Article(id=1324044747362411092, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202509278, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1758038400000, receivedDateStr=2025-09-17, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793606467332, onlineDateStr=2026-11-02, pubDate=1779638400000, pubDateStr=2026-05-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793606467332, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793606467332, creator=13701087609, updateTime=1793606467332, updator=13701087609, issue=Issue{id=1324044701648695723, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='10', pageStart='1729', pageEnd='1920', issueExtLink='null', onlineDate='null', pubDate='1779638400000', pubDateStr='2026-05-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793606456434, creator='13701087609', updateTime=1793670074552, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311535425815306, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311535425815307, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1729, endPage=1734, ext={EN=ArticleExt(id=1324044747790230102, articleId=1324044747362411092, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Longitudinal study on the association between activities of daily living, depression symptoms, and cognitive function in rural elderly, Guizhou, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective Based on longitudinal survey data, this study aimed to explore the associations between Activities of Daily Living (ADL), depressive symptoms, and cognitive function among rural elderly individuals in Guizhou Province, so as to provide scientific evidence for promoting the health of rural elderly populations.
Methods A multi-stage cluster sampling method was adopted to select rural elderly individuals aged 60 years and above from 12 villages in 5 townships (towns) of 2 counties (districts) in Guizhou Province. A baseline survey (T1) was conducted in 2019, and a follow-up survey (T2) was carried out in 2022. Generalized Estimating Equations (GEE) were used to analyze the associations and interaction effects between ADL, depressive symptoms, and cognitive function.
Results A total of 763 elderly individuals were included as participants in this study. The results showed that both ADL scores (β=-0.57, 95%CI: -0.68 - -0.47) and depression scores (β=-0.20 95%CI: -0.33 - -0.06) were negatively associated with cognitive function (assessed by Mini-Mental State Examination ［MMSE］ scores). Furthermore, a significant interaction effect was observed between these two factors on cognitive function (β=0.11, 95%CI: 0.08-0.15). Stratified analysis by depression score levels revealed that ADL scores remained negatively associated with cognitive function across all strata (all P<0.05). When stratified by ADL score levels, depression scores were negatively associated with cognitive function in the low ADL group (P<0.05), whereas no statistically significant association was found in the high ADL group (β=-0.06, 95%CI: -0.28-0.17).
Conclusion Impaired ADL and depressive symptoms increase the risk of cognitive decline in elderly individuals in rural areas. Depression can moderate the association between ADL and cognitive function: elderly individuals with unimpaired ADL may be more vulnerable to the impact of depression on cognitive function. Strengthening the monitoring and intervention of ADL and depressive symptoms in the elderly is conducive to preventing or delaying cognitive decline among elderly individuals in rural areas.
