城市老年人抑郁与认知功能的相关性及性别差异研究

Associations and Sex Differences between Depression and Cognitive Function in the Urban Elderly

背景我国人口老龄化问题日趋严重,抑郁是老年人群中较为常见的精神疾病之一,可导致显著的残疾和死亡风险增加。研究发现抑郁与认知障碍之间关联密切,并且这种关系可能受到性别的影响。在老年人群中,抑郁与认知功能及不同认知领域之间相关性的性别差异尚不明确。目的对城市老年人抑郁和认知功能状况进行调查,并分析抑郁与认知功能的相关性及性别差异。方法2022年9—10月采用分层抽样方法,选取安徽省合肥市某社区的65岁及以上老年居民作为调查对象。收集其一般资料,采用老年抑郁量表(GDS)、痴呆简易筛查量表(BSSD)分别对抑郁和认知功能状况进行评估,探讨老年人抑郁的相关因素,并分析抑郁、性别因素及二者的交互作用对认知功能的影响。结果共纳入328名老年人,抑郁的总体检出率为14.9%。回归分析结果显示,饮酒(OR=0.362,95%CI=0.155~0.847)、与子女居住(OR=2.445,95%CI=1.021~5.853)是抑郁的独立相关因素(P<0.05)。析因设计的方差分析显示,抑郁老年人的BSSD总分及语言(命令)理解、计算/注意、地点定向、时间定向和即刻记忆因子分均低于非抑郁老年人(P<0.05)。女性BSSD总分及常识/图片理解和地点定向因子分均低于男性,而语言(命令)理解得分高于男性(P<0.05)。抑郁与性别在常识/图片理解、语言(命令)理解和地点定向上的交互作用显著(P<0.05)。结论城市老年人抑郁风险较高,合并抑郁的老年人可能存在一定的认知功能减退,并伴有性别差异。应加强关注老年人抑郁和痴呆等精神问题,尤其是针对女性老年群体,有必要制定个体化的综合干预措施,提高老年人心理健康水平和生活质量。

Background The aging of ouRpopulation is a growing problem,and depression is one of the more common psychiatric disorders in the elderly population,leading to a significantly increased risk of disability and death.The studies found a significant association between depression and cognitive disorders,and that this association may be influenced by sex.Sex differences in the associations between depression with cognitive functions and different cognitive domains are not clear in the elderly population.Objective Population ageing has become a common global phenomenon,and psychiatric problems associated with ageing are of great concern.This study investigated the status of depression and cognitive function in the urban elderly and examined the associations and sex differences between depression and cognitive function.Methods From September to OctobeR2022,a stratified sampling method was used to select elderly residents aged 65 years and above in a community within the city of Hefei,Anhui province as the participants.General information was collected and depression and cognitive function status were assessed using the Geriatric Depression Scale(GDS)and the Brief Screening Scale foRDementia(BSSD),respectively.We explored the factors associated with depression in the elderly and analyzed the effects of depression,sex factors and theiRinteractions on cognitive functioning.Results A total of 328 oldeRadults were included and the overall detection rate for depression was 14.9%.Regression analyses showed that drinking(OR=0.362,95%CI=0.155-0.847),and living with children(OR=2.445,95%CI=1.021-5.853)were independently associated with depression(P<0.05).Factorial design analysis of variance showed that the total score of BSSD and scores of language(command)comprehension,attention and computation,orientation in place,orientation in time,and immediate memory factors were loweRin the depressed group of the elderly than in the non-depressed group.Females had a loweRtotal score of BSSD,loweRscores of general knowledge and picture and orientation in place,and a higheRscore of language(command)comprehension than males(P<0.05).Depression and sex had significant interactions in general knowledge and picture,language(command)comprehension,and orientation in place(P<0.05).Conclusion The urban elderly are at a higheRrisk of depression,and those with comorbid depression may have a certain degree of cognitive decline,with sex differences.Increased attention should be paid to psychiatric problems such as depression and dementia among the elderly,especially foRthe female geriatric population.It is necessary to develop individualised and comprehensive interventions to improve the mental health and quality of life of the elderly.