双重感觉障碍与抑郁症状：三个队列中的关联与路径及一项荟萃分析
Dual Sensory Impairment and Depressive Symptoms: Association and Pathways in Three Cohorts and a Meta-Analysis.
文献信息
| PMID | 42819014 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ping Ni |
| 作者单位 | Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province West China Hospital Sichuan University/West China School of Nursing Sichuan University Chengdu China scu.edu.cn. |
| 期刊 | Depression and anxiety |
| SCI 分区 | Q2 |
| IF | 5.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 双重感觉障碍（DSI）对抑郁症状的总体影响及其潜在机制仍不清楚，尤其是在不同文化背景下。本研究旨在考察三个不同人群中DSI与抑郁症状之间的关联，同时探讨社会参与和认知功能的中介作用。
方法： 参与者来自三个老龄化队列：中国健康与养老追踪调查（CHARLS）、健康与退休研究（HRS）和英国老龄化纵向研究（ELSA）。分析了协调后的调查波次数据（2011/2012、2015/2016和2018）。抑郁症状采用流行病学研究中心抑郁量表（CES-D）评估，DSI根据自我报告的听力和视力障碍定义。为解决潜在混杂，逻辑回归模型对人口学、生活方式和健康因素进行了调整。使用PROCESS宏（模型4）进行中介分析，以考察社会参与和认知功能的作用。此外，通过将本研究结果与既往队列研究结果整合，进行了荟萃分析。
结果： 本研究共纳入来自三个队列的19,310名参与者。分别分析显示，DSI与这些队列中较高的抑郁症状几率显著相关（CHARLS中比值比[OR]=1.24，95%置信区间[CI]=1.15-1.33；HRS中OR=2.04，95% CI=1.78-2.31；ELSA中OR=2.40，95% CI=1.79-3.00）。荟萃分析证实了这种关联（OR=1.73，HR=1.30）。这种关系部分由社会参与减少（2.31%-6.35%）和认知下降（5.72%-14.00%）中介。
结论： 在中国、美国和英国的中老年人中，DSI与抑郁症状持续相关。社会参与减少和认知下降均显著中介了这种关联，效应量相当。中介效应在很大程度上稳健，仅在一项敏感性分析中观察到不稳定性。
英文摘要
BACKGROUND: The overall impact of dual sensory impairment (DSI) on depressive symptoms and its underlying mechanisms remains unclear, particularly across different culture contexts. This study aimed to examine the association between DSI and depressive symptoms in three distinct populations while exploring the mediating roles of social engagement and cognitive function.
METHODS: Participants were recruited from three aging cohorts: the China Health and Retirement Longitudinal Study (CHARLS), the Health and Retirement Study (HRS), and the English Longitudinal Study of Ageing (ELSA). Harmonized survey wave data (2011/2012, 2015/2016, and 2018) were analyzed. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), and DSI was defined based on self-reported hearing and vision impairments. To address potential confounding, logistic regression models were adjusted for demographic, lifestyle, and health factors. Mediation analyses were conducted using the PROCESS Macro (model 4) to examine the roles of social engagement and cognitive function. Furthermore, a meta-analysis was performed by integrating the results of the present study with those from previous cohort studies.
RESULTS: The study included 19,310 participants from the three cohorts. Separate analyses showed that DSI was significantly associated with higher odds of depressive symptoms across these cohorts (odds ratio [OR] = 1.24, 95% confidence interval [CI] = 1.15-1.33 in CHARLS; OR = 2.04, 95% CI = 1.78-2.31 in HRS; OR = 2.40, 95% CI = 1.79-3.00 in ELSA). A meta-analysis confirmed this association (OR = 1.73 and HR = 1.30). This relationship was partially mediated by reduced social engagement (2.31%-6.35%) and cognitive decline (5.72%-14.00%).
CONCLUSIONS: DSI is consistently associated with depressive symptoms in middle-aged and older adults across China, the United States, and England. Both reduced social engagement and cognitive decline significantly mediated this association, with comparable effect sizes. The mediation effects are largely robust, with instability observed only in one sensitivity analysis.