PM_(2.5)暴露对中国老年人抑郁症状患病情况影响分析

Impact of PM_(2.5)exposure on depressive symptoms among elderly residents in China,2018:a CHARLS data analysis

目的了解PM_(2.5)暴露对中国老年人抑郁症状发生的影响,为预防老年人抑郁症状的发生提供参考依据。方法收集2018年中国健康与养老追踪调查(CHARLS)中10350名≥60岁老年人相关数据,并匹配2015—2018年样本所在124个地级市的空气污染和气象数据,应用工具变量法两阶段回归模型分析PM_(2.5)暴露对中国老年人抑郁症状的影响。结果中国10350名≥60岁老年人中,存在抑郁症状者3535例,抑郁症状检出率为34.15%;在调整了性别、年龄、文化程度、婚姻状况、户籍类型、所在区域、慢性病患病情况、参与社交情况、参与医疗保险情况、参与养老保险情况、平均国内生产总值(GDP)对数、年均气温和年均降水量等混杂因素后,工具变量法两阶段回归分析结果显示,当期PM_(2.5)暴露水平增高(OR=1.02,95%CI=1.01~1.04)、滞后1期PM_(2.5)暴露水平增高(OR=1.02,95%CI=1.01~1.03)、滞后2期PM_(2.5)暴露水平增高(OR=1.01,95%CI=1.00~1.02)和处于PM_(2.5)连续污染暴露地区(OR=1.41,95%CI=1.13~1.77)中国老年人抑郁症状发生的风险增高。结论中国老年人抑郁症状的检出率较高,PM_(2.5)暴露会增加老年人抑郁症状的发生风险。

Objective To assess the effect of exposure to particulate matter less than 2.5 micrometers in aerodynamic diameter(PM_(2.5))on the prevalence of depressive symptoms in elderly people in China,to provide a reference for the prevention of symptoms in the population.Methods Data on 10350 residents aged 60 years and older living in 124 prefecture-level cities across China during 2015-2018 were extracted from the China Health and Retirement Longitudinal Study(CHARLS)conducted in 2018,and city-specific data on air pollution and meteorology during the 4-year period were also collected simultaneously.The two-stage least squares regression model with instrumental variable method was used to analyze the effect of PM_(2.5)exposure on the prevalence of depressive symptoms assessed by the 10-item Center for Epidemiologic Studies Depression Scale(CESD-10)in the CHARLS survey among the elderly.Results Of all the elderly residents,3535(34.15%)were assessed as having depressive symptoms.After adjusting for gender,age,education level,marital status,type of household registration,region of residence,chronic disease status,social participation,participation in health and pension insurance schemes,the logarithm of average gross domestic product,average annual temperature,and average annual precipitation,the results of instrumental variable method twostage regression analysis showed that higher PM_(2.5)concentration was associated with increased prevalence of depressive symptoms among the elderly residents,with the odds ratios(95%confidence interval)of 1.02(1.01-1.04)for current higher annual average PM_(2.5),1.02(1.01-1.03),1.01(1.00-1.02)for lagged one-,two-year higher annual average PM_(2.5)concentrations,and 1.41(1.13-1.77)for continuous exposure to PM_(2.5)pollution(≥35μg/m3).Conclusion The prevalence of depressive symptoms is relatively high,and exposure to higher PM_(2.5)might increase the risk of depressive symptoms among elderly people in China.