, authors=Mei WU
1, Jin-nian YIN
1, Mei-xia LIU
1, Zhi-yue JIANG
1, Jin HU
1, Xing YANG
1, 2, Quan-xiang ZHOU
3, Jing-yuan YANG
1, authorsList=Mei WU, Jin-nian YIN, Mei-xia LIU, Zhi-yue JIANG, Jin HU, Xing YANG, Quan-xiang ZHOU, Jing-yuan YANG, authorCompany=null, correspAuthors=Jing-yuan YANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324044749228876382, articleId=1324044747362411092, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=贵州农村老年人日常生活能力、抑郁症状与认知功能关联的纵向研究, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的 基于纵向调查资料探讨贵州农村老年人日常生活能力（Activities of Daily Living，ADL）、抑郁症状与认知功能的关联，为促进农村老年人健康提供科学依据。
方法 采用多阶段整群抽样方法，选取贵州省2个县（区）内5个乡（镇）的12个村60岁及以上的农村老年人为研究对象，于2019年进行基线（T1）调查，并于2022年进行随访（T2），采用广义估计方程（Generalized Estimating Equations，GEE）分析ADL、抑郁症状与认知功能的关联及交互作用。
结果 本次共纳入763名老年人作为研究对象，结果显示，老年人ADL得分（β=-0.57，95%CI：-0.68~-0.47）、抑郁得分（β=-0.20，95%CI：-0.33~-0.06）均与认知功能（MMSE评分）呈负关联，且两者与认知功能得分的关联存在交互作用（β=0.11，95%CI：0.08~0.15）。进一步对抑郁得分水平分层分析，ADL得分与认知功能得分均存在负关联（P均<0.05）；对ADL得分水平分层分析，在低ADL得分水平的人群中，抑郁得分与认知功能得分存在负关联（P<0.05）；而在高ADL得分水平的人群中，则无统计学关联（β=-0.06，95%CI：-0.28~0.17）。
结论 农村老年人的ADL受损、抑郁症状增加认知功能下降风险，抑郁可调节ADL与认知功能的关联，ADL未受损老年人认知功能可能易受到抑郁的影响，加强老年人ADL和抑郁症状的监测及干预有助于预防或延缓农村老年人认知功能下降。
, authors=吴玫
1, 尹金念
1, 刘美霞
1, 蒋芝月
1, 胡谨
1, 杨星
1, 2, 周全湘
3, 杨敬源
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吴玫（2001—），女，硕士在读，研究方向：慢性病流行病学
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本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=BnHsPym9a8U46HPSsTETCA==, magXml=fhU/fyADgoiyyM10KW1/Ag==, pdfUrl=null, pdf=RGIj8JJdDIMQtCJLXW13Hw==, pdfFileSize=743689, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=QXbzRAeeAr7HvV/BkpQ3Sw==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=zcOrEafewhbHao5mPWZM8w==, mapNumber=null, fund=null)}, authors=[Author(id=1324044751166644839, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1324044751254725225, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, authorId=1324044751166644839, language=EN, stringName=Mei WU, firstName=Mei, middleName=null, lastName=WU, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=
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1.贵州医科大学公共卫生与健康学院，环境污染与疾病监控教育部重点实验室 贵州 贵阳 561113)]), AuthorCompany(id=1324044750956929634, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, xref=2., ext=[AuthorCompanyExt(id=1324044750965318243, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, companyId=1324044750956929634, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=
2.贵州医科大学医药卫生管理学院)]), AuthorCompany(id=1324044751070175844, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, xref=3., ext=[AuthorCompanyExt(id=1324044751078564453, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, companyId=1324044751070175844, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=
3.黔南民族医学高等专科学校)])], figs=[ArticleFig(id=1324044755532915351, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, language=EN, label=Fig.1, caption=
