影响老年原发性高血压患者抑郁的因素

目的 了解北京社区老年原发性高血压(EH)患者抑郁及影响因素.方法 抽样调查了北京城乡社区1064例老年EH患者,并进行抑郁量表的测试等.结果 居住在农村(21.6%比城市7.3%)、文盲(19.9%比非文盲11.2%)、无配偶(19.7比有配偶12.4%)、经济收入低(21.9%比收入高9.8%)、有生活事件(23.2%比无生活事件8.6%)、睡眠质量差(31.0%比睡眠好8.7%)和生活活动能力差(26.7%比生活活动能力好9.0%)的老年EH患者抑郁症患病率高(P均<0.01);Logistic回归分析显示文化程度(P=0.023)、重要不幸生活事件(P=0.001)、睡眠质量(P=0.001)和生活活动能力(农村21.6%比城市7.3%)(P=0.001)对老年EH患者抑郁具有独立影响作用.结论 积极进行降压治疗,控制影响因素,并积极进行心理调节,是减少老年EH患者抑郁的关键.     

遵义市社区老年膝关节骨性关节炎患者抑郁现状及其影响因素

目的调查遵义市社区老年膝关节骨性关节炎患者抑郁现状及其影响因素。方法运用一般情况调查表、中文版老年抑郁短量表(GDS-15)和西安大略和麦克马斯特大学骨关节炎指数量表(WOMAC)对140例遵义地区的老年骨关节炎患者进行问卷调查。结果患者抑郁总发生率为45.7%。多因素Logistic回归分析显示,体重指数(BMI,OR=3.768,P=0.001)、家庭月收入(OR=1.567,P=0.028)、疼痛程度(OR=13.581,P=0.001)和婚姻状况(OR=5.871,P=0.030),是老年膝关节骨性关节炎患者抑郁症状发生的主要影响因素。结论老年膝关节骨性关节炎患者的抑郁发生率较高,应注重对关节炎患者的心理护理,针对抑郁的影响因素施以干预,改善其抑郁症状。     

老年糖尿病患者配偶的抑郁状况调查

目的 了解老年糖尿病患者配偶的抑郁状况及影响因素.方法 采用抑郁自评量表(SDS)和家庭功能问卷(APGAR)对78例老年糖尿病患者及其配偶进行调查.结果 老年糖尿病患者配偶抑郁发生率为 35.90%,配偶的性别、负性生活事件、家庭支持、患者有无抑郁症状是影响其抑郁症状发生的主要因素.结论 老年糖尿病患者配偶具有不同程度的抑郁情绪,与多种社会心理因素有关.     

长春市社区老年人抑郁现状及影响因素

目的探讨分析长春市老人抑郁现状及影响因素。方法随机抽取长春市两个行政区,6个社区的348名老年人问卷调查,进行一般资料调查,老年人抑郁水平,社会支持评定问卷,睡眠质量调查问卷,并进行单因素分析。结果抑郁发生率为19.54%。其中轻度占14.36%,中重度占5.17%。老年人女性抑郁发生率高于男性,但差异无统计学意义(χ2=3.254,P=0.079)。婚姻状况、慢性病、体育锻炼的频率、近2 w负性生活事件对老年人抑郁的发生有显著影响(均P0.05)。不同睡眠质量、社会支持程度的老年人,抑郁的发生率不同(χ2=9.822,P=0.007;χ2=12.973,P=0.007)。结论长春市应加强关注女性、配偶丧失、慢性病、业余还好缺乏、体育锻炼次数少、睡眠质量障碍、社会支持程度低的老年人。     

