实用老年医学 ›› 2026, Vol. 40 ›› Issue (8): 764-769.doi: 10.3969/j.issn.1003-9198.2026.08.003
邓吉宝, 谭丽, 王艳荣
收稿日期:2026-06-16
出版日期:2026-08-20
发布日期:2026-08-24
通讯作者:
王艳荣,Email:ronger-2006@163.com
作者简介:王艳荣 教授
DENG Jibao, TAN Li, WANG Yanrong
Received:2026-06-16
Online:2026-08-20
Published:2026-08-24
Contact:
WANG Yanrong, Email:ronger-2006@163.com
摘要: 老年躯体疾病患者伴发焦虑抑郁的概率较高,反之,抑郁和焦虑症状又会加重躯体疾病进程。如何治疗老年患者的焦虑抑郁就显得尤为重要,了解其发病机制并选择合适的评估工具是治疗的关键。本文就老年躯体疾病患者伴发焦虑抑郁的病理机制及其诊疗进展的相关研究进行了回顾,以期为老年躯体疾病患者伴发的焦虑抑郁提供诊疗参考。
中图分类号:
邓吉宝, 谭丽, 王艳荣. 老年躯体疾病伴发焦虑抑郁的临床诊治进展[J]. 实用老年医学, 2026, 40(8): 764-769.
DENG Jibao, TAN Li, WANG Yanrong. Advances in the clinical diagnosis and treatment of anxiety and depression in elderly patients with somatic diseases[J]. Practical Geriatrics, 2026, 40(8): 764-769.
| [1] BEARD J R, OFFICER A, DE CARVALHO I A, et al. The world report on ageing and health: a policy framework for healthy ageing[J]. Lancet, 2016, 387(10033): 2145-2154. [2] CHENG C, DU Y, BAI J. Physical multimorbidity and psychological distress among Chinese older adults: findings from Chinese Longitudinal Healthy Longevity Survey[J]. Asian J Psychiatr, 2022, 70: 103022. [3] CHENG Y, FANG Y, ZHENG J, et al. The burden of depression, anxiety and schizophrenia among the older population in ageing and aged countries: an analysis of the Global Burden of Disease Study 2019[J]. Gen Psychiatr, 2024, 37(1): e101078. [4] HALLAB A. Mediating effect of pro-inflammatory cytokines in the association between depression, anxiety, and cardiometabolic disorders in an ethnically diverse community-dwelling middle-aged and older US population[J]. medRxiv, 2025.[Preprint]. doi: 10.1101/2025.04.14.25325836. [5] DERRY H M, JOHNSTON C D, BURCHETT C O, et al. Links between inflammation, mood, and physical function among older adults with HIV[J]. J Gerontol B Psychol Sci Soc Sci, 2022, 77(1): 50-60. [6] JANTSCH J, DA SILVA RODRIGUES F, WICKERT F, et al. Cannabidiol attenuates diet-induced metabolic endotoxemia, neuroinflammation, and anxiety-like behaviors in male aged rats[J]. Brain Behav Immun, 2025, 130: 106121. [7] ABBOTT R, WHEAR R, NIKOLAOU V, et al. Tumour necrosis factor-α inhibitor therapy in chronic physical illness: a systematic review and meta-analysis of the effect on depression and anxiety[J]. J Psychosom Res, 2015, 79(3): 175-184. [8] KEMALA SARI N, BURHAN E, ISBANIAH F, et al. Emotional freedom techniques for elderly patients with COVID-19: a case series on clinical recovery, frailty, and inflammatory biomarkers[J]. Front Psychol, 2025, 16: 1627592. [9] KRAUSE-SORIO B, SIDDARTH P, MILILLO M M, et al. Regional gray matter volume correlates with anxiety, apathy, and resilience in geriatric depression[J]. Int Psychogeriatr, 2023, 35(12): 698-706. [10] CELLE S, BOUTET C, ANNWEILER C, et al. Leukoaraiosis and gray matter