北京市社区老年高血压合并抑郁患者生活质量及相关因素分析

Quality of life and its association in elderly patients with hypertension and depression in Beijing community

目的:评估北京市社区老年高血压合并抑郁患者的生活质量,并且探索其相关因素,为社区管理老年高血压合并抑郁患者提供理论依据。方法:纳入于北京市朝阳区大屯社区服务中心就诊的65岁以上高血压患者503例,采用面对面方式调查基线资料和老年抑郁量表(GDS),自我完成生活质量问卷(SF-36问卷)。以GDS评分将患者分为抑郁组和无抑郁组,对比分析两组生活质量,并且探索影响抑郁组生活质量的相关因素。结果:488例患者完成所有问卷,无抑郁384例(78.7%),合并抑郁104例(21.3%)。抑郁组在躯体健康维度(PCS)和心理健康维度(MCS)明显低于无抑郁组(P<0.05)。多因素分析显示年龄越大、有睡眠问题和血压分级高的患者躯体健康更差。抑郁程度更重的患者心理健康更差。结论:合并抑郁的老年高血压患者生活质量明显低于无抑郁患者。与PCS相关的因素有年龄、睡眠和高血压分级,与MCS相关的因素主要是抑郁评分,为社区尽早针对性的干预和管理,提高这类人群生活质量具有指导性建议。

Objective:To assess the quality of life and to explore its related factors in the elderly with hypertension and depression in Beijing community.Methods:A total of 503 hypertensive patients over 65 years old participated in this investigation in the Datun Community health service center of Chaoyang District,Beijing.The baseline data and the Geriatric Depression Scale(GDS)were investigated in a face-to-face manner,and the Short-Form 36 Health Survey(SF-36)was asked to self-completed.Patients were divided into hypertension complicated with depression group(n=104)and without hypertension group(n=384)according to the result of GDS.Compared the quality of life in two groups and explore the factors that associate the quality of life in the depression group.Results:All 488 patients completed all questionnaires.104 patients(21.3%)were with depression and 384 patients(78.7%)without depression.The physical and mental health scores of the depression group were significantly lower than those of the non-depression group(P<0.05).Multivariate analysis showed that elder patients had lower physical health score who had sleep problem and higher blood pressure grading.Patients who had worse depression had lower mental health score.Conclusions:Quality of life in elderly hypertensive patients with depression is lower than patients without depression.The association factors of PCS are age,sleep,and hypertension.The main factor related with MCS is depression score.It provides a theoretical basis for improving the quality of life in elderly patients with hypertension and depression.