Analysis of the interaction effect of ADL and depression on cognitive function, figureFileSmall=yfC2u/QjWomYOu+pWxut8g==, figureFileBig=QXbzRAeeAr7HvV/BkpQ3Sw==, tableContent=null), ArticleFig(id=1324044755595829912, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, language=CN, label=图1, caption=
ADL与抑郁对认知的交互效应分析注：图1中A为按抑郁得分水平分层后ADL得分对认知得分的影响，B为按ADL得分水平分层后抑郁得分对认知得分的影响。
, figureFileSmall=yfC2u/QjWomYOu+pWxut8g==, figureFileBig=QXbzRAeeAr7HvV/BkpQ3Sw==, tableContent=null), ArticleFig(id=1324044755805545113, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, language=EN, label=Table 1, caption=
Basic characteristics of research objects (n=763)
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | T1 | T2 | χ2/Z | P值 |
|---|
| 年龄［M(P25, P75)］ | 70.0(66.0, 75.0) | 73.0(69.0, 77.5) | - | - |
| 性别［n(%)］ | | | - | - |
| 男 | 307(40.2) | - | | |
| 女 | 456(59.8) | - | | |
| 文化程度［n(%)］ | | | - | - |
| 文盲/半文盲 | 573(75.1) | - | | |
| 小学 | 113(14.8) | - | | |
| 初中及以上 | 77(10.1) | - | | |
| 家庭年收入［n(%)］ | | | 39.934 | <0.001 |
| 0~3万元 | 481(63.0) | 592(77.6) | | |
| >3万元 | 282(37.0) | 171(22.4) | | |
| 婚姻状况［n(%)］ | | | 5.480 | 0.019 |
| 在婚 | 480(62.9) | 459(60.2) | | |
| 非在婚 | 283(37.1) | 304(39.8) | | |
| 患慢性病情况［n(%)］ | | | 95.010 | <0.001 |
| 是 | 509(66.7) | 606(79.4) | | |
| 否 | 254(33.3) | 157(20.6) | | |
| 吸烟［n(%)］ | | | - | - |
| 是 | 200(26.3) | 200(26.3) | | |
| 否 | 563(73.8) | 563(73.8) | | |
| 饮酒［n(%)］ | | | 0.520 | 0.471 |
| 是 | 184(24.1) | 193(25.3) | | |
| 否 | 579(75.9) | 570(74.7) | | |
| 健康自评［n(%)］ | | | -3.822 | <0.001 |
| 较差 | 286(37.5) | 199(26.1) | | |
| 一般 | 219(28.7) | 291(38.1) | | |
| 较好 | 258(33.8) | 273(35.8) | | |
| 社会支持得分［M(P25, P75)］ | 39(35, 44) | 30(25, 35) | 22.000 | <0.001 |
| ADL［M(P25, P75)］ | 15(14, 17) | 14(14, 16) | 8.720 | <0.001 |
| 抑郁得分［M(P25, P75)］ | 0(0, 2) | 0(0, 2) | - | - |
| MMSE［M(P25, P75)］ | 22(18, 26) | 21(16, 25) | 9.707 | <0.001 |
), ArticleFig(id=1324044755881042586, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, language=CN, label=表1, caption=
研究对象的基本情况(n=763)
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | T1 | T2 | χ2/Z | P值 |
|---|
| 年龄［M(P25, P75)］ | 70.0(66.0, 75.0) | 73.0(69.0, 77.5) | - | - |
| 性别［n(%)］ | | | - | - |
| 男 | 307(40.2) | - | | |
| 女 | 456(59.8) | - | | |
| 文化程度［n(%)］ | | | - | - |
| 文盲/半文盲 | 573(75.1) | - | | |
| 小学 | 113(14.8) | - | | |
| 初中及以上 | 77(10.1) | - | | |
| 家庭年收入［n(%)］ | | | 39.934 | <0.001 |
| 0~3万元 | 481(63.0) | 592(77.6) | | |
| >3万元 | 282(37.0) | 171(22.4) | | |
| 婚姻状况［n(%)］ | | | 5.480 | 0.019 |
| 在婚 | 480(62.9) | 459(60.2) | | |
| 非在婚 | 283(37.1) | 304(39.8) | | |
| 患慢性病情况［n(%)］ | | | 95.010 | <0.001 |
| 是 | 509(66.7) | 606(79.4) | | |
| 否 | 254(33.3) | 157(20.6) | | |
| 吸烟［n(%)］ | | | - | - |
| 是 | 200(26.3) | 200(26.3) | | |
| 否 | 563(73.8) | 563(73.8) | | |
| 饮酒［n(%)］ | | | 0.520 | 0.471 |
| 是 | 184(24.1) | 193(25.3) | | |
| 否 | 579(75.9) | 570(74.7) | | |
| 健康自评［n(%)］ | | | -3.822 | <0.001 |
| 较差 | 286(37.5) | 199(26.1) | | |
| 一般 | 219(28.7) | 291(38.1) | | |
| 较好 | 258(33.8) | 273(35.8) | | |
| 社会支持得分［M(P25, P75)］ | 39(35, 44) | 30(25, 35) | 22.000 | <0.001 |
| ADL［M(P25, P75)］ | 15(14, 17) | 14(14, 16) | 8.720 | <0.001 |
| 抑郁得分［M(P25, P75)］ | 0(0, 2) | 0(0, 2) | - | - |
| MMSE［M(P25, P75)］ | 22(18, 26) | 21(16, 25) | 9.707 | <0.001 |
), ArticleFig(id=1324044755964928667, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, language=EN, label=Table 2, caption=
