Mediating role of depressive symptoms in the relationship between polypharmacy and accelerated biological aging in older adults
10.3760/cma.j.issn.0254-9026.2025.11.018
- VernacularTitle:抑郁情绪对多重用药加速老年人生物学衰老的中介效应分析
- Author:
Yanping YANG
1
;
Kai WEI
1
Author Information
1. 贵州省人民医院药剂科，贵阳 550002
- Publication Type:Journal Article
- Keywords:
Polypharmacy;
Biological aging;
Depressive symptoms;
Mediating effect.
- From:
Chinese Journal of Geriatrics
2025;44(11):1590-1595
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of polypharmacy on accelerated biological aging in older adults and to examine the mediating role of depressive symptoms in this relationship.Methods:This study utilized data from the National Health and Nutrition Examination Survey(NHANES), including participants aged 65 years and older who reported taking at least one prescription medication across seven survey cycles from 2005 to 2018.Polypharmacy was defined as the use of five or more medications.Depressive symptoms were assessed using the Patient Health Questionnaire-9(PHQ-9). Accelerated biological aging(AgeDelta)was quantified as the difference between chronological age and biological age, calculated using three distinct algorithms: phenotypic age(PhenoAge), Klemera-Doubal biological age(KD-BioAge), and anthropometric age(AnthroAge). Correlation matrices were employed to evaluate associations between the number of medications, depressive symptoms, and biological aging.Weighted multiple linear regression models were used to assess the impact of polypharmacy on biological aging, while mediation analyses were conducted to determine the mediating effect of depressive symptoms on the relationship between polypharmacy and accelerated biological aging.Results:The study included 8 597 older adults, among whom 3 973(weighted percentage: 45.1%)were identified as polypharmacy users.After adjusting for multiple covariates, weighted linear regression analyses revealed that polypharmacy remained significantly associated with PhenoDelta( β=2.114, 95% CI: 1.618-2.612, P<0.001), KD-Delta( β=1.181, 95% CI: 0.909-1.452, P<0.001), and AnthroDelta( β=0.275, 95% CI: 0.158-0.393, P<0.001). Mediation analyses indicated that depressive symptoms accounted for 8.7%, 3.6%, and 11.5% of the mediating effects between polypharmacy and the three biological aging phenotypes, respectively. Conclusions:Polypharmacy in older adults may contribute to accelerated biological aging, with depressive symptoms partially mediating this relationship.
