中国老年人抑郁症状的地区分布及与心脑血管疾病的关系

张紫薇; 花语蒙; 陈阳阳; 刘爱萍

doi:10.16462/j.cnki.zhjbkz.2023.02.012

中国老年人抑郁症状的地区分布及与心脑血管疾病的关系

doi: 10.16462/j.cnki.zhjbkz.2023.02.012

100191 北京，北京大学公共卫生学院社会医学与健康教育系

详细信息

通讯作者:
刘爱萍，E-mail: apingliu@bjmu.edu.cn

中图分类号: R749.92
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出版历程
- 收稿日期: 2022-03-29
- 修回日期: 2022-08-01
- 网络出版日期: 2023-02-20
- 刊出日期: 2023-02-10

Regional distribution of depression symptoms in Chinese elder and relationship with cardiovascular and cerebrovascular diseases

Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China

More Information

Corresponding author: LIU Ai-ping, E-mail: apingliu@bjmu.edu.cn

摘要

摘要: 目的探讨中国60岁及以上老年人抑郁症状的地区分布及与心脑血管疾病的关系。方法基于中国健康与养老追踪调查(China Health Retirement Longitudinal Study, CHARLS)2018年全国调查数据，以3 778名60岁及以上的老年人为研究对象，采用Spearman相关分析分析地区经济发展与老年抑郁症状及心脑血管疾病关联的城乡差异，logistic回归分析模型分析不同地区老年心脑血管疾病与抑郁症状的关系。结果中国老年人抑郁症状检出率为45.9%，人均生产总值(gross domestic product, GDP)与老年抑郁症状检出率呈负相关(r_s=-0.651, P < 0.001)，城市和农村人均GDP水平均与老年抑郁症状检出率呈负相关(r_s城市=-0.850, P < 0.05; r_s农村=-0.810, P < 0.05)，农村人均GDP水平与心脑血管疾病患病率呈负相关(r_s农村= -0.876, P < 0.05)。心脑血管疾病老年患者的抑郁症状检出率是未患心脑血管疾病老年人的1.876倍(OR=1.876, 95% CI: 1.561~2.255, P < 0.05)。结论地区经济发展水平低、患心脑血管疾病会造成老年心理健康的双重负担，因此发展地区经济对促进老年人群身心健康具有重要作用，同时应关注心脑血管疾病老年患者的心理健康。
- 抑郁症状 /
- 人均生产总值 /
- 心脏病 /
- 脑卒中
Abstract: Objective To explore the regional distribution of depressive symptoms and the relationship with cardiovascular and cerebrovascular diseases in the elderly over 60 years old in China. Methods Based on China Health Retirement Longitudinal Study (CHARLS) in 2018, 3 778 elderly people aged 60 and above were enrolled. The Spearman correlation was adopted to analyze the urban-rural differences between regional economic development and depressive symptoms and cardiovascular and cerebrovascular diseases among the elderly. The logistic regression analysis was used to analyze the relationship between cardiovascular and cerebrovascular diseases and depressive symptoms in the elderly in different regions. Results The prevalence of depressive symptoms in the elderly in China was 45.9%. The per capita GDP was negatively correlated with the prevalence of depression symptoms in the elderly (r_s=-0.651, P < 0.001). The per capita GDP level in urban and rural areas was negatively correlated with the prevalence of depression symptoms (r_{s city}=-0.850, P < 0.05; r_{s country}=-0.810, P < 0.05). The level of per capita GDP in rural areas was negatively correlated with the prevalence of cardiovascular and cerebrovascular diseases (r_{s country}=-0.876, P < 0.05). The risk of depression symptoms in patients with cardiovascular and cerebrovascular diseases was 1.876 times than that in the elderly without cardiovascular and cerebrovascular diseases (OR=1.876, 95% CI: 1.561-2.255, P < 0.05). Conclusions The low level of regional economic development and cardiovascular and cerebrovascular diseases pose a double burden on the mental health of the elderly. Therefore, developing regional economy plays an important role in promoting the physical and mental health of the elderly, and more attention should be paid to the mental health of the elderly patients with cardiovascular and cerebrovascular diseases.
- Depression symptoms /
- GDP /
- Cardiac disease /
- Apoplexy

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图 1 2018年中国28个省份人均GDP和60岁以上老年抑郁症状检出率Spearman相关分析

注：气泡大小为该省市60岁以上老年心脑血管疾病患病率相对大小。

Figure 1. Spearman correlation analysis of per capita GDP and prevalence of depression symptoms in the elderly over 60 in 28 provinces of China in 2018

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图 2 2018年中国地区人均GDP与老年抑郁症状及心脑血管疾病患病的城乡差异Spearman相关分析

注：气泡大小为该人均GDP范围省份的60岁以上老年人心脑血管疾病患病率相对大小。

Figure 2. Spearman correlation analysis of urban-rural differences between per capita GDP and senile depression symptoms and cardiovascular and cerebrovascular diseases in China in 2018

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表 1 2018年中国60岁以上老年人抑郁症状的分布特征[n(%)/(x±s)]

Table 1. Basic situation of depression in Chinese elderly over 60 years old in 2018 [n(%)/(x±s)]

