丧偶老人再婚前后心理状态分析

本文采用状态一特质焦虑问卷对２０对丧偶老人再婚前后及２０对未丧偶老人进行测查，结果表明丧偶者再婚前ＳＴＡＩ总分明显高于未丧偶者，丧偶者再婚前后及男性与女性丧偶者比较均有显著性差异。然而，丧偶者再婚后与未丧偶者比较则无显著性差异。作者认为经“老年婚姻介绍所”牵线搭桥促进丧偶老人再婚，有利于其焦虑心理障碍的改善。     

居家养老老人睡眠质量对抑郁情绪的影响

目的:了解居家养老老人睡眠和抑郁状况,进一步考察老年人睡眠质量对抑郁情绪的影响作用。方法:采用匹兹堡睡眠质量指数量表(PSQI)和老年抑郁量表(GDS)对186名老年人进行问卷调查。结果:122.6%的老人存在睡眠障碍,其中女性比男性需要更长的时间入睡(t=-2.00,P0.05),高龄老人的睡眠总体情况明显比低龄老人差(t=2.85,P0.05),丧偶老人的睡眠效率比在婚的老人低(t=-2.81,P0.05);239.8%的老人有抑郁情绪,丧偶老人比在婚老人更易有抑郁情绪(t=-3.20,P0.005),受教育程度越高其抑郁情绪越低(F=5.246,P0.005);3PSQI总分与GDS总分显著正相关,日间功能障碍对老年抑郁有显著的预测作用,解释量达14.2%。结论:居家养老老人的睡眠质量与抑郁情绪呈显著负相关,睡眠质量对老年抑郁有一定的预测作用。     

丧偶对农村老年人主观幸福感的影响

目的探讨丧偶对农村老年人主观幸福感的影响。方法以安徽省皖南皖北农村丧偶老人为对象,采用纽芬兰纪念大学幸福度量表及自编的调查表进行调查,进行方差分析和回归分析。结果单因素方差分析的结果,非丧偶老人与丧偶老人主观幸福感各维度差异有统计学意义(t=5.059,5.817,6.843,6.432,7.423;P<0.05);逐步回归分析结果,对社区环境是否满意、是否空巢进入回归方程。结论农村老人主观幸福感总体处于中等水平,但是非丧偶老人明显高于丧偶老人。对社区环境不满意及是否空巢是影响丧偶老人主观幸福感的重要因素。     

中国高龄老人认知下降及相关因素

目的 :了解高龄老人认知能力情况 ,为老年健康研究提供资料。方法 :对 2 0 0 0年中国高龄老人健康长寿调查中的 44 82名高龄老人 ,使用MMSE修改量表 ,将认知能力得分按照有关标准划界 ,把认知能力分为不健全 健全 ,认知能力转变为二分变量作为因变量进行logistic回归分析。结果 :发现女性、增龄、低受教育程度、身体健康状况差、婚姻状况为丧偶和从未结婚、情绪不乐观、不进行身体锻炼和出生地乡村等因素是高龄老人认知能力下降的危险因素。结论 :中国高龄老人认知能力受到其生物、心理社会、经济等多种因素影响。     

丧偶老年人主观幸福感及其影响因素

目的:探讨丧偶老年人主观幸福感及其影响因素.方法:本研究为横断面调查.以性别为分层标准,采用等距抽样法随机抽取西安市社区丧偶1年及以上的老人292名,男性149例,女性143例;年龄60～86岁.采用纽芬兰纪念大学幸福度量表、康奈尔医学指数(Cornell Medical Index, CMI)、应对方式问卷、社会支持评定量表及自编调查表进行测查,进行方差分析和结构方程模型分析.结果:男性丧偶老人主观幸福感高于女性丧偶老人[(25.5±5.7)vs.(22.8±6.9),P<0.01].CMI总分、解决问题、退避、支持利用度、主观支持对老年人主观幸福感具有直接影响(权重分别为:-0.358,0.567,-0.469,0.320,0.152);解决问题、自责、求助、支持利用度、主观支持对老年人主观幸福感具有间接影响(权重分别为:0.124,-0.087,0.091,0.049,0.098).结构方程模型显示,解决问题对主观幸福感的正性影响最大,其次是支持利用度和主观支持(权重分别为:0.691,0.369,0.250);退避对主观幸福感具有最大负性影响(权重为:-0.469).结论:本研究提示缺乏社会支持是丧偶老年人低主观幸福感的危险因素,合理的应对方式对提高个体主观幸福感具有积极意义.     