volume alteration in older adults: the PROOF Study[J]. Front Neurosci, 2021, 15: 747569. [11] LI H, ZHAO J, LAI L, et al. Loss of SST and PV positive interneurons in the ventral hippocampus results in anxiety-like behavior in 5xFAD mice[J]. Neurobiol Aging, 2022, 117: 165-178. [12] SEAH C W T, HO M, CHU C, et al. Immunosenescence and its impact on ischemic stroke risk and outcomes in older adults: a systematic review[J]. Front Aging Neurosci, 2026, 18: 1776458. [13] ZHUBI E, LEHOCZKI A, TOTH P, et al. Intracerebral hemorrhage in aging: pathophysiology, clinical challenges, and future directions[J]. Life: Basel, 2025, 15(10). [14] MéTIVIER L, VIVIEN D, GOY R, et al. Plasminogen activator inhibitor-1 in the pathophysiology of late life depression[J]. Int J Geriatr Psychiatry, 2024, 39(11): e70015. [15] WEN H, MAO Q, JIANG Z, et al. The relationship between disability, anxiety and depression in older adults with chronic disease comorbidities: the mediating role of frailty[J]. BMC Geriatr, 2025, 25(1): 972. [16] LI B, GUAN S, HUANG C, et al. Depression severity and chronic disease risk: interactive effects on cognitive function and life satisfaction in Chinese middle-aged and older adults[J]. Front Public Health, 2025, 13: 1530513. [17] LIU Y, TONG J, CHEN L, et al. Nutritional frailty and the incidence of depression and anxiety among middle-aged and older adults: a prospective cohort study[J]. Clin Nutr, 2025, 50: 10-19. [18] SHI Y Q, YANG H C, HE C, et al. Inflammatory links between epilepsy and depression: a review of mechanisms and therapeutic strategies[J]. Front Neurosci, 2025, 19: 1614297. [19] LICINIO J, LICINIO A W, BUSNELLO J V, et al. The emergence of chronic diseases of adulthood and middle age in the young: the COIDS (chronic inflammation, obesity, insulin resistance/type 2 diabetes, and depressive syndromes) noxious quartet of pro-inflammatory stress outcomes[J]. Mol Psychiatry, 2025, 30(7): 3348-3356. [20] MISHRA S P, JAIN S, WANG B, et al. Abnormalities in microbiota/butyrate/FFAR3 signaling in aging gut impair brain function[J]. JCI Insight, 2024, 9(3) :e168443. [21] HUANG H, LU M, ZHANG P, et al. Association between malnutrition, depression, anxiety and fatigue after stroke in older adults: a cross-lagged panel analysis[J]. Aging Clin Exp Res, 2024, 37(1): 4. [22] WANG N, TU Q. Analysis of factors influencing anxiety and depression disorders among hospitalized patients[J]. Front Psychiatry, 2026, 17: 1757945. [23] JOKELAINEN J, TIMONEN M, KEINÄNEN-KIUKAANNIEMI S, et al. Validation of the Zung self-rating depression scale (SDS) in older adults[J]. Scand J Prim Health Care, 2019, 37(3): 353-357. [24] PENG L, PENG Y, HUANG W. Social participation and insomnia in Chinese older adults with multimorbidity: mediating roles of frailty, anxiety, and