中国20~79岁居民心理健康现状及其与体育锻炼的关系

Psychological well-being and its relationship with exercise among Chinese residents aged 20~79 years

目的基于全国代表性样本,探索中国20~79岁居民心理健康现状及其与体育锻炼的关系。方法以第五次国民体质监测中161901名20~79岁居民为研究对象开展横断面调查,其中包含121928名20~59岁成年人和39973名60~79岁老年人;通过心理健康指标综合问卷评估其心理健康状况,调查体育锻炼参与情况、锻炼频率和时长。使用SPSS 26.0进行统计学分析,采用卡方检验和Logistic回归分析检验体育锻炼与心理健康的关系。结果中国20~79岁居民的抑郁症状检出率为16.6%(26311/158518)。其中,20~59岁成年人抑郁、焦虑症状检出率分别为18.0%(21465/119409)和13.8%(16435/119444),经常或总是感到压力者占比为15.3%(18373/120444);60~79岁老年人抑郁症状检出率为12.4%(4846/39109),孤独感量表得分>25分者占比为32.8%(12650/38525),经常或总是感到压力者占比为4.0%(1587/39395)。Logistic回归分析显示,与不参加体育锻炼者相比,参加体育锻炼者抑郁症状风险降低了20%(β=-0.22,OR=0.80,95%CI:0.78~0.82)。随着体育锻炼频率和强度的增加,向好趋势更为明显,每周锻炼至少3 d且中等强度以上者,抑郁症状检出率降低了35%(β=-0.39,OR=0.65,95%CI:0.63~0.67)。亚组分析结果显示,体育锻炼与抑郁的负相关性在成年人和老年人、男性和女性、城镇和乡村人群中均存在。参加体育锻炼的成年人焦虑风险检出率降低6%(β=-0.06,OR=0.94,95%CI:0.91~0.97)、每周锻炼≥3 d且中等强度以上者降低15%(β=-0.16,OR=0.85,95%CI:0.81~0.89)。未观察到参与体育锻炼与压力风险检出率存在关联(P>0.05),但随着锻炼频率和强度增加其积极效应同样出现。参与体育锻炼的老年人有高孤独感得分的风险降低了50%(β=-0.70,OR=0.50,95%CI:0.47~0.52)、压力风险检出率降低了35%(β=-0.43,OR=0.65,95%CI:0.59~0.72)。结论参加体育锻炼的人群表现出更加积极、健康的心理和情绪状态。运动能够积极有效地预防和改善心理健康。

Objective To explore the mental health level of Chinese adults aged 20~79 years and its association with exercise based on the surveillance data.Methods A cross-sectional study was conducted in a total of 161901 samples from the Fifth National Physical Fitness Surveillance,including 121928 adults aged 20-59 years and 39973 elderly aged 60-79 years.The mental health status was assessed by a comprehensive questionnaire,and the participation in frequency and duration of exercise were investigated.Chi-square test and Logistic regression were applied to test the relationship between exercise and mental health using SPSS 26.0 software.Results The rate of depressive symptoms among residents aged 20-79 years in China was 16.6%(26311/158518).In the adults aged 20-59 years,the rates of depression and anxiety symptoms were 18.0%(21465/119409)and 13.8%(16435/119444),respectively,and the proportion of those who often or always felt stressed was 15.3%(18373/120444).In the elderly aged 60-79 years,the rate of depression symptoms was 12.4%(4846/39109),the proportion of those with loneliness scale scores higher than 25 was 32.8%(12650/38525),and 4.0%(1587/39395)elderly often or always felt stressed.Compared with the non-exercisers,the risk of depression symptoms in the exercisers was reduced by 20%(β=-0.22,OR=0.80,95%CI:0.78-0.82).With increased frequency and intensity of physical exercise,the mental health condition improved significantly.For those who exercised at least 3 days a week and had moderate intensity or above,the detection rate of depression symptoms decreased by 35%(β=-0.39,OR=0.65,95%CI:0.63-0.67).The negative associations between exercise and depression were found in different ages,genders and resident subgroups.The risk of anxiety was 6%lower in the adults who participated in physical activity(β=-0.06,OR=0.94,95%CI:0.91-0.97)and 15%lower in those who exercised over 3 days per week at moderate-to-vigorous intensity(β=-0.16,OR=0.85,95%CI:0.81-0.89).No association between exercise and risk of stress was observed(P>0.05),but the positive effect was also found as exercise frequency and intensity increased.Older adults with exercise had a reduced risk of high loneliness scores by 50%(β=-0.70,OR=0.50,95%CI:0.47-0.52)and a 35%lower detection of stress risk(β=-0.43,OR=0.65,95%CI:0.59-0.72).ConclusionExercise was significantly and meaningfully associated with self-reported mental health.Exercise can actively and effectively prevent and improve mental health.