基于健康社会决定因素的中国老年人抑郁相关因素识别研究  

The identification of depression-related factors among the elderly in China based on social determinants of health

作　　者：葛怀举 董士红 柳言 齐元涛 杜金 高杰 马桂峰[1,5] GE Huai-ju;DONG Shi-hong;LIU Yan;QI Yuan-tao;DU Jin;GAO Jie;MA Gui-feng(School of Public Health,Weifang Medical College,Weifang,Shandong 261053,China)

机构地区：[1]潍坊医学院公共卫生学院,山东潍坊261053 [2]山东省肿瘤医院 [3]山东省戴庄医院 [4]潍坊市市直机关医院 [5]潍坊医学院公共卫生危机管理研究所

出　　处：《现代预防医学》2023年第22期4147-4152,4163,共7页Modern Preventive Medicine

基　　金：国家自然科学基金面上项目(71673202);国家食品安全风险中心联合攻关计划项目(LH2022GG06)。

摘　　要：目的基于健康社会决定因素,探究我国老年人抑郁的相关因素,为我国老年人抑郁防治提供参考。方法选取2020年中国家庭追踪调查中≥60岁的老年人作为研究对象(n=6976),利用健康社会决定因素对变量进行筛选,最终纳入样本4361例。对变量进行单因素χ^(2)检验和多因素logistic回归模型分析,探究老年人抑郁的相关因素。结果我国≥60岁的老年人中抑郁症状检出率为29.40%。多因素logistic回归分析结果显示男性(OR=0.732,95%CI:0.620~0.864),有配偶(OR=0.681,95%CI:0.551~0.842),文化程度初中及以上(OR=0.749,95%CI:0.613~0.915),有读书习惯(OR=0.727,95%CI:0.556~0.950),自评健康一般(OR=0.463,95%CI:0.370~0.580)和良好(OR=0.462,95%CI:0.383~0.557)等与老年人抑郁呈负相关;有慢性病(OR=1.300,95%CI:1.101~1.535),在业(OR=1.261,95%CI:1.061~1.498),对生活满意度低(OR=5.349,95%CI:3.367~8.500)和一般(OR=2.357,95%CI:1.923~2.889),对未来的信心程度低(OR=1.601,95%CI:1.142~2.244)和一般(OR=1.566,95%CI:1.290~1.902),同子女关系一般(OR=1.735,95%CI:1.418~2.124)与老年人抑郁呈正相关,均有统计学意义(P<0.05)。结论我国老年人抑郁症状检出率较高,健康不平等问题依然突出,抑郁的相关因素是多方面、多层次的,应对老年人实施多维度、有针对性的综合干预,满足其心理健康服务需要,改善老年人群的心理健康状况。Objective To investigate the factors associated with depression among older adults in China based on social determinants of health,and to provide reference for the prevention and treatment of depression among older adults in China.Methods Older adults aged≥60 years from the 2020 China Household Tracking Survey were selected as the study population(n=6976),and the variables were screened using the social determinants of health,and the final sample of 4361 cases was included.The variables were analyzed by one-wayχ^(2)test and multi-factor logistic regression model to explore the factors associated with depression in older adults.Results The detection rate of depressive symptoms among elderly people aged≥60 years in China was 29.40%.The results of multi-factor logistic regression analysis showed that males(OR=0.732,95%CI:0.620-0.864),having a spouse(OR=0.681,95%CI:0.551-0.842),having a junior high school education or above(OR=0.749,95%CI:0.613-0.915),having reading habits(OR=0.727,95%CI:0.556-0.950),having average(OR=0.463,95%CI:0.370-0.580)and good(OR=0.462,95%CI:0.383-0.557)self-rated health were negatively associated with depression in older adults.Having chronic diseases(OR=1.300,95%CI:1.101-1.535),being employed(OR=1.261,95%CI:1.061-1.498),having low(OR=5.349,95%CI:3.367-8.500)and average(OR=2.357,95%CI:1.923-2.889)satisfaction with life,having low(OR=1.601,95%CI:1.142-2.244)and average(OR=1.566,95%CI:1.290-1.902)confidence in the future,having average relationship with children(OR=1.735,95%CI:1.418-2.124)were positively correlated with depression in the elderly,and all of them were statistically significant(P<0.05).Conclusion The detection rate of depressive symptoms among the elderly in China is high,and the problem of health inequality is still prominent.The factors associated with depression are multifaceted and multilevel,and multidimensional and targeted comprehensive interventions should be implemented for the elderly to meet their mental health service needs and improve the mental health status of

关 键 词：健康社会决定因素 老年人 抑郁症状 相关因素 

分 类 号：R749.4[医药卫生—神经病学与精神病学]