老年2型糖尿病患者衰弱和抑郁:心理弹性的中介作用和社会网络规模的调节作用

Frailty and depression in elderly patients with type 2 diabetes: mediating effect of resilience and moderating role of social network size

摘要

背景 随着老龄化进程加快,老年糖尿病患者数量激增。老年人群在罹患糖尿病和衰弱的双重压力下,发生抑郁的风险显著升高。目的探索老年2型糖尿病患者衰弱对抑郁的影响,以及心理弹性的中介作用和社会网络规模的调节作用。方法 使用社会网络调查、衰弱筛查量表、Connor-Davidson心理弹性量表简版和简短老年抑郁量表对2024年7月—12月于济宁医学院附属医院内分泌遗传代谢科住院的144例老年2型糖尿病患者进行问卷调查,采用SPSS 22.0进行假设检验和相关分析,采用SPSS PROCESS宏程序进行中介效应和调节效应检验。结果 老年糖尿病患者的社会网络规模为(3.37±1.08)人,心理弹性、衰弱和抑郁的评分分别为(30.45±6.04)分、0(0,1)分和0(0,1)分。心理弹性与网络规模呈正相关(r=0.240,P＜0.05),与衰弱和抑郁呈负相关(r=-0.202,-0.283,均P＜0.05);衰弱与抑郁呈正相关(r=0.329,P＜0.05)。心理弹性在老年糖尿病患者衰弱和抑郁之间具有部分中介作用,中介效应为0.059(95%CI:0.008~0.143),占总效应22.96%。社会网络规模的调节作用显著,对于低衰弱水平的老年糖尿病患者,高水平的社会网络规模能够显著减少抑郁的发生,而在高衰弱水平下,社会网络规模的调节作用相对减小。结论 心理弹性在老年2型糖尿病患者衰弱和抑郁之间具有部分中介作用,社会网络规模的调节作用显著,良好的心理弹性和较大规模的社会网络能够预防低衰弱水平的老年2型糖尿病患者产生抑郁情绪。

Abstract

Background With the accelerated aging process,the number of elderly patients with diabetes has increased dramatically.Under the dual pressure of diabetes and frailty,the risk of depression in the elderly population has significantly increased. Objective To explore the effect of frailty on depression in elderly patients with type 2 diabetes, as well as the mediating effect of resilience and the moderating effect of social network scale. Methods From July to December 2024,a questionnaire survey was conducted among 144 elderly patients with type 2 diabetes who were hospitalized in the Department of Endocrine Genetic Metabolism,Affiliated Hospital of Jining Medical University using the social network survey,the FRAIL scale,Connor-Davidson resilience scale,and the geriatric depression scale.SPSS 22.0 was used for hypothesis test and correlation analysis,and SPSS PROCESS macro program was used to test the mediating effect and moderating role. Results The social network size of elderly diabetic patients was 3.37±1.08,and the scores of resilience,frailty and depression were 30.45±6.04,0(0,1) and 0(0,1) respectively.Resilience was positively correlated with social network size (r=0.240,P＜0.05),and negatively correlated with frailty and depression (r=-0.202,-0.283,both P＜0.05).Frailty was positively correlated with depression (r=0.329,P＜0.05).Resilience had a partial mediating effect between frailty and depressive symptoms in elderly diabetic patients,with a mediating effect of 0.059(95%CI:0.008~0.143),accounting for 22.96% of the total effect.The social network size had a significant moderating effect.For the elderly diabetic patients at low frailty level,the bigger social network size could significantly reduce the incidence of depression,while the social network scale had a relatively low moderating effect under the high level of frailty. Conclusion Resilience played a mediating role in the frailty and depression of elderly patients with type 2 diabetes and the regulation of social network size was significant.Good resilience and large social network size can prevent depression in elderly patients with type 2 diabetes at low frailty level.

关键词

2型糖尿病 / 老年人 / 衰弱 / 抑郁 / 心理弹性 / 社会网络

Key words

Type 2 diabetes mellitus / Aged / Frailty / Depression / Psychological resilience / Social network scale

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基金资助

济宁市重点研发计划(2024YXNS032)