青年卒中患者复发的危险因素及其与心理社会因素的相关性

目的:探讨青年卒中复发危险因素及其与患者心理社会因素的相关性。方法:以2013年1月-2015年8月新诊断的350例青年脑卒中患者为研究对象,出院后6个月、12个月、24个月进行随访,统计复发情况,据此分为复发组与未复发组,收集两组基本信息、疾病史、心理社会因素等资料,单因素及Logistic多因素回归分析青年卒中复发危险因素。结果:随访24个月期间失访12例,获访率96.57%,其中复发68例(20.12%,68/338);高血压、脑卒中家族史、TIA史、情绪波动阳性、行为A型、焦虑及抑郁比例方面,复发组均显著大于未复发组(χ~2=5.438,8.081,8.607,5.170,5.456,4.657,7.758;P0.05);负性生活事件、家庭生活事件、社交生活事件、工作生活事件紧张值及总紧张值方面,复发组均显著高于未复发组(t=21.927,18.714,5.086,11.066,18.601;P0.05);Logistic回归分析显示,青年卒中复发独立因子包括高血压、脑卒中家族史、情绪波动、抑郁、负性生活事件、家庭生活事件(Or=2.385,3.070,2.126,2.645,3.780,3.257;P0.05)。结论:青年卒中复发危险因素除了与高血压、脑卒中家族史外,还与患者情绪波动、心理社会因素密切相关。     

北京月坛社区老年高血压患者抑郁情绪调查及危险因素分析

目的 探讨北京月坛社区老年高血压患者抑郁的流行病学特征及危险因素，为健康老化制定个体化干预方案提供依据。方法 2019年6月至2019年10月，采用整体抽样方法，在北京市西城区月坛社区选取60岁及以上老年高血压患者613例，采用患者健康问卷(PHQ-9)抑郁量表行抑郁情绪判定。同时搜集受试者一般人口学信息及慢性病史等健康情况。分别采用单因素及二元Logistic回归模型分析不同性别老年高血压患者抑郁情绪的影响因素及独立危险因素。结果 老年高血压患者抑郁情绪总体阳性检出率为11.58%,9.81%的男性患者存在抑郁状态，12.53%的女性患者存在抑郁状态。男性中患有冠心病、存在睡眠障碍者的抑郁情绪发病比例更高，女性中存在经济压力、患有听力障碍、视力障碍、慢性胃炎、慢性肝胆疾病及存在睡眠障碍者存在抑郁情绪的比例更高(P<0.05)。存在睡眠障碍的男性患者发生抑郁情绪的风险更高，OR值为4.825(95%CI:1.777～13.105);存在经济压力、患有听觉障碍、视力障碍、慢性胃炎及存在睡眠障碍的女性患者发生抑郁情绪的风险更高，OR值分别为：14.362 (95%CI:2.224～9...     

河北省18岁以上居民睡眠质量及相关因素

目的:了解河北省18岁以上居民睡眠质量及相关因素.方法:采用匹茨堡睡眠质量指数(PSQI)、简易应对方式问卷(SCSQ)对20716名18岁以上人群进行调查.结果:20716人中低睡眠质量者2411人,检出率为11.6%;低睡眠质量检出率女性为13.6%,男性9.7%,经标准化后女性多于男性(6.8%/4.8%);Logistic回归分析显示:1睡眠障碍的危险因素有70岁以上、再婚、离婚、丧偶、消极应对(OR=1.776、1.515、2.046、1.254、1.097);2保护性因素有汉族、男性、农民、收入5001-10000元、收入10001-20000元、收入20001-40000元、积极应对(OR=0.839、0.703、0.732、0.750、0.660、0.573、0.936).结论:河北省18岁以上居民低睡眠质量检出率较高,且与深圳市的检出率近似.性别、婚姻状况、民族、收入、职业、应对方式是睡眠质量的影响因素.     