Spearman correlations between ADL, depression, and cognitive function at baseline and follow-up
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | M(P25, P75) | T1抑郁 | T1ADL | T1认知 | T2抑郁 | T2ADL | T2认知 |
|---|
| T1抑郁 | 0(0, 2) | 1.00 | | | | | |
| T1ADL | 15(14, 17) | 0.09b | 1.00 | | | | |
| T1认知 | 22(18, 26) | -0.13c | -0.63c | 1.00 | | | |
| T2抑郁 | 0(0, 2) | 0.28c | 0.10b | -0.18c | 1.00 | | |
| T2ADL | 14(14, 16) | 0.07a | 0.49c | -0.45c | 0.19c | 1.00 | |
| T2认知 | 21(16, 25) | -0.06 | -0.55c | 0.72c | -0.19c | -0.49c | 1.00 |
), ArticleFig(id=1324044756040426140, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, language=CN, label=表2, caption=
基线和随访ADL、抑郁与认知的Spearman秩相关
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | M(P25, P75) | T1抑郁 | T1ADL | T1认知 | T2抑郁 | T2ADL | T2认知 |
|---|
| T1抑郁 | 0(0, 2) | 1.00 | | | | | |
| T1ADL | 15(14, 17) | 0.09b | 1.00 | | | | |
| T1认知 | 22(18, 26) | -0.13c | -0.63c | 1.00 | | | |
| T2抑郁 | 0(0, 2) | 0.28c | 0.10b | -0.18c | 1.00 | | |
| T2ADL | 14(14, 16) | 0.07a | 0.49c | -0.45c | 0.19c | 1.00 | |
| T2认知 | 21(16, 25) | -0.06 | -0.55c | 0.72c | -0.19c | -0.49c | 1.00 |
), ArticleFig(id=1324044756145283741, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, language=EN, label=Table 3, caption=
Analysis of the main effects of ADL and depression on cognitive function and their interaction effect using the GEE model
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | 模型1 | 模型2 |
|---|
| β(95%CI) | P值 | β(95%CI) | P值 |
|---|
| 截距 | 20.84(20.53~21.16) | <0.001 | 23.83(21.57~26.10) | <0.001 |
| ADL | -0.58(-0.68~-0.47) | <0.001 | -0.57(-0.68~-0.47) | <0.001 |
| 抑郁 | -0.37(-0.53~-0.20) | <0.001 | -0.20(-0.33~-0.06) | 0.005 |
| ADL×抑郁 | 0.12(0.09~0.16) | <0.001 | 0.11(0.08~0.15) | <0.001 |
), ArticleFig(id=1324044756233364126, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, language=CN, label=表3, caption=
GEE模型分析ADL、抑郁对认知功能的主效应及交互作用
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | 模型1 | 模型2 |
|---|
| β(95%CI) | P值 | β(95%CI) | P值 |
|---|
| 截距 | 20.84(20.53~21.16) | <0.001 | 23.83(21.57~26.10) | <0.001 |
| ADL | -0.58(-0.68~-0.47) | <0.001 | -0.57(-0.68~-0.47) | <0.001 |
| 抑郁 | -0.37(-0.53~-0.20) | <0.001 | -0.20(-0.33~-0.06) | 0.005 |
| ADL×抑郁 | 0.12(0.09~0.16) | <0.001 | 0.11(0.08~0.15) | <0.001 |
), ArticleFig(id=1324044756313055903, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, language=EN, label=Table 4, caption=
Stratified analysis of the association between ADL, depression, and cognitive function
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | β(95%CI) | P值 |
|---|
| 按抑郁水平分层后，ADL与认知功能的关联 | | |
| 低抑郁得分组 | -0.61(-0.73~-0.50) | <0.001 |
| 高抑郁得分组 | -0.35(-0.49~-0.22) | <0.001 |
| 按ADL水平分层后，抑郁与认知功能的关联 | | |
| 低ADL得分组（0~M） | -0.25(-0.42~-0.07) | 0.006 |
| 高ADL得分组（>M） | -0.06(-0.28~0.17) | 0.621 |
), ArticleFig(id=1324044756380164768, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044747362411092, language=CN, label=表4, caption=
ADL、抑郁与认知功能关联的分层分析
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | β(95%CI) | P值 |
|---|
| 按抑郁水平分层后，ADL与认知功能的关联 | | |
| 低抑郁得分组 | -0.61(-0.73~-0.50) | <0.001 |
| 高抑郁得分组 | -0.35(-0.49~-0.22) | <0.001 |
| 按ADL水平分层后，抑郁与认知功能的关联 | | |
| 低ADL得分组（0~M） | -0.25(-0.42~-0.07) | 0.006 |
| 高ADL得分组（>M） | -0.06(-0.28~0.17) | 0.621 |
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