A study of the mediating effect of daily mobility between heart disease and depressive symptoms in older women and its potential profile analysis

A study of the mediating effect of daily mobility between heart disease and depressive symptoms in older women and its potential profile analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A study of the mediating effect of daily mobility between heart disease and depressive symptoms in older women and its potential profile analysis Lu LIN, Pingping HE, Wentao OUYANG, Xiaohui QIU, Sihui QIU, Jiangping CHEN This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4598003/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background To explore the mediating effect of daily activity ability between heart disease and depressive symptoms in elderly women, and to analyze the potential categories of daily activity ability in elderly women in China, so as to provide a reference basis for preventing and intervening in the development of depressive symptoms in elderly women. Methods Using the 2020 CHARLS data, stepwise regression analysis and Bootstrap mediation test were used to analyze the mediating effect of daily activity capacity between heart disease and depressive symptoms in elderly women, and latent category approach was used to identify the categories of daily activity capacity in elderly women in China. Results Three thousand seven hundred and ninety-three elderly women were included, with a prevalence of heart disease of 30.13% and a detection rate of depressive symptoms of 49.27%.Spearman's correlation analyses showed a positive correlation between the prevalence of heart disease and impaired ability to perform activities of daily living (r=0.157, P < 0.01), and between the prevalence of heart disease and depressive symptoms (r=0.108, P < 0.01), and ability to perform daily living activities impaired was positively associated with depressive symptoms (r = 0.321, P < 0.01). The results of the mediation effect test showed that ability to perform daily activities partially mediated the relationship between heart disease and depressive symptoms, with a mediation effect value of 0.0401 for ability to perform daily activities on depressive symptoms, and a mediation effect of 29.55% of the total effect. Potential profiles were categorized into 2 groups, the no impairment group (91.4%) and the impairment group (8.6%). Conclusion The types of daily activity ability of elderly women in China are heterogeneous and can be categorized into 2 types. Heart disease can have a certain impact on the depression symptoms of elderly women through daily activity ability, and comprehensive interventions should be taken to improve the heart health of elderly women, reduce the prevalence of heart disease, and improve the daily activity ability of elderly women, thereby preventing the occurrence of depression symptoms in elderly women. older adults women depressive symptoms heart disease ability to perform daily activities mediating role latent profile analysis Figures Figure 1 Figure 2 Introduction In recent years, the situation of population aging in China has become more and more serious, at the end of 2022, the elderly population aged 60 years and above in China reached 280 million, accounting for 19.8% of the total population, and it is expected that by 2050, the elderly population in China will exceed 480 million, accounting for 38.8% of the total population [ 1 ]. Depression, as a highly prevalent disease in the elderly population, not only seriously affects the quality of life of the elderly, but also leads to an excessive burden of care, disability and high mortality [ 2 ]. Studies have shown [ 3 , 4 ] that women and heart disease are two important factors influencing depression, with approximately 20–25% of women experiencing depression during their lifetime [ 5 ] and the propensity for depression being more pronounced in older women [ 6 ]. Women usually change over to heart disease during old age [ 7 ] and the risk of developing the disease increases significantly after menopause with the loss of estrogen [ 8 ]. The onset and progression of heart disease affects patients' daily activities, which in turn reduces their quality of life and disease regression [ 9 ]. And the impaired ability of daily activities in the elderly will promote the occurrence of depression [ 10 ]. Currently, more scholars have explored the association between depressive symptoms, daily activity ability, and heart disease in older adults, but whether heart disease indirectly affects depressive symptoms by influencing daily activity ability in older women remains to be explored. Therefore, this study analyzed the depressive symptoms of 3,793 older women ≥ 60 years of age using data from the 2020 China Health and Aging Tracking Survey (CHARLS), explored the relationship between heart disease and depressive symptoms, explored the potential mediating role of daily activity capacity, and identified the categories of daily activity capacity among China's older women using the latent category approach, in order to slow down the progression of depression symptoms among older women and develop a mental health promotion program for older women. progress and develop mental health promotion measures for elderly women, providing theoretical basis and intervention direction. Methods Data sources and Sample This study used data from the 2020 China Health and Aging Tracking Survey (CHARLS). The study included 5,501 elderly women aged ≥ 60 years, and 3,793 elderly women were finally included after removing outliers and missing values. Control variables The control variables in this study included age, marriage, education, place of residence, self-rated health, smoking and drinking status. Explanatory variables The explanatory variable in this study was the prevalence of heart disease, which was defined by the questionnaire question, "Have you been diagnosed with heart disease by a doctor?" Defined by the questionnaire question "Have you been diagnosed with heart disease by a doctor?", the answer of "yes" was judged as having heart disease and "no" as not having heart disease. Mediating variable The mediating variable in this study was the ability to perform daily activities, which was assessed using the Daily Activities Ability Scale [ 11 ]. The scale is divided into basic and instrumental activities of daily living (ADLs). There are a total of 12 entries, each of which is scored from 1 to 4 points according to the degree of "no difficulty" to "unable to complete", with a total score of 12 to 48 points, and the higher the score, the worse the ability to perform daily activities of the elderly. In this study, the Cronbach's alpha coefficient of the scale was 0.853. Explanatory variables The explanatory variable in this study was depressive symptoms, which were evaluated using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) [ 12 ], which consists of 10 entries in 2 domains: non-somatic depressive symptoms and somatic symptoms. Each entry ranges from "little or nothing = 0" to "most of the time = 3", with the positive mood entry in the non-somatic symptom category being reverse scored, and the total score ranging from 0 to 30, with higher scores indicating more severe depressive symptoms. A CESD-10 score of ≥ 10 is considered to be the presence of depressive symptoms [ 13 ]. In this study, the scale Cronbach's alpha coefficient was 0.795. Data analysis Data were cleaned and organized and statistically analyzed using SPSS 27.0 software. X2 tests were performed for between-group comparisons of the occurrence of depressive symptoms in elderly women with different characteristics; Spearman correlation analyses were performed for heart disease, daily activity ability, and depressive symptoms after controlling for demographic variables; and stepwise regression analyses and model 4 in the Process 4.0 program developed by Hayes were used to test the mediating effect of declining daily activity ability in the effect of heart disease prevalence on depressive symptoms in elderly women. Effects. Potential profile analysis was done using M plus 8.3 software. The test level is 0.05. Common method bias test The Harman one-way method was used to test the common method bias for the 23 entries. It was found that the eigenroots of five factors were greater than 1, and the first common factor explained 23.4% of the total variance, which was less than the critical value of 40%, suggesting that there was no common method bias in this study. Results Baseline characteristics of the total sample A total of 3,793 elderly women were enrolled in this study, including age: 2,580 (68.0%) aged 60-69 years, 1,030 (27.2%) aged 70-79 years, and 183 (4.8%) aged ≥80 years; literacy level: 1,554 (40.9%) illiterate, 1,523 (40.2%) in elementary school, and 716 (18.9%) in junior high school and higher; marital status: 2,823 (73.1%) in marriage, 1,020 (26.9%) not in marriage; place of residence: 2,389 (63.0%) in rural areas, 1,404 (37.0%) in urban areas; smoking status: No 3,763 (99.2%), Yes 30 (0.8%); drinking status: No 3,229 (85.1%), Yes 564 (14.9%); Self-assessed health: 2,637 (69.5%) good, 1,156 (30.5%) poor. In addition, a total of 1,143 elderly women in this study suffered from heart disease, with an overall prevalence rate of 30.13%; and 1,869 elderly women had depressive symptoms, with a percentage of 49.27%. Comparison of the occurrence of depressive symptoms in older adults with different characteristics The group was divided into depressive symptom group (CESD-10 ≥10 points) and non-depressive symptom group (CESD-10 <10 points) based on CESD-10 scores, with 1,924 (50.73%) in the non-depressive symptom group and 1,869 (49.27%) in the depressive symptom group. The results showed statistically significant differences in the composition ratios of different