老年人躯体健康与抑郁症状发病的相关研究

目的 探讨社区老年人群躯体健康状况与抑郁症状发病之间的关系.方法 采用分层随机整群的抽样原则,在北京市城乡社区老年人群中抽取有效样本2506人,分别于2000年和2004年采用综合问卷进行人户调查.结果 北京市社区老年人抑郁症状的4年累积发病率是10.58%.单因素分析结果显示,文化程度越低抑郁症状发生率越高(文盲组、小学组和初中以上文化组的发生率分别为15.2%、10.5%和5.1%;χ2=26.587,P=0.000);居住在农村的老年人抑郁症状发生率明显高于城市的老年人(15.4%、6.1%;χ2=31.163,P=0.000).健康自评差的老年人抑郁症状的发生率明显增加(健康自评为良好、一般和差的各组老年人抑郁症状的发生率分别为7.3%、13.2%和38.0%;χ2=23.385,P=0.000);有认知功能障碍的老年人抑郁症状的发生率明显高于认知功能正常的老年人(19.3%、9.6%;χ2=11.947,P=0.001);生活不能自理的老年人抑郁症状的发生率也明显高于能够自理的老年人基本日常生活自理能力(ADL):37.5%、10.1%;χ2=15.930,P=0.000;操作性日常生活自理能力(IADL):17.5%、9.6%;χ2=9.501,P=0.002].logistic回归分析结果显示,文化程度、居住地区、健康自评和ADL是老年抑郁症状发病的独立影响因子.结论 文化程度低、居住在农村、健康自评差以及ADL不能自理的老年人抑郁症状发病风险增高.

Study on the relationship between somatic health and incidence of depression in the elderly

OBJECTIVE: In order to explore the risk factors of geriatric depression, a longitudinal follow-up study was conducted on elderly population living in the community so as to provide evidence for the development of depression prevention and control. METHODS: A sampled population consisting 2506 elderly was selected from urban and rural communities in Beijing, using well-established sampling techniques as cluster, stratification and random selection. Data was collected by trained staff members, using standard survey instruments in 2000 and 2004. RESULTS: Longitudinal study showed that the four-year cumulative incidence of the geriatric depression in Beijing was 10.58%. Difference on were evident intelligence/education, with the rates for illiteracy (15.2%) and primary school (10.5%) significantly higher than that of junior high school and above (5.1%) (chi2 = 26.587, P = 0.000). Rates also varied substantially with place of residence, individuals living in rural areas had a substantially higher rate of depression (15.4%) than those individuals dwelling in urban district (6.1%) (chi2 = 31.163, P = 0.000). Poor self-rated health condition (chi2 = 23.385, P = 0.000), cognitive impairment (chi2 = 11.947, P = 0.001) and limitations in physical functioning (ADL: chi2 = 15.930, P = 0.000; IADL: chi2 = 9.501, P = 0.002) were related to the worsening of depressive symptoms. Results from logistic regression analysis indicated that education level, dwelling area, self-rated health condition and ADL were the independent risk factors. CONCLUSION: Lower educational level, dwelling situation, poor self-rated health condition as well as ADL damage might increase the incidence of depression, suggesting more attention needs to be paid to improve somatic function of elderly in order to decrease the incidence of geriatric depression and to improve the prognosis of the disease and the quality of life.