社区老年脑卒中高危人群抑郁状态筛查及危险因素分析

Depression and its risk factors in community elderly people at high risk of ischemic stroke

目的调查社区老年脑卒中高危人群中抑郁状态的发生情况,探讨抑郁的危险因素及对抑郁早期发生的影响机制。方法采用分层随机整群抽样的方法,对天津市河西区4个社区年龄≥45岁的居民进行脑卒中高危人群的横断面筛查,登记人口基本情况及脑卒中危险因素,最终选择年龄≥60岁者469例,分为抑郁组146例,非抑郁组323例。应用汉密尔顿抑郁量表（HAMD,17项版本）对其抑郁状态进行评估。结果 469例社区脑卒中高危者中,合并抑郁状态者146例,发生率为31.1%。与非抑郁组比较,抑郁组女性、单身、既往有抑郁病史、心脏病、缺乏体育锻炼或体力劳动及有脑卒中家族史比例明显升高,差异有统计学意义（P〈0.05）。多因素logistic回归分析显示,女性（OR=2.542,95%CI：1.373-4.707,P=0.003）、单身（OR=4.272,95%CI：1.706-10.696,P=0.002）、心脏病史（OR=2.734,95%CI：1.728-4.325,P=0.000）和脑卒中家族史（OR=1.583,95%CI：1.013-2.474,P=0.044）是社区老年脑卒中高危人群抑郁发生的独立危险因素。结论社区脑卒中高危人群以轻度抑郁状态多见,应对脑卒中高危人群进行抑郁量表筛查,早期诊断和早期干预抑郁状态。

Objective To investigate the prevalence of depression and its risk factors in community elderly people at high risk of ischemic stroke.Methods Four hundred and sixty-nine elderly people with their age≥60years sampled from 4communities in Hexi District of Tianjin were divided into depression group（n=146）and non-depression group（n=323）.Their depression was assessed according to the Hamilton＇s Depression Scale（edition 17）.Results Of the 469 elderly people at high risk of ischemic stroke,146（31.1%）suffered from depression.The incidence of depression was significantly higher in females,singles,those with a history of depression and heart disease,those who had insufficient physical exercises,physical labourers,and those with a family history of ischemic stroke of depression group than in those of non-depression group（P〈0.05）.Logistic regression analysis revealed that females,singles,history of heart disease and family history of ischemic stroke were the independent risk factors for depression in community elderly people at high risk of ischemic stroke（OR=2.542,95%CI：1.373-4.707,P=0.003;OR=4.272,95%CI：1.706-10.696,P=0.002;OR=2.734,95%CI：1.728-4.325,P=0.000;OR=1.583,95%CI：1.013-2.474,P=0.044）.Conclusion Mild depression is more commonly observed in community elderly people at high risk of ischemic stroke.It should be diagnosed and treated as early as possible.