老年人身体活动与生活质量及抑郁的相关性研究

Study on the relationship between physical activity, quality of life and depression among the elderly

目的探讨社区和养老机构老年人身体活动（PA）与健康相关生活质量（HRQOL）及抑郁的相关性。方法采用耶鲁大学身体活动问卷（YPAS）、生活质量评定量表（SF-36）、老年抑郁量表（GDS）调查某市253名社区和183名养老机构共436名老年人的身体活动、HRQOL及抑郁症状，并分析三者相关性。结果老年人每周活动总时间比较，社区（40．5±1．2）h，养老机构（35．2±0．5）h，差异有统计学意义（F=26．9，P〈0．01）；社区老年人SF-36得分中生理领域（66．3±0．9）分，心理领域（63．5±0．8）分，均高于养老机构老年人的（56．3±0．8），（51．3±0．7）分，差异有统计学意义（t分别为4．7，3．9；P〈0．01）；社区老人中度抑郁者占11．1％，低于养老机构的18．5％，差异有统计学意义（χ2=3．9，P〈0．05）；两组重度抑郁率比较，差异无统计学意义（χ2=6．5，P〉0．05）。相关分析显示，老年人HRQOL除情感职能外均与PA呈正相关（r=0．108-0．255，P〈0．01）；抑郁症状得分与YPAS总分及每周能量消耗呈正相关（r分别为0．156，0．121；P〈0．05）。结论老年人身体活动与HRQOL生理和心理维度显著相关，身体活动对社区与养老机构老年人有积极效应。

Objective To discuss the relationship between physical activity （PA）, health related quality of life （HRQOL） and depression among community dwelling and institutionalized elderly. Methods YPAS,SF-36 and GDS were used to investigate physical activity, HRQOL and depression in 436 elderly （58% community-dwellers and 42% institutionalized ）, and their relationship was analyzed. Results Physical activity time of elderly was （40.5 ± 1. 2） h in the community and （ 35.2 ± 0. 5 ） h in the institutions, and the difference was statistically significant （ F = 26. 9, P 〈 0. 01 ）. The psychical score and psychological score in SF-36 were （66.3 ± 0.9） and （63.5 ± 0.8 ）in community elderly, higher than（56.3 ± 0. 8）and（51.3 ± 0.7 ）in institutionalized elderly, and the differences were statistically significant （t = 4. 7, 3.9, respectively;P 〈 0. 01 ）. 11. 1% of elderly in community and 18.5% of institutionalized elderly had moderate depression, and the difference was statistically significant （ χ2 = 3.9, P 〈 0. 05 ）. There was no statistically significant difference of severe depression rate between two groups （χ2 = 6.5, P 〉 0. 05 ）. HRQOL of elderly, except for emotional function, had positive relationship with PA （ r = 0. 108 - 0. 255, P 〈 0. 01 ）, and depression score had positive relationship with YPAS score and weekly energy cost （ r = 0. 156, 0. 121, respectively; P 〈 0. 05 ）. Conclusions Physical activity is significantly related to both physical and psychological dimensions in HRQOL, and QA has positive effect on both community-dwelling and institutionalized elderly.