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不同类型日常生活活动能力与老年人抑郁的关联

崔珑严,  丁玎,  王明慧,  赫繁荣,  马菁遥,  陈俊峰

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文章导航 > 中华疾病控制杂志  > 2023 >  27(6): 717-721
崔珑严, 丁玎, 王明慧, 赫繁荣, 马菁遥, 陈俊峰. 不同类型日常生活活动能力与老年人抑郁的关联[J]. 中华疾病控制杂志, 2023, 27(6): 717-721. doi: 10.16462/j.cnki.zhjbkz.2023.06.017
引用本文: 崔珑严, 丁玎, 王明慧, 赫繁荣, 马菁遥, 陈俊峰. 不同类型日常生活活动能力与老年人抑郁的关联[J]. 中华疾病控制杂志, 2023, 27(6): 717-721. doi: 10.16462/j.cnki.zhjbkz.2023.06.017
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CUI Longyan, DING Ding, WANG Minghui, HE Fanrong, Ma Jingyao, CHEN Junfeng. The relationship between different types of daily living abilities and depression among older adults[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2023, 27(6): 717-721. doi: 10.16462/j.cnki.zhjbkz.2023.06.017
Citation: CUI Longyan, DING Ding, WANG Minghui, HE Fanrong, Ma Jingyao, CHEN Junfeng. The relationship between different types of daily living abilities and depression among older adults[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2023, 27(6): 717-721. doi: 10.16462/j.cnki.zhjbkz.2023.06.017
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不同类型日常生活活动能力与老年人抑郁的关联

doi: 10.16462/j.cnki.zhjbkz.2023.06.017
  • 1.

    大连医科大学公共卫生学院社会医学教研室，大连 116044

  • 2.

    大连医科大学人文与社会科学学院心理学系，大连 116044

基金项目: 

2021年辽宁省社科规划基金项目 L21CRK001

大连市卫生健康事业发展十四五规划采购项目 HFZ201102

详细信息
    通讯作者:

    陈俊峰，E-mail: john5151@vip.163.com

  • 中图分类号: R181.3

The relationship between different types of daily living abilities and depression among older adults

  • 1.

    Faculty of Social Medicine, School of Public Health, Dalian Medical University, Dalian 116044, China

  • 2.

    Faculty of Psychology, School of Humanities and Social Sciences, Dalian Medical University, Dalian 116044, China

Funds: 

2021 Liaoning Provincial Social Science Pianning Fund Project L21CRK001

The 14th Five-Year Plan Procurement Project of Dalian Health Care Development HFZ201102

More Information

    摘要
  • 摘要:   目的  了解中国老年人抑郁及日常生活能力现状，并分析两者的联系。  方法  选取2018年7月10日—9月13日中国健康与养老追踪调查中60岁及以上老年人，运用χ2检验和logistic回归分析模型探索日常生活能力对老年人抑郁的影响。  结果  中国老年人抑郁检出率为43.82%；基本日常生活自理能力(basic activity of daily living, BADL)受损率为8.78%；工具性日常生活自理能力(instrumental activity of daily living, IADL)受损率为25.82%。BADL(OR=1.621, 95% CI: 1.304~2.016, P < 0.001)、IADL(OR=1.520, 95% CI: 1.321~1.748, P < 0.001)受损老年人抑郁可能性较高。IADL受损对不同地域老年人抑郁皆有影响，而BADL受损对中部地域老年人抑郁作用不明显。  结论  日常生活能力受损老年人抑郁的可能性较高。建议将心理健康服务融入失能老年人的照护体系，配置相应的养老资源时注重地域差异。
    Abstract:   Objective  This study seeks to understand the current situation of depression and the level of daily living abilities in China′s elderly population, and to analyze their interconnection.  Methods  We selected individuals aged 60 years and above from China Health and Retirement Longitudinal Study between 10th July to 13th September in 2018. Chi-square test and logistic regression models were used to explore the effect of daily living ability on depression among the elderly.  Results  Our study revealed that 43.82% of Chinese elders experienced symptoms of depression. Furthermore, the rates of impaired basic activities of daily living (BADL) and impaired instrumental activities of daily living (IADL) were 8.78% and 25.82%, respectively. Elderly individuals with impaired BADL (OR=1.621, 95% CI: 1.304-2.016, P < 0.001) and IADL (OR=1.520, 95% CI: 1.321-1.748, P < 0.001) demonstrated a higher propensity towards depression. Notably, IADL impairment influenced depression rates among the elderly across various regions, whereas BADL impairment showed no discernible effect on depression rates in middle-aged seniors.  Conclusions  Declining daily living abilities increase the likelihood of depression among the elderly. Accordingly, attention should be paid to the mental health status of elderly groups with disabilities, and regional disparities should be considered when allocating resources for senior care.
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  • 表  1  不同特征老年人抑郁检出率比较

    Table  1.   Comparison of the detection rate of depression in the elderly with different characteristics