高龄原发性高血压患者合并慢性肾脏病的危险因素

目的了解80岁以上原发性高血压(EH)住院患者合并慢性肾脏病(CKD)的情况,分析相关危险因素。方法选取南京医科大学第二附属医院心血管内科住院的1 555例65岁以上EH患者,依据是否≥80岁分为2组:高龄组(n=575)和非高龄组(n=980)。收集患者的临床资料。采用SPSS 22.0软件进行数据处理,logistic回归分析EH合并CKD的危险因素。结果与非高龄EH组患者比较,高龄EH组患者CKD发生率显著升高(52.9%vs 29.5%,P0.05)。高龄EH患者合并CKD的危险因素依次为高尿酸血症(OR=2.514,95%CI 1.750～3.611; P 0.001)、年龄(OR=1.072,95%CI1.018～1.129;P=0.009)和收缩压(OR=1.019,95%CI 1.011～1.028; P 0.001),保护因素为高密度脂蛋白胆固醇(OR=0.516,95%CI 0.315～0.847;P=0.009);非高龄老年EH患者合并CKD的危险因素依次为高尿酸血症(OR=2.729,95%CI 1.991～3.740;P0.001)、糖尿病(OR=1.944,95%CI 1.420～2.662;P0.001)、年龄(OR=1.140,95%CI 1.101～1.182;P0.001)和收缩压(OR=1.009,95%CI 1.003～1.016; P=0.007),保护因素为高密度脂蛋白胆固醇(OR=0.448,95%CI0.278～0.722;P=0.001)。结论高龄老年EH患者合并CKD的比例显著高于非高龄老年EH患者,高龄EH患者合并CKD与高尿酸血症、年龄、收缩压及高密度脂蛋白胆固醇水平有关。     

老年消化系统器质性疾病患者的心理特征及影响因素

目的了解老年消化系统器质性疾病患者的心理特征等情况及其可能的影响因素。方法选取老年消化系统器质性疾病患者120例、中青年消化系统器质性疾病患者330例及老年健康体检人群30例,应用汉密尔顿焦虑量表、汉密尔顿抑郁量表、90项症状清单、匹茨堡睡眠质量指数量表、生活满意度量表、生存质量测定量表进行调查,并记录年龄、性别、文化程度及婚姻状况等一般情况,收集的数据录入心理测验专业分析软件。结果老年与中青年消化系统器质性疾病患者及老年健康人群焦虑、抑郁情绪发生率、90项症状清单筛查阳性率、睡眠质量、生活满意度、生存质量比较差异无统计学意义(P0.05)。老年消化系统器质性疾病患者年龄与睡眠质量、生活满意度、生存质量得分无相关性。不同性别、文化程度、婚姻状况老年消化系统器质性疾病患者焦虑、抑郁情绪发生率、90项症状清单阳性率、睡眠质量、生活满意度比较差异无统计学意义(P0.05)。不同性别、文化程度及婚姻状况老年消化系统器质性疾病患者生存质量比较差异显著(P0.05),女性患者生存质量比男性差,文盲患者生存质量最差、丧偶患者生存质量最差。结论老年消化系统器质性疾病患者焦虑、抑郁情绪发生率及90项症状清单阳性率均较高。年龄、性别、文化程度、婚姻状况与其睡眠质量、生活满意度无明显相关,老年消化系统器质性疾病患者中女性、文盲及丧偶患者生存质量较低。     

住院冠心病患者1083例心理状况的调查与相关分析

目的 探讨住院冠心病患者焦虑和抑郁症状的发生情况及相关因素.方法 采用现况调查研究,自2007年6月至2009年5月连续入选经冠状动脉造影诊断的住院冠心病患者.选用Zung焦虑自评量表(SAS)和抑郁自评量表(SDS)对入选患者进行心理测评,同时对受试者的经济状况、家庭情况、生活及工作场所环境等因素进行流行病学调查.统计学处理采用Student's t检验、卡方检验和多元逐步logistic回归分析.结果 共入选住院冠心病患者1083例,年龄(64.8±10.2)岁,其中男性863例,女性220例.单纯焦虑、单纯抑郁、焦虑合并抑郁的症状患病率分别为7.9%、28.3%和14.3%.女性患者焦虑、抑郁的症状患病率明显高于男性(29.5%比20.3%,P=0.003;50.0%比40.7%,P=0.012);老年(≥65岁)患者焦虑症状的患病率明显高于非老年患者(25.9%比17.9%,P=0.001);老年人、受教育年限少于9年、睡眠质量差与焦虑症状的发生显著相关,相应OR值分别为1.63(95%CI:1.21～2.21,P=0.002)、1.54(95%CI:1.15～2.07,P=0.004)和1.62(95%CI:1.34～1.96,P=0.000);长期工作地噪音、合并慢性疾病及睡眠质量差与抑郁症状的发生显著相关,OR值分别为1.52(95%CI:1.18～1.98,P=0.002)、1.36(95%CI:1.06～1.75,P=0.016)和1.27(95%CI:1.08～1.50,P=0.005);女性、老年人、长期工作地噪音、合并慢性疾病、睡眠质量差与焦虑合并抑郁症状的发生显著相关,OR值分别为1.91(95%CI:1.22～2.98,P=0.005)、1. 84(95%CI:1.23～2.76,P=0.003)、1.61(95%CI:1.07～2.42,P=0.022)、1.84(95%CI:1.24～2.71,P=0.002)和1.73(95%CI:1.35～2.21,P=0.000).结论 在住院冠心病患者中,约50%患者并发不同程度的焦虑和(或)抑郁症状,女性和老年患者是高发人群.受教育年限少于9年、合并慢性疾病、睡眠质量差、工作地噪音等与焦虑、抑郁症状的发生相关.     