characteristics such as education level, marital status, and place of residence between the depressive symptom group and the non-depressive symptom group of elderly women (P < 0.001). Table 1 The basic situation and difference test of depressive symptoms in the elderly women[n(%)] Variables Non-depressive symptom group depressive symptom group X 2 -value P -value Age (years) 60~69 1326（68.9） 1254（67.1） 7.076 0.029 70~79 493（25.6） 537（28.7） ≥80 educational level 105（5.5） 78（4.2） 97.305 ＜0.001 illiteracy 704（36.3） 850（45.4） Primary School 740（38.5） 783（41.9） Middle School and above 480（24.9） 236（12.6） Marriage Not in Marriage Married Residence Rural Urban Smoking status Yes No Alcohol consumption Yes No Self-rated health Good Bad 475（24.7） 1499（75.3） 1080（56.1） 844（43.9） 18（0.9） 1906（99.1） 291（15.1） 1633（84.9） 1592（82.7） 332（17.3） 545（29.2） 1324（70.8） 1309（70.0） 560（30.0） 12（0.6） 1857（99.4） 273（14.6） 1596（85.4） 1045（55.9） 824（44.1） 12.793 78.617 1.041 0.201 322.134 ＜0.001 ＜0.001 0.308 0.654 ＜0.001 Correlation Analysis of Heart Disease, Daily Activity Capacity and Depressive Symptoms in Elderly Women After controlling for demographic variables, Spearman correlation analyses were performed on heart disease, ability to perform daily activities, and depressive symptoms.Spearman correlation analyses showed that both heart disease prevalence and impaired ability to perform daily activities were positively correlated with depressive symptoms in older women (r1=0.157, P<0.01; r2=0.321, P<0.01); there was also a positive correlation between heart disease prevalence and depressive symptoms (r3=0.108, P<0.01). symptoms were also positively correlated (r3=0.108, P<0.01). Table 2 Correlation analysis of heart disease, activity of daily living, and depressive symptoms in the elderly women Variables heart diseases Ability to perform daily activities depressive symptom heart diseases 1.000 Ability to perform daily activities 0.157 ** 1.000 depressive symptom 0.108 ** 0.321 ** 1.000 * P <0.05;** P <0.01;*** P <0.001。 Analysis of the mediating effect of ability to perform daily activities on the association between heart disease and depression After standardizing all the variables, Model 4 in the Process 4.0 program prepared by Hayes was used to test the mediating effect of decreased ability to perform daily activities in the effect of heart disease prevalence on depressive symptoms in older women. The results of Models 1 and 2 in Table 3 show that heart disease has an effect on both ability to perform daily activities and depressive symptoms (c-value, t=7.598, P<0.001; a-value, t=8.436, P<0.001); the results of Model 3 show that heart disease, and the ability to perform daily activities scores have an effect on depressive symptoms after the introduction of the ability to perform daily activities scores (i.e., c' value, t=6.241, P<0.001; b value, t=21.401, P<0.001). The mediation modeling showed, see Figure 1, that the total effect value of heart disease on depressive symptoms was 0.1357, and the direct effect value was 0.0956, and ab and c' had the same sign, which suggests that there is a partially mediated effect of the ability to perform daily activities between heart disease and depressive symptoms. In addition, the results of Table 4 showed that the mediating effect of daily activity ability with 95% CI excluding 0 was statistically significant and the direct effect was significant, suggesting that there was a partial mediating effect of daily activity ability between heart disease and depressive symptoms with a mediating effect of 0.0401 and a total effect of 0.1357, which is 29.55% of the mediating effect. Table 3 Results of regression analysis of heart disease and activities of daily living on depressive symptoms in the elderly women 预测变量 Model1 β t-value Model 2 β t-value Model 3 β t-value heart diseases 0.136 8.436 *** 0.122 7.598 *** 0.096 6.241 *** Ability to perform daily activities 0.328 21.401 *** R 2 -value 0.108 0.015 0.270 F-value 71.164 *** 268.868 *** 149.290 *** * P <0.05;** P <0.01;*** P <0.001；Model 1 heart disease predicted depressive symptoms; Model 2 heart disease predicted ability to perform daily activities, Model 3 heart disease and ability to perform daily activities together predicted depressive symptoms. Table 4 Bootstrap mediated effect test of activity of daily living between heart disease and depression symptoms in the elderly women efficiency value Boot SE Boot CI lower bound Boot CI limit Efficacy as a percentage of（%） total effect 0.1357 0.0161 0.1042 0.1673 direct effect 0.0956 0.0153 0.0656 0.1256 70.4495 intermediary effect 0.0401 0.0061 0.0288 0.0524 29.5505 Potential profiling of daily mobility AIC, BIC and aBIC values decreased with the number of profiles, and the Enthropy value was maximum at 4 and 5 profiles, but at this time, P(BLRT) > 0.05, so 2 profiles were selected for comprehensive consideration. Table 5 Fitting indexes of 1-5 profile solutions in potential profile analysis Model AIC BIC aBIC Enthropy P(BLRT) P -value 1 66064.315 66214.097 66137.836 1.00000 2 51851.313 52082.227 51964.659 0.990 ＜0.001 0.91420/ 0.08580 3 47289.752 47601.798 47442.921 0.992 0.646 0.03322/0.07515/ 0.89163 4 38317.861 38711.039 38510.854 0.995 0.727 0.07610/ 0.00870/ 0.02452/0.89068 5 35449.320 35923.629 35682.137 0.995 0.518 0.02452/0.06700/0.83803/ 0.06175/ 0.00870 Discussion In this study, we found that 49.27% of elderly women had depressive symptoms, which was higher than the detection rate (44.0%) in the study by Tang Cai et al [ 14 ] and higher than the detection rate of depressive symptoms in elderly women (45.07%) derived from the 2018 CHARLS cross-sectional data, which on the one hand, may be related to the fact that 2020 is in the period of the New Crown Epidemic, where elderly people are worried about whether or not they are infected with the disease, and the decrease in their sense of security will lead to the occurrence of depressive symptoms [ 15 ]. On the other hand, impaired cognitive function and decreased physical activity in older adults with increasing age can also lead to increased depressive symptoms [ 16 ]. In addition, differences in sampling method, sample size, sampling area, and other factors may also lead to differences in results. The high level of detection of depressive symptoms in elderly women suggests that medical personnel should pay more attention to the psychological status of elderly women in their future work, and intervene early to improve the quality of life of elderly women. In this study, we found a positive correlation between heart disease and impaired ability to perform daily activities in elderly women, which is consistent with the findings of Ni Zhihong [ 17 ], and may be due to the fact that elderly patients with heart disease tend to suffer from myocardial ischemia and hypoxia and impaired cardiac function, which makes daily activities more likely to induce fatigue, palpitations, dyspnea, chest pain and other discomforts. The results of the study showed that impaired ability to perform daily activities was positively associated with depressive symptoms, which is consistent with the results of related studies [ 11 ]. It is possible that impaired ability to perform activities of daily living leads to decreased social participation in older adults, which in turn may increase the incidence of depression [ 18 ]. In addition, the prevalence of heart disease in older women was positively associated with depressive symptoms, consistent with the findings of Chi Ran et al [ 19 ]. Several studies have shown [ 20 – 22 ] that heart disease and depression are causal to each other. The occurrence of heart disease will bring physical pain and psychological burden to the elderly, triggering their depressive symptoms [ 23 ], and the elderly will change their lifestyles, such as diet, sleep, and exercise, because of the influence of negative emotions [ 24 ], and the poor lifestyle is a risk factor for heart disease [ 25 ], which in turn forms a negative cycle and seriously jeopardizes the physical and mental health of the elderly. The results of this study suggest that there is a partial mediating role of daily activity ability between the prevalence of heart disease and depressive symptoms, i.e., reducing the prevalence of heart disease can directly alleviate the depressive symptoms of older women, and the effect of heart disease on the depressive symptoms of older women can also be reduced by improving the daily activity ability of older women. The mechanism may be that when older women suffer from heart disease, it reduces daily activity capacity because of activity limitation and decreased activity endurance due to decreased cardiac function, decreased cognitive function, and so on [ 26 ]. The decline in activity ability of elderly women limits their range of activities, reduces their original social circle, and decreases their social participation; and the decline in their activity ability will lead to the need to rely on others for their activities, lowering their self-esteem, and prone to inducing depression [ 27 ]. In addition, the results of mediation effect analysis showed that the direct effect value of daily activity ability on depressive symptoms was greater than that of heart disease, which indicated that the impairment of daily activity ability had a greater impact on depressive symptoms in elderly women. Therefore, in order to promote the mental health of elderly women, healthcare workers should pay attention to the physical mobility of elderly women, enhance the awareness of preventive healthcare of the elderly, fully mobilize the mobility of the elderly individuals, and strengthen the health management of heart disease in order to reduce the prevalence of heart disease in elderly women; at the same time, they should pay more attention to strengthening the enhancement