Mediating role of activities of daily living and self-rated health in chronic disease-caused depressive symptoms among the elderly / 预防医学

ABSTRACT

Objective@#To investigate the mediating role of activities of daily living (ADL) and self-rated health in chronic disease-caused depressive symptoms among the elderly, so as to provide insights into depression control among the elderly. @*Methods@#Basic features, depressive symptoms, number of chronic diseases, ADL and self-rated health of the elderly at ages of 60 years and older were collected from the China Health and Retirement Longitudinal Study 2018. Multiple linear regression model was created using the Process program to examine the mediating role of ADL and self-rated health in number of chronic disease-caused depressive symptoms, and the significance of the mediating role was tested using the Bootstrap test. @*Results@#A total of 5 892 elderly participants were enrolled, with a mean age of (68.42±6.23) years and including 2 744 men (46.57%). The participants had a median depressive symptom score of 8 (interquartile range, 10) points, a median number of chronic diseases of 1 (interquartile range, 1), a median ADL score of 12 (interquartile range, 3) points, and a median self-rated health score of 3 (interquartile range, 1) points. Mediation analysis showed that number of chronic diseases affected depressive symptoms via the independent mediating role of ADL (β=0.163, 95%CI 0.120-0.206) and self-rated health (β=0.303, 95%CI 0.259-0.351), and affected depressive symptoms via the chain mediating role of ADL and self-rated health (β=0.057, 95%CI 0.043-0.074) among the elderly, and the gross mediating role consisted of 58.44% of total effects. @*Conclusions@#The number of chronic diseases may incease the risk of depressive symptoms through aggravating the impairment of ADL and decreasing self-rated health levels among the elderly.