老年人抑郁症状与慢性病及日常生活活动能力的关联性研究

Correlation between depressive symptoms, chronic diseases and daily activities in the elderly

目的 分析老年人慢性病、抑郁症状及日常生活活动能力三者之间的相互关系,探讨老年人抑郁症状和老年人日常生活活动能力受限的危险因素.方法 采用多阶段整群抽样方法,应用老年抑郁短量表、Katz日常生活活动量表（Katz-ADL）和Lawton工具性日常生活活动量表（Lawton-IADL）,对济宁市部分县区≥65岁的504例老年人进行问卷调查.结果 济宁市部分县区老年人总患病率为74.01％,抑郁症状阳性率为7.14％,ADL、IADL功能受限率分别为19.05％和66.67％,男性老年人抑郁症状阳性率及ADL、IADL功能受限率低于女性（x2分别为18.15、12.31、30.18,P均＜0.05）；老年人现患有慢性病的种类数是抑郁症状和ADL受限的危险因素（OR分别为1.71、1.53）,ADL和IADL受限也是老年人抑郁症状的危险因素（OR分别为3.15、9.36）；控制性别、年龄因素后,患有慢性病种类数对老年人抑郁症状、ADL、IADL的影响以及ADL和IADL受限对老年人抑郁症状的影响均无统计学意义.结论 性别、年龄是老年人抑郁症状、ADL和IADL受限的最根本的危险因素,家庭和社会在对老年人照护时,应积极锻炼提高老年人的日常生活活动能力,提升老年人的正性情绪,减少抑郁症状的发生.

Objective To analyze the correlation between chronic diseases,depression and activities of daily living （ADL） in the elderly,and to explore the risk factors of depressive symptoms and ADL.Methods Randomized multi-stage sampling method was used to select 504 elderly （aged ≥65 years old） in Jining City.The participants were then investigated and assessed by using Geriatric Depression Scale15,Katz-Activity of Daily Living （Katz-ADL） and Lawton instrumental ADL （Lawton-IADL）.Results The prevalence of chronic diseases was 74.01％ among the elderly who lived in Jining City.The positive rate of depressive symptom was 7.14％ and the rate of ADL or IADL limitation was 19.05％ and 66.67％,respectively.The positive rate of depressive symptom and the rate of ADL or IADL limitation of the male were lower than those of female （x2 values were 18.15,12.31 and 30.18,respectively; all P＜ 0.05）.The number of chronic diseases was a risk factor of depressive symptom and ADL limitation （odds ratio （OR） =1.71 or 1.53,respectively）.ADL and IADL limitations were also the risk factors of depressive symptom （OR =3.15 or 9.36,respectively）.Over adjustment of gender and age,the impact of the number of chronic diseases on depressive symptom,ADL and IADL and the influence of ADL and IADL limitations on depressive symptom showed no statistical significance.Conclusions Gender and age may be fundamental risk factors of depressive symptom and ADL and IADL limitations in the elderly.Family members and society workers should improve ADL and positive emotion and reduce the likelihood of depressive symptom among aging population.