社区环境支持对中老年人抑郁状况影响的队列研究  

Effects of social environment on the depression of middle-aged and elderly Chinese:a cohort study

作　　者：殷蕾 魏洪娟 马秀梅 刘俊敏 袁雪[1] 韩树国 崔立然[4] YIN Lei;WEI Hongjuan;MA Xiumei;LIU Junmin;YUAN Xue;HAN Shuguo;CUI Liran(Department of Neurology Ⅳ,The Second Affiliated Hospital of Qiqihar Medical University,Qiqihar,Heilongjiang 161006,China;不详)

机构地区：[1]齐齐哈尔医学院附属第二医院神经内四科,黑龙江齐齐哈尔161006 [2]齐齐哈尔医学院护理学院 [3]齐齐哈尔市卫生健康综合监督执法局 [4]齐齐哈尔医学院附属第一医院

出　　处：《中国预防医学杂志》2024年第7期905-911,共7页Chinese Preventive Medicine

基　　金：齐齐哈尔市科技计划联合引导项目(LHYD-2021028)。

摘　　要：目的基于中国健康与养老追踪(China Health and Retirement Longitudinal Study,CHARLS)数据库,分析社区环境支持因素对中国中老年人抑郁发生风险的影响,为中老年人精神健康制定针对性的措施提供参考。方法本研究利用CHARLS2011—2018年数据,纳入≥45岁社区居民。利用聚类分析方法将社区环境因素进行分类,利用多因素Cox回归模型计算社区支持因素对中老年抑郁发生风险的相对危险度(hazard ratios,HR)和95%置信区间(confidence interval,CI)。结果本研究共随访6765人(25599人年),失访563人(3253人年),失访率12.70%,发生抑郁2719例。文化水平偏低、女性、从不吸烟、从不饮酒、年龄越小、身体功能完好、从事农业工作、家庭收入水平较低、午睡或者夜间睡眠时长较短、居住在南方和农村的中老年人更易发生抑郁,差异有统计学意义(P<0.05)。社区环境因素对中老年抑郁发生影响差异无统计学意义(P>0.05)。在低收入人群中,基本设施的配备可以显著降低中老年人抑郁发生风险(HR=0.80,95%CI:0.99~0.98,P=0.031)。按城市和农村亚组分析,文化娱乐社区支持和基本生活设施对降低中老年人抑郁发生风险无影响(P>0.05)。结论对于低收入人群,基本生活设施的社区支持对降低中老年人抑郁发生风险有积极作用,基本生活设施的配备更应向低收入人群倾斜。Objective Based on the China Health and Retirement Longitudinal Study(CHARLS)database,this study analyzed the impact of community environmental support factors on the risk of depression among middleaged and elderly adults in China to provide a reference for developing targeted measures for their mental health.Methods This study used the CHARLS data from 2011 to 2018 and included community-dwelling residents aged≥45 years.Cluster analysis was used to classify community environmental factors,and a multivariate COX regression model was used to calculate the hazard ratios(HRs)and 95%confidence intervals(CIs)of community support factors on the risk of late-life depression.Results A total of 6765 participants(25599person-years)were followed up,with 563(3253 person-years)lost to follow-up at a rate of 12.70%.2719participants developed depression.Lower education level,female gender,non-smoking,non-drinking,younger age,better physical function,agricultural occupation,lower household income,shorter daytime napping or nighttime sleep duration,and living in the south or rural areas were risk factors for late-life depression(P<0.05).Community environmental factors had no statistically significant impact on the occurrence of late-life depression(P>0.05).In the low-income population,the availability of basic facilities significantly reduced the incidence of depression among middle-aged and older adults(HR=0.80,95%CI:0.99-0.98,P=0.031).In subgroup analysis by urban and rural areas,the presence of relatively complete cultural and basic living facilities did not significantly reduce the risk of late-life depression(P>0.05).Conclusions For low-income populations,community support of basic living facilities has a positive effect on reducing the risk of depression in middle-aged and elderly people.The construction of basic living facilities should be tilted towards low-income groups.Further large-scale quantitative research is needed on the relationship between cultural and entertainment social support and depression risk in middle

关 键 词：抑郁 社区支持 中老年人 队列研究 

分 类 号：R126[医药卫生—环境卫生学]