Trajectory and influencing factors of changes in anxiety and depression in elderly patients after lumbar interbody fusion

Table 1 Fitting indicators of the latent class growth model for anxiety levels

No.	AIC	BIC	aBIC	Entropy	LMR	BLRT	Probability
1	3823.352	3844.211	3825.193				1.000
2	3481.818	3513.106	3484.579	0.984	< 0.001	< 0.001	0.121/0.879
3	3334.745	3376.462	3338.426	0.956	< 0.001	< 0.001	0.115/0.119/0.766
4	3251.977	3304.124	3256.578	0.899	0.083	< 0.001	0.114/0.129/0.279/0.477
5	3193.969	3256.546	3199.491	0.924	0.003	< 0.001	0.055/0.065/0.134/0.271/0.476

AIC: Akaike information criterion; BIC: Bayesian information criterion; aBIC: Adjusted Bayesian information criterion; LMR: Lo-Mendell-Rubin-adjusted likelihood ratio test; BLRT: Bootstrap likelihood ratio test.

Table 2 Fitting indicators of the latent class growth model for depression levels

No.	AIC	BIC	aBIC	Entropy	LMR	BLRT	Probability
1	3864.588	3885.446	3866.428	1.000			1.000
2	3509.856	3541.144	3512.616	0.958	0.034	< 0.001	0.163/0.837
3	3354.116	3395.833	3357.797	0.951	0.007	< 0.001	0.122/0.124/0.754
4	3316.620	3368.767	3321.221	0.843	0.136	< 0.001	0.115/0.120/0.257/0.508
5	3262.497	3325.074	3268.019	0.894	0.051	< 0.001	0.050/0.075/0.113/0.234/0.527

AIC: Akaike information criterion; BIC: Bayesian information criterion; aBIC: Adjusted Bayesian information criterion; LMR: Lo-Mendell-Rubin-adjusted likelihood ratio test; BLRT: Bootstrap likelihood ratio test.

Table 3 Univariate analysis of anxiety and depression levels in elderly patients after lumbar interbody fusion, mean ± SD/n (%)

