{"title":"老年人慢性肺部疾病和抑郁症状：来自观察性研究和孟德尔随机化的见解","authors":"Huifang Liu, Yisong Yao, Yujuan Yang, Jianwei Wang, Jingyi Yu, Xinjun Xu, Xianghuang Luo, Yu Zhang, Xicheng Song","doi":"10.2147/JMDH.S515745","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>To elucidate the currently unknown relationship between chronic lung diseases (CLDs) and depressive symptoms among older adults.</p><p><strong>Methods: </strong>A total of 8079 older adults from China Longitudinal Aging Social Survey (CLASS) and 1119 individuals from a Sichuan Province cohort were included in this study. We used regression analysis and propensity score matching (PSM) to assess the association between CLDs and depressive symptoms among older adults, while the causal relationship was assessed using Mendelian randomization (MR). Our sensitivity analyses included heterogeneity tests, tests of multiple validity, and leave-one-out tests. A two-way mediation analysis was also used to assess the mediating role of basic activities of daily living (BADL) between CLDs and depressive symptoms.</p><p><strong>Results: </strong>In this cross-sectional study, we found that depressive symptoms significantly (<i>P</i> < 0.001) increased the risk of CLDs (β = 0.047). The robustness test showed that there were significant association between CLDs and depressive symptoms (β = 0.220, <i>P</i> < 0.001), Qi depression constitution (β = 8.564, <i>P</i> < 0.001). This finding was also confirmed through robustness tests using different PSM methods. The results of the inverse-variance weighting (IVW) analysis showed that depression increased the risk of idiopathic pulmonary fibrosis and asthma, with Beta coefficients of 2.822 [standard error (SE) = 1.087; <i>P</i> = 0.009] and -1.090 (SE = 0.491; <i>P</i> = 0.027), accordingly. The results of the IVW analysis showed that idiopathic pulmonary fibrosis and asthma increased the risk of depression, with Beta coefficients of 2.822 [standard error (SE) = 1.087; <i>P</i> = 0.009] and -1.559 (SE = 0.633; <i>P</i> = 0.013). The sensitivity analysis results confirmed the reliability of this conclusion. The mediating role of BADL was observed from depressive symptoms to CLDs.</p><p><strong>Conclusion: </strong>Depressive symptoms are associated with an increased risk of CLDs, reduced BADL promote the risk of CLDs in older adults with depressive symptoms, but the underlying pathological mechanism still needs to be clarified in future research.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3465-3475"},"PeriodicalIF":2.4000,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178258/pdf/","citationCount":"0","resultStr":"{\"title\":\"Chronic Lung Diseases and Depressive Symptoms in Older Adults: Insights from Observational Studies and Mendelian Randomization.\",\"authors\":\"Huifang Liu, Yisong Yao, Yujuan Yang, Jianwei Wang, Jingyi Yu, Xinjun Xu, Xianghuang Luo, Yu Zhang, Xicheng Song\",\"doi\":\"10.2147/JMDH.S515745\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>To elucidate the currently unknown relationship between chronic lung diseases (CLDs) and depressive symptoms among older adults.</p><p><strong>Methods: </strong>A total of 8079 older adults from China Longitudinal Aging Social Survey (CLASS) and 1119 individuals from a Sichuan Province cohort were included in this study. We used regression analysis and propensity score matching (PSM) to assess the association between CLDs and depressive symptoms among older adults, while the causal relationship was assessed using Mendelian randomization (MR). Our sensitivity analyses included heterogeneity tests, tests of multiple validity, and leave-one-out tests. A two-way mediation analysis was also used to assess the mediating role of basic activities of daily living (BADL) between CLDs and depressive symptoms.</p><p><strong>Results: </strong>In this cross-sectional study, we found that depressive symptoms significantly (<i>P</i> < 0.001) increased the risk of CLDs (β = 0.047). The robustness test showed that there were significant association between CLDs and depressive symptoms (β = 0.220, <i>P</i> < 0.001), Qi depression constitution (β = 8.564, <i>P</i> < 0.001). This finding was also confirmed through robustness tests using different PSM methods. The results of the inverse-variance weighting (IVW) analysis showed that depression increased the risk of idiopathic pulmonary fibrosis and asthma, with Beta coefficients of 2.822 [standard error (SE) = 1.087; <i>P</i> = 0.009] and -1.090 (SE = 0.491; <i>P</i> = 0.027), accordingly. The results of the IVW analysis showed that idiopathic pulmonary fibrosis and asthma increased the risk of depression, with Beta coefficients of 2.822 [standard error (SE) = 1.087; <i>P</i> = 0.009] and -1.559 (SE = 0.633; <i>P</i> = 0.013). The sensitivity analysis results confirmed the reliability of this conclusion. The mediating role of BADL was observed from depressive symptoms to CLDs.