养老离不开爱情和婚姻基础

随着我国人口老龄化的到来,老年人口呈不断增加的发展趋势,解决老年人特别是丧偶老人的孤独和照料问题,已成为社会和家庭的一大难题。因此,老有所养、老有所伴问题也越来越引起社会广泛的关注。社会的进步显示出更多的宽容,在这种氛围下,越来越多的丧偶老人选择了“搭伴养老”,他们把“搭伴养老”、“走婚养老”和“代际婚姻”等再婚方式作为自己继续构筑新家庭的模式,人们对老年人未婚同居的现象表示理解和接纳(起码是不干预),丧偶老人也不再拘泥于传统固定的家庭模式,不再用惟一的模式去禁锢自己,他们开始大胆地选择适合自己的婚姻方式,在…     

城镇化进程中农村老年人的抑郁情绪及相关因素

目的:调查城镇化进程中,"城乡结合部"和"传统农村"两类农村老年人的抑郁情绪,并分析主要的相关因素。方法:在福建省福鼎市的山前街道和点头镇所辖行政村选取老年受访者1135人,采用CES-D的10题简版评估抑郁情绪(得分≥10分有抑郁情绪问题),自编问卷调查相关基本情况。结果:传统农村老年人中有抑郁情绪问题的比例高于城乡结合部老年人(49.6%vs.30.3%,P0.001)。Logistic回归分析的结果显示,在控制其他因素的影响后,传统农村老年人出现抑郁情绪问题的危险性是城乡结合部老年人的1.40倍;进一步的分析表明,与农村老年人抑郁情绪最重要的相关因素(P0.001),城乡结合部是健康自评差(OR=7.52)、经济紧张(OR=4.41)、负性生活事件(OR=2.91)、独居(OR=2.72),而传统农村地区则主要是经济紧张(OR=8.52)。结论:城乡结合部老年人中抑郁情绪问题相对更少;在城镇化过程中,建议从改善经济、保障医疗、提升社会支持等方面提升农村老年人的情绪幸福感。     

Low prevalence of depression and anxiety is linked to statutory retirement ages rather than personal work exit: a national survey

BACKGROUND: Common mental disorder prevalence decreases substantially around the conventional retirement age for men in the UK, but trends for older women are more continuous. Prevalence changes in depression and anxiety around retirement are less clear, as is the role of risk factors. The aim of this study was to establish whether work status, age or other known risk factors account for the reduced prevalence of depressive episode and anxiety disorder around retirement ages for men and for women. METHOD: The British Psychiatric Morbidity Survey (BPMS) 2000 was analysed, including 1875 men and 2253 women aged 45-75 years. Diagnoses were from the Revised Clinical Interview Schedule (CIS-R). Logistic models were adjusted for sociodemographic factors, social network, work status, life events, physical illness and disability. RESULTS: There are marked reductions in the prevalence of depressive episode after 60 years for women [60% lower prevalence, 95% confidence interval (CI) 40-80] and 65 years for men (90% lower prevalence, 95% CI 70-100), compared to the youngest age groups. For anxiety disorder, the reduction in prevalence was 80% (95% CI 60-90) for men and 40% (95% CI 20-60) for women. In fully adjusted multivariate models, the strong association between diagnoses and age groups remained, for both genders. Work status was a significant factor for men but not for women. CONCLUSION: There is a discontinuity in the prevalence of depressive episode for both men and women, coinciding with statutory retirement ages. No studied risk factor reduced the associations between age group and disorders. This population scale recovery may provide a model for understanding non-genetic factors.     

Life events and psychosocial factors in elderly suicides--a case-control study.

BACKGROUND: Stressful life events, such as family conflicts, separation, bereavement, somatic illness and financial problems are common antecedents of suicide. Studies on suicide among younger persons dominate the literature, despite the fact that a large proportion of suicides occur among elderly persons. METHODS: The occurrence of stressful life events was investigated among elderly suicide cases and population controls. The study was conducted in the southwestern part of Sweden and included 85 persons (46 males and 39 females) 65 years and above who had committed suicide from January 1994 to May 1996. Population controls (84 males and 69 females) were randomly selected. Interviews were carried out with the controls and with informants for the suicide cases. Questions on sociodemographic background, mental and somatic health status, and life events (0-6, 7-12 and 13-24 months preceding suicide/interview) were included in the interviews. RESULTS: Somatic illness, family discord and financial trouble were significant risk factors during all three time periods. Other risk factors were mental disorder, lower education, feelings of loneliness and previous suicide in the family. Factors associated with a decreased risk included active participation in organizations and having a hobby. Variables that remained in the multivariate logistic regression model were mental disorder (men, odds ratio (OR) = 62.4, 95% CI 17.9-217.5; women, OR = 55.9, 95% CI 14.1-222.3) and family discord (men, OR = 10.0. 95% CI 1.7-59.8; women, OR = 9.2, 95% CI 1.9-44.8). CONCLUSIONS: Mental disorder and family discord were the two major risk factors for suicide among elderly men and women.     