老年慢性心力衰竭住院病人抑郁状态及相关因素分析

目的分析住院的老年心力衰竭(心衰)病人抑郁的发生情况及影响因素。方法连续纳入2017年6月至2018年6月收入我院老年心血管科的老年慢性心衰病人,收集病人的临床资料,采用汉密尔顿焦虑量表(HAMA)和老年抑郁量表(GDS)对病人焦虑、抑郁状态进行评估,并对抑郁相关危险因素进行分析。结果纳入的123例慢性心衰病人当中,轻度抑郁35例(28.46%),中度抑郁9例(7.32%)。相关分析显示,年龄(r=0.191,P=0.035)、HAMA评分(r=0.459,P0.001)、FRAIL衰弱量表评分(r=0.238,P=0.008)、简易营养评估量表(MNA-SF)评分(r=0.359,P0.001)、病人健康问卷-9项评分(PHQ-9)(r=0.343,P0.001)与抑郁评分呈正相关,而6 min步行距离(r=-0.298,P=0.001)、修订版跌倒效能量表(MFES)评分(r=-0.429,P0.001)、社会支持量表评分(r=-0.288,P=0.001)、Barthel指数评分(r=-0.102,P0.001)与抑郁评分呈负相关。多因素线性回归分析显示,HAMA评分、MFES评分以及PHQ-9评分是住院老年慢性心衰病人抑郁的独立危险因素。结论老年住院慢性心衰病人抑郁患病率高,需要重视及提高住院老年慢性心衰病人的心理健康。     

营养不良在社区老年人抑郁和衰弱之间的中介作用

目的探讨营养不良在社区老年人抑郁和衰弱之间的中介作用。方法采用多阶段分层抽样方法,采用自制的一般资料问卷、老年抑郁量表(GDS-5)、微型营养评价精简法(MNA-SF)及Fried身体表型衰弱量表,对济南市社区936名老年人进行调查。结果社区老年人衰弱和衰弱前期发生率为3.8%和52.8%,抑郁和营养不良风险率为10.4%与11.5%。Logistic回归分析表明老年人抑郁增加营养不良(OR=21.632,P0.001)和衰弱(OR=3.149,P0.001)发生风险,营养不良增加了衰弱发生风险(OR=2.377,P=0.001),并减弱了抑郁与衰弱关系强度(OR=2.075,P=0.006),Z检验证实间接效应具有统计学意义(Z=3.234,P0.01)。结论营养不良在社区老年人抑郁和衰弱间起中介作用,改善社区抑郁老年人的营养状况有助于延缓衰弱的发生。     

肠易激综合征患者精神心理因素对生活质量、睡眠质量以及症状严重程度的影响

背景:肠易激综合征(IBS)患者多伴有焦虑、抑郁等精神心理障碍,但精神心理障碍对患者的影响尚未完全明确。目的:探讨IBS患者精神心理因素对生活质量、睡眠质量以及症状严重程度的影响。方法:纳入2014年11月—2015年5月安徽医科大学附属省立医院收治的IBS患者101例,采用Zung焦虑自评量表(SAS)和Zung抑郁自评量表(SDS)对患者心理状态进行评估;采用IBS生活质量量表(IBS-QOL)对患者生活质量进行评估;采用匹兹堡睡眠质量指数量表(PSQI)对患者睡眠质量进行评估;采用IBS症状严重程度量表(IBS-SSS)对患者症状严重程度进行评估。对患者精神心理因素、生活质量、睡眠质量以及症状严重程度行相关性分析。结果:57.4%(58/101)的IBS患者伴有不同程度的焦虑和(或)抑郁。101例患者IBS-QOL评分为73.28±12.79,其中以焦虑不安、忌食和健康忧虑影响最为严重。73.3%(74/101)的患者伴有不同程度的睡眠障碍,其中以日间功能障碍、睡眠质量和睡眠效率受损最为严重。101例患者中13例症状为轻度,63例为中度,25例为重度,IBS-SSS评分为253.00±72.58。相关性分析结果显示焦虑、抑郁与生活质量呈负相关(r=-0.426,P0.001;r=-0.501,P0.001),与睡眠质量呈正相关(r=0.556,P=0.000;r=0.513,P=0.000),与症状严重程度呈正相关(r=0.231,P=0.020;r=0.357,P0.001);生活质量与症状严重程度呈负相关(r=-0.417,P0.001)。结论:IBS患者具有精神心理障碍以及生活质量、睡眠质量下降的表现,且精神心理障碍愈严重,生活质量、睡眠质量受损愈明显,IBS症状愈严重。     