</p><p><strong>Conclusion: </strong>Depressive symptoms are associated with an increased risk of CLDs, reduced BADL promote the risk of CLDs in older adults with depressive symptoms, but the underlying pathological mechanism still needs to be clarified in future research.</p>\",\"PeriodicalId\":16357,\"journal\":{\"name\":\"Journal of Multidisciplinary Healthcare\",\"volume\":\"18 \",\"pages\":\"3465-3475\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-06-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178258/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Multidisciplinary Healthcare\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/JMDH.S515745\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Multidisciplinary Healthcare","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/JMDH.S515745","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Chronic Lung Diseases and Depressive Symptoms in Older Adults: Insights from Observational Studies and Mendelian Randomization.
Introduction: To elucidate the currently unknown relationship between chronic lung diseases (CLDs) and depressive symptoms among older adults.
Methods: A total of 8079 older adults from China Longitudinal Aging Social Survey (CLASS) and 1119 individuals from a Sichuan Province cohort were included in this study. We used regression analysis and propensity score matching (PSM) to assess the association between CLDs and depressive symptoms among older adults, while the causal relationship was assessed using Mendelian randomization (MR). Our sensitivity analyses included heterogeneity tests, tests of multiple validity, and leave-one-out tests. A two-way mediation analysis was also used to assess the mediating role of basic activities of daily living (BADL) between CLDs and depressive symptoms.
Results: In this cross-sectional study, we found that depressive symptoms significantly (P < 0.001) increased the risk of CLDs (β = 0.047). The robustness test showed that there were significant association between CLDs and depressive symptoms (β = 0.220, P < 0.001), Qi depression constitution (β = 8.564, P < 0.001). This finding was also confirmed through robustness tests using different PSM methods. The results of the inverse-variance weighting (IVW) analysis showed that depression increased the risk of idiopathic pulmonary fibrosis and asthma, with Beta coefficients of 2.822 [standard error (SE) = 1.087; P = 0.009] and -1.090 (SE = 0.491; P = 0.027), accordingly. The results of the IVW analysis showed that idiopathic pulmonary fibrosis and asthma increased the risk of depression, with Beta coefficients of 2.822 [standard error (SE) = 1.087; P = 0.009] and -1.559 (SE = 0.633; P = 0.013). The sensitivity analysis results confirmed the reliability of this conclusion. The mediating role of BADL was observed from depressive symptoms to CLDs.
Conclusion: Depressive symptoms are associated with an increased risk of CLDs, reduced BADL promote the risk of CLDs in older adults with depressive symptoms, but the underlying pathological mechanism still needs to be clarified in future research.
期刊介绍：
The Journal of Multidisciplinary Healthcare (JMDH) aims to represent and publish research in healthcare areas delivered by practitioners of different disciplines. This includes studies and reviews conducted by multidisciplinary teams as well as research which evaluates or reports the results or conduct of such teams or healthcare processes in general. The journal covers a very wide range of areas and we welcome submissions from practitioners at all levels and from all over the world. Good healthcare is not bounded by person, place or time and the journal aims to reflect this. The JMDH is published as an open-access journal to allow this wide range of practical, patient relevant research to be immediately available to practitioners who can access and use it immediately upon publication.
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