超高龄老年人慢性阻塞性肺疾病与抑郁症状的关系及失能的中介作用

目的:探讨超高龄老年人慢性阻塞性肺疾病(COPD)患病与抑郁症状的关联并分析日常生活失能的中介作用。方法:采用2018年中国老年健康影响因素跟踪调查(CLHLS)数据,纳入90岁以上的超高龄老年人4898例,其中男性1861例(38.0%),女性3037例(62.0%)。用流调中心用抑郁量表简版(CES-D-10)和日常活动能力量表(ADL)评估抑郁症状和日常生活自理能力。根据既往病史判断COPD患病情况。结果:共有COPD患病者549例(11.2%)。超高龄老年人群CES-D-10评分中位数为7分(0,30),抑郁症状的阳性检出446例(9.1%),日常生活失能者共2096例(42.8%)。COPD患病者的抑郁症状阳性的检出率高于COPD未患病者(12.4%vs.8.7%,P<0.001),失能率高于COPD未患病者(52.3%vs.41.6%,P<0.01)。中介效应检验结果显示,COPD对抑郁症状的直接效应占总效应量的81.2%,失能在COPD与抑郁的关联中具有明显的中介效应,中介效应占总效应量的18.8%。结论:失能在超高龄老年人COPD患病与抑郁的相关关系中起部分...

Relationship between COPD and depression in the super-aged elderly and mediating effect of disability

Objective:To explore the relationship among disability of chronic obstructive pulmonary disease(COPD)and depression in Chinese super-aged elderly.Methods:The data of Chinese Longitudinal Healthy Longevity Survey(CLHLS)2018 was used,and 4898 super-aged people over 90 years old,1861(38.0%)males and3037(62.0%)females,were included.The short version of the Center for Epidemiological Studies Depression Scale(CES-D)and the Activities of Daily Life(ADL)Scale were used to assess the depressive symptoms and the activities of daily life of the super-aged elderly,respectively.Results:According to previous medical history,549(11.2%)super-aged elderly reported to have COPD.The median of CES-D-10 score of the super-aged elderly was7 points(0-30),446(9.1%)had depression,2096(42.8%)had disability.The prevalence of depression and disability rates were higher in patients with COPD than those without COPD significantly(12.4%vs.8.7%,52.3%vs.41.6%,Ps<0.01).The mediating effect analysis showed that the direct effect of COPD on depression accounted for 81.2%of the total effect size.Disability partially mediates the effect of the relationship between COPD and depression,and the mediating effect accounted for 18.8%of the total effect size.Conclusion:It suggests that disability maybe play a partly mediating role in the correlation between COPD and depression in the super-aged elderly.