depression[J]. BMC Geriatr, 2025, 25(1): 605. [25] BYRNE G J, PACHANA N A. Development and validation of a short form of the Geriatric Anxiety Inventory-the GAI-SF[J]. Int Psychogeriatr, 2011, 23(1): 125-131. [26] SNELLMAN S, HöRNSTEN C, OLOFSSON B, et al. Validity and test-retest reliability of the Swedish version of the geriatric depression scale among very old adults[J]. BMC Geriatr, 2024, 24(1): 261. [27] PACHANA N A, BYRNE G J, SIDDLE H, et al. Development and validation of the geriatric anxiety inventory[J]. Int Psychogeriatr, 2007, 19(1): 103-114. [28] CHEN J, YAN Y, YUAN F, et al. Brain grey matter volume reduction and anxiety-like behavior in lipopolysaccharide-induced chronic pulmonary inflammation rats: a structural MRI study with histological validation[J]. Brain Behav Immun, 2019, 76: 182-197. [29] YE S, DAVE A, SALAMI A, et al. Frontoparietal functional dedifferentiation during naturalistic movie watching among older adults at risk of emotional vulnerability[J]. Neurobiol Aging, 2025, 156: 150-162. [30] WINTER N R, LEENINGS R, ERNSTING J, et al. Quantifying deviations of brain structure and function in major depressive disorder across neuroimaging modalities[J]. JAMA Psychiatry, 2022, 79(9): 879-888. [31] WANG H, REN Y, ZHOU S, et al. Depression, pain, and seven chronic diseases in middle-aged and older adults: findings from five prospective cohort studies[J]. J Affect Disord, 2026, 401: 121251. [32] LUTZ J, MACKIN R S, OTERO M C, et al. Improvements in functional disability after psychotherapy for depression are associated with reduced suicide ideation among older adults[J]. Am J Geriatr Psychiatry, 2021, 29(6): 557-561. [33] BABA H, KITO S, NUKARIYA K, et al. Guidelines for diagnosis and treatment of depression in older adults: a report from the Japanese society of mood disorders[J]. Psychiatry Clin Neurosci, 2022, 76(6): 222-234. [34] ESKANDARI B, NOURIZADEH R, MEHRABI E, et al. Evaluating the impact of home supportive counseling and telephone supportive counseling on postpartum depression and anxiety: a randomized controlled trial[J]. BMC Psychiatry, 2025, 25(1): 510. [35] HAUSMAN H K, ALEXANDER G E, COHEN R, et al. tDCS reduces depression and state anxiety symptoms in older adults from the augmenting cognitive training in older adults study (ACT)[J]. Brain Stimul, 2024, 17(2): 283-311. [36] MANOR B, ZHOU J, HARRISON R, et al. Transcranial direct current stimulation may improve cognitive-motor function in functionally limited older adults[J]. Neurorehabil Neural Repair, 2018, 32(9): 788-798. [37] MOLEÓN-RUIZ Á, ÁLVAREZ DE TOLEDO P, NARBONA-ANTÁNEZ J, et al. Rapid relief of suicidal ideation via repetitive transcranial magnetic stimulation (rTMS) in depressed patients[J]. Clin Neurophysiol, 2025, 178: 2110941. [38] 李上达, 胡少华, 周和统, 等. 