中国城乡老年人抑郁现状及其影响因素分析

Depression status and its influencing factors in urban and rural elderly in China

目的分析我国城乡老年人抑郁症状现况及影响因素。方法数据来源于中国健康与养老追踪调查(CHARLS)第四轮追踪调查,老年人抑郁症状评价采用抑郁自评量表(CES-D-10),老年人抑郁症状的影响因素采用多因素logistic回归模型进行分析。结果7690名老年人中抑郁症状阳性率为30.73%,其中城市为21.5%、农村为43.0%。与城市相比,农村老年人的OR(95%CI)为1.515(1.311~1.751);相比男性,女性的OR(95%CI)为1.609(1.423~1.820);与结婚并与配偶生活在一起的老年人相比,丧偶老年人的OR(95%CI)为1.222(1.052~1.419);相比生活完全满意的老年人,比较满意、不太满意、完全不满意的OR(95%CI)分别为1.963(1.472~2.614)、7.278(5.179~10.228)和16.922(9.997~28.644);与无慢性病的老年人相比,患慢性病老年人的OR(95%CI)为1.221(1.090~1.369)。相比文盲,文化程度为初中、高中/中专/职高、本科及以上老年人的OR(95%CI)分别为0.677(0.557~0.823)、0.482(0.370~0.626)和0.339(0.137~0.838);相比睡眠时间≤5 h,睡眠时间为6~9 h和≥10 h的老年人的OR(95%CI)分别为0.481(0.428~0.541)和0.537(0.440~0.656);与无社交活动的老年人相比,有社交活动的老年人的OR(95%CI)为0.865(0.773~0.968);相比无工资收入的,近一年有工资收入的老年人的OR(95%CI)为0.794(0.691~0.913)。结论农村、女性、丧偶、生活满意度低、患有慢性病是老年人抑郁症状的危险因素。文化程度高、睡眠时间长、有社交活动、近一年有工资收入是老年人抑郁症状的保护性因素。应在精准识别城乡老年人抑郁症状影响因素的基础上,提出针对性的干预措施。

Objective To analyze the status and influencing factors of depression symptoms in urban and rural elderly in China.Methods The data were collected from the fourth round of China Health and Retirement Longitudinal Study(CHARLS)and the 10-item Center for Epidemiological Studies Depression Scale(CES-D-10)to assess depressive symptoms of the elderly.Logistic regression model was used to analyze the influencing factors of depression of the elderly.Results The positive rate of depression symptoms in 7690 elderly was 30.73%,with 21.5%in urban area and 43.0%in rural area.Compared with that of the urban elderly,the OR(95%CI)of the rural elderly was 1.515(1.311-1.751).Compared with that of males,the OR(95%CI)of females was 1.609(1.423-1.820).The OR(95%CI)of the widowed elderly was 1.222(1.052-1.419),compared with the married elderly who lived with their spouses.Compared with that of the elderly who were completely satisfied with their life,the OR(95%CI)of more satisfied,less satisfied and completely dissatisfied were 1.963(1.472-2.614),7.278(5.179-10.228)and 16.922(9.997-28.644)respectively.Compared with that of the elderly without chronic diseases,the OR(95%CI)of the elderly with chronic diseases was 1.221(1.090-1.369).Compared with that of the illiterate,the OR(95%CI)of the elderly with junior high school education,senior high school/technical secondary school/vocational high school education,undergraduate education and above were 0.677(0.557-0.823),0.482(0.370-0.626)and 0.339(0.137-0.838)respectively.Compared with that of the elderly with sleep time≤5 h,the OR(95%CI)of the elderly with sleep time of 6~9 h and≥10 h were 0.481(0.428-0.541)and 0.537(0.440-0.656)respectively.Compared with that of the elderly without social activities,the OR(95%CI)of the elderly with social activities was 0.865(0.773-0.968).The OR(95%CI)of the elderly having wage income was 0.794(0.691-0.913).Conclusion Rural area,female,widowhood,low life satisfaction,and chronic diseases were risk factors for depression symptoms in older adults.High educational level,long sleep time,social activities,and income in the past year were protective factors for depression symptoms in the elderly.Targeted intervention measures should be put forward on the basis of accurately identifying the influencing factors of depression in urban and rural elderly.