中国中老年妇女吸烟、饮酒行为与抑郁症状相关性分析

Associations of smoking and alcohol drinking with depressive symptoms in middle-aged and elderly women in China

目的探索吸烟、饮酒行为对中国中老年妇女抑郁症状的影响,为改善中老年妇女抑郁状况提供政策依据和干预措施。方法选用2013和2015年中国健康与养老追踪调查(CHARLS)数据,采用10项流调中心抑郁量表(CES-D10)评估中老年妇女的抑郁症状,运用logistic模型分析吸烟、饮酒行为对中老年妇女抑郁症状的影响。结果本研究中基线5 532名无抑郁症状的中老年妇女2年后出现抑郁症状1 405例,抑郁症状发生率为25.40%,农村(29.25%)高于城镇(19.93%)。Logistic分析结果显示,与不吸烟的中老年妇女相比,吸烟者(OR=1.23,95%CI=0.95~1.60)和戒烟者(OR=0.70,95%CI=0.47~1.08)发生抑郁症状的风险无显著增加;与不饮酒的中老年妇女相比,每周饮酒者(OR=1.16,95%CI=0.90~1.52)与偶尔饮酒者(OR=1.03,95%CI=0.83~1.29)发生抑郁症状的风险无显著增加。按居住地对中老年妇女进行分层后发现,居住在城镇的中老年妇女,吸烟者(OR=1.53,95%CI=1.01~2.32)发生抑郁症状的风险高于不吸烟者;居住在农村的中老年妇女,相比不吸烟者,吸烟者(OR=1.10,95%CI=0.78~1.57)和戒烟者(OR=0.77,95%CI=0.46~1.29)发生抑郁症状的风险无显著性差异。无论是居住在农村还是城镇,相比不饮酒者而言,每周饮酒和偶尔饮酒的中老年妇女发生抑郁症状的风险无显著变化。结论中国中老年妇女抑郁症状发生率较高,农村高于城市。应加强中老年妇女的健康教育,告诫其减少吸烟,同时加强中老年妇女的心理干预,为提高中老年妇女的身心健康提供保障。

Objective To explore effects of smoking and alcohol drinking on depressive symptoms among middle-aged and elderly women in China, and to provide evidences for developing strategies and intervention measures for improving mental health of middle-aged and elderly women. Methods The data of the study were from two waves of China Health and Retirement Longitudinal Study(CHARLS) conducted in 2013 and 2015. the Center for Epidemiological Studies Depression Scale(CES-D10) was used to assess the depressive symptoms. The influence of smoking and alcohol drinking on the symptoms of the women were analyzed with logistic regression model. Results Of the 5 532 participants without depressive symptoms at the first wave survey, 1 405 were identified having depressive symptoms in the second wave survey and the incidence of depressive symptoms was 25.40%. The incidence of depressive symptoms was higher among the rural participants than among the urban participants(29.25% vs. 19.93%). Logistic analysis showed that for all the participants,current smokers(odds ratio [OR] = 1.23, 95% confidence interval [95% CI] : 0.95-1.60), ex-smokers(OR = 0.70, 95% CI:0.47-1.08), weekly alcohol drinkers(OR = 1.16, 95% CI: 0.90-1.52), and occasional alcohol drinkers(OR = 1.03, 95% CI:0.83-1.29) were not at significantly increased risk of depressive symptoms compared to the non-smokers and non alcohol drinkers. However, for the urban participants, current smokers had a higher risk of depressive symptoms(OR = 1.53, 95% CI:1.01-2.32) than the non-smokers;no significantly increased risk of depressive symptoms was observed among the rural current smokers(OR = 1.10, 95% CI: 0.78-1.57) and ex-smokers(OR = 0.77, 95% CI: 0.46-1.29) in comparison with the rural non-smokers. Conclusion The incidence of depressive symptoms is relatively high among middle-aged and elderly women in China and the incidence is higher among the rural women than that among the urban women. Relevant health education should be promoted in middle-aged and elderly women.