Low Level Disability in Activities of Daily Living in Elderly People Living Independently: Risk Factors and Implications

Objectives: To determine the prevalence and risk factors for low level disability in activities of daily living in elderly people living independently, and the association with quality of life and accidents. Design: Cross sectional survey of 334 individuals aged ≥ 80 years randomly selected from the electoral roll. Results: 15.9% of participants had significant disability in at least one of the activities of daily living assessed. Risk of disability was associated with taking 4 or more medications, female gender, arthritis and a previous cerebrovascular event. Those with disabilities had more recent accidents (67.9% vs. 43.8%, p=0.0001) and poorer quality of life as measured by the SF 36. Self reporting was a poor method for identifying disabilities (sensitivity = 68.5%). Conclusions: Low level disabilities in activities of daily living are common in elderly people living independently and are associated with lowered quality of life and increased accidents. This highlights the need for a targeted screening program to identify such disabilities and examine interventions to minimise them.     

Evaluation of sleep disturbances in older adults

Older patients are at risk for a variety of sleep disorders, ranging from insomnia to circadian rhythm disturbances. The clinical consequence of unremitting sleep disturbances in the elderly population often includes hypersomnolence and may result in disorientation, delirium, impaired intellect, disturbed cognition, psychomotor retardation, or increased risk of accidents and injury. These symptoms may compromise overall quality of life and create social and economic burdens for the health care system, as well as for the caregivers. The clinical assessment of aging patients who have sleep complaints involves an in-depth multidisciplinary approach.     

Factors influencing persistent subjective insomnia in old age: a follow-up study of good and poor sleepers aged 65 to 74

Of 82 subjective insomniacs aged 65-74 years identified during a community survey and classified on the basis of self-reported sleep quality, 69 (84%) continued to complain of poor sleep when re-interviewed 18-24 months later. When compared with a control group of similarly stable 'good sleepers' (n = 64) drawn from the same community sample these persistent subjective insomniacs showed significantly higher levels of constitutional (trait) and transitory (state) anxiety, and neuroticism. Discriminant analysis indicated that elevated levels of neuroticism, reduced health status (as measured by the number of drugs prescribed) and relatively high levels of tea consumption were most closely associated with persistent complaints of poor sleep. Thus, despite the existence of health problems as a major cause of sleep disturbance in later life, personality factors appear to exert a pervasive influence on subjective sleep quality among the 'younger' elderly.     

Accidents of the elderly living in Kocaeli Region (Turkey)

The accidents seen in the elderly have a remarkable impact on their family life and the society they live in. In this study, we have aimed to assess the prevalence, types and characteristics of the accidents seen among the elderly. We performed a cross-sectional study. The data was collected from 486 old people living in Kocaeli Region, in 2003. Demographic features, numbers and the variety of accidents were recorded after interviews. The data were also obtained from a questionnaire given after a physical examination. The ratio of accidents was found to be 9.5% (46 cases) in the study group; of those 71.7% were indoor and 28.3% outdoor accidents. The causes of the accidents were falls (69.6%), cuts (13.0%) and stings (10.9%). The distribution of the indoor accidents was 72.7% for falls, 12.1% for cuts, 9.1% for stings and 6.1% for other injuries. The distribution of the outdoor accidents was 61.5% for falls, 15.4% for cuts, 15.4% for stings and 7.7% for burns. Fall-induced injuries seem to be a major problem among the elderly. The results of our study indicate that the occurrence of indoor accidents is an important health problem in the geriatric population.     

