had a significant negative impact on cognitive function in middle-aged and older adults across gender, residential area, and region of life, with higher levels of depression associated with poorer cognitive function.
    Conclusion The prevalence of depressive symptoms is high and cognitive function is poor among middle-aged and elderly people in China. Depressive symptoms have a negative predictive effect on cognitive function, and the effect of depressive symptoms on cognitive function shows no significant differences among genders, living regions, and residential areas.

     

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