of the daily mobility of the elderly women, and provide the guidance and support of the rehabilitation training and other activities, so as to improve the daily mobility of elderly women, in order to prevent the depression of elderly women. At the same time, more attention should be paid to enhancing the daily activity ability of elderly women, providing guidance and support such as rehabilitation training, and improving the daily activity ability of elderly women to prevent the occurrence of depression in elderly women. In this study, we found that there was heterogeneity in the daily activity ability of elderly women in China, which could be categorized into the unimpaired group (91.4%) and the impaired group (8.6%). The scores of each entry in the no-impediment group were low, indicating that the elderly women in this group had no obstacles to daily activities; the scores of each entry in the obstacle group were high, indicating that there were obstacles to daily activities in this group, with the highest scores in the entries of housework and cooking, suggesting that healthcare personnel should focus on helping elderly women with obstacles to daily activities in housework and cooking, and provide targeted help according to different types of elderly women. This suggests that healthcare professionals should focus on helping elderly women with daily activity barriers in the areas of housework and cooking, and provide targeted assistance according to the different types of elderly women, in order to improve the quality of life of elderly women, alleviate their depression, and achieve the goal of healthy aging through the intervention of their ability to perform daily activities. Conclusions In summary, heart disease and daily activity ability can affect depressive symptoms in older women, with daily activity ability playing a partially mediating role, and the heterogeneity of daily activity ability is divided into 2 categories. Therefore, while reducing the prevalence of heart disease in elderly women, healthcare workers should pay more attention to the daily activity ability of elderly women, conduct dynamic assessment and screening and early targeted intervention, and give full play to its role in improving the level of mental health of elderly women to reduce and alleviate the occurrence and development of depressive symptoms. Meanwhile, this study used a cross-sectional study to verify the causal relationship between heart disease, ability to perform activities of daily living and depressive symptoms with some limitations, and did not verify the bidirectional role between heart disease and depression; there were no medical records in the CHARLS and self-reported information was used to measure the main variables, which may lead to recall bias, and a multicenter, longitudinal study is needed to further explore the impact of the subsequent mechanisms. Declarations Conflict of interest statement There is no conflict of interest in this study. Data availability statement The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author. Authors’ contributions LL and XHQ: design of the study and interpretation of data. XPOY: data processing. SHQ and JPC: data processing, article design, and revision. PPH: article modification. All authors contributed to the article and approved the submitted version. Acknowledgments The authors would like to thank the CHARLS team for collecting the data and providing an open access platform for the data and the respondents. Funding Statement This research was supported by the Hunan Provincial Natural Science Foundation Upper-level Project Fund (Grant number: 2023JJ30426) Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. References Ju M, Lulu W. Policy tools for urban geriatric education and their classification optimization in the era of active aging[J]. Journal of Hebei Normal University (Education Science Edition), 2024, 26: 111-117. DEFRANCESCO M, PECHLANER R, KIECHL S, et al. What Characterizes Depression in Old Age? Results from the Bruneck Study[J]. Pharmacopsychiatry, 2018, 51(4): 153-160. Pengpeng L, Feng Y, Guangqiang L, et al. Research progress on the relationship between depression and cardiovascular disease in the elderly[J]. Journal of Chinese Academy of Medical Sciences, 2022, 44: 1089-1094. Youguo L, Benyu Z. Trajectories of depressive mood in mid-adulthood: based on a growth mixture model[J]. Psychological Science, 2024, 47: 300-307. BUCCIARELLI V, CATERINO A L, BIANCO F, et al. Depression and cardiovascular disease: The deep blue sea of women's heart[J]. Trends Cardiovasc Med, 2020, 30(3): 170-176. Haichun Y, Yajie Y, Qian H, et al. Comparative analysis of depression tendency and influencing factors between middle-aged and elderly women in China[J]. Modern Preventive Medicine, 2022, 49: 2024-2030. ELERTSON K M, MORGAN L L. Consideration of Gender in Cardiovascular Disease Prevention and Management[J]. Nurs Clin North Am, 2023, 58(4): 595-605. DESAI S, MUNSHI A, MUNSHI D. Gender Bias in Cardiovascular Disease Prevention, Detection, and Management, with Specific Reference to Coronary Artery Disease[J]. J Midlife Health, 2021, 12(1): 8-15. Jie W, GZ S, Min G,et al. Research progress on fear of exercise in patients with cardiovascular disease[J]. Chinese Journal of Rehabilitation Medicine, 2023, 38: 712-715. Xianjin X, Jian W, Tian G, et al. Analysis of the relationship between the ability to perform activities of daily living and chronic disease co-morbidities and depressive symptoms among the elderly in China[J]. Medicine and Society, 2023, 36: 123-128. Sisi Z, WL W, Lin L, et al. Study on the mediating effect of daily activity ability between arthritis and depressive symptoms in elderly people[J]. Modern Preventive Medicine, 2024, 51: 123-126+155. Hui C, Zhuwei W. Mediating effects of depression on daily activity ability and self-neglect in empty-nesting elderly[J]. Modern Preventive Medicine, 2023, 50: 1669-1674. Linxuan Z, Lin J, Meijing H, et al. Relationship between the number of cumulative C-reactive protein elevations and somatic and non-somatic depressive symptoms in Chinese middle-aged and elderly people: a prospective cohort study[J]. Chinese Family Medicine, 2024, 27: 2070-2076+2090. Caiyun T, Rong H, Yao W, et al. Relationship between depression, loneliness and quality of life among widowed elderly women living alone in rural areas[J]. Journal of Central South University (Medical Edition), 2023, 48: 1865-1873. Chengcheng P, Huali W. Common psychological reactions and coping strategies of elderly people during the epidemic of new crown pneumonia[J]. Chinese Journal of Mental Health, 2020, 34: 257-258. Qifei L, Jiahui W, Jiaoyu B, et al. Survey on Alzheimer's disease and analysis of influencing factors[J]. Modern Preventive Medicine, 2024, 51: 759-763. Zhihong N. Construction of a risk prediction model for elderly cardiac patients with limited ability to perform activities of daily living[J]. Geriatrics Research, 2023, 4: 33-38. Hui Q, Na C, Li Z. Impact of social participation on the trajectory of depression in older adults: mediating effect based on quality of life[J]. Modern Preventive Medicine, 2024, 51: 888-892+898. Ran Q, Baihe S, Xinyu Z, et al. Association of depression and anxiety symptoms with heart disease and chronic noncommunicable respiratory diseases among older adults in China[J].China Chronic Disease Prevention and Control, 2023, 31: 881-886. HARE D L. Depression and cardiovascular disease[J]. Curr Opin Lipidol, 2021, 32(3). 167-174. LI G H, CHEUNG C L, CHUNG A K, et al. Evaluation of bi-directional causal association between depression and cardiovascular diseases: a Mendelian randomization study[J]. Psychol Med, 2022, 52(9). 1765-1776. MA X, ZHANG H, TIAN Y, et al. Mediating effect of depression on the association between cardiovascular disease and the risk of all-cause mortality. NHANES in 2005-2018[J]. Clin Cardiol, 2023, 46(11): 1380-1389. Hongwei W, Yalin H, Yunxin D, et al. Meta-analysis of the effect of positive thinking intervention on negative emotions in elderly patients with coronary atherosclerotic heart disease[J]. CHINESE JOURNAL OF GERONOMICS, 2023, 43: 2450-2454. LI H, ZHENG D, LI Z, et al. Association of Depressive Symptoms With Incident Cardiovascular Diseases in Middle-Aged and Older Chinese Adults[J]. JAMA Netw Open, 2019, 2(12): e1916591. JJ L, FS X, JK L, et al. Association of Sleep Duration with Cardiovascular Diseases in Older Adults in China[J]. Ruifen W, Yan L, Zishuo C, et al. Relationship between cardiac metabolic co-morbidities and disability in Chinese middle-aged and elderly people[J]. Journal of Jilin University (Medical Edition), 2021, 47: 761-769. Xiaoqin C, Tianqi Y, Yanru S, et al. Network analysis of loneliness, depression and anxiety among disabled elderly in the community[J]. Military Nursing, 2024, 41: 21-24. Additional Declarations No competing interests reported. 