1990—2021年中国老年抑郁症的疾病负担分析及预测  

Analysis and Prediction of Disease Burden of Depression in Old Age in China from 1990 to 2021

作　　者：包晓琳 魏洪娟 边鑫鑫 马秀梅 高音 张英艳[2] 刘微 马月仙[1] 张伟新[2] 杨雪雯 BAO Xiaolin;WEI Hongjuan;BIAN Xinxin;MA Xiumei;GAO Yin;ZHANG Yingyan;LIU Wei;MA Yuexian;ZHANG Weixin;YANG Xuewen(The Second Affiliated Hospital of Qiqihar Medical University,Qiqihar,Heilongjiang 161006,China;School of Nursing,Qiqihar Medical University,Qiqihar,Heilongjiang 161006,China;The Third Affiliated Hospital of Qiqihar Medical University,Qiqihar,Heilongjiang 161002,China)

机构地区：[1]齐齐哈尔医学院附属第二医院,黑龙江齐齐哈尔161006 [2]齐齐哈尔医学院护理学院,黑龙江齐齐哈尔161006 [3]齐齐哈尔医学院附属第三医院,黑龙江齐齐哈尔161002

出　　处：《协和医学杂志》2025年第2期361-369,共9页Medical Journal of Peking Union Medical College Hospital

基　　金：2020年度黑龙江省省属高等学校基本科研业务费项目(2020-KYYWF-0034)。

摘　　要：目的分析1990—2021年中国老年抑郁症的疾病负担变化趋势及危险因素,为中国老年抑郁症的防治和政策制定提供理论依据。方法从2021年全球疾病负担(Global Burden of Disease,GBD)数据库提取1990—2021年中国老年抑郁症发病人数、伤残调整生命年(disability adjusted life year,DALY)、发病率和DALY率等疾病负担数据,采用Joinpoint模型通过年度变化百分比(annual change percentage,APC)和平均年度变化百分比(average annual change percentage,AAPC)分析其变化趋势。通过自回归积分滑动平均模型预测未来5年老年抑郁症疾病负担。采用人群归因分值对1990年和2021年中国老年抑郁症的危险因素进行描述。结果1990—2021年,中国老年抑郁症的发病人数和发病率整体呈上升趋势,其中60~64岁年龄段发病率上升趋势最显著,≥95岁年龄段患病率上升趋势最显著,65~69岁年龄段DALY率上升趋势最显著。女性老年抑郁症的发病率、患病率和DALY率均高于男性。主要危险因素包括儿童期性虐待和亲密伴侣暴力,特别是在女性中,亲密伴侣暴力的影响显著。自回归积分滑动平均模型预测结果显示,未来5年内,中国老年抑郁症的发病率、患病率和DALY率将呈下降趋势,女性的下降幅度大于男性。结论1990—2021年中国老年抑郁症的发病率、患病率和DALY率整体呈上升趋势,女性高于男性,应重点关注老年女性人群,做到早期预防,进而降低老年抑郁症的疾病负担。Objective To analyze the trends in disease burden and risk factors of depression among the elderly population in China from 1990 to 2021,and to provide a theoretical basis for the prevention,treatment,and policy⁃making of geriatric depression in China.Methods Data on the disease burden of geriatric depres⁃sion in China from 1990 to 2021,including the number of incident cases,disability⁃adjusted life years(DALYs),incidence rate,and DALY rate,were extracted from the 2021 Global Burden of Disease(GBD)database.The Joinpoint regression model was used to analyze the trends by calculating the annual percentage change(APC)and average annual percentage change(AAPC).The autoregressive integrated moving average(ARIMA)model was employed to predict the disease burden of geriatric depression over the next five years.Population attributable fractions(PAFs)were used to describe the risk factors for geriatric depression in China in 1990 and 2021.Results From 1990 to 2021,the number of incident cases and the incidence rate of geri⁃atric depression in China showed an overall upward trend.The most significant increase in incidence was ob⁃served in the 60-64 age group,while the prevalence rate increased notably in the≥95 age group.The DALY rate showed the most pronounced upward trend in the 65-69 age group.The incidence,prevalence,and DALY rates of geriatric depression were higher in women than in men.Major risk factors included child⁃hood sexual abuse and intimate partner violence,with the impact of intimate partner violence being particularly significant among women.The ARIMA model predicted that the incidence,prevalence,and DALY rates of geriatric depression in China would decline over the next five years,with a greater decline observed in women than in men.Conclusions From 1990 to 2021,the incidence,prevalence,and DALY rates of geriatric de⁃pression in China showed an overall upward trend,with higher rates observed in women than in men.Greater attention should be paid to the elderly female population,with a focus

关 键 词：老年 抑郁症 疾病负担 预测 

分 类 号：R749[医药卫生—神经病学与精神病学] R181[医药卫生—临床医学]