|
|
老年人抑郁的现状及其影响因素——以广东省为例
|
Abstract:
目的：了解老年人抑郁的现状，分析其主要的影响因素。方法：采用分层随机抽样法，选取广东省5个城市的1510名老年人(男性776名，女性734名)，使用老年抑郁量表(geriatric depression scale, GDS)、社会支持评定量表(social support rating scale, SSRS)、简明精神状态量表(mini-mental state examination, MMSE)、老年人一般个人情况和生活状况调查表为工具，对他们进行调查。结果：本组的GDS的总分为(10.20 ± 6.37)、SSRS的总分和客观支持、主观支持和社会支持的利用度的得分分别为(30.79 ± 5.51)、(9.24 ± 2.37)、(19.38 ± 4.95)和(9.22 ± 2.15)。多元二项Logistic回归分析结果显示，地区经济发达或经济落后、女性、高学历、未婚、丧偶、健康状况不良、每月退休金2500元以下、社会支持水平不够满意是老年抑郁的危险因素(OR = 1.067~20.224, P = 0.000~0.778)，经济水平中上的地区、有子女、与配偶或子女一起生活、退休金高于2500元、获得满意的社会支持、退休前从事公务员以外的其他职业等6项是老年抑郁的保护因素(OR = 0.035~0.849, P = 0.000~0.476)。结论：抑郁是老年人常见的心理障碍，社会支持、个人的经济状况和生活适应能力可能是老年人抑郁的影响因素。
Objective: To explore the status of depression of eldly, and analyze its possible influencing factors. Method: Totally 1510 eldly (776 males, 734 females) from 5 cities in Guangdong Province were se-lected by stratified random sampling and conducted with geriatric depression scale (GDS), social support rating scale (SSRS), mini-mental state examination (MMSE) and a self-edited questionnaire on the general information and life condition of eldly. Results: The total score of GDS was 10.20 ± 6.37. The total score and the scores of the 3 dimensions of objective support, subject support, the use of support in SSRS were 30.79 ± 5.51, 9.24 ± 2.37, 19.38 ± 4.95 and 9.22 ± 2.15, respectively. Multivariable binary Logistic regression showed that developed or backward regional economy, fe-male, high education level, unmarried, widowed, poor health, monthly pension less than 2500 Yuan, unsatisfactory social support were the risk factors on the depressive symptoms in the elderly (OR = 1.067 - 20.224, P = 0.000 - 0.778), and upper regional economy, having children, married, living with spouse or children, monthly pension more than 2500 Yuan and satisfactory social support, engaging in other professions rather than civil servants before retirement were the protective fac-tors on the depressive symptoms in the elderly (OR = 0.035 - 0.849, P = 0.000 - 0.476). Conclusion: It suggested that depression was one of the most common mental diseases among eldly. Social sop-port, personal economic ability and life adaptability may be related factors of the depression in eld-ly.
| [1] | 国家统计局. 中华人民共和国2018年国民经济和社会发展统计公报[EB/OL].
http://www.stats.gov.cn/tjsj/zxfb/201902/t20190228_1651265.html, 2019-02-28. |
| [2] | Soysal, P., Veronese, N., Thompson, T., et al. (2017) Relationship between Depression and Frailty in Older Adults: A Systematic Review and Meta-Analysis. Ageing Research Reviews, 36, 78-87. https://doi.org/10.1016/j.arr.2017.03.005 |
| [3] | Li, L.L., Luo, H., Wang, Y.L., et al. (2017) Epidemiological Investigation and Analysis on Mental Health Status of 2787 Elderly People in Xi’an City. Chinese Journal of Social Medicine, 34, 474-477. |
| [4] | Mohd Sidik, S., Mohd Zulkefli, N.A. and Mus-taqim, A. (2015) Prevalence of Depression with Chronic Illness among the Elderly in a Rural Community in Malaysia. Asia Pacific Family Medicine, 2, 196-199.
https://doi.org/10.1111/j.1444-1683.2003.00100.x |
| [5] | Sj？berg, L., Karlsson, B., Atti, A.-R., et al. (2017) Preva-lence of Depression: Comparisons of Different Depression Definitions in Population-Based Samples of Older Adults. Journal of Affective Disorders, 221, 123-131.