    变量 总体①(n=5 894) 抑郁人数①(n=2 583) χ2值 P值 变量 总体①(n=5 894) 抑郁人数①(n=2 583) χ2值 P值
    地区 94.901 < 0.001 慢性病 60.590 < 0.001
      东部 1 973(33.47) 703(27.22)   有 3 039(51.56) 1 103(42.70)
      中部 1 988(33.73) 895(34.65)   无 2 855(48.44) 1 480(57.30)
      西部 1 933(32.80) 985(38.13) 自评健康 525.959 < 0.001
    性别 82.329 < 0.001   好 935(15.86) 224(8.67)
      男 2 746(46.58) 1 031(39.91)   一般 2 877(48.81) 1 047(40.53)
      女 3 148(53.42) 1 552(60.09)   差 2 082(35.33) 1 312(50.80)
    年龄/岁 6.771 0.035 BADL状况 127.941 < 0.001
      60~＜70 3 745(63.54) 1 664(64.42)   受损 518(8.78) 349(13.51)
      70~＜80 1 763(29.91) 774(29.97)   完好 5 376(91.22) 2 234(86.49)
      ≥80 386(6.55) 145(5.61) IADL状况 241.343 < 0.001
    教育程度 113.013 < 0.001   受损 1 522(25.82) 926(35.85)
      小学及以下 4 376(74.25) 2 092(80.99)   完好 4 372(74.18) 1 657(64.15)
      初中 1 106(18.76) 374(14.48) 社交活动 22.668 < 0.001
      高中及以上 412(6.99) 117(4.53)   有 2 936(49.81) 1 196(46.30)
    婚姻状况 25.322 < 0.001   无 2 958(50.19) 1 387(53.70)
      在婚 4 787(81.22) 2 023(78.32) 夜间睡眠/h 151.165 < 0.001
      非在婚 1 107(18.78) 560(21.68)   < 7 3 619(61.40) 1 814(70.23)
    居住地 98.336 < 0.001   ≥7 2 275(38.60) 769(29.77)
      农村 4 201(71.28) 2 012(77.89) 与子女居住 3.334 0.068
      城镇 1 693(28.72) 571(22.11)   有 1 301(22.07) 599(23.19)
    个人年收入/元 158.095 < 0.001   无 4 593(77.93) 1 984(76.81)
    < 10 000 3 482(59.08) 1 707(66.09)
    10 000~ < 20 000 1 154(19.58) 517(20.01)
    ≥20 000 1 258(21.34) 359(13.90)
    注：1. BADL：基本日常生活自理能力。2. IADL：工具性日常生活自理能力。
    ①使用[人数(占比/%)]表示。
    下载: 导出CSV

    表  2  不同地域不同类型ADL状况老年人抑郁检出率比较

    Table  2.   Comparison of the detection rate of depression in the elderly with different types of ADL in different regions

    变量 例数 BADL χ2值 P值 IADL χ2值 P值
    完好者抑郁 受损者抑郁 完好者抑郁 受损者抑郁
    地区
    东部 1 973 33.53(614/1 831) 62.68(89/142) 48.797 < 0.001 30.76(479/1 557) 53.85(224/416) 76.259 < 0.001
    中部 1 988 42.87(767/1 789) 64.32(128/199) 33.284 < 0.001 38.55(552/1 432) 61.69(343/556) 86.664 < 0.001
    西部 1 933 48.57(853/1 756) 74.58(132/177) 43.494 < 0.001 45.26(626/1 383) 65.27(359/550) 63.040 < 0.001
    合计 5 894 41.56(2 234/5 376) 67.37(349/518) 127.941 < 0.001 37.90(1 657/4 372) 60.84(926/1 522) 241.343 < 0.001
    注：1. ADL：日常生活能力。2. BADL：基本日常生活自理能力。3. IADL：工具性日常生活自理能力。
    下载: 导出CSV

    表  3  不同ADL受损状况对老年人抑郁影响的回归分析

    Table  3.   Regression analysis of the influence of different ADL impairment statuses on the depression among the elderly

    变量 值 sx Wald值 OR值(95% CI) P值 变量 β值 sx Wald值 OR值(95% CI) P值
    模型1 ① 模型4 ④
      BADL受损 0.660 0.104 40.259 1.935(1.578~2.373) < 0.001   东部
      IADL受损 0.797 0.065 152.636 2.220(1.956~2.519) < 0.001     BADL受损 0.645 0.208 9.639 1.906(1.269~2.865) 0.002
    模型2 ②     IADL受损 0.502 0.131 14.558 1.652(1.276~2.137) < 0.001
      BADL受损 0.483 0.111 18.877 1.621(1.304~2.016) < 0.001   中部
      IADL受损 0.418 0.071 34.247 1.520(1.321~1.748) < 0.001     BADL受损 0.308 0.177 3.040 1.361(0.963~1.923) 0.081
    模型3 ③     IADL受损 0.403 0.121 11.053 1.496(1.180~1.896) 0.001
      BADL地域 -0.033 0.125 0.069 0.968(0757~1.237) 0.793   西部
      IADL地域 -0.075 0.077 0.946 0.928(0.798~1.079) 0.331     BADL受损 0.582 0.199 8.523 1.788(1.207~2.649) 0.004
        IADL受损 0.356 0.119 8.935 1.422(1.122~1.803) 0.003
    注：1. ADL：日常生活能力。2. BADL：基本日常生活自理能力。3. IADL：工具性日常生活自理能力。
    ①仅含BADL、IADL变量。②调整人口学特征、健康状况及健康行为。③表示地区与BADL和IADL的交互作用。④地区分层+模型2的结果。
    下载: 导出CSV
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