不同共病程度社区老年患者生活质量与焦虑和抑郁情绪的相关性  

Correlation between quality of life and anxiety/depression in elderly community patients with different levels of comorbidity

作　　者：崔紫阳 齐颖[1] 富晶[1] 宋丹萍[1] 张京慧[1] 孙达[1] Cui Ziyang;Qi Ying;Fu Jing;Song Danping;Zhang Jinghui;Sun Da(Department of Geriatrics,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院老年医学科,北京100038

出　　处：《中华老年多器官疾病杂志》2025年第2期135-139,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：北京市保健科研(调研)课题(京13-14)。

摘　　要：目的探讨不同共病程度的老年患者生活质量与焦虑和抑郁情绪的关系。方法对2017年5月至2018年5月首都医科大学附属北京世纪坛医院老年医学科开展的社区老年多重用药管理调查数据进行二次分析,最终纳入患者917例。根据Charlson共病指数(CCI)将患者分为CCI评分≤3分组(n=363)、CCI评分4~6分组(n=400)及CCI评分≥7分组(n=154)。收集患者人口学特征、慢性疾病情况、健康调查简表-36(SF-36)及医院焦虑抑郁量表(HADS)等资料。采用Pearson相关法分析CCI和SF-36评分与焦虑和抑郁的关系。采用多重线性回归分析老年共病患者焦虑和抑郁的影响因素。结果CCI评分≥7分组及CCI评分4~6分组老年共病患者平均年龄均显著高于CCI评分≤3分组(P<0.05)。CCI评分4~6分组和CCI评分≥7分组老年共病患者SF-36量表各维度评分均显著低于CCI评分≤3分组,差异均有统计学意义(均P<0.05)。CCI评分4~6分组和CCI评分≥7分组老年共病患者医院焦虑量表(HAS)和医院抑郁量表(HDS)评分均显著高于CCI评分≤3分组,且CCI评分≥7分组HAS和HDS评分均显著高于CCI评分4~6分组,差异均有统计学意义(均P<0.05)。Pearson相关性分析显示,CCI、HAS及HDS与SF-36各维度评分均呈负相关;CCI与HAS及HDS评分,HAS与HDS评分均呈正相关(均P<0.05)。多重线性回归分析结果显示,男性(β=-0.301,-0.233)、SF-36中躯体疼痛(β=-0.026,-0.018)、一般健康状况(β=-0.015,-0.009)、社会功能(β=-0.026,-0.008)、情感职能(β=-0.007,-0.002)、精神健康(β=-0.021,-0.020)维度是HAS和HDS的保护因素(P<0.05),年龄(β=0.022,0.016)、月收入(β=0.353,0.236)、CCI评分(β=0.145,0.152)以及SF-36中生理功能维度(β=0.015,0.008)是HAS和HDS的危险因素(P<0.05)。结论老年共病患者的共病程度和生活质量与焦虑和抑郁之间存在明显相关性。Objective To explore the relationship between quality of life and anxiety as well as depression in elderly patients with different comorbidity levels.Methods A secondary analysis was performed on the obtained survey data from a community-based elderly polypharmacy management study(including 917 patients finally)conducted at our department between May 2017 and May 2018.According to the Charlson comorbidity index(CCI)scores,the subjects were divided into CCI score≤3 group(n=363),CCI score 4-6 group(n=400),and CCI score≥7 group(n=154).Data collection encompassed demographic characteristics,chronic disease profiles,and results of 36-item short form health survey(SF-36)and hospital anxiety and depression scale(HADS).Pearson correlation analysis was employed to investigate the relationship of CCI and SF-36 scores with anxiety and depression.Furthermore,multiple linear regression analysis was utilized to identify factors influencing anxiety and depression in the elderly patients.Results The patients from the CCI score 4-6 and≥7 groups had significantly older average age and lower scores in all dimensions of the SF-36 scale than those from the CCI score≤3 group(all P<0.05).The hospital anxiety scale(HAS)and hospital depression scale(HDS)scores were obviously higher in the CCI score 4-6 and≥7 groups than the CCI score≤3 group,and in the CCI score≥7 group than the CCI score 4-6 group(all P<0.05).Pearson correlation analysis showed a negative correlation of CCI,HAS and HDS scores with the score in each dimension of the SF-36 scale.CCI score was positively correlated with HAS and HDS scores,and HAS score was positively with HDS score(all P<0.05).Multiple linear regression analysis indicated that male(β=-0.301,-0.233),the scores of bodily pain(β=-0.026,-0.018),general health(β=-0.015,-0.009),social functioning(β=-0.026,-0.008),role emotional(β=-0.007,-0.002),and mental health(β=-0.021,-0.020)dimensions in the SF-36 scale were protective factors for HAS and HDS scores(P<0.05);age(β=0.022,0.016),monthly inc

关 键 词：老年人 Charlson共病指数 焦虑 抑郁 健康调查简表-36 

分 类 号：R592[医药卫生—老年医学]