https://doi.org/10.1016/j.jad.2017.06.011 |
| [6] | Li, D., Zhang, D.J., Shao, J.J., et al. (2014) A Meta-Analysis of the Prevalence of Depressive Symptoms in Chinese Older Adults. Arch Gerontol Geriatr, 58, 1-9. https://doi.org/10.1016/j.archger.2013.07.016 |
| [7] | 刘婷, 王青丽, 邱源, 等. 宜昌城区老年人群焦虑抑郁调查及影响因素分析[J]. 长江大学学报(自然科学版). 2019, 16(3): 118-121. |
| [8] | 寇小君, 龚传鹏, 刘修军, 等. 武汉市社区老年人群焦虑、抑郁现况及影响因素[J]. 中国老年学杂志, 2018, 38(10): 2530-2532. |
| [9] | 王晓燕, 戚燕. 江西省吉安市社区老年居民焦虑抑郁现状及影响因素[J]. 中国老年学杂志, 2016, 36(6): 1463-1465. |
| [10] | 温金锁, 李新利. 宝鸡市农村社区老年抑郁情绪影响因素分析[J]. 健康教育与健康促进, 2015, 10(4): 184-186, 291. |
| [11] | 曹颖, 王意君, 吕莉霞, 等. 成都地区老年抑郁现状及影响因素分析[J]. 中华老年心脑血管病杂志, 2019, 31(11): 138-142. |
| [12] | 韩进美, 王子云, 杨兰, 等. 中国医院来源老年人群抑郁检出率的Meta分析[J]. 中国老年学杂志, 2019, 39(5): 1117-1121. |
| [13] | Han, B., Page, E.E., Stewart, L.M., et al. (2015) Depression and Cognitive Impairment Following Recovery from Thrombotic Thrombocytopenic Purpura. American Journal of Hematology, 90, 709-714. https://doi.org/10.1002/ajh.24060 |
| [14] | Lauriola, M., Mangiacotti, A., D’Onofrio, G., et al. (2018) Late-Life De-pression versus Amnestic Mild Cognitive Impairment: Alzheimer’s Disease Incidence in 4 Years of Follow-Up. Demen-tia and Geriatric Cognitive Disorders, 46, 140-153. https://doi.org/10.1159/000492489 |
| [15] | Taylor, W.D. (2017) Lack of a role for Azheimer’s Disease Pathology in Late-Life Depression, or Just No Relationship with Amyloid? Amer-ican Journal of Psychiatry, 174, 197-198. https://doi.org/10.1176/appi.ajp.2016.16111317 |
| [16] | 梁国栋, 刘广遐, 徐瑾, 等. 抗抑郁治疗对老年功能性消化不良疗效的影响[J]. 实用老年医学, 2018, 32(12): 1142-1145. |
| [17] | Vaughan, L., Corbin, A.L. and Goveas, J.S. (2015) Depression and Frailty in Later Life: A Systematic Review. Clinical Interventions in Aging, 10, 1947-1958. https://doi.org/10.2147/CIA.S69632 |
| [18] | Luo, H., Tang, J.Y., Wong, G.H., et al. (2015) The Effect of Depressive Symptoms and Antidepressant Use on Subsequent Physical Decline and Number of Hospitalizations in Nursing Home Residents: A 9-Year Longitudinal Study. Journal of the American Medical Directors Association, 16, 1048-1054. https://doi.org/10.1016/j.jamda.2015.06.016 |
| [19] | Downer, B., Rote, S., Markides, K.S., et al. (2016) The Comor-bid Influence of High Depressive Symptoms and Diabetes on Mortality and Disability in Mexican Americans Aged 75 and Above. Gerontology and Geriatric Medicine, 2, undefined. https://doi.org/10.1177/2333721416628674 |
| [20] | Karlsson, B., Johnell, K., Sigstrom, R., et al. (2016) Depression and Depression Treatment in a Population-Based Study of Individuals Over 60 Years Old without Dementia. American Journal of Geriatric Psychiatry, 24, 615-623.
https://doi.org/10.1016/j.jagp.2016.03.009 |
| [21] | Celik, E., Cay, S., Sensoy, et al. (2016) Heart Failure Functional Class Associated with Depression Severity but Not Anxiety Severity. Acta Cardiol Sin, 32, 55-61. |
| [22] | Ahn, S.N., Kim, S. and Zhang, H. (2017) Changes in Depressive Symptoms among Older Adults with Multiple Chronic Conditions: Role of Positive and Negative Social Support. International Journal of Environmental Research & Public Health, 14, 16. https://doi.org/10.3390/ijerph14010016 |
| [23] | Mohd Sidik, S., Mohd Zulkefli, N.A. and Shah, S.A. (2015) Factors Associated with Depression among Elderly Patients in a Primary Health Care Clinic in Malaysia. Asia Pacific Family Medicine, 2, 148-152.
https://doi.org/10.1046/j.1444-1683.2003.00080.x |
| [24] | 殷怡, 袁嘉祺, 屈智勇. 老年抑郁症状与日常烦心事和应对方式的关系[J]. 中国心理卫生杂志, 2020, 34(1): 39-44. |
| [25] | Faul, F., Erdfelder, E., Lang, A.G., et al. (2007) G*Power 3: A Flexible Statistical Power Analysis Program for the Social, Behavioral, and Biomedical Sciences. Behav-ior Research Methods, 39, 175-191.
https://doi.org/10.3758/BF03193146 |
| [26] | Cohen, J. (1992) Statistical Power Analysis. Current Directions in Psy-chological Science, 1, 98-101.
https://doi.org/10.1111/1467-8721.ep10768783 |
| [27] | 汪向东, 王希林, 马弘(主编). 心理卫生评定量表手册(增订版) [M]. 北京: 中国心理卫生杂志社, 1999: 217-219. |
| [28] | 汪向东, 王希林, 马弘(主编). 心理卫生评定量表手册(增订版) [M]. 北京: 中国心理卫生杂志社, 1999: 127-131. |
| [29] | 张明园(主编). 精神科评定量表手册2版[M]. 长沙: 湖南科学技术出版社, 2003: 184-188. |
| [30] | Bouali, S., Evrard, A., Chastanet, M., et al. (2003) Sex hor-mone-Dependent Desensitization of 5-HT1A Autoreceptors in Knockout Mice Deficient in 5-HT Transported. European Journal of Neuroscience, 18, 2203-2212.
https://doi.org/10.1046/j.1460-9568.2003.02960.x |
| [31] | Chang, S.H., Chen, M.C., Chien, N.H., et al. (2015) Gen-der Differences in the Relationship of Lifestyle and Depressive Symptoms among Taiwanese Older People. Collegian S132276961500027X. |
