Full
Outline
To examine the bidirectional dynamic relationship between activities of daily living (ADL) and depressive symptoms among older adults with dual sensory impairment (DSI), identify key driving symptoms, and provide targets for precision interventions.
This study used longitudinal data from the 2018 and 2020 waves of the China Health and Retirement Longitudinal Study (CHARLS), including 2 674 participants aged≥60 years with DSI. Depressive symptoms were assessed using the short form of the Center for Epidemiologic Studies Depression Scale, and ADL limitations were measured using the ADL scale. A cross-lagged panel network (CLPN) model was applied to examine time-lagged effects and symptom network characteristics.
A significant cross-lagged pathway was identified from ADL item A11 “Managing money” to depressive symptom A1 “Being bothered by little things” (OR=1.19, 95% CI: 1.07-1.28), followed by D3 “Felt depressed” to A4 “Getting in, out of bed” (OR=1.16, 95% CI: 1.00-1.32), and D2 “Felt fearful” to A1 “Dressing” (OR=1.14, 95% CI: 1.00-1.35). Centrality analysis revealed that D3 “Felt depressed” (BEI=0.73) and A11 “Managing money” (BEI=0.59) were key bridge symptoms. D3 “Felt depressed” showed the highest out-expected influence (OEI=1.03), while A10 “Taking medication” was most susceptible to influence (IEI=0.77).
In older adults with DSI, ADL limitations and depressive symptoms may influence each other through specific pathways, and the CLPN indicates reciprocal prospective predictive associations between them, potentially forming a bidirectional vicious cycle via these pathways. Targeted interventions focusing on core bridge symptoms may help disrupt this cycle, thereby improving functional independence, enhancing psychological well-being, promoting healthy aging, and carrying important public health significance.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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