{"title":"中国老年人功能障碍转化模式与抑郁症状风险的纵向关联","authors":"Jinghong Huang, Dongrui Peng, Yuanjie Gou, Ying Luo, Hui Yao, Hairong Zhang, Huayu Zhang, Jiarui Mei, Xiaohui Wang","doi":"10.1002/gps.70086","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Functional disability has been identified as a risk factor for depressive symptoms (DS). However, most studies have measured functional disability at only one time point, and functional disability is dynamic and changeable over the life course, and can vary between individuals. Therefore, we aimed to examine the longitudinal association between conversion patterns of functional disability and the risk of DS.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Based on the China Health and Retirement Longitudinal Study (CHARLS) participants in 2013, we retrospectively assessed their functional disability from 2011 to 2013 through activities of daily living ability (ADLs) and instrumental activities of daily living ability (IADLs), which were categorized as ten conversion patterns. A total of 2057 participants who met the inclusion criteria were included in the final analysis and were followed from 2013 to 2018 to determine the incidence of DS, measured by the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). Cox proportional hazards regression models were applied to estimate association between conversion patterns of functional disability and the risk of DS.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Over the 61 months follow-up period, 508 incident DS cases were identified. Three conversion patterns of functional disability were more likely to develop DS than those with never both ADLs and IADLs disabilities: relieved both ADLs and IADLs disabilities (adjusted HR = 2.01, 95% CI = 1.21–3.32), persistent only IADLs disability (adjusted HR = 1.81, 95% CI = 1.04–3.12), and persistent both ADLs and IADLs disabilities (adjusted HR = 4.75, 95% CI = 2.19–10.31).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Older adults with persistent both ADLs and IADLs disabilities may be at a greater risk of DS. Meanwhile, those with relief should not be ignored for functional disability. Attention should be paid to psychological monitoring of older adults with a history of or current functional disability.</p>\n </section>\n </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 5","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Longitudinal Association of Conversion Patterns of Functional Disability With Risk of Depressive Symptoms in Older Chinese Adults\",\"authors\":\"Jinghong Huang, Dongrui Peng, Yuanjie Gou, Ying Luo, Hui Yao, Hairong Zhang, Huayu Zhang, Jiarui Mei, Xiaohui Wang\",\"doi\":\"10.1002/gps.70086\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Functional disability has been identified as a risk factor for depressive symptoms (DS). However, most studies have measured functional disability at only one time point, and functional disability is dynamic and changeable over the life course, and can vary between individuals. Therefore, we aimed to examine the longitudinal association between conversion patterns of functional disability and the risk of DS.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Based on the China Health and Retirement Longitudinal Study (CHARLS) participants in 2013, we retrospectively assessed their functional disability from 2011 to 2013 through activities of daily living ability (ADLs) and instrumental activities of daily living ability (IADLs), which were categorized as ten conversion patterns. A total of 2057 participants who met the inclusion criteria were included in the final analysis and were followed from 2013 to 2018 to determine the incidence of DS, measured by the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). Cox proportional hazards regression models were applied to estimate association between conversion patterns of functional disability and the risk of DS.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Over the 61 months follow-up period, 508 incident DS cases were identified. Three conversion patterns of functional disability were more likely to develop DS than those with never both ADLs and IADLs disabilities: relieved both ADLs and IADLs disabilities (adjusted HR = 2.01, 95% CI = 1.21–3.32), persistent only IADLs disability (adjusted HR = 1.81, 95% CI = 1.04–3.12), and persistent both ADLs and IADLs disabilities (adjusted HR = 4.75, 95% CI = 2.19–10.31).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Older adults with persistent both ADLs and IADLs disabilities may be at a greater risk of DS. Meanwhile, those with relief should not be ignored for functional disability. Attention should be paid to psychological monitoring of older adults with a history of or current functional disability.</p>\\n </section>\\n </div>\",\"PeriodicalId\":14060,\"journal\":{\"name\":\"International Journal of Geriatric Psychiatry\",\"volume\":\"40 5\",\"pages\":\"\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-04-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Geriatric Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/gps.70086\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Geriatric Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/gps.70086","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：功能性残疾已被确定为抑郁症状（DS）的一个危险因素。然而，大多数研究只测量了一个时间点的功能残疾，而功能残疾在整个生命过程中是动态和可变的，并且在个体之间可能存在差异。因此，我们的目的是研究功能残疾转换模式与退行性痴呆风险之间的纵向关联。方法基于2013年中国健康与退休纵向研究（CHARLS）的参与者，我们通过日常生活能力活动（ADLs）和日常生活能力工具活动（IADLs）回顾性评估了他们2011年至2013年的功能残疾，并将其分类为10种转换模式。共有2057名符合纳入标准的参与者被纳入最终分析，并在2013年至2018年期间进行了随访，以确定DS的发病率，通过10项流行病学研究中心抑郁量表（csd -10）进行测量。应用Cox比例风险回归模型估计功能残疾转换模式与退行性痴呆风险之间的关系。结果在61个月的随访中，共发现508例DS病例。三种功能残疾的转换模式比没有ADLs和IADLs残疾的人更容易发生DS：缓解ADLs和IADLs残疾（调整后的HR = 2.01, 95% CI = 1.21-3.32），持续性仅IADLs残疾（调整后的HR = 1.81, 95% CI = 1.04-3.12），持续性ADLs和IADLs残疾（调整后的HR = 4.75, 95% CI = 2.19-10.31）。结论持续ADLs和IADLs残疾的老年人可能有更大的DS风险。与此同时，那些有肢体残疾的人也不应该被忽视。应注意对有功能障碍病史或当前功能障碍的老年人进行心理监测。
Longitudinal Association of Conversion Patterns of Functional Disability With Risk of Depressive Symptoms in Older Chinese Adults
Background
Functional disability has been identified as a risk factor for depressive symptoms (DS). However, most studies have measured functional disability at only one time point, and functional disability is dynamic and changeable over the life course, and can vary between individuals. Therefore, we aimed to examine the longitudinal association between conversion patterns of functional disability and the risk of DS.
Methods
Based on the China Health and Retirement Longitudinal Study (CHARLS) participants in 2013, we retrospectively assessed their functional disability from 2011 to 2013 through activities of daily living ability (ADLs) and instrumental activities of daily living ability (IADLs), which were categorized as ten conversion patterns. A total of 2057 participants who met the inclusion criteria were included in the final analysis and were followed from 2013 to 2018 to determine the incidence of DS, measured by the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). Cox proportional hazards regression models were applied to estimate association between conversion patterns of functional disability and the risk of DS.
Results
Over the 61 months follow-up period, 508 incident DS cases were identified. Three conversion patterns of functional disability were more likely to develop DS than those with never both ADLs and IADLs disabilities: relieved both ADLs and IADLs disabilities (adjusted HR = 2.01, 95% CI = 1.21–3.32), persistent only IADLs disability (adjusted HR = 1.81, 95% CI = 1.04–3.12), and persistent both ADLs and IADLs disabilities (adjusted HR = 4.75, 95% CI = 2.19–10.31).
Conclusions
Older adults with persistent both ADLs and IADLs disabilities may be at a greater risk of DS. Meanwhile, those with relief should not be ignored for functional disability. Attention should be paid to psychological monitoring of older adults with a history of or current functional disability.
期刊介绍：
The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers.
The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.
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