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Industry","correspondingAuthor":false,"prefix":"","firstName":"Wentao","middleName":"","lastName":"OUYANG","suffix":""},{"id":324991739,"identity":"1619e131-fa6c-4b12-b897-4ce7682eaa6b","order_by":3,"name":"Xiaohui QIU","email":"","orcid":"","institution":"Chinese Academy of Medical Sciences Nanhua University, Nanhua University","correspondingAuthor":false,"prefix":"","firstName":"Xiaohui","middleName":"","lastName":"QIU","suffix":""},{"id":324991740,"identity":"6dfa7be5-2229-44b7-889c-c7a65ccfc8ac","order_by":4,"name":"Sihui QIU","email":"","orcid":"","institution":"Chinese Academy of Medical Sciences Nanhua University, Nanhua University","correspondingAuthor":false,"prefix":"","firstName":"Sihui","middleName":"","lastName":"QIU","suffix":""},{"id":324991741,"identity":"e6ba1e76-163e-4763-b271-1afab133f26f","order_by":5,"name":"Jiangping CHEN","email":"","orcid":"","institution":"Chinese Academy of Medical Sciences Nanhua University, Nanhua University","correspondingAuthor":false,"prefix":"","firstName":"Jiangping","middleName":"","lastName":"CHEN","suffix":""}],"badges":[],"createdAt":"2024-06-18 07:12:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4598003/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4598003/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":60068267,"identity":"781f9395-6f8f-48c1-aec9-12c1bd23e0de","added_by":"auto","created_at":"2024-07-11 10:16:30","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":26122,"visible":true,"origin":"","legend":"\u003cp\u003eMediating model and regression coefficient of daily activity ability between heart disease and depressive symptoms\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4598003/v1/c30cea6e524ac3eb8073acee.jpg"},{"id":60068266,"identity":"067da453-7671-4523-8109-3ab03d73eb63","added_by":"auto","created_at":"2024-07-11 10:16:30","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":22010,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of each type of model 2\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4598003/v1/13732dd84607d24355b09c68.jpg"},{"id":71126885,"identity":"b252bf6f-3675-4a42-bbf0-dd19a913c093","added_by":"auto","created_at":"2024-12-11 11:31:56","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":605692,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4598003/v1/a331c529-682c-4e55-b96c-2925a29984dc.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A study of the mediating effect of daily mobility between heart disease and depressive symptoms in older women and its potential profile analysis","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn recent years, the situation of population aging in China has become more and more serious, at the end of 2022, the elderly population aged 60 years and above in China reached 280\u0026nbsp;million, accounting for 19.8% of the total population, and it is expected that by 2050, the elderly population in China will exceed 480\u0026nbsp;million, accounting for 38.8% of the total population [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Depression, as a highly prevalent disease in the elderly population, not only seriously affects the quality of life of the elderly, but also leads to an excessive burden of care, disability and high mortality [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Studies have shown [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] that women and heart disease are two important factors influencing depression, with approximately 20\u0026ndash;25% of women experiencing depression during their lifetime [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] and the propensity for depression being more pronounced in older women [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Women usually change over to heart disease during old age [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] and the risk of developing the disease increases significantly after menopause with the loss of estrogen [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. The onset and progression of heart disease affects patients' daily activities, which in turn reduces their quality of life and disease regression [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. And the impaired ability of daily activities in the elderly will promote the occurrence of depression [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCurrently, more scholars have explored the association between depressive symptoms, daily activity ability, and heart disease in older adults, but whether heart disease indirectly affects depressive symptoms by influencing daily activity ability in older women remains to be explored. Therefore, this study analyzed the depressive symptoms of 3,793 older women\u0026thinsp;\u0026ge;\u0026thinsp;60 years of age using data from the 2020 China Health and Aging Tracking Survey (CHARLS), explored the relationship between heart disease and depressive symptoms, explored the potential mediating role of daily activity capacity, and identified the categories of daily activity capacity among China's older women using the latent category approach, in order to slow down the progression of depression symptoms among older women and develop a mental health promotion program for older women. progress and develop mental health promotion measures for elderly women, providing theoretical basis and intervention direction.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eData sources and Sample\u003c/h2\u003e \u003cp\u003eThis study used data from the 2020 China Health and Aging Tracking Survey (CHARLS). The study included 5,501 elderly women aged\u0026thinsp;\u0026ge;\u0026thinsp;60 years, and 3,793 elderly women were finally included after removing outliers and missing values.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eControl variables\u003c/h2\u003e \u003cp\u003eThe control variables in this study included age, marriage, education, place of residence, self-rated health, smoking and drinking status.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eExplanatory variables\u003c/h2\u003e \u003cp\u003eThe explanatory variable in this study was the prevalence of heart disease, which was defined by the questionnaire question, \"Have you been diagnosed with heart disease by a doctor?\" Defined by the questionnaire question \"Have you been diagnosed with heart disease by a doctor?\", the answer of \"yes\" was judged as having heart disease and \"no\" as not having heart disease.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eMediating variable\u003c/h2\u003e \u003cp\u003eThe mediating variable in this study was the ability to perform daily activities, which was assessed using the Daily Activities Ability Scale [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The scale is divided into basic and instrumental activities of daily living (ADLs). There are a total of 12 entries, each of which is scored from 1 to 4 points according to the degree of \"no difficulty\" to \"unable to complete\", with a total score of 12 to 48 points, and the higher the score, the worse the ability to perform daily activities of the elderly. In this study, the Cronbach's alpha coefficient of the scale was 0.853.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eExplanatory variables\u003c/h2\u003e \u003cp\u003eThe explanatory variable in this study was depressive symptoms, which were evaluated using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], which consists of 10 entries in 2 domains: non-somatic depressive symptoms and somatic symptoms. Each entry ranges from \"little or nothing\u0026thinsp;=\u0026thinsp;0\" to \"most of the time\u0026thinsp;=\u0026thinsp;3\", with the positive mood entry in the non-somatic symptom category being reverse scored, and the total score ranging from 0 to 30, with higher scores indicating more severe depressive symptoms. A CESD-10 score of \u0026ge;\u0026thinsp;10 is considered to be the presence of depressive symptoms [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. In this study, the scale Cronbach's alpha coefficient was 0.795.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eData were cleaned and organized and statistically analyzed using SPSS 27.0 software. X2 tests were performed for between-group comparisons of the occurrence of depressive symptoms in elderly women with different characteristics; Spearman correlation analyses were performed for heart disease, daily activity ability, and depressive symptoms after controlling for demographic variables; and stepwise regression analyses and model 4 in the Process 4.0 program developed by Hayes were used to test the mediating effect of declining daily activity ability in the effect of heart disease prevalence on depressive symptoms in elderly women. Effects. Potential profile analysis was done using M plus 8.3 software. The test level is 0.05.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eCommon method bias test\u003c/h2\u003e \u003cp\u003eThe Harman one-way method was used to test the common method bias for the 23 entries. It was found that the eigenroots of five factors were greater than 1, and the first common factor explained 23.4% of the total variance, which was less than the critical value of 40%, suggesting that there was no common method bias in this study.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eBaseline characteristics of the total sample\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 3,793 elderly women were enrolled in this study, including age: 2,580 (68.0%) aged 60-69 years, 1,030 (27.2%) aged 70-79 years, and 183 (4.8%) aged \u0026ge;80 years; literacy level: 1,554 (40.9%) illiterate, 1,523 (40.2%) in elementary school, and 716 (18.9%) in junior high school and higher; marital status: 2,823 (73.1%) in marriage, 1,020 (26.9%) not in marriage; place of residence: 2,389 (63.0%) in rural areas, 1,404 (37.0%) in urban areas; smoking status: No 3,763 (99.2%), Yes 30 (0.8%); drinking status: No 3,229 (85.1%), Yes 564 (14.9%); Self-assessed health: 2,637 (69.5%) good, 1,156 (30.5%) poor. In addition, a total of 1,143 elderly women in this study suffered from heart disease, with an overall prevalence rate of 30.13%; and 1,869 elderly women had depressive symptoms, with a percentage of 49.27%.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison of the occurrence of depressive symptoms in older adults with different characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe group was divided into depressive symptom group (CESD-10 \u0026ge;10 points) and non-depressive symptom group (CESD-10 \u0026lt;10 points) based on CESD-10 scores, with 1,924 (50.73%) in the non-depressive symptom group and 1,869 (49.27%) in the depressive symptom group. The results showed statistically significant differences in the composition ratios of different characteristics such as education level, marital status, and place of residence between the depressive symptom group and the non-depressive symptom group of elderly women (P \u0026lt; 0.001).