空气污染与中国中老年人群抑郁症状关联研究  

Association between air pollution and depressive symptoms in middleaged and elderly adults in China

作　　者：姚寒砺 栾荣生[1] YAO Han-li;LUAN Rong-sheng(Department of Epidemiology and Health Statistics,West China School of Public Health/West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西公共卫生学院/四川大学华西第四医院流行病与卫生统计学系,四川成都610041

出　　处：《现代预防医学》2023年第5期826-831,共6页Modern Preventive Medicine

摘　　要：目的 研究室内固体燃料使用和室外空气污染与中老年人群抑郁症状的关联。方法 使用2015和2018年中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS)数据,利用组基轨迹模型识别2015—2018年空气质量指数(air quality index, AQI)发展轨迹,运用二分类logistic回归分析室内固体燃料使用、室外AQI发展轨迹与中老年人群抑郁症状的关联。结果 以清洁-清洁燃料组为参照,持续使用固体燃料与中老年抑郁症状相关(OR=1.405,95%CI:1.211~1.630);而燃料类型变化组与中老年抑郁症状无关(OR=1.282,95%CI:0.983~1.672;OR=1.103,95%CI:0.913~1.333)。识别出“陡降”、“升-降”、“缓降”3种室外AQI发展轨迹,以AQI陡降组为参照,AQI升-降组(OR=1.347,95%CI:1.152~1.573)、缓降组(OR=1.423,95%CI:1.235~1.639)与中老年抑郁症状相关。室内外空气污染各亚组间存在相乘交互作用,可能会增加抑郁症状发生风险。结论 空气污染短期暴露可能会增加中老年人群抑郁症状发生风险,控制室内外空气污染有利于维护中老年人群心理健康水平。Objective To investigate the association of indoor solid fuel use and outdoor air pollution with depressive symptoms in middle-aged and elderly adults.Methods The data of China Health and Retirement Longitudinal Study(CHARLS)in 2015 and 2018 were collected.The group-based trajectory model was used to identify the development trajectory of air quality index(AQI)from 2015 to 2018,and binary logistic regression was used to evaluate the associations between indoor solid fuel use,outdoor AQI development trajectory,and depressive symptoms in the middle-aged and elderly.Results Compared with the clean-clean fuel group,continuous use of solid fuel was associated with depressive symptoms in the middle-aged and elderly(OR=1.405,95%CI:1.211-1.630).However,in the fuel type change group,no association was found in the middle-aged and elderly(OR=1.282,95%CI:0.983-1.672;OR=1.103,95%CI:0.913-1.333).Three kinds of outdoor AQI development trajectories,namely“steep drop”,“rise-drop”,and“slow drop”were identified.With the AQI steep drop group as reference,the AQI rise-drop group(OR=1.347,95%CI:1.152-1.573)and the AQI slow drop group(OR=1.423,95%CI:1.235-1.639)were associated with depressive symptoms in the middle-aged and elderly.There was multiplicative interaction between the subgroups of indoor and outdoor air pollution,which may increase the risk of depressive symptoms.Conclusion Short-term exposure to air pollution may increase the risk of depressive symptoms in middle-aged and elderly people.Mitigating indoor and outdoor air pollution is beneficial for maintaining the mental health of middle-aged and elderly.

关 键 词：抑郁症状 室内固体燃料使用 空气质量指数 组基轨迹模型 中老年人群 

分 类 号：R749.4[医药卫生—神经病学与精神病学] X51[医药卫生—临床医学]