Abstract:Objective To explore the mediating effects of activities of daily living (ADL) and social participation on depressive symptoms and cognitive function among the elderly, so as to provide the basis for preventing cognitive decline. Methods Basic information, depressive symptoms, cognitive function, ADL, and social participation of the elderly aged 60 and above were collected through the 2020 database of China Health and Retirement Longitudinal Study. The Process 4.3 program was used to analyze the mediating effects of ADL and social participation on depressive symptoms and cognitive function among the elderly. Results A total of 6 722 elderly people were enrolled, including 3 791 males (56.40%) and 2 931 females (43.60%). The mean age was (68.52±6.00) years. The median depressive symptoms score was 7.00 (interquartile range, 9.00) points, with 2 436 individuals (36.24%) having depressive symptoms. The median cognitive function score was 12.50 (interquartile range, 4.50) points. The median ADL score was 0 (interquartile range, 1.00) point, with 2 173 individuals (32.33%) having ADL impairment. The median social participation score was 1.00 (interquartile range, 1.00) point. Mediating effect analysis showed that, after controlling for variables such as age, educational level, and residence, depressive symptoms indirectly negatively affected cognitive function through the independent mediating effects of ADL (β=-0.031, 95%CI: -0.042 to -0.020) and social participation (β=-0.008, 95%CI: -0.011 to -0.004), and negatively affected cognitive function via the chain mediating effects of ADL and social participation (β=-0.002, 95%CI: -0.003 to -0.001). The total mediating effect accounted for 25.79% of the total effect. Conclusion Depressive symptoms may indirectly and negatively affect the cognitive function among the elderly through ADL and social participation.
王熙, 乔婷婷. 老年人日常生活活动能力、社会参与在抑郁症状与认知功能间的中介效应分析[J]. 预防医学, 2025, 37(5): 438-442.
WANG Xi, QIAO Tingting. Mediating effects of activities of daily living and social participation on depressive symptoms and cognitive function among the elderly. Preventive Medicine, 2025, 37(5): 438-442.
[1] 段芮,王红.2011—2018年我国中老年人抑郁症状流行趋势分析[J].预防医学,2023,35(8):649-654. DUAN R,WANG H.Trends in prevalence of depression symptoms among middle-aged and elderly residents in China from 2011 to 2018[J].China Prev Med J,2023,35(8):649-654.(in Chinese) [2] 张丛笑,沈利明,吴丽萍,等.西湖区中老年人群轻度认知障碍的影响因素研究[J].预防医学,2025,37(4):331-335. ZHANG C X,SHEN L M,WU L P,et al.Influencing factors for mild cognitive impairment among middle-aged and elderly people in Xihu District[J].China Prev Med J,2025,37(4):331-335.(in Chinese) [3] 董文烁,王美娟,李梦丽,等.农村老年人抑郁症状的潜在剖面及与认知功能的关系[J].护理学杂志,2024,39(1):98-102. DONG W S,WANG M J,LI M L,et al.Latent profiles of depressive symptoms and their relationships with cognitive function among rural older adults[J].J Nurs Sci,2024,39(1):98-102.(in Chinese) [4] 冯晓晨,王永强,王欣,等.日常生活活动能力对慢性病共病认知功能的影响——社会参与和抑郁的链式参与效应[J].现代预防医学,2024,51(19):3576-3582. FENG X C,WANG Y Q,WANG X,et al.The impact of activities of daily living on cognitive function in elderly individuals with chronic comorbidities:the chain mediating effects of social participation and depression[J].Mod Prev Med,2024,51(19):3576-3582.