抑郁症状在首次观察到视力和听力联合受损之前就已加重：基于CHARLS的纵向轨迹研究
Depressive symptoms worsen before combined vision and hearing impairment is first observed: a longitudinal trajectory study using CHARLS.
文献信息
| PMID | 42934743 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Daolei Wu |
| 作者单位 | Department of Ophthalmology, Lishui Municipal Central Hospital, Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China. |
| 期刊 | BMC psychology |
| SCI 分区 | Q1 |
| IF | 4.6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 视力和听力联合受损，即双重感觉障碍（DSI），与抑郁症状相关，但目前尚不清楚抑郁症状主要是在首次观察到DSI之后才加重，还是在之前就已明显加重。
方法： 我们使用了2011年至2020年中国健康与养老纵向研究（CHARLS）的数据。共纳入5,210名基线时无DSI且无显著抑郁症状的中老年人。抑郁症状采用10条目流行病学研究中心抑郁量表（CESD-10）评估。采用分段线性混合效应模型检验首次观察到DSI之前和之后的抑郁症状轨迹。对基线协变量缺失采用多重插补。模型调整了社会人口学因素、健康行为、慢性疾病和体重指数。
结果： 随访期间，3,371名参与者首次被观察到DSI，而1,839名仍未出现DSI。在完全调整模型中，随访期间首次观察到DSI的参与者基线CESD-10评分更高（β = 0.777，95%置信区间[CI]：0.526至1.028），并且在首次观察到DSI之前抑郁症状增加速度快于仍未出现DSI者（β = 0.166，95% CI：0.077至0.255）。首次观察到DSI之后，该组继续表现出更不利的抑郁症状轨迹（β = 0.149，95% CI：0.090至0.209）。然而，此后斜率差异并未进一步增大（β = -0.017，95% CI：-0.148至0.115）。
结论： 随访期间首次观察到DSI的参与者在首次观察到DSI之前就表现出抑郁症状更快加重，而不仅仅是在之后。这些发现提示，DSI与抑郁症状之间的关联可能部分反映了更早开始的共同衰老相关风险过程。
临床试验编号： 不适用。
英文摘要
BACKGROUND: Combined vision and hearing impairment, referred to as dual sensory impairment (DSI), has been associated with depressive symptoms, but it remains unclear whether depressive symptoms worsen mainly after DSI is first observed or whether worsening is already evident beforehand.
METHODS: We used data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020. A total of 5,210 middle-aged and older adults who were free of DSI and significant depressive symptoms at baseline were included. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Piecewise linear mixed-effects models were used to examine depressive symptom trajectories before and after DSI was first observed. Multiple imputation was used for missing baseline covariates. Models were adjusted for sociodemographic factors, health behaviors, chronic conditions, and body mass index.
RESULTS: During follow-up, 3,371 participants were first observed with DSI, whereas 1,839 remained free of DSI. In fully adjusted models, participants who were first observed with DSI during follow-up had higher baseline CESD-10 scores (β = 0.777, 95% confidence interval [CI]: 0.526 to 1.028) and showed a faster increase in depressive symptoms before DSI was first observed than those who remained free of DSI (β = 0.166, 95% CI: 0.077 to 0.255). After DSI was first observed, this group continued to show a more unfavorable depressive symptom trajectory (β = 0.149, 95% CI: 0.090 to 0.209). However, the slope difference did not further increase thereafter (β = -0.017, 95% CI: -0.148 to 0.115).
CONCLUSIONS: Participants who were first observed with DSI during follow-up showed faster worsening of depressive symptoms before DSI was first observed, rather than only afterward. These findings suggest that the association between DSI and depressive symptoms may partly reflect shared aging-related risk processes that begin earlier.
CLINICAL TRIAL NUMBER: Not applicable.