Frailty and Incident Depressive Symptoms During Short- and Long-Term Follow-Up Period in the Middle-Aged and Elderly: Findings From the Chinese Nationwide Cohort Study.
Frailty and Incident Depressive Symptoms During Short- and Long-Term Follow-Up Period in the Middle-Aged and Elderly: Findings From the Chinese Nationwide Cohort Study.
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DOI：
10.3389/fpsyt.2022.848849
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发表时间：
2022
影响因子：
4.7
通讯作者：
Zhang, Lin
中科院分区：
文献类型：
--
作者：
Liu, Haiyang;Yang, Xu;Guo, Lei-lei;Li, Jin-long;Xu, Guang;Lei, Yunxiao;Li, Xiaoping;Sun, Lu;Yang, Liu;Yuan, Ting;Wang, Congzhi;Zhang, Dongmei;Wei, Huanhuan;Li, Jing;Liu, Mingming;Hua, Ying;Li, Yuanzhen;Che, Hengying;Zhang, Lin
衰弱前期和衰弱是老年人中的两种常见状况。最近的研究报告了虚弱与抑郁症状之间的关联，但在一些纵向研究中，这些条件是否可以预测抑郁症状仍然不一致。在我们的研究中，我们旨在评估具有全国代表性的中国社区中老年人样本中的虚弱与抑郁症状之间的横向和纵向关联。数据来自中国健康与退休追踪研究 (CHARLS)，该研究纳入了 17,284 名年龄 ≥ 45 岁的成年人。每两年对参与者进行一次面对面的计算机辅助个人访谈（CAPI）和结构化问卷调查。我们排除了没有后续数据的参与者。完成基线调查的人数为 2,579 人，短期（2011 年至 2013 年 2 年）跟踪调查为 839 人，长期（2011 年至 2015 年 4 年）跟踪调查为 788 人。此外，虚弱程度采用Fried标准进行测量，抑郁症状采用中国流行病学研究中心抑郁量表（CES-D）进行评估。 Logistic 回归用于分析基线参与者虚弱及其组成部分与抑郁症状的横截面关联的比值比 (OR) 和 95% 置信区间 (CI)。使用风险比 (HR) 和 95% 置信区间 (CI) 进行 Cox 比例风险分析，以了解基线虚弱和虚弱前期及其在基线时没有抑郁症状的参与者中的组成部分的前瞻性关联。基线时，57.93% 的参与者有抑郁症状，55.84% 的参与者有前衰弱症状，11.63% 的参与者有虚弱症状。在横断面分析中，衰弱前（OR = 5.293，95%CI 4.363–6.422）和衰弱（OR = 16.025，95%CI 10.948–23.457）均与抑郁症状相关。在纵向分析中，在短期内没有基线抑郁症状的参与者的全面调整模型中，虚弱[HR = 1.395 (0.966–2.013)]和虚弱前[HR = 2.458 (0.933, 6.479)]与抑郁症状的发生没有显着相关性。然而，虚弱[HR = 1.397 (1.017, 1.920)]和虚弱前[HR = 2.992 (1.210, 7.397)]与短期内抑郁症状的发生显着相关。在虚弱的组成部分中，缓慢[HR = 1.597 (1.078, 2.366)]与短期内抑郁症状发作的风险增加相关。虚弱[HR = 2.08 (1.055, 4.104)]和疲惫[HR = 1.928 (1.297, 2.867)]与短期内抑郁症状发作的风险增加相关。在中老年人中，在两年的随访期间，虚弱、虚弱前期并不能预测抑郁症状，当考虑到潜在的混杂因素时，单独考虑缓慢可以预测抑郁症状。此外，当考虑到潜在的混杂因素、单独考虑的虚弱和疲惫可预测抑郁症状时，虚弱、虚弱前期预测了 4 年随访期间的抑郁症状。
Prefrailty and frailty are two common conditions among older individuals. Recent studies have reported the association between frailty and depressive symptoms, but whether those conditions could predict depressive symptoms is still inconsistent in a few longitudinal studies. In our study, we aimed to estimate the cross-sectional and longitudinal associations between frailty and incident depressive symptoms in a nationally representative sample of community-dwelling middle-aged and older Chinese adults. Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), which included 17,284 adults aged ≥ 45 years. Participants were followed every two years using a face-to-face, computer-aided personal interview (CAPI) and structured questionnaire. We excluded participants with no follow-up data. The numbers of individuals who completed the baseline surveys were 2,579 and follow-up surveys were 839 for the short-term (2 years from 2011 to 2013) and 788 for the long-term (4 years from 2011 to 2015). In addition, Frailty was measured by the Fried criteria and depressive symptoms were estimated by the Chinese version of the Center for Epidemiologic Studies-Depression scale (CES-D). Logistic regression was used to analyze the odds ratio (OR), and 95% confidence interval (CI) for the cross-sectional associations of frailty and its components with depressive symptoms in the participants at baseline. Cox proportional hazards analysis was conducted using the hazard ratio (HR), and 95% confidence interval (CI) for the prospective associations of baseline frailty and pre-frailty and its component in the participants without depressive symptoms at baseline. At baseline, 57.93% of participants had depressive symptoms and 55.84% had pre-frail and 11.63% had frailty. In the cross-sectional analysis, both pre-frailty (OR = 5.293, 95%CI 4.363–6.422) and frailty (OR = 16.025, 95%CI 10.948–23.457) were associated with depressive symptoms. In the longitudinal analysis, frailty [HR = 1.395 (0.966–2.013)] and pre-frailty [HR = 2.458 (0.933, 6.479)] were not significantly associated with incident depressive symptoms in a full-adjusted model among participants free of baseline depressive symptoms during the short-term. However, frailty [HR = 1.397 (1.017, 1.920)] and pre-frailty [HR = 2.992 (1.210, 7.397)] were significantly associated with incident depressive symptoms during the short term. In the components of frailty, slowness [HR = 1.597 (1.078, 2.366)] was associated with an increased risk of depressive symptoms onset during the short-term. Weakness [HR = 2.08 (1.055, 4.104)] and exhaustion [HR = 1.928 (1.297, 2.867)] were associated with increased risk of depressive symptoms onset during the short-term. Among the middle-aged and older adults, frailty, pre-frailty did not predict depressive symptoms during 2 years of follow-up, when accounting for the potential confounders, slowness considered alone predicted depressive symptoms. Additionally, frailty, pre-frailty predicted depressive symptoms during 4 years of follow-up, when accounting for the potential confounders, weakness and exhaustion considered alone predicted depressive symptoms.
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