中国3省60岁及以上老年人抑郁情况及其影响因素研究

王丹; 齐士格; 王宝华; 胡亚男; 王秋童; 王志会

Abstract

王丹,齐士格,王宝华,胡亚男,王秋童,王志会.中国3省60岁及以上老年人抑郁情况及其影响因素研究[J].Chinese journal of Epidemiology,2022,43(12):1925-1931

中国3省60岁及以上老年人抑郁情况及其影响因素研究

Depression status and its influencing factors among the elderly aged 60 years and above in three provinces of China

Received:April 18, 2022

DOI：10.3760/cma.j.cn112338-20220418-00313

KeyWord: 抑郁症状老年人影响因素地域

English Key Word: Depressive symptom Elderly Influence factor Region

FundProject:财政部重大公共卫生专项（131091106000150003）

Author Name	Affiliation	E-mail
Wang Dan	Cancer and Key Chronic Disease Control and Prevention Laboratory, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China School of Public Health, China Medical University, Shenyang 110122, China
Qi Shige	Division of Elderly Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Wang Baohua	Cancer and Key Chronic Disease Control and Prevention Laboratory, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China	baohua2000@126.com
Hu Yanan	School of Public Health, China Medical University, Shenyang 110122, China
Wang Qiutong	Cancer and Key Chronic Disease Control and Prevention Laboratory, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Wang Zhihui	Division of Elderly Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China

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Abstract:

目的调查了解我国社区≥60岁老年人抑郁情况，并探索其影响因素。方法调查对象来自“老年期重点疾病预防和干预”项目，该项目采用多阶段分层整群随机抽样方法于2019年在辽宁、河南和广东3省16个县（区）共完成14 335名≥60岁老年人的抑郁筛查。通过问卷调查研究对象人口学特征、是否与家人居住、是否与邻居有交往、日常锻炼、认知功能和日常生活活动能力（ADL）等信息，使用PHQ-9抑郁筛查量表评估老年人近半个月内的抑郁情况。采用二元logistic回归分析老年人抑郁的影响因素。结果辽宁省、河南省、广东省老年人抑郁症状检出率为15.45%，3省分别为18.17%、18.87%、9.93%。不同地域间老年人抑郁症状检出率存在城乡差异，其中河南省为17.09% vs. 20.61%，广东省为7.99% vs. 11.03%，差异均有统计学意义（P<0.05）。多因素logistic回归分析结果显示，老年女性抑郁症状检出率高于男性（OR=1.76，95%CI：1.58~1.96），离异/分居（OR=2.08，95%CI：1.01~4.30）、认知功能异常（OR=1.78，95%CI：1.59~1.98）、基础性日常生活活动能力（BADL）受损（OR=1.74，95%CI：1.23~2.46）、工具性日常生活活动能力（IADL）受损（OR=2.23，95%CI：1.97~2.54）是老年人抑郁的危险因素（P<0.05），且IADL受损对老年人抑郁的影响高于BADL受损（2.23 vs. 1.74）；≥80岁（OR=0.82，95%CI：0.68~0.99）、与家人居住（OR=0.67，95%CI：0.57~0.80）、与邻居有交往（OR=0.86，95%CI：0.76~0.98）、每周锻炼多次（OR=0.82，95%CI：0.69~0.96）、几乎每天锻炼（OR=0.63，95%CI：0.56~0.70）是老年人抑郁的保护因素（P<0.05）。结论我国社区≥60岁老年人抑郁症状检出率较高，性别、婚姻状况、社会交往、体育锻炼、认知功能、ADL均是老年人抑郁的影响因素，老年卫生保健部门应开展重点人群心理预防和干预工作。

English Abstract:

Objective The survey learned about the current status of depression in community's elderly aged 60 years and older and explored its influencing factors. Methods Respondents from the "Prevention and Intervention of Key Diseases in the Elderly" project used a multi-stage stratified cluster random sampling method to complete the depression screening of 14 335 ≥60-year-old elderly people in 16 counties and districts Liaoning, Henan, and Guangdong provinces in 2019. Through the questionnaire survey on the demographic characteristics of the subjects, whether they live with their families or interact with neighbors, daily exercise, cognitive function, and activity of daily living (ADL), the PHQ-9 depression screening scale was used to assess the depression status of the elderly in the last fortnight. Binary logistic regression was used to analyze the influencing factors of depression in the elderly. Results The prevalence of depressive symptoms among the elderly in Liaoning province, Henan province, and Guangdong province was 15.45%, and those in the three provinces were 18.17%, 18.87% and 9.93%, respectively. There were differences between urban and rural areas in the detection rate of depressive symptoms among the elderly in different regions, among which Henan: 17.09% vs. 20.61%; Guangdong province: 7.99% vs. 11.03%, the differences were statistically significant (P<0.05). The results of multivariate logistic regression analysis showed that the detection rate of depressive symptoms in older women was higher than that in men (OR=1.76, 95%CI: 1.58-1.96), in those divorced or separated (OR=2.08, 95%CI: 1.01-4.30), with cognitive dysfunction (OR=1.78, 95%CI: 1.59-1.98) or impaired essential ability of daily living (BADL) (OR=1.74, 95%CI: 1.23-2.46). The impaired instrumental ability of daily living (IADL) (OR=2.23, 95%CI: 1.97-2.54) was a risk factor for depression in the elderly (P<0.05), and the impact of IADL impairment on depression in the elderly was higher than that of BADL impairment (2.23 vs. 1.74). Results also showed that factors as: 80 years old and above (OR=0.82, 95%CI: 0.68-0.99), living with family members (OR=0.67, 95%CI: 0.57-0.80), interacting with neighbors (OR=0.86, 95%CI: 0.76-0.98), exercise multiple times per week (OR=0.82, 95%CI: 0.69-0.96), and exercise almost every day (OR=0.63, 95%CI: 0.56-0.70) were protective for depression in the elderly (P<0.05). Conclusions The detection rate of depressive symptoms in the elderly aged 60 and above in the community is relatively high in China. Gender, marital status, social interaction, physical exercise, cognitive function, and ADL are all influencing factors of depression in the elderly. The elderly health care sector should carry out psychological prevention and intervention of critical populations.

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