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Abstract：
Early studies have shown a relationship between activities of daily living (ADL) disability and depressive symptoms in older people. However, discussions on the direction of this relationship are insufficient. The study\'s objective was to assess the reciprocal relationship between ADL disability and depressive symptoms among middle-aged and older Chinese people.
Data was collected in four waves of a nationwide survey, the China Health and Retirement Longitudinal Study (CHARLS), which was carried out in 2011, 2013, 2015, and 2018. In total, this study included 4,124 participants aged ≥ 45 years at baseline. A summing score of the eleven items for basic activities of daily living (BADL) and instrumental activities of daily living (IADL) was calculated to indicate the degree of ADL disability. The 10-item Centre for Epidemiological Studies Depression Scale (CESD-10) was adopted to measure depressive symptoms. The reciprocal relationship between ADL disability and depressive symptoms was tested by cross-lagged models.
At baseline, 911 (22.1%) participants were classified as having difficulties with ADL, and the prevalence of depressive symptoms was 34.4% (1,418). Among middle-aged and older people in China, there was a significant reciprocal and longitudinal relationship between ADL disability and depressive symptoms. People who had difficulty with ADL faced a higher risk of depressive symptoms, and those who suffered from depressive symptoms were accompanied by an increase in ADL disability in the following years. The subgroup analysis on age also showed that ADL disability was reciprocally and longitudinally related to depressive symptoms. However, only women showed similar results in the subgroup analysis on gender.
This study shows that ADL disability is bi-directionally related to depressive symptoms in middle-aged and older Chinese people over time. The results suggest we should identify ADL disability and bad psychological conditions in time to prevent subsequent mutual damage among middle-aged and older Chinese people, a vulnerable group rising in the future.
Data was collected in four waves of a nationwide survey, the China Health and Retirement Longitudinal Study (CHARLS), which was carried out in 2011, 2013, 2015, and 2018. In total, this study included 4,124 participants aged ≥ 45 years at baseline. A summing score of the eleven items for basic activities of daily living (BADL) and instrumental activities of daily living (IADL) was calculated to indicate the degree of ADL disability. The 10-item Centre for Epidemiological Studies Depression Scale (CESD-10) was adopted to measure depressive symptoms. The reciprocal relationship between ADL disability and depressive symptoms was tested by cross-lagged models.
At baseline, 911 (22.1%) participants were classified as having difficulties with ADL, and the prevalence of depressive symptoms was 34.4% (1,418). Among middle-aged and older people in China, there was a significant reciprocal and longitudinal relationship between ADL disability and depressive symptoms. People who had difficulty with ADL faced a higher risk of depressive symptoms, and those who suffered from depressive symptoms were accompanied by an increase in ADL disability in the following years. The subgroup analysis on age also showed that ADL disability was reciprocally and longitudinally related to depressive symptoms. However, only women showed similar results in the subgroup analysis on gender.
This study shows that ADL disability is bi-directionally related to depressive symptoms in middle-aged and older Chinese people over time. The results suggest we should identify ADL disability and bad psychological conditions in time to prevent subsequent mutual damage among middle-aged and older Chinese people, a vulnerable group rising in the future.
摘要：
背景：早期研究表明，老年人的日常生活活动（ADL）残疾与抑郁症状之间存在关系。然而,关于这种关系的方向的讨论是不够的。该研究的目的是评估中国中老年人ADL残疾与抑郁症状之间的相互关系。
方法：在全国范围的四波调查中收集了数据，中国健康与退休纵向研究(CHARLS)，分别于2011年、2013年、2015年和2018年进行。总的来说,这项研究包括4,124名基线年龄≥45岁的参与者.计算了基本日常生活活动（BADL）和工具日常生活活动（IADL）的11个项目的总和得分，以表明ADL残疾的程度。采用10项流行病学研究中心抑郁量表（CESD-10）测量抑郁症状。通过交叉滞后模型检验ADL残疾与抑郁症状之间的相互关系。
结果：在基线时，911(22.1%)参与者被归类为ADL有困难，抑郁症状的患病率为34.4％（1,418）。在中国的中老年人中，ADL残疾与抑郁症状之间存在显著的相互关系和纵向关系.ADL有困难的人面临抑郁症状的风险更高，在接下来的几年中，患有抑郁症状的患者伴随着ADL残疾的增加。对年龄的亚组分析还显示，ADL残疾与抑郁症状具有相互关系和纵向关系。然而,只有女性在性别亚组分析中表现出相似的结果.
结论：这项研究表明，随着时间的推移，中国中老年人ADL残疾与抑郁症状双向相关。结果表明，我们应该及时识别ADL残疾和不良心理状况，以防止中老年人随后的相互损害，未来崛起的弱势群体。
方法：在全国范围的四波调查中收集了数据，中国健康与退休纵向研究(CHARLS)，分别于2011年、2013年、2015年和2018年进行。总的来说,这项研究包括4,124名基线年龄≥45岁的参与者.计算了基本日常生活活动（BADL）和工具日常生活活动（IADL）的11个项目的总和得分，以表明ADL残疾的程度。采用10项流行病学研究中心抑郁量表（CESD-10）测量抑郁症状。通过交叉滞后模型检验ADL残疾与抑郁症状之间的相互关系。
结果：在基线时，911(22.1%)参与者被归类为ADL有困难，抑郁症状的患病率为34.4％（1,418）。在中国的中老年人中，ADL残疾与抑郁症状之间存在显著的相互关系和纵向关系.ADL有困难的人面临抑郁症状的风险更高，在接下来的几年中，患有抑郁症状的患者伴随着ADL残疾的增加。对年龄的亚组分析还显示，ADL残疾与抑郁症状具有相互关系和纵向关系。然而,只有女性在性别亚组分析中表现出相似的结果.
结论：这项研究表明，随着时间的推移，中国中老年人ADL残疾与抑郁症状双向相关。结果表明，我们应该及时识别ADL残疾和不良心理状况，以防止中老年人随后的相互损害，未来崛起的弱势群体。