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003eThe basic situation and difference test of depressive symptoms in the elderly women[n(%)]\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.661016949152543%\" valign=\"top\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.338983050847457%\" valign=\"top\"\u003e\n \u003cp\u003eNon-depressive symptom group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.940677966101696%\" valign=\"top\"\u003e\n \u003cp\u003edepressive symptom group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.983050847457626%\" valign=\"top\"\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.076271186440678%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.661016949152543%\" valign=\"top\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003cp\u003e60~69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.338983050847457%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1326（68.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.940677966101696%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1254（67.1）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.983050847457626%\" valign=\"top\"\u003e\n \u003cp\u003e7.076\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.076271186440678%\" valign=\"top\"\u003e\n \u003cp\u003e0.029\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.661016949152543%\" valign=\"top\"\u003e\n \u003cp\u003e70~79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.338983050847457%\" valign=\"top\"\u003e\n \u003cp\u003e493（25.6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.940677966101696%\" valign=\"top\"\u003e\n \u003cp\u003e537（28.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.983050847457626%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.076271186440678%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.661016949152543%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;80\u003c/p\u003e\n \u003cp\u003eeducational level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.338983050847457%\" valign=\"top\"\u003e\n \u003cp\u003e105（5.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.940677966101696%\" valign=\"top\"\u003e\n \u003cp\u003e78（4.2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.983050847457626%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e97.305\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.076271186440678%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.661016949152543%\" valign=\"top\"\u003e\n \u003cp\u003eilliteracy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.338983050847457%\" valign=\"top\"\u003e\n \u003cp\u003e704（36.3）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.940677966101696%\" valign=\"top\"\u003e\n \u003cp\u003e850（45.4）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.983050847457626%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.076271186440678%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.661016949152543%\" valign=\"top\"\u003e\n \u003cp\u003ePrimary School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.338983050847457%\" valign=\"top\"\u003e\n \u003cp\u003e740（38.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.940677966101696%\" valign=\"top\"\u003e\n \u003cp\u003e783（41.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.983050847457626%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.076271186440678%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.661016949152543%\" valign=\"top\"\u003e\n \u003cp\u003eMiddle School and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.338983050847457%\" valign=\"top\"\u003e\n \u003cp\u003e480（24.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.940677966101696%\" valign=\"top\"\u003e\n \u003cp\u003e236（12.6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.983050847457626%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.076271186440678%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.661016949152543%\" valign=\"top\"\u003e\n \u003cp\u003eMarriage\u003c/p\u003e\n \u003cp\u003eNot in Marriage\u003c/p\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003cp\u003eResidence\u003c/p\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003cp\u003eSmoking status\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eAlcohol consumption\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eSelf-rated health\u003c/p\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003cp\u003eBad\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.338983050847457%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e475（24.7）\u003c/p\u003e\n \u003cp\u003e1499（75.3）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1080（56.1）\u003c/p\u003e\n \u003cp\u003e844（43.9）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e18（0.9）\u003c/p\u003e\n \u003cp\u003e1906（99.1）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e291（15.1）\u003c/p\u003e\n \u003cp\u003e1633（84.9）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1592（82.7）\u003c/p\u003e\n \u003cp\u003e332（17.3）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.940677966101696%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e545（29.2）\u003c/p\u003e\n \u003cp\u003e1324（70.8）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1309（70.0）\u003c/p\u003e\n \u003cp\u003e560（30.0）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e12（0.6）\u003c/p\u003e\n \u003cp\u003e1857（99.4）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e273（14.6）\u003c/p\u003e\n \u003cp\u003e1596（85.4）\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1045（55.9）\u003c/p\u003e\n \u003cp\u003e824（44.1）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.983050847457626%\" valign=\"top\"\u003e\n \u003cp\u003e12.793\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e78.617\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.041\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.201\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e322.134\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.076271186440678%\" valign=\"top\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.308\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.654\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorrelation Analysis of Heart Disease, Daily Activity Capacity and Depressive Symptoms in Elderly Women\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter controlling for demographic variables, Spearman correlation analyses were performed on heart disease, ability to perform daily activities, and depressive symptoms.Spearman correlation analyses showed that both heart disease prevalence and impaired ability to perform daily activities were positively correlated with depressive symptoms in older women (r1=0.157, P\u0026lt;0.01; r2=0.321, P\u0026lt;0.01); there was also a positive correlation between heart disease prevalence and depressive symptoms (r3=0.108, P\u0026lt;0.01). symptoms were also positively correlated (r3=0.108, P\u0026lt;0.01).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u0026nbsp;\u003c/strong\u003eCorrelation analysis of heart disease, activity of daily living, and depressive symptoms in the elderly women\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.5497287522604%\" valign=\"top\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.540687160940326%\" valign=\"top\"\u003e\n \u003cp\u003eheart diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003eAbility to perform daily activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003edepressive symptom\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.5497287522604%\" valign=\"top\"\u003e\n \u003cp\u003eheart diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.540687160940326%\" valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.5497287522604%\" valign=\"top\"\u003e\n \u003cp\u003eAbility to perform daily activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.540687160940326%\" valign=\"top\"\u003e\n \u003cp\u003e0.157\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.5497287522604%\" valign=\"top\"\u003e\n \u003cp\u003edepressive symptom\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.540687160940326%\" valign=\"top\"\u003e\n \u003cp\u003e0.108\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e0.321\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05;**\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01;***\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001。\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnalysis of the mediating effect of ability to perform daily activities on the association between heart disease and depression\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter standardizing all the variables, Model 4 in the Process 4.0 program prepared by Hayes was used to test the mediating effect of decreased ability to perform daily activities in the effect of heart disease prevalence on depressive symptoms in older women. The results of Models 1 and 2 in Table 3 show that heart disease has an effect on both ability to perform daily activities and depressive symptoms (c-value, t=7.598, P\u0026lt;0.001; a-value, t=8.436, P\u0026lt;0.001); the results of Model 3 show that heart disease, and the ability to perform daily activities scores have an effect on depressive symptoms after the introduction of the ability to perform daily activities scores (i.e., c\u0026apos; value, t=6.241, P\u0026lt;0.001; b value, t=21.401, P\u0026lt;0.001). The mediation modeling showed, see Figure 1, that the total effect value of heart disease on depressive symptoms was 0.1357, and the direct effect value was 0.0956, and ab and c\u0026apos; had the same sign, which suggests that there is a partially mediated effect of the ability to perform daily activities between heart disease and depressive symptoms. In addition, the results of Table 4 showed that the mediating effect of daily activity ability with 95% CI excluding 0 was statistically significant and the direct effect was significant, suggesting that there was a partial mediating effect of daily activity ability between heart disease and depressive symptoms with a mediating effect of 0.0401 and a total effect of 0.1357, which is 29.55% of the mediating effect.