老年人睡眠时长与抑郁的关系:基于日常生活自理能力和生活满意度的链式中介作用

The Chain Mediating Role of Activity of Daily Living and Life Satisfaction in the Relationship between Sleep Duration and Depression in Older Adults

  • 摘要: 探讨日常生活自理能力(Activity of Daily Living, ADL)与生活满意度在老年人睡眠时长与抑郁之间的中介效应,揭示睡眠时长影响抑郁的路径。基于中国健康与养老追踪调查(CHARLS)2020年数据,纳入8 323名年龄在60岁及以上的老年人,采用Katz量表、生活满意度问卷和抑郁量表简版(CES-D10)分别评估ADL、生活满意度及抑郁,同时运用Bootstrap法检验链式中介效应。研究发现,睡眠时长与抑郁呈负相关(c=-0.111,P < 0.001)。ADL和生活满意度在睡眠时长与抑郁间起链式中介作用,间接效应为-0.002 4(95% CI: -0.003 4, -0.001 5),睡眠时长通过ADL和生活满意度间接影响了老年人的抑郁。为此,建议加强社区健康教育,引导老年人科学睡眠;加强康复训练与辅助器具使用指导,延缓功能衰退;组织丰富的社交与文化活动,提升老年人的生活满意度;向存在情绪风险的个体及时提供认知行为疗法等心理支持,阻断抑郁发生路径;系统构建社区医疗一体化与社会支持相结合的支持网络,形成互补性的老年心理健康保障体系。

     

    Abstract: This paper aims to discuss the mediating effect of activity of daily living (ADL) and life satisfaction between sleep duration and depression in the elderly, and to reveal the pathways through which sleep affects depression. Based on data from the 2020 China Health and Retirement Longitudinal Study (CHARLS), a total of 8 323 individuals aged 60 years and above were included. The Katz Scale, the Life Satisfaction Questionnaire, and the Chinese version of the CES-D10 Scale were used to assess ADL, life satisfaction, and depression, respectively. The bootstrap method was employed to test the chain mediating effect. The results showed that sleep duration was negatively correlated with depression (c = -0.111, P < 0.001). ADL and life satisfaction played a chain mediating role between sleep duration and depression, with an indirect effect of -0.002 4 (95% CI: -0.003 4, -0.001 5), indicating that sleep duration indirectly affected depression in the elderly by affecting ADL and life satisfaction. Therefore, it is recommended to popularize scientific sleep knowledge through community health education to guide the elderly towards healthy sleep; to strengthen ADL rehabilitation training and assistive device guidance to delay functional decline; to organize diverse social and cultural activities to enhance life satisfaction among the elderly; to provide timely psychological support such as cognitive behavioral therapy to individuals at risk of emotional problems, thereby blocking the pathway to depression; and to systematically build a support network integrating community-based medical services and social support, forming a complementary mental health protection system for the elderly.

     

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