Sleep optimizes motor skill in older adults

OBJECTIVES: To determine whether sleep benefits motor memory in healthy elderly adults and, if so, whether the observed sleep‐related benefits are comparable with those observed in healthy young adults. DESIGN: Repeated‐measures cross‐over design. SETTING: Boston, Massachusetts (general community) and Harvard University. PARTICIPANTS: Sixteen healthy older and 15 healthy young participants. MEASUREMENTS: Motor sequence task (MST) performance was assessed at training and at the beginning and end of the retest session; polysomnographic sleep studies were recorded for the elderly participants. RESULTS: After 12 hours of daytime wakefulness, elderly participants showed a dramatic decline in MST performance on the first three retest trials, and only a nonsignificant improvement by the end of retest (the last 3 retest trials). In contrast, when the same participants trained in the morning but were retested 24 hours after training, after a day of wake plus a night of sleep, they maintained their performance at the beginning of retest and demonstrated a highly significant 17.4% improvement by the end of the retest session, essentially identical to the 17.3% improvement seen in young participants. These strikingly similar improvements occurred despite the presence of other age‐related differences, including overall slower motor speed, a lag in the appearance of sleep‐dependent improvement, and an absence of correlations between overnight improvement and sleep architecture or sleep spindle density in the elderly participants. CONCLUSION: These findings provide compelling evidence that sleep optimizes motor skill performance across the adult life span.     

Age-Related Differences in the Mechanism of Nondipping Among Patients with Obstructive Sleep Apnea Syndrome

The frequency of nondipper (those lacking the normal drop in nocturnal blood pressure [BP]) is high in patients with obstructive sleep apnea syndrome (OSAS). The objective of this study is to investigate age-related differences in the nocturnal BP profile of patients with OSAS. The study subjects included 214 patients with polysomnography-diagnosed OSAS. The status of dipper or nondipper was determined by 24-hour ambulatory BP measurements. We divided the subjects into three groups by age (younger, middle-aged, and elderly) and compared the frequency and sleep profiles of nondippers in the different age groups. The prevalence of nondippers was significantly higher in the elderly OSAS group than in the younger and middle-aged OSAS groups (69% vs. 45%, 47%; P < .05). In the younger OSAS group, nondippers, when compared with dippers, were characterized by higher apnea–hypopnea index (AHI, 48.2 ± 27.1 vs. 37.4 ± 23.0 times/h, P < .05), whereas in the middle-aged and elderly OSAS groups, the AHI of nondippers was almost identical to that of dippers. On the other hand, in the elderly OSAS group, nondippers, when compared with dippers, had shorter periods of slow wave sleep as measured by nonrapid eye movement stage 3–4, whereas nondippers and dippers in the other two age groups were not different in terms of slow wave sleep. These results indicate age-related differences in major mechanisms leading to nondipping. Severe apnea causes nondipping only in young OSAS patients, whereas disturbance of sleep quality plays a more important role in elderly OSAS patients.     

The “Nondipper” Elderly: A Clinical Entity or a Bias?

Objectives: To determine the prevalence of nondipper (ND) blood pressure profile in the elderly and to ascertain whether the ND pattern of ambulatory blood pressure in the elderly is an artifact or represents a specific clinical entity.
Design: Cross-sectional, observational study.
Setting: Cardiovascular diagnostic center, division of geriatrics, secondary care, institutional practice.
Participants: Sixty-five consecutive community-dwelling elderly hypertensive patients referred to the cardiovascular center.
Measurements: The patients underwent actigraphy and ambulatory blood pressure monitoring and completed a sleep assessment questionnaire. Patients were divided based on the night-time decrease in blood pressure (>10%: "dippers" (n=19); <10%: "NDs" (n=46)).
Results: Nondippers displayed poorer quality of sleep, as demonstrated objectively by actigraphic data; they obtained a higher mean score±standard deviation on the sleep questionnaire (4.6±2.9 vs 3.0±1.1, P =.030) and were taking more benzodiazepines (33.1% vs 10.7%, P =.035), indicating that their usual sleep quality was worse than that of dippers. Multivariate analysis showed a strong correlation between nondipper profile and quality of sleep and also with comorbidity, total number of drugs being taken, and pulse pressure.
Conclusion: Actigraphy demonstrates impaired sleep in the nondipper elderly. Nevertheless, the nondipping pattern seems independent of the discomfort of cuff-inflation during the night and occurs in association with higher comorbidity and polypharmacy; therefore, it cannot be considered a "bias," but is related to detrimental clinical conditions that should be studied in depth.     