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u0026nbsp;\u003c/strong\u003eResults of regression analysis of heart disease and activities of daily living on depressive symptoms in the elderly women\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.71841155234657%\"\u003e\n \u003cp\u003e预测变量\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.71480144404332%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eModel1\u003c/p\u003e\n \u003cp\u003e\u0026beta; \u0026nbsp; \u0026nbsp; \u0026nbsp;t-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.783393501805055%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eModel 2\u003c/p\u003e\n \u003cp\u003e\u0026beta; \u0026nbsp; \u0026nbsp; \u0026nbsp; t-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.783393501805055%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eModel 3\u003c/p\u003e\n \u003cp\u003e\u0026beta; \u0026nbsp; \u0026nbsp; \u0026nbsp;t-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.370705244122966%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eheart diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.669077757685352%\" valign=\"top\"\u003e\n \u003cp\u003e0.136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e8.436\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.551537070524413%\" valign=\"top\"\u003e\n \u003cp\u003e0.122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e7.598\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.551537070524413%\" valign=\"top\"\u003e\n \u003cp\u003e0.096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e6.241\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.370705244122966%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eAbility to perform daily activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.669077757685352%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.551537070524413%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.551537070524413%\" valign=\"top\"\u003e\n \u003cp\u003e0.328\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e21.401\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.370705244122966%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eR\u003csup\u003e2\u003c/sup\u003e-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.8372513562387%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.8372513562387%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.270\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.370705244122966%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eF-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e71.164\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.8372513562387%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e268.868\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.8372513562387%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e149.290\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.634146341463415%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"1.3303769401330376%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.086474501108647%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"14.634146341463415%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"14.19068736141907%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"14.634146341463415%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"14.19068736141907%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"15.299334811529933%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05;**\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01;***\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001；Model 1 heart disease predicted depressive symptoms; Model 2 heart disease predicted ability to perform daily activities, Model 3 heart disease and ability to perform daily activities together predicted depressive symptoms.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u0026nbsp;\u003c/strong\u003eBootstrap mediated effect test of activity of daily living between heart disease and depression symptoms in the elderly women\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.743218806509946%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.934900542495479%\" valign=\"top\"\u003e\n \u003cp\u003eefficiency value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.998191681735985%\" valign=\"top\"\u003e\n \u003cp\u003eBoot SE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.179023508137433%\" valign=\"top\"\u003e\n \u003cp\u003eBoot CI\u0026nbsp;\u003c/p\u003e\n \u003cp\u003elower bound\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003eBoot CI limit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003eEfficacy as a percentage of（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.743218806509946%\" valign=\"top\"\u003e\n \u003cp\u003etotal effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.934900542495479%\" valign=\"top\"\u003e\n \u003cp\u003e0.1357\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.998191681735985%\" valign=\"top\"\u003e\n \u003cp\u003e0.0161\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.179023508137433%\" valign=\"top\"\u003e\n \u003cp\u003e0.1042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e0.1673\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.743218806509946%\" valign=\"top\"\u003e\n \u003cp\u003edirect effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.934900542495479%\" valign=\"top\"\u003e\n \u003cp\u003e0.0956\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.998191681735985%\" valign=\"top\"\u003e\n \u003cp\u003e0.0153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.179023508137433%\" valign=\"top\"\u003e\n \u003cp\u003e0.0656\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e0.1256\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e70.4495\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.743218806509946%\" valign=\"top\"\u003e\n \u003cp\u003eintermediary effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.934900542495479%\" valign=\"top\"\u003e\n \u003cp\u003e0.0401\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.998191681735985%\" valign=\"top\"\u003e\n \u003cp\u003e0.0061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.179023508137433%\" valign=\"top\"\u003e\n \u003cp\u003e0.0288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e0.0524\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e29.5505\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003ePotential profiling of daily mobility\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAIC, BIC and aBIC values decreased with the number of profiles, and the Enthropy value was maximum at 4 and 5 profiles, but at this time, P(BLRT) \u0026gt; 0.05, so 2 profiles were selected for comprehensive consideration.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5\u0026nbsp;\u0026nbsp;\u003c/strong\u003eFitting indexes of 1-5 profile solutions in potential profile analysis\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"614\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.98051948051948%\" valign=\"top\"\u003e\n \u003cp\u003eModel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003eAIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003eBIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003eaBIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.902597402597403%\" valign=\"top\"\u003e\n \u003cp\u003eEnthropy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.064935064935066%\" valign=\"top\"\u003e\n \u003cp\u003eP(BLRT)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"39.935064935064936%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.98051948051948%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e66064.315\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e66214.097\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e66137.836\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.902597402597403%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.064935064935066%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"39.935064935064936%\" valign=\"top\"\u003e\n \u003cp\u003e1.00000\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.98051948051948%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e51851.313\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e52082.227\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e51964.659\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.902597402597403%\" valign=\"top\"\u003e\n \u003cp\u003e0.990\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.064935064935066%\" valign=\"top\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"39.935064935064936%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;0.91420/ 0.08580\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.98051948051948%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e47289.752\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e47601.798\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e47442.921\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.902597402597403%\" valign=\"top\"\u003e\n \u003cp\u003e0.992\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.064935064935066%\" valign=\"top\"\u003e\n \u003cp\u003e0.646\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"39.935064935064936%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;0.03322/0.07515/ 