慢性躯体疾病与休闲活动对社区老年人抑郁情绪的交互影响  

The interactive effects of chronic physical diseases and leisure activities on depression among the elderly in community

作　　者：张静 张海峰[1] 吕晓珍[1] 于欣[1] 王华丽[1] Zhang Jing;Zhang Haifeng;Lyu Xiaozhen;Yu Xin;Wang Huali(Peking University Institute of Mental Health(Peking University Sixth Hospital)Key Laboratory of Mental Health,Ministry of Health(Peking University),Beijing Key Laboratory of Translational Medicine Research on Diagnosis and Treatment of Dementia,National Clinical Research Center for Mental Disorders,Beijing 100191,China)

机构地区：[1]北京大学精神卫生研究所(第六医院)卫生部精神卫生学重点实验室(北京大学)痴呆诊治转化医学研究北京市重点实验室,国家精神心理疾病临床医学研究中心,100191

出　　处：《中华精神科杂志》2021年第5期337-343,共7页Chinese Journal of Psychiatry

基　　金：首都卫生发展科研专项(2016-1-4117,2011-4024-02)。

摘　　要：目的研究社区老年人罹患慢性躯体疾病及参加休闲活动情况与抑郁情绪存在的交互影响。方法通过横断面调查研究,以2014年6月20日至8月20日完成社区老年心理状况调查的3007名社区老年人(年龄≥60岁)为研究对象,采用老年抑郁问卷(Geriatric Depression Inventory,GDI)评价抑郁情绪,采用休闲活动问卷评估休闲活动参与情况。通过Logistic回归分析慢性躯体疾病和休闲活动与抑郁情绪之间的关系,并分析两者之间的交互作用。结果(1)社区调查老年人抑郁情绪检出率为35.78%(1076/3007)。(2)Logistic回归分析显示,糖尿病(OR=1.42,95%CI:1.14-1.76)、高脂血症(OR=1.27,95%CI:1.09-1.56)、冠心病(OR=1.31,95%CI:1.04-1.63)、短暂性脑缺血发作(OR=1.31,95%CI:1.04-1.63)与抑郁情绪发生风险增加有关(均P<0.05);伸展弹性运动(OR=0.79,95%CI:0.68-0.92)与抑郁情绪发生风险降低有关(P<0.05)。(3)糖尿病和不参加伸展弹性运动作为抑郁情绪发生的危险因素具有交互作用[交互作用归因比(attributable proportion due to interaction,AP)=41.75%]。结论社区老年人抑郁情绪较常见,慢性躯体疾病可能增加社区老年人抑郁障碍发生风险,尤其是糖尿病、高脂血症、冠心病、短暂性脑缺血发作等疾病;积极参加伸展弹性运动,可能对于减少抑郁情绪的发生具有一定意义。Objective The purpose of this study is to investigate the interactive effects of chronic physical diseases and leisure activities on depression in the elderly.Methods Through a cross-sectional study design,3007 adults aged 60 and over were recruited for eligibility psychological status screening between June 20,2014 and August 20,2014 in communities of China.Geriatric Depression Inventory(GDI)was used to assess depressive symptoms.Leisure Activity Questionnaire was used to assess the participation of leisure activities.Logistic regression was used to analyze the relationship between chronic physical disease and leisure activity and depression,and the interaction between was also analyzed.Results In the community cross-sectional survey,the incidence of depression among the elderly in community was 35.78%(1076/3007).Logistic regression analysis showed that Diabetes(OR=1.42,95%CI:1.14-1.76),hyperlipidemia(OR=1.27,95%CI:1.09-1.56),coronary heart disease(OR=1.31,95%CI:1.04-1.63),and transient ischemic attack(OR=1.31,95%CI:1.04-1.63)were significantly associated with increased risk of geriatric depression(all P<0.05),while stretching and flexibility exercises(OR=0.79,95%CI:0.68-0.92)was associated with a decrease in the risk of depression(P<0.05).Diabetes and non-participation in stretching exercises had an interactive effect as a risk factor for depression[attributable proportion due to interaction(AP)=41.75%].Conclusions Depression is common in the elderly in the community.Chronic physical diseases may increase the risk of geriatric depression,especially diabetes,hyperlipidemia,coronary heart disease,and transient ischemic attack.Active participation in stretching exercises may be beneficial to reduce the occurrence of depression.

关 键 词：抑郁 老年人 交互分析 慢性躯体疾病 休闲活动 

分 类 号：R749[医药卫生—神经病学与精神病学]