Characteristic	A1 (n = 26)	A2 (n = 27)	A3 (n = 186)	χ2/F value	P value	D1 (n = 30)	D2 (n = 26)	D3 (n = 183)	χ2/F value	P value
Sex				8.320	0.016				6.101	0.047
Male	6 (23.08)	11 (40.74)	97 (52.15)			18 (60.00)	8 (30.77)	101 (55.19)
Female	20 (76.92)	16 (59.26)	89 (47.85)			12 (40.00)	18 (69.23)	82 (44.81)
Age (year)	72.45 ± 5.36	71.85 ± 5.50	73.37 ± 4.04	0.582	0.560	71.47 ± 4.52	72.62 ± 5.78	72.49 ± 5.23	0.653	0.521
BMI (kg/m2)	21.58 ± 1.17	21.59 ± 1.16	21.23 ± 0.88	1.143	0.321	21.22 ± 1.20	21.75 ± 1.11	21.57 ± 1.13	1.633	0.197
Symptom duration				5.479	0.065				4.887	0.087
< 1 year	9 (34.62)	18 (66.67)	92 (49.46)			18 (60.00)	17 (65.38)	84 (45.90)
≥ 1 year	17 (65.38)	9 (33.33)	94 (50.54)			12 (40.00)	9 (34.62)	99 (54.10)
Education level				11.532	0.073				6.003	0.423
Secondary school	14 (53.85)	6 (22.22)	50 (26.88)			9 (30.00)	8 (30.77)	53 (28.96)
Junior high school	6 (23.08)	7 (25.93)	41 (22.04)			7 (23.33)	4 (15.38)	43 (23.50)
High school	3 (11.54)	10 (37.04)	53 (28.49)			10 (33.33)	11 (42.31)	45 (24.59)
College and above	3 (11.54)	4 (14.81)	42 (22.58)			4 (13.33)	3 (11.54)	42 (22.95)
Residence				2.315	0.314				2.702	0.259
City	13 (50.00)	17 (62.96)	88 (47.31)			18 (60.00)	15 (57.69)	85 (46.45)
Countryside	13 (50.00)	10 (37.04)	98 (52.69)			12 (40.00)	11 (42.31)	98 (53.55)
Have a partner				6.250	0.044				7.429	0.024
Yes	9 (34.62)	18 (66.67)	107 (57.53)			19 (63.33)	8 (30.77)	105 (57.38)
No	17 (73.08)	9 (33.33)	79 (42.47)			11 (36.67)	18 (69.23)	78 (42.62)
Smoking				0.250	0.882				5.927	0.052
Yes	13 (50.00)	15 (55.56)	94 (50.54)			11 (36.67)	18 (69.23)	93 (50.82)
No	13 (50.00)	12 (44.44)	92 (49.46)			19 (63.33)	8 (30.77)	90 (49.18)
Alcohol abuse				0.570	0.752				3.252	0.198
Yes	15 (57.69)	13 (48.15)	94 (50.54)			14 (46.67)	9 (34.62)	97 (53.01)
No	11 (42.31)	14 (51.85)	92 (49.46)			16 (53.33)	17 (65.38)	86 (46.99)
History of diabetes				3.348	0.187				1.465	0.481
Yes	17 (65.38)	17 (62.96)	93 (50.00)			19 (63.33)	13 (50.00)	95 (51.91)
No	9 (34.62)	10 (37.04)	93 (50.00)			11 (36.67)	13 (50.00)	88 (48.09)
History of hypertension				1.301	0.522				1.704	0.427
Yes	16 (61.54)	16 (59.26)	96 (51.61)			15 (50.00)	17 (65.38)	96 (52.46)
No	10 (38.46)	11 (40.74)	90 (48.39)			15 (50.00)	9 (34.62)	87 (47.54)
History of coronary heart disease				0.235	0.889				5.089	0.079
Yes	14 (53.85)	15 (55.56)	95 (51.08)			21 (70.00)	11 (42.31)	92 (50.27)
No	12 (46.15)	12 (44.44)	91 (48.92)			9 (30.00)	15 (57.69)	91 (49.73)
Preoperative diagnosis				9.069	0.134				2.877	0.825
Spondylolisthesis	17 (65.38)	10 (37.04)	121 (65.05)			16 (53.33)	15 (57.69)	117 (63.93)
Scoliosis	4 (15.38)	7 (25.93)	24 (12.90)			6 (20.00)	4 (15.38)	25 (13.66)
Recurrent disc herniation	1 (3.85)	2 (7.41)	7 (3.76)			2 (6.67)	1 (3.85)	7 (3.83)
Stenosis	4 (15.38)	8 (29.63)	34 (18.28)			6 (20.00)	6 (23.08)	34 (18.58)
Number of levels decompressed				8.169	0.354				10.085	0.225
1	8 (30.77)	12 (44.44)	63 (33.87)			14 (46.67)	13 (50.00)	56 (30.60)
2	8 (30.77)	6 (22.22)	72 (38.71)			10 (33.33)	4 (15.38)	72 (39.34)
3	3 (11.54)	6 (22.22)	22 (11.83)			3 (10.00)	4 (15.38)	24 (13.11)
4	4 (15.38)	1 (3.71)	19 (10.22)			2 (6.67)	2 (7.69)	20 (10.93)
5	3 (11.54)	2 (7.41)	10 (5.39)			1 (3.33)	3 (11.54)	11 (6.01)
Number of levels fused				11.654	0.020				7.542	0.103
1	8 (30.77)	12 (44.44)	87 (46.77)			10 (33.33)	10 (38.46)	87 (47.54)
2	8 (30.77)	8 (29.63)	74 (39.78)			14 (46.67)	7 (26.92)	69 (37.71)
≥ 3	10 (38.46)	7 (25.93)	25 (13.44)			6 (20.00)	9 (34.62)	27 (14.75)
Chronic opioid use postop				1.002	0.606				6.777	0.034
Yes	14 (53.85)	17 (62.96)	98 (52.69)			11 (36.67)	18 (69.23)	82 (44.81)
No	12 (46.15)	10 (37.04)	88 (47.31)			19 (63.33)	8 (30.77)	101 (55.19)
Post- vs pre-surgery ODI scores				10.926	0.027				10.466	0.032
Elevated	11 (42.31)	7 (25.93)	30 (16.13)			8 (26.67)	11 (42.31)	33 (18.03)
Reduced	6 (23.08)	9 (33.33)	57 (30.65)			11 (36.67)	6 (23.08)	51 (27.87)
No significant change	9 (34.62)	11 (40.74)	99 (53.23)			11 (36.67)	9 (34.62)	99 (54.10)
Post- vs pre-surgery SF-36 scores				10.232	0.033				10.207	0.034
Elevated	7 (26.92)	14 (51.85)	87 (46.77)			12 (40.00)	9 (34.62)	86 (46.99)
Reduced	9 (34.62)	6 (22.22)	24 (12.90)			6 (20.00)	11 (42.31)	27 (14.75)
No significant change	10 (38.46)	7 (25.93)	75 (40.32)			12 (40.00)	6 (23.08)	70 (38.25)

A1: Increasing anxiety; A2: Deceasing anxiety; A3: Stable anxiety; D1: Decreasing depression; D2: Increasing depression; D3: Stable depression; BMI: Body mass index; ODI: Oswestry dysfunction index; SF-36: 36-Item Short Form Health Survey.

Table 4 Logistic regression analysis of factors influencing anxiety levels in elderly patients after lumbar interbody fusion

	β	SE	OR	95%CI	P value
A1 vs A2
Have a partner	1.202	0.595	3.326	1.036-10.682	0.043
A1 vs A3
Sex	-1.186	0.500	0.305	0.115-0.815	0.018
ODI scores	-0.567	0.285	0.567	0.325-0.992	0.047
SF-36 scores	0.596	0.295	1.815	1.012-3.255	0.045

OR: Odds ratio; CI: Confidence interval; A1: Increasing anxiety; A2: Deceasing anxiety; A3: Stable anxiety; ODI: Oswestry dysfunction index; SF-36: 36-Item Short Form Health Survey.

Table 5 Logistic regression analysis of factors influencing depression levels in elderly patients after lumbar interbody fusion

	β	SE	OR	95%CI	P value
D1 vs D2
Sex	-1.291	0.585	0.275	0.087-0.866	0.027
Chronic opioid use postop	-1.413	0.618	0.243	0.073-0.817	0.022
D2 vs D3
Sex	-1.010	0.469	0.364	0.145-0.913	0.031
ODI scores	-0.638	0.265	0.528	0.314-0.888	0.016

OR: Odds ratio; CI: Confidence interval; D1: Decreasing depression; D2: Increasing depression; D3: Stable depression; ODI: Oswestry dysfunction index; SF-36: 36-Item Short Form Health Survey.