河北省城市社区老年人抑郁情绪与认知功能的相关性调查

Investigation of the correlation between depression and cognitive function of elderly people in community of Hebei Province

目的分析河北省城市社区老年人抑郁情绪的危险因素及与认知功能的相关性。方法采用多阶段整群随机抽样方法，于20lO年1～12月在河北省四地区60岁以上城市社区老年人进行问卷调查。按照流调用抑郁自评量表（cEs—D）得分将老年人分为有抑郁情绪组和无抑郁情绪组，评估抑郁症状的发生率，分析两组社会人口学资料、认知危险因素以及认知功能损害的发生率差异，并对抑郁情绪与认知功能进行相关分析。结果共完成3149倒有效问卷，其中有抑郁情绪组268例，无抑郁情绪组2881例，抑郁症状的发生率为8．51％。两组在性别，受教育水平，婚姻状况，居住方式，经历生活事件数量，业余活动及社交方面的差异有统计学意义（P〈0．05）。有抑郁情绪组MMSE得分（23．70±5．116）分、MoCA得分（19．14±5．980）分明显低于无抑郁情绪组（26．32=fi3．904），（23．05±5．233）分，ADL得分（27．25±12．782）分明显高于无抑郁情绪组（21．08±4．553）分，差异均有统计学意义（t分别为10．215，11．557，-16．871；P〈0．01）。Logistic多元回归分析显示，抑郁情绪的危险因素包括女性（β=0．667，β＇=0．157，OR=1．949，95％CI—1．432～2．653，Wald=17．983，P=0．000）、经历生活事件[〉2件（β=1．960，β＇=0．250，OR=7．100，95％CI=4．348～11．595，Wald=61．359，P=0．000），1～2件（8—0．892，β＇=0．229，OR=2．441，95％CI—1．558～3．825，Wald=15．157，P=0．000）]及业余活动低（β=0．963，β＇=0．162，OR=2．621，95％CI—1．909～3．598，Wald=35．489，P=0．000）。结论老年人抑郁情绪的影响因素较为复杂，存在抑郁症状的老年人其认知功能和生活能力均低于无抑郁情绪的老年人。

Objective To analyze the risk factors of depressive symptoms and investigate the cor- relation between depression and cognitive function in elderly people in community of Hebei Province. Methods We used multi-- stage cluster random sampling method to conduct a survey of elderly people a- bove 60 years old in four areas of Hebei Province from January to December in 2010. The elderly people were divided into depression group and no depression group according to the Center for Epidemiological Studies,Depression Scale （CES--D）. We assessed the prevalence of depressive symptoms, and compared the differences of social demographic, risk factors and the incidence of cognitive impairment. We also an- alyzed the correlation between depression and cognitive function. Results Totals of 3 149 valid question- naires were completed, including depression group （n ~ 268） and no depression group （n = 2 881）, the incidence of depressive symptoms was 8.51%. There were differences in gender, educational level,mar- riage status , living style , experiences of life events, leisure time and social activities （P ~ 0.05）. The Minimum Mental State Examination （MMSE） [（23.70±5. 116） vs. （26.32±3. 904）; t = 10. 215,P 0.01] and Montreal Cognitive Assessment （MoCA） [（19.14±5. 980） vs. （23.05±5. 233）; t =11. 557, P 〈 0.01] scores were significantly lower in depression group than no depression group, Activities of Daily Living （ADL） [（27.25±12. 782） vs. （21.08±4. 553） ; t =-16. 871,P〈0.01] score was signifi- cantly higher in depression group than no depression group. Logistic multivariate regression analysis showed that the risk factors of depression included female （β= 0. 667 ,] = 0. 157,β＇ =1. 949,95% CI =1. 432-- 2. 653, Wald = 17. 983,P = 0. 000）, experiences of life events [ 〉2（β = 1. 960,] = 0. 250,β＇ = 7. 100, 95M CI =4. 348-11. 595, Wald = 61. 359,P = 0. 000）, 1-2 （β = 0. 892,] = 0. 229,OR = 2. 441,95% CI =1. 558--3. 825, Wald = 15. 157,P = 0. 000）] and low leisure time and social activities （β = 0. 963,] = 0. 162,OR = 2. 621, 95% CI =1. 909--3. 598, Wald = 35. 489,P = 0. 000）. Conclu- sions Depressive symptoms of elderly people is affected with many complicated factors. The cognitive function and daily living activities of elderly people with depressive symptoms are lower than elderly peo- ple without depression symptoms.