特征	总人群 (N=3 778)	抑郁症状 (n=1 733)	t/χ²值	P值	特征	总人群 (N=3 778)	抑郁症状 (n=1 733)	t/χ²值	P值
年龄(岁)	67.90±6.11	67.85±6.08	0.431	0.066	吸烟			2.490	0.288
性别			60.570	< 0.001	否	3 485(92.2)	1 609(46.2)
男	885(23.4)	305(34.5)			戒烟	156(4.1)	70(44.9)
女	2 893(76.6)	1 428(49.4)			吸烟	137(3.6)	54(39.4)
省份人均GDP			52.240	< 0.001	饮酒频率			25.850	< 0.001
低	1 801(47.7)	935(51.9)			不饮酒	2 949(78.1)	1 411(47.8)
中	1 726(45.7)	706(40.9)			＜1次/月	249(6.6)	111(44.6)
高	251(6.6)	92(36.7)			＞1次/月	580(15.4)	211(36.4)
城乡			43.600	< 0.001	中风			23.660	< 0.001
城市	1 580(41.8)	625(39.6)			否	3 567(94.4)	1 602(44.9)
农村	2 198(58.2)	1 108(50.4)			是	211(5.6)	131(62.1)
受教育水平			60.870	< 0.001	心脏病			29.900	< 0.001
文盲	2 169(57.4)	1 097(50.6)			否	3 359(88.9)	1 490(44.4)
小学	743(19.7)	316(42.5)			是	419(11.1)	243(58.0)
初中	519(13.7)	215(41.4)			心脑血管疾病			43.630	< 0.001
高中及以上	347(9.2)	105(30.3)			否	3 196(84.6)	1 393(43.6)
体力活动			18.860	< 0.001	是	582(15.4)	340(58.4)
低体力	746(19.7)	368(49.3)
中体力	2 610(69.1)	1 139(43.6)
高体力	422(11.2)	226(53.6)

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表 2 2018年中国28个省份地区经济发展与老年人群抑郁症状检出率及心脑血管疾病患病率[n(%)]

Table 2. Economic development and prevalence of depression symptoms and cardiovascular and cerebrovascular diseases among the elderly in 28 provinces and regions of China in 2018 [n(%)]

省/自治区/直辖市	总人口(人)	心脑血管疾病	抑郁症状	人均GDP (元)	省/自治区/直辖市	总人口(人)	心脑血管疾病	抑郁症状	人均GDP (元)
北京	22	4(18.18)	4(18.18)	140 211	湖南	172	25(14.53)	79(45.93)	52 949
上海	13	1(7.69)	5(38.46)	134 982	河南	300	67(22.33)	127(42.33)	50 152
天津	22	3(13.64)	4(18.18)	120 711	新疆	16	7(43.75)	11(68.75)	49 475
江苏	194	22(11.34)	79(40.72)	115 168	四川	375	43(11.47)	215(57.33)	48 883
浙江	211	12(5.69)	63(29.86)	98 643	江西	225	31(13.78)	113(50.22)	48 434
福建	101	9(8.91)	32(31.68)	91 197	河北	160	37(23.13)	89(55.63)	47 772
广东	177	14(7.91)	76(42.94)	86 412	安徽	186	44(23.66)	96(51.61)	47 712
山东	306	45(14.71)	119(38.89)	76 267	青海	27	4(14.81)	21(77.78)	47 689
内蒙古	113	34(30.09)	41(36.28)	68 302	山西	125	24(19.20)	42(33.60)	45 328
湖北	122	15(12.30)	67(54.92)	66 616	黑龙江	59	20(33.90)	23(38.98)	43 274
重庆	69	4(5.80)	39(56.52)	65 933	广西	172	15(8.72)	84(48.84)	41 489
陕西	93	14(15.05)	52(55.91)	63 477	贵州	54	6(11.11)	26(48.15)	41 244
辽宁	107	26(24.30)	43(40.19)	58 008	云南	224	23(10.27)	111(49.55)	37 136
吉林	48	11(22.92)	20(41.67)	55 611	甘肃	85	22(25.88)	52(61.18)	31 336

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表 3 2018年中国老年人群不同地区心脑血管疾病与抑郁症状关系的logistic回归分析模型分析

Table 3. logistic regression analysis of the relationship between cardiovascular and cerebrovascular diseases and depression symptoms in different regions of Chinese elderly population in 2018

变量	总例数(N)	抑郁症状[n(%)]	模型一^a OR (95% CI)值	P值	模型二^b OR (95% CI)值	P值
总体
心脑血管疾病
否	3 196	1 393(43.6)	1.000		1.000
是	582	340(58.4)	1.895(1.578~2.276)	< 0.001	1.876(1.561~2.255)	< 0.001
城市
心脑血管疾病
否	1 301	481(37.0)	1.000		1.000
是	279	144(51.6)	1.875(1.437~2.446)	< 0.001	1.871(1.433~2.442)	< 0.001
农村
心脑血管疾病
否	1 895	912(48.1)	1.000		1.000
是	303	196(64.7)	1.976(1.531~2.551)	< 0.001	1.926(1.488~2.492)	< 0.001

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