《重复经颅磁刺激技术在精神障碍临床应用中的操作规范》团体标准解读[J]. 中华精神科杂志, 2024, 57(3): 133-137. [39] LENZE E J, KARP J F, GEBARA M A, et al. Pharmacotherapy of major depressive disorder in older adults: from an evidence-informed stepwise algorithm to precision medicine[J]. Neuropsychopharmacology, 2026. doi: 10.1038/s41386-026-02338-w. Online ahead of print. [40] SRIFUENGFUNG M, PENNINGTON B R T, LENZE E J. Optimizing treatment for older adults with depression[J]. Ther Adv Psychopharmacol, 2023. doi: 10.1177/20451253231212327. [41] CHOI N G, CHOI B Y, MARTI C N, et al. Depression/anxiety symptoms and self-reported difficulty managing medication regimen among community-dwelling older adults[J]. Gen Hosp Psychiatry, 2022, 78: 50-57. [42] NG T K S, LIM Z H, TODD M, et al. Effects of choral singing on depression and anxiety in older adults: a randomized controlled trial[J]. J Psychiatr Res, 2025, 188: 162-168. [43] REMISZEWSKI M, RAJTAR G, KOMAREK Z, et al. Long-term aerobic exercise enhances interoception and reduces symptoms of depression and anxiety in physically inactive young adults: a randomized controlled trial[J]. Psychol Sport Exerc, 2025, 81: 102939. [44] ROSSON S, BRESOLIN N, D’AMICO A, et al. Long-term efficacy and safety of vagus nerve stimulation in treatment-resistant depression: a systematic review[J]. J Affect Disord, 2026, 394(Pt A): 120483. [45] YU L, CHEN C. Symptom patterns of comorbid depression and anxiety among older adults in China and their predictors[J]. Psych J, 2024, 13(3): 494-511. |
| [1] | 袁宇承, 陈刚. 老年人精神类药物使用原则[J]. 实用老年医学, 2026, 40(8): 759-763. |
| [2] | 王兰兰, 季蕴辛. 老年躯体疾病伴发谵妄的诊疗进展[J]. 实用老年医学, 2026, 40(8): 770-774. |
| [3] | 吴珩, 袁勇贵. 老年躯体痛苦障碍的临床诊治进展[J]. 实用老年医学, 2026, 40(8): 775-780. |
| [4] | 杨柳, 梁志芳, 王燕, 魏静, 成晓梅, 李妮, 荊玉洁, 李昊. 老年上消化道出血并发多器官功能障碍的危险因素分析以及风险预测模型构建[J]. 实用老年医学, 2026, 40(8): 781-786. |
| [5] | 王雪菲, 康圣琴, 王伟, 王洁, 蔡崔春. 老年心房颤动患者跌倒发生率及影响因素的meta分析[J]. 实用老年医学, 2026, 40(8): 787-792. |
| [6] | 方媛媛, 陈欣欣, 蔡春雨, 孔丽丽. 血清copeptin、sST2和NGAL预测老年急性心肌梗死患者PCI术后发生心力衰竭的价值[J]. 实用老年医学, 2026, 40(8): 793-797. |
| [7] | 李阳波, 赵政昆. 残余胆固醇炎症指数对老年不稳定型心绞痛患者预后的预测价值[J]. 实用老年医学, 2026, 40(8): 811-815. |
| [8] | 毕靓, 王依诺, 于冬梅. 基于ICFM模型的老年脑卒中患者社会支持、抑郁和口腔衰弱的相关性研究[J]. 实用老年医学, 2026, 40(8): 826-830. |
| [9] | 高欣语, 孔晓明, 耿昊, 吕思文. 肌少症对老年抑郁症患者情景记忆功能的影响[J]. 实用老年医学, 2026, 40(8): 831-836. |
| [10] | 杨路延, 叶青, 王志勇, 胡彩红, 许慧清, 敖国凤, 徐斐. 南京市≥60岁社区老年人疲劳与衰弱的关联性研究[J]. 实用老年医学, 2026, 40(8): 843-849. |
| [11] | 邓婷, 杨伟, 王伟华, 辛媛媛. 老年人数字排斥的研究进展[J]. 实用老年医学, 2026, 40(8): 850-854. |
| [12] | 周春霞, 田萌, 李倩, 陈瑛. 老年住院跌倒患者跌倒风险等级特征及影响因素研究[J]. 实用老年医学, 2026, 40(8): 860-864. |
| [13] | 曾妙, 雷佳炜, 王晟. 老年常见慢性肾脏纤维化疾病诊疗的研究进展[J]. 实用老年医学, 2026, 40(7): 651-657. |
| [14] | 王思亚, 殷实. 老年人肝脏纤维化的诊疗进展[J]. 实用老年医学, 2026, 40(7): 662-666. |
| [15] | 邓纪旺, 郭莹. 老年人常见肺部慢性纤维化疾病的诊疗进展[J]. 实用老年医学, 2026, 40(7): 667-673. |
| 阅读次数 | ||||||
|
全文 |
|
|||||
|
摘要 |
|
|||||
|