(in Chinese) [5] 王琼,刘晨,侯晓春,等.社会参与类型对老年人认知功能的影响研究[J].中国预防医学杂志,2023,24(7):632-636. WANG Q,LIU C,HOU X C,et al.A study on the effect of social participation types on cognitive function in the elderly population[J].Chin Prev Med,2023,24(7):632-636.(in Chinese) [6] 张宝辉,张益嘉,郭海强,等.基于我国开放研究数据的论文国际影响力研究——以北京大学开放研究数据平台的中国健康与养老追踪调查数据为例[J].中国科技期刊研究,2024,35(11):1571-1579. ZHANG B H,ZHANG J Y,GUO H Q,et al.International influence of papers based on Chinese open research data:China Health and Retirement Longitudinal Study data from Peking University Open Research Data as an example[J].Chin J Sci Tech Period,2024,35(11):1571-1579.(in Chinese) [7] 葛汝旭,井激,郭桐桐,等.老年人社会参与对认知功能的影响:代际精神支持和抑郁的链式作用[J].现代预防医学,2024,51(22):4159-4164,4218. GE R X,JING J,GUO T T,et al.Effects of social participation on cognitive functioning in older adults:the chain-mediated role of intergenerational psychosocial support and depression[J].Mod Prev Med,2024,51(22):4159-4164,4218.(in Chinese) [8] 孙宇超,冯晶,雷子辉,等.中国中老年人群抑郁症状与认知功能关系[J].中国公共卫生,2024,40(10):1206-1211. SUN Y C,FENG J,LEI Z H,et al.Correlation between depressive symptoms and cognitive function in middle-aged and elderly population in China:an analysis of CHARLS baseline data[J].Chin J Public Health,2024,40(10):1206-1211.(in Chinese) [9] 赵元萍,丁睿,谢红.中国版日常生活活动能力量表编制与信效度验证[J].实用老年医学,2022,36(12):1215-1219. ZHAO Y P,DING R,XIE H.Development and validation of reliability and validity of Chinese version of activities of daily living scale[J].Pract Geriatr,2022,36(12):1215-1219.(in Chinese) [10] 袁玫,杜金,王婉晨,等.抑郁在老年人日常生活活动能力和认知功能状况的中介效应研究[J].现代预防医学,2022,49(24):4500-4504. YUAN M,DU J,WANG W C,et al.The mediating effect of depression on the ability of daily living and cognitive function in the elderly[J].Mod Prev Med,2022,49(24):4500-4504.(in Chinese) [11] 徐金燕,曹秀清.老年人认知衰退与抑郁的动态关系及社会参与的调节作用[J].中国人口科学,2025,39(2):29-44. XU J Y,CAO X Q.The dynamic relationship between cognitive decline and depression in older adults and the moderating role of social participation[J].Chin J Popul Sci,2025,39(2):29-44.(in Chinese) [12] 韩雨生,袁建新.抑郁症认知功能障碍神经生物学机制研究进展[J].神经疾病与精神卫生,2021,21(12):873-878. HAN Y S,YUAN J X.Advances in neurobiological mechanisms of cognitive dysfunction in depression[J].J Neurosci Mental Health,2021,21(12):873-878.(in Chinese) [13] 田英汉,刘乐伟,杨铖,等.城市老年人抑郁与认知功能的相关性及性别差异研究[J].中国全科医学,2025,28(1):47-52. TIAN Y H,LIU L W,YANG C,et al.Associations and sex differences between depression and cognitive function in the urban elderly[J].Chin Gen Pract,2025,28(1):47-52.(in Chinese) [14] 陈金凤,方明旺,肖成汉,等.中国老年人日常生活活动能力与抑郁症状的关系研究[J].中国全科医学,2020,23(22):2852-2855,2862. CHEN J F,FANG M W,XIAO C H,et al.Activities of daily living and depressive symptoms in the Chinese elderly[J].Chin Gen Pract,2020,23(22):2852-2855,2862.(in Chinese) [15] 王怀昭,乔婷婷,范艳存.老年人日常生活活动能力、自评健康状况在慢性病影响抑郁症状中的效应研究[J].预防医学,2023,35(7):574-577. WANG H Z,QIAO T T,FAN Y C.Mediating role of activities of daily living and self-rated health in chronic disease-caused depressive symptoms among the elderly[J].China Prev Med J,2023,35(7):574-577.(in Chinese) [16] 朱荟. 中国老年人社会参与对其孤独感的影响探究——基于CLHLS2018数据的验证[J].人口与发展,2021,27(5):12-23. ZHU H.On the influence of social participation on loneliness of the elderly in China:based on data of CLHLS2018[J].Popul Dev,2021,27(5):12-23.(in Chinese)