焦虑在老年肺癌患者认知功能与肌少症间的中介作用^*

The mediation role of anxiety in elderly lung cancer patients between cognitive function and sarcopenia

摘要

目的 探讨焦虑在老年肺癌患者认知功能与肌少症间的中介作用,为老年肺癌患者的临床干预提供理论依据。方法 采用回顾性研究方法,选取2022年10月—2025年1月克拉玛依市中心医院的258例老年肺癌患者为研究对象,使用一般资料调查表、简易精神状态检查量表(MMSE)及广泛性焦虑障碍量表(GAD-7)进行评估。数据分析采用Spearman秩相关分析及PROCESS程序进行中介效应检验。结果 老年肺癌患者肌少症患病率为43.8%。Spearman相关系数得出认知功能与焦虑呈显著负相关(r=-0.869,P＜0.001),焦虑与肌少症呈显著正相关(r=0.560,P＜0.001)。中介效应分析显示,认知功能与肌少症之间无直接关联(B=-0.053,P=0.271),焦虑在认知功能与肌少症之间具有显著中介效应(间接效应a×b=-0.176,95%CI:-0.277～-0.095,a×b为间接效应值,反映认知功能通过焦虑对肌少症的影响强度)。结论 焦虑在老年肺癌患者认知功能与肌少症之间具有重要中介作用,临床管理中应加强心理健康干预,以改善老年肺癌患者整体健康状况。

Abstract

Objective To investigate the mediation role of anxiety in the relationship between cognitive function and sarcopenia in elderly lung cancer patients, providing a theoretical basis for clinical interventions in this population. Methods A retrospective study was conducted involving 258 elderly lung cancer patients from Karamay Central Hospital from October 2022 to January 2025. Participants were assessed using a demographic questionnaire, the Mini-Mental State Examination (MMSE), and the Generalized Anxiety Disorder-7 (GAD-7) scale. Data analysis employed Spearman's rank correlation analysis and the PROCESS procedure to evaluate mediation effects. Results The prevalence of sarcopenia among elderly lung cancer patients was 43.8%. Spearman's correlation coefficient revealed a significant negative correlation between cognitive function and anxiety (r=-0.869, P＜0.001), and a significant positive correlation between anxiety and sarcopenia (r=0.560, P＜0.001). Mediation effect analysis revealed no direct association between cognitive function and sarcopenia (B=-0.053, P=0.271). Anxiety exerted a significant mediation effect between cognitive function and sarcopenia (indirect effect a×b=-0.176, 95% CI: -0.277 to -0.095; Here, a×b represents the indirect effect value, reflecting the strength of cognitive function's influence on sarcopenia through anxiety). Conclusion Anxiety plays a significant mediation role between cognitive function and sarcopenia in elderly lung cancer patients. Clinical management should prioritize mental health interventions to enhance overall health outcomes in this population.

关键词

肺癌 / 肌少症 / 焦虑 / 认知功能 / 中介效应

Key words

Lung cancer / Sarcopenia / Anxiety / Cognitive function / Mediation effect

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基金资助

^*天山英才医药卫生高层次人才培养计划(TSYC202301B150);新疆维吾尔自治区自然科学基金(2024D01C131)