Depression and risk of heart failure among the elderly: a prospective community-based study

OBJECTIVE: Although the association between depression and the incidence of coronary heart disease has been established in many studies, the impact of depression on the incidence of heart failure has not been previously investigated. METHODS: We examined the effect of depression (assessed by means of the Center for Epidemiological Studies Depression Scale (CES-D) with a cutoff point of > or =21) on the incidence of heart failure in a community sample of persons aged > or =65 years who were participants in the New Haven cohort of the Established Populations for Epidemiological Studies in the Elderly. RESULTS: At baseline 2501 individuals were free of heart failure. Of these, 188 (132 women and 56 men) scored as depressed. Depressed participants were significantly more likely to have hypertension, diabetes, and mobility-related functional limitations and were less likely to be male or married. During the 14-year follow-up period, 313 participants (146 men and 167 women) developed heart failure, defined as hospital admission for heart failure or mortality with heart failure as the underlying cause of death. After adjusting for baseline differences in demographic and comorbidity factors and functional status using Cox regression, depression tended to be associated with a greater risk of heart failure (hazard ratio (HR) = 1.52, 95% confidence interval (CI) = 0.94-2.43, p =.09). This effect was significant in women (HR = 1.96, 95% CI = 1.11-3.46, p =.02) but not in men (HR = 0.62, 95% CI = 0.23-1.71, p =.05 for the interaction term between sex and depression). CONCLUSIONS: Depression is an independent risk factor for heart failure among elderly women but not elderly men.     

Age and sex variations in adiposity and central fat distribution among elderly Bengalee Hindus of Calcutta, India.

BACKGROUND: Although a sizeable portion of India's population (13%, over 110 million) is elderly (aged > 55 years) very little information exists on their levels of adiposity and central body fat distribution. AIM: The present study seeks to investigate age and sex variations in adiposity and central fat distribution among urban elderly Bengalee men and women. SUBJECTS AND METHODS: A cross-sectional study of 410 (210 men and 200 women) elderly (> 55 years) urban Bengalee Hindu individuals resident in Calcutta, India, was undertaken utilizing various measures of adiposity and central fat distribution. RESULTS: There existed significant sex differences in various anthropometric variables and indices. Age had significant negative association with most variables and indices in both sexes. In general, the associations were much stronger in men. Regression analysis demonstrated that age had significant negative effect on height, sitting height (SH), weight, body mass index (BMI), minimum waist (MWC), maximum hip (MHC) and mid upper arm (MUAC) circumferences and triceps skinfold (TSF), in both sexes. Age also had significant negative impact on conicity index (CI) in men. CONCLUSIONS: The present investigation revealed that there is a significant inverse age trend in adiposity among urban elderly Bengalee Hindus. Moreover, there existed sex differences in the effect of age on various anthropometric measures.     

Sex differences in cardiovascular disease: are women with low socioeconomic status at high risk?

BACKGROUND: Cardiovascular disease is still portrayed as a typical male disease, and men are more often submitted to invasive procedures or referred earlier. AIM: To explore sex differences in morbidity and referral patterns in cardiovascular disease in general practice, and the role of age and socioeconomic status. METHOD: Data were obtained from a continuous morbidity registration project in the Netherlands from 1986 to 1995 in which 12,000 patients were followed over 10 years. The effects of sex, age, and socioeconomic status on morbidity of cardiovascular disease and the referral patterns were established. RESULTS: The sex difference in morbidity becomes smaller with increasing age. Morbidity was highest in the lower socioeconomic status in general and for angina pectoris in particular. Women with angina pectoris with low socioeconomic status have a relative risk of 2.24 (CI = 1.17-3.26) compared with women with high socioeconomic status. In men, no significant difference was found between the socioeconomic status groups. For angina pectoris the sex difference in referral to the specialist was most significant: 50.6% and 26.6% (P = 0.002) for men and women respectively. CONCLUSION: For women, low socioeconomic status was associated with relatively higher morbidity of angina pectoris and myocardial infarction than for men. Women are less likely to be referred than men are, in particular for angina pectoris.     