0.89163\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.98051948051948%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e38317.861\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e38711.039\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e38510.854\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.902597402597403%\" valign=\"top\"\u003e\n \u003cp\u003e0.995\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.064935064935066%\" valign=\"top\"\u003e\n \u003cp\u003e0.727\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"39.935064935064936%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;0.07610/ 0.00870/ 0.02452/0.89068\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.98051948051948%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e35449.320\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e35923.629\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.03896103896104%\" valign=\"top\"\u003e\n \u003cp\u003e35682.137\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.902597402597403%\" valign=\"top\"\u003e\n \u003cp\u003e0.995\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.064935064935066%\" valign=\"top\"\u003e\n \u003cp\u003e0.518\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"39.935064935064936%\" valign=\"top\"\u003e\n \u003cp\u003e0.02452/0.06700/0.83803/ 0.06175/ 0.00870\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, we found that 49.27% of elderly women had depressive symptoms, which was higher than the detection rate (44.0%) in the study by Tang Cai et al [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] and higher than the detection rate of depressive symptoms in elderly women (45.07%) derived from the 2018 CHARLS cross-sectional data, which on the one hand, may be related to the fact that 2020 is in the period of the New Crown Epidemic, where elderly people are worried about whether or not they are infected with the disease, and the decrease in their sense of security will lead to the occurrence of depressive symptoms [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. On the other hand, impaired cognitive function and decreased physical activity in older adults with increasing age can also lead to increased depressive symptoms [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. In addition, differences in sampling method, sample size, sampling area, and other factors may also lead to differences in results. The high level of detection of depressive symptoms in elderly women suggests that medical personnel should pay more attention to the psychological status of elderly women in their future work, and intervene early to improve the quality of life of elderly women.\u003c/p\u003e \u003cp\u003eIn this study, we found a positive correlation between heart disease and impaired ability to perform daily activities in elderly women, which is consistent with the findings of Ni Zhihong [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], and may be due to the fact that elderly patients with heart disease tend to suffer from myocardial ischemia and hypoxia and impaired cardiac function, which makes daily activities more likely to induce fatigue, palpitations, dyspnea, chest pain and other discomforts. The results of the study showed that impaired ability to perform daily activities was positively associated with depressive symptoms, which is consistent with the results of related studies [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. It is possible that impaired ability to perform activities of daily living leads to decreased social participation in older adults, which in turn may increase the incidence of depression [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In addition, the prevalence of heart disease in older women was positively associated with depressive symptoms, consistent with the findings of Chi Ran et al [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Several studies have shown [\u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] that heart disease and depression are causal to each other. The occurrence of heart disease will bring physical pain and psychological burden to the elderly, triggering their depressive symptoms [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], and the elderly will change their lifestyles, such as diet, sleep, and exercise, because of the influence of negative emotions [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], and the poor lifestyle is a risk factor for heart disease [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], which in turn forms a negative cycle and seriously jeopardizes the physical and mental health of the elderly.\u003c/p\u003e \u003cp\u003eThe results of this study suggest that there is a partial mediating role of daily activity ability between the prevalence of heart disease and depressive symptoms, i.e., reducing the prevalence of heart disease can directly alleviate the depressive symptoms of older women, and the effect of heart disease on the depressive symptoms of older women can also be reduced by improving the daily activity ability of older women. The mechanism may be that when older women suffer from heart disease, it reduces daily activity capacity because of activity limitation and decreased activity endurance due to decreased cardiac function, decreased cognitive function, and so on [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. The decline in activity ability of elderly women limits their range of activities, reduces their original social circle, and decreases their social participation; and the decline in their activity ability will lead to the need to rely on others for their activities, lowering their self-esteem, and prone to inducing depression [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. In addition, the results of mediation effect analysis showed that the direct effect value of daily activity ability on depressive symptoms was greater than that of heart disease, which indicated that the impairment of daily activity ability had a greater impact on depressive symptoms in elderly women. Therefore, in order to promote the mental health of elderly women, healthcare workers should pay attention to the physical mobility of elderly women, enhance the awareness of preventive healthcare of the elderly, fully mobilize the mobility of the elderly individuals, and strengthen the health management of heart disease in order to reduce the prevalence of heart disease in elderly women; at the same time, they should pay more attention to strengthening the enhancement of the daily mobility of the elderly women, and provide the guidance and support of the rehabilitation training and other activities, so as to improve the daily mobility of elderly women, in order to prevent the depression of elderly women. At the same time, more attention should be paid to enhancing the daily activity ability of elderly women, providing guidance and support such as rehabilitation training, and improving the daily activity ability of elderly women to prevent the occurrence of depression in elderly women.\u003c/p\u003e \u003cp\u003eIn this study, we found that there was heterogeneity in the daily activity ability of elderly women in China, which could be categorized into the unimpaired group (91.4%) and the impaired group (8.6%). The scores of each entry in the no-impediment group were low, indicating that the elderly women in this group had no obstacles to daily activities; the scores of each entry in the obstacle group were high, indicating that there were obstacles to daily activities in this group, with the highest scores in the entries of housework and cooking, suggesting that healthcare personnel should focus on helping elderly women with obstacles to daily activities in housework and cooking, and provide targeted help according to different types of elderly women. This suggests that healthcare professionals should focus on helping elderly women with daily activity barriers in the areas of housework and cooking, and provide targeted assistance according to the different types of elderly women, in order to improve the quality of life of elderly women, alleviate their depression, and achieve the goal of healthy aging through the intervention of their ability to perform daily activities.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn summary, heart disease and daily activity ability can affect depressive symptoms in older women, with daily activity ability playing a partially mediating role, and the heterogeneity of daily activity ability is divided into 2 categories. Therefore, while reducing the prevalence of heart disease in elderly women, healthcare workers should pay more attention to the daily activity ability of elderly women, conduct dynamic assessment and screening and early targeted intervention, and give full play to its role in improving the level of mental health of elderly women to reduce and alleviate the occurrence and development of depressive symptoms. Meanwhile, this study used a cross-sectional study to verify the causal relationship between heart disease, ability to perform activities of daily living and depressive symptoms with some limitations, and did not verify the bidirectional role between heart disease and depression; there were no medical records in the CHARLS and self-reported information was used to measure the main variables, which may lead to recall bias, and a multicenter, longitudinal study is needed to further explore the impact of the subsequent mechanisms.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of interest statement \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere is no conflict of interest in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLL and XHQ: design of the study and interpretation of data. XPOY: data processing. SHQ and JPC: data processing, article design, and revision. PPH: article modification. All authors contributed to the article and approved the submitted version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the CHARLS team for collecting the data and providing an open access platform for the data and the respondents.