我国老年人抑郁和焦虑症状与心脏病及慢性非传染性呼吸系统疾病的关联性研究

Relationship between depression/anxiety symptoms and heart disease or chronic non-communicable respiratory disease in elderly of China

目的探讨中国老年人抑郁症状和焦虑症状与心脏病及慢性非传染性呼吸系统疾病的关联,为改善老年人群精神健康状况及降低心脏病及慢性非传染性呼吸系统疾病患病风险提供科学参考。方法利用中国老年健康影响因素跟踪调查(CLHLS)2018年的数据,选取其中7973名65岁及以上的老年人为研究对象。采用10项流调中心抑郁量表评估抑郁症状,采用广泛焦虑量表评估焦虑症状。使用SPSS 20.0进行χ2检验与多因素logistic回归分析。结果7973名研究对象中17.7%患心脏病,10.3%患慢性非传染性呼吸系统疾病。多因素logistic回归分析结果显示,与无抑郁症状相比,轻度抑郁症状与心脏病(OR=1.32,95%CI:1.13~1.54)、慢性非传染性呼吸系统疾病(OR=1.37,95%CI:1.14~1.65)高风险相关;中重度抑郁症状与心脏病(OR=1.44,95%CI:1.13~1.82)、慢性非传染性呼吸系统疾病(OR=2.10,95%CI:1.62~2.73)高风险相关,均有统计学意义(P<0.01)。与无焦虑症状相比,轻度焦虑症状与心脏病(OR=1.32,95%CI:1.08~1.62)、慢性非传染性呼吸系统疾病(OR=1.32,95%CI:1.04~1.68)高风险相关(P<0.05),但中重度焦虑症状与心脏病或慢性非传染性呼吸系统疾病的关联无统计学意义(P>0.05)。与无抑郁和焦虑症状相比,单一抑郁或焦虑症状与心脏病(OR=1.34,95%CI:1.15~1.56)、慢性非传染性呼吸系统疾病(OR=1.57,95%CI:1.31~1.87)高风险相关;抑郁和焦虑症状共病与心脏病(OR=1.44,95%CI:1.16~1.80)、慢性非传染性呼吸系统疾病(OR=1.56,95%CI:1.20~2.02)高风险相关(P<0.01)。结论抑郁和焦虑症状与老年人患心脏病及慢性非传染性呼吸系统疾病有关,在老年人群中采取积极的干预措施预防抑郁和焦虑症状发生和恶化,可以有效降低心脏病和慢性非传染性呼吸系统疾病的患病可能。

Objective To explore the relationship between depression/anxiety symptoms and heart disease or chronic noncommunicable respiratory disease in elderly of China,and provide the scientific reference for improving the mental health and reducing the risk of heart disease or chronic non-communicable respiratory disease in the elderly population.Methods The data of“Chinese Longitudinal Healthy Longevity Survey(CLHLS)2018”were used,7973 elderly(≥65 years old)served as the subjects.“Center for Epidemiologic Studies Depression Scale(CES-D)with 10 items”was used to evaluate the depression symptoms,and“Generalised Anxiety Disorder(GAD-7)”was used to evaluate the anxiety symptoms.Theχ2 test and multi-factor logistic regression analysi were used to analyze the data.The used software was SPSS 20.0.Results There were 17.7%of subjects with heart disease,10.3%of subjects with chronic non-communicable respiratory disease among 7973 subjects.Multivariate logistic regression analysis showed that as compared with no depressive symptoms,mild depressive symptoms was related to the higher risk of heart disease(OR=1.32,95%CI:1.13-1.54)and chronic non-infectious respiratory disease(OR=1.37,95%CI:1.14-1.65),moderate/severe depressive symptoms was related to the higher risk of heart disease(OR=1.44,95%CI:1.13-1.82)and chronic non-infectious respiratory disease(OR=2.10,95%CI:1.62-2.73),P<0.01;as compared with no anxiety symptoms,mild depressive symptoms was related to the higher risk of heart disease(OR=1.32,95%CI:1.08-1.62)and chronic non-infectious respiratory disease(OR=1.32,95%CI:1.04-1.68),P<0.05;but moderate/severe depressive symptoms was not related to the risk of heart disease and chronic noninfectious respiratory disease(P>0.05).As compared with no depression/anxiety symptom,single symptoms of depression or anxiety were related to the higher risk of heart disease(OR=1.34,95%CI:1.15-1.56)and chronic noncommunicable respiratory disease(OR=1.57,95%CI:1.31-1.87);the comorbidity of depression and anxiety symptoms was related to the higher risk of heart disease(OR=1.44,95%CI:1.16-1.80)and chronic non-infectious respiratory disease(OR=1.56,95%CI:1.20-2.02),P<0.01.Conclusion Depression and anxiety symptoms are related to heart disease and chronic noncommunicable respiratory disease in elderly.It should take the active intervention measures to prevent the development and deterioration of depression/anxiety symptoms,and to reduce effectively the incidence of heart disease and chronic noncommunicable respiratory disease for elderly.