Health related quality of life in women with elderly onset rheumatoid arthritis

OBJECTIVE: To examine the association of elderly onset rheumatoid arthritis (RA) with health related quality of life in a population based cohort of older women. METHODS: A nested case-control study of elderly onset RA within the Iowa Women's Health Study (IWHS), a prospective cohort established in 1986 of 41,000 women aged 55 to 69 years. A supplemental questionnaire was mailed to 122 RA cases and 1132 frequency matched controls from the cohort. We used unconditional logistic regression and linear regression to examine the association of elderly onset RA with self-reported measures of functional disability and quality of life. RESULTS: Elderly onset RA was associated with a 6-fold risk (OR 6.0, 95% CI 3.6-10.1) of significant functional disability (Health Assessment Questionnaire score (3) 1). Similarly, elderly onset RA was significantly associated with lower physical component scores of the Medical Outcome Study Short Form-12 (37.2 +/- 10.9 vs 43.6 +/- 11.6; p < 0.001). CONCLUSION: Among a community based cohort, elderly onset RA was strongly associated with functional disability and reduced quality of life. These associations were independent of other age associated factors including depression, recent fracture, and multiple comorbidities.     

Prevalence of sleep apnea syndrome in lone atrial fibrillation: a case-control study

BACKGROUND: According to several studies, obstructive sleep apnea predisposes to cardiac arrhythmias, but the prevalence of sleep apnea in specific arrhythmias has not been determined. Our case-control study assesses prevalence of sleep apnea syndrome (SAS) in lone atrial fibrillation (AF). METHODS: Patients with AF (n = 59; 48 men and 11 women; mean age, 59 years; age range, 25 to 84 years) without evident cardiovascular diseases, and their 56 gender-matched, age-matched, and cardiovascular morbidity-matched community control subjects underwent an overnight sleep study. RESULTS: Prevalence of SAS in the AF group was 32%, which did not differ from that in control subjects (29%, p = 0.67). In men, mean neck circumference was higher in the AF group (40.9 cm vs 39.5 cm, p = 0.01) than in control subjects. In men, after adjusting for body mass index and waist circumference, neck circumference was independently related to AF, with an odds ratio (OR) of 1.8 (95% confidence interval, 1.3 to 2.5) per 1-cm increase, and an OR of 5.2 (95% confidence interval, 1.6 to 17.0) for values > 40 cm. Compared to control subjects, the AF group reported more daily/almost-daily tiredness (29% vs 4%, p < 0.001), daily/almost-daily sleepiness (27% vs 7%, p = 0.005), and nightly/almost-nightly breathing pauses during sleep (12% vs 2%, p = 0.03). CONCLUSIONS: SAS seems to be common in lone AF. Nevertheless, we could not show SAS to be more common in patients with AF than in gender-matched, age-matched, and cardiovascular morbidity-matched community control subjects. Compared to control subjects, men with AF seem to have thicker necks, and patients with lone AF report more daytime tiredness, daytime sleepiness, and breathing pauses during sleep.     

北京市社区老年高血压合并抑郁患者生活质量及相关因素分析

目的:评估北京市社区老年高血压合并抑郁患者的生活质量,并且探索其相关因素,为社区管理老年高血压合并抑郁患者提供理论依据。方法:纳入于北京市朝阳区大屯社区服务中心就诊的65岁以上高血压患者503例,采用面对面方式调查基线资料和老年抑郁量表(GDS),自我完成生活质量问卷(SF-36问卷)。以GDS评分将患者分为抑郁组和无抑郁组,对比分析两组生活质量,并且探索影响抑郁组生活质量的相关因素。结果:488例患者完成所有问卷,无抑郁384例(78.7%),合并抑郁104例(21.3%)。抑郁组在躯体健康维度(PCS)和心理健康维度(MCS)明显低于无抑郁组(P<0.05)。多因素分析显示年龄越大、有睡眠问题和血压分级高的患者躯体健康更差。抑郁程度更重的患者心理健康更差。结论:合并抑郁的老年高血压患者生活质量明显低于无抑郁患者。与PCS相关的因素有年龄、睡眠和高血压分级,与MCS相关的因素主要是抑郁评分,为社区尽早针对性的干预和管理,提高这类人群生活质量具有指导性建议。