Age and sex variations in adiposity and central fat distribution among elderly Bengalee Hindus of Calcutta,India

Background : Although a sizeable portion of India's population (13%, over 110 million) is elderly (aged > 55 years) very little information exists on their levels of adiposity and central body fat distribution. Aim : The present study seeks to investigate age and sex variations in adiposity and central fat distribution among urban elderly Bengalee men and women. Subjects and methods : A cross-sectional study of 410 (210 men and 200 women) elderly (> 55 years) urban Bengalee Hindu individuals resident in Calcutta, India, was undertaken utilizing various measures of adiposity and central fat distribution. Results : There existed significant sex differences in various anthropometric variables and indices. Age had significant negative association with most variables and indices in both sexes. In general, the associations were much stronger in men. Regression analysis demonstrated that age had significant negative effect on height, sitting height (SH), weight, body mass index (BMI), minimum waist (MWC), maximum hip (MHC) and mid upper arm (MUAC) circumferences and triceps skinfold (TSF), in both sexes. Age also had significant negative impact on conicity index (CI) in men. Conclusions : The present investigation revealed that there is a significant inverse age trend in adiposity among urban elderly Bengalee Hindus. Moreover, there existed sex differences in the effect of age on various anthropometric measures.     

A further examination of the "epidemiologic paradox": birth outcomes among Latinas

PURPOSE: Low rates of low birthweight (LBW) among foreign-born Latinas of low socioeconomic status have been called the "epidemiologic paradox." This study examined the extent to which the paradox can be explained by differential distribution of risk factors. PROCEDURES: The data source was the 1996-1997 New York City Birth File with 78,364 singleton births to Latinas. Ancestries included Colombians, Dominicans, Ecuadorians, Mexicans, Puerto Ricans and other Hispanics. First, a logistic regression was used to predict a LBW birth with ancestry and birthplace as the only independent variables. Demographic, medical and behavioral risks were added in subsequent regression models. FINDINGS: The LBW rate for the sample was 6.8%, with significant differences between birthplace subgroups and among ancestries. Puerto Ricans had the highest LBW rates, 9.1% for the mainland-born and 9.2% for the island-born. In separate regressions for six ancestry groups, birthplace was a significant predictor of LBW only among Mexicans and other Hispanics. CONCLUSION: In this population-based study of Latina women in New York City, the positive birth outcomes of foreign-born women are largely due to their more favorable distribution of behavioral risk factors. The "epidemiologic paradox" does not account for the LBW rates among Puerto Ricans in New York City, a high percentage of whom are mainland-born (73.4%). Compared to other Latinas, Puerto Rican women are likely to have experienced far more years of acculturation, which can result in negative health behaviors.     

Associates of bone mineral density in older African Americans

OBJECTIVES: To assess correlates of bone mineral density (BMD) in older African Americans. PARTICIPANTS: 189 women and 115 men over age 64. METHODS: Variables investigated: BMD by dual X-ray absorptiometry (DXA), medications, cardiovascular disease risk factors, demographic, lifestyle factors and functional status. Variables showing univariate correlation with BMD (p < or = 0.1) were entered into sex-stratified linear regression models. RESULTS: Age range 67-96 (mean 75). The mean BMD (gm/ cm2 +/- standard deviation) is reported for three sites. Total body: 1.03 (+/- 0.12) in women, 1.21 (+/- 0.11) in men. Spine: 1.05 (+/- 0.24) in women, 1.22 (+/- 0.26) in men. Total hip: 0.85 (+/- 0.15) in women, 1.04 (+/- 0.17) in men. Gender was significantly associated with BMD (t-test, p < 0.001). The R2 for tested variables were highly significant only for weight. Age was only significant for total hip in women (p < 0.05). Each kilogram of weight change was associated with a 5.3-6.8 mg/cm2 change in BMD. CONCLUSIONS: In a population-based cohort of older African Americans, average BMD was significantly greater in men than women. Weight accounted for most of the explained variability (R2) in BMD; age added little to the overall R2. Lower-weight, older African-American men and women are at significantly increased risk for low BMD and, thus, likely to be at greater risk for osteoporotic fracture.