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was supported by the Hunan Provincial Natural Science Foundation Upper-level Project Fund (Grant number: 2023JJ30426)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eJu M, Lulu W. Policy tools for urban geriatric education and their classification optimization in the era of active aging[J]. Journal of Hebei Normal University (Education Science Edition), 2024, 26: 111-117.\u003c/li\u003e\n\u003cli\u003eDEFRANCESCO M, PECHLANER R, KIECHL S, et al. What Characterizes Depression in Old Age? Results from the Bruneck Study[J]. Pharmacopsychiatry, 2018, 51(4): 153-160.\u003c/li\u003e\n\u003cli\u003ePengpeng L, Feng Y, Guangqiang L, et al. Research progress on the relationship between depression and cardiovascular disease in the elderly[J]. Journal of Chinese Academy of Medical Sciences, 2022, 44: 1089-1094.\u003c/li\u003e\n\u003cli\u003eYouguo L, Benyu Z. Trajectories of depressive mood in mid-adulthood: based on a growth mixture model[J]. Psychological Science, 2024, 47: 300-307.\u003c/li\u003e\n\u003cli\u003eBUCCIARELLI V, CATERINO A L, BIANCO F, et al. Depression and cardiovascular disease: The deep blue sea of women\u0026apos;s heart[J]. Trends Cardiovasc Med, 2020, 30(3): 170-176.\u003c/li\u003e\n\u003cli\u003eHaichun Y, Yajie Y, Qian H, et al. Comparative analysis of depression tendency and influencing factors between middle-aged and elderly women in China[J]. Modern Preventive Medicine, 2022, 49: 2024-2030.\u003c/li\u003e\n\u003cli\u003eELERTSON K M, MORGAN L L. Consideration of Gender in Cardiovascular Disease Prevention and Management[J]. Nurs Clin North Am, 2023, 58(4): 595-605.\u003c/li\u003e\n\u003cli\u003eDESAI S, MUNSHI A, MUNSHI D. Gender Bias in Cardiovascular Disease Prevention, Detection, and Management, with Specific Reference to Coronary Artery Disease[J]. J Midlife Health, 2021, 12(1): 8-15.\u003c/li\u003e\n\u003cli\u003eJie W, GZ S, Min G,et al. Research progress on fear of exercise in patients with cardiovascular disease[J]. Chinese Journal of Rehabilitation Medicine, 2023, 38: 712-715.\u003c/li\u003e\n\u003cli\u003eXianjin X, Jian W, Tian G, et al. Analysis of the relationship between the ability to perform activities of daily living and chronic disease co-morbidities and depressive symptoms among the elderly in China[J]. Medicine and Society, 2023, 36: 123-128.\u003c/li\u003e\n\u003cli\u003eSisi Z, WL W, Lin L, et al. Study on the mediating effect of daily activity ability between arthritis and depressive symptoms in elderly people[J]. Modern Preventive Medicine, 2024, 51: 123-126+155.\u003c/li\u003e\n\u003cli\u003eHui C, Zhuwei W. Mediating effects of depression on daily activity ability and self-neglect in empty-nesting elderly[J]. Modern Preventive Medicine, 2023, 50: 1669-1674.\u003c/li\u003e\n\u003cli\u003eLinxuan Z, Lin J, Meijing H, et al. Relationship between the number of cumulative C-reactive protein elevations and somatic and non-somatic depressive symptoms in Chinese middle-aged and elderly people: a prospective cohort study[J]. Chinese Family Medicine, 2024, 27: 2070-2076+2090.\u003c/li\u003e\n\u003cli\u003eCaiyun T, Rong H, Yao W, et al. Relationship between depression, loneliness and quality of life among widowed elderly women living alone in rural areas[J]. Journal of Central South University (Medical Edition), 2023, 48: 1865-1873.\u003c/li\u003e\n\u003cli\u003eChengcheng P, Huali W. Common psychological reactions and coping strategies of elderly people during the epidemic of new crown pneumonia[J]. Chinese Journal of Mental Health, 2020, 34: 257-258.\u003c/li\u003e\n\u003cli\u003eQifei L, Jiahui W, Jiaoyu B, et al. Survey on Alzheimer\u0026apos;s disease and analysis of influencing factors[J]. Modern Preventive Medicine, 2024, 51: 759-763.\u003c/li\u003e\n\u003cli\u003eZhihong N. Construction of a risk prediction model for elderly cardiac patients with limited ability to perform activities of daily living[J]. Geriatrics Research, 2023, 4: 33-38.\u003c/li\u003e\n\u003cli\u003eHui Q, Na C, Li Z. Impact of social participation on the trajectory of depression in older adults: mediating effect based on quality of life[J]. Modern Preventive Medicine, 2024, 51: 888-892+898.\u003c/li\u003e\n\u003cli\u003eRan Q, Baihe S, Xinyu Z, et al. Association of depression and anxiety symptoms with heart disease and chronic noncommunicable respiratory diseases among older adults in China[J].China Chronic Disease Prevention and Control, 2023, 31: 881-886.\u003c/li\u003e\n\u003cli\u003eHARE D L. Depression and cardiovascular disease[J]. Curr Opin Lipidol, 2021, 32(3). 167-174.\u003c/li\u003e\n\u003cli\u003eLI G H, CHEUNG C L, CHUNG A K, et al. Evaluation of bi-directional causal association between depression and cardiovascular diseases: a Mendelian randomization study[J]. Psychol Med, 2022, 52(9). 1765-1776.\u003c/li\u003e\n\u003cli\u003eMA X, ZHANG H, TIAN Y, et al. Mediating effect of depression on the association between cardiovascular disease and the risk of all-cause mortality. NHANES in 2005-2018[J]. Clin Cardiol, 2023, 46(11): 1380-1389.\u003c/li\u003e\n\u003cli\u003eHongwei W, Yalin H, Yunxin D, et al. Meta-analysis of the effect of positive thinking intervention on negative emotions in elderly patients with coronary atherosclerotic heart disease[J]. CHINESE JOURNAL OF GERONOMICS, 2023, 43: 2450-2454.\u003c/li\u003e\n\u003cli\u003eLI H, ZHENG D, LI Z, et al. Association of Depressive Symptoms With Incident Cardiovascular Diseases in Middle-Aged and Older Chinese Adults[J]. JAMA Netw Open, 2019, 2(12): e1916591.\u003c/li\u003e\n\u003cli\u003eJJ L, FS X, JK L, et al. Association of Sleep Duration with Cardiovascular Diseases in Older Adults in China[J].\u003c/li\u003e\n\u003cli\u003eRuifen W, Yan L, Zishuo C, et al. Relationship between cardiac metabolic co-morbidities and disability in Chinese middle-aged and elderly people[J]. Journal of Jilin University (Medical Edition), 2021, 47: 761-769.\u003c/li\u003e\n\u003cli\u003eXiaoqin C, Tianqi Y, Yanru S, et al. Network analysis of loneliness, depression and anxiety among disabled elderly in the community[J]. Military Nursing, 2024, 41: 21-24.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"older adults, women, depressive symptoms, heart disease, ability to perform daily activities, mediating role, latent profile analysis","lastPublishedDoi":"10.21203/rs.3.rs-4598003/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4598003/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo explore the mediating effect of daily activity ability between heart disease and depressive symptoms in elderly women, and to analyze the potential categories of daily activity ability in elderly women in China, so as to provide a reference basis for preventing and intervening in the development of depressive symptoms in elderly women.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUsing the 2020 CHARLS data, stepwise regression analysis and Bootstrap mediation test were used to analyze the mediating effect of daily activity capacity between heart disease and depressive symptoms in elderly women, and latent category approach was used to identify the categories of daily activity capacity in elderly women in China.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThree thousand seven hundred and ninety-three elderly women were included, with a prevalence of heart disease of 30.13% and a detection rate of depressive symptoms of 49.27%.Spearman's correlation analyses showed a positive correlation between the prevalence of heart disease and impaired ability to perform activities of daily living (r=0.157, P \u0026lt; 0.01), and between the prevalence of heart disease and depressive symptoms (r=0.108, P \u0026lt; 0.01), and ability to perform daily living activities impaired was positively associated with depressive symptoms (r = 0.321, P \u0026lt; 0.01). The results of the mediation effect test showed that ability to perform daily activities partially mediated the relationship between heart disease and depressive symptoms, with a mediation effect value of 0.0401 for ability to perform daily activities on depressive symptoms, and a mediation effect of 29.55% of the total effect. Potential profiles were categorized into 2 groups, the no impairment group (91.4%) and the impairment group (8.6%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe types of daily activity ability of elderly women in China are heterogeneous and can be categorized into 2 types. Heart disease can have a certain impact on the depression symptoms of elderly women through daily activity ability, and comprehensive interventions should be taken to improve the heart health of elderly women, reduce the prevalence of heart disease, and improve the daily activity ability of elderly women, thereby preventing the occurrence of depression symptoms in elderly women.\u003c/p\u003e","manuscriptTitle":"A study of the mediating effect of daily mobility between heart disease and depressive symptoms in older women and its potential profile analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-11 10:16:26","doi":"10.21203/rs.3.rs-4598003/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2871ae44-3683-4d9f-98ce-c7abf721ff60","owner":[],"postedDate":"July 11th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-12-11T11:23:49+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-11 10:16:26","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4598003","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4598003","identity":"rs-4598003","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}