中国50岁及以上人群社会参与度和抑郁的关联研究

李甘; 郭雁飞; 黄哲宙; 阮晔; 孙双圆; 施燕; 吴凡

doi:10.16462/j.cnki.zhjbkz.2020.04.006

中国50岁及以上人群社会参与度和抑郁的关联研究

doi: 10.16462/j.cnki.zhjbkz.2020.04.006

李甘¹,
郭雁飞²,
黄哲宙²,
阮晔²,
孙双圆²,
施燕²,
吴凡^1, ,

1.
200025 上海交通大学医学院公共卫生学院
2.
200366 上海市疾病预防控制中心慢性非传染疾病与伤害防治所

基金项目: 美国国立老化研究所资助项目(R01-AG034479);上海市卫生健康委员会科研项目面上课题(201640148)

详细信息

通讯作者:
吴凡, E-mail:wufan@shmu.edu.cn

中图分类号: R844.4;R749.1+6
计量
- 文章访问数: 887
- HTML全文浏览量: 284
- PDF下载量: 72
- 被引次数: 0
出版历程
- 收稿日期: 2019-11-21
- 修回日期: 2020-02-13
- 刊出日期: 2020-04-10

Social engagement and depression among Chinese aged 50 years and older

1.
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
2.
Division of Non-communicable Disease and Injury Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China

Funds: The US National Institute on Aging(R01-AG034479); Shanghai Municipal Health Commission(201640148)

More Information

Corresponding author: WU Fan, E-mail:wufan@shmu.edu.cn

摘要

摘要: 目的探究我国50岁及以上人群社会参与度与抑郁发生的关系。方法利用世界卫生组织(world health organization, WHO)“全球老龄化与成人健康研究(study on global ageing and adult health, SAGE)”中国项目第一轮横断面数据, 采用《疾病和有关健康问题的国际统计分类第十版》(international Classification of diseases, ICD-10)中的抑郁量表评价调查对象抑郁状况, 社会参与度得分来自于研究对象参加社会活动的频率。采用Logistic回归分析模型分析社会参与度和抑郁的关系, 按照年龄组、性别和地区进行分层分析。结果本研究一共纳入12 196名调查对象, 抑郁检出率为1.72%(95% CI:1.54%~2.00%)。调整年龄、性别、地区、文化程度、家庭收入、婚姻状况、体力活动和吸烟饮酒等因素后, 多元分析结果显示社会参与度和抑郁发生相关(OR=0.94, 95% CI:0.90~0.98, P=0.006)。在分层分析中, 该关联只在城市、女性和50~60岁年龄组有统计学意义(均有P < 0.05)。结论本研究发现社会参与度和抑郁的发生相关, 提示通过采取针对性措施提高社会参与度有助于预防老年人抑郁。
- 社会参与度 /
- 抑郁 /
- 老年人
Abstract: Objective To investigate the association between social engagement and depression among Chinese aged 50 and over. Methods Cross-sectional data was collected from the World Health Organization(WHO) study on global ageing and adult health(SAGE) wave 1 in China. The International Classification of Diseases 10 th revision depression scale(ICD-10) was used to evaluate the depression status of the respondents and the score of social engagement originating the frequency of social activities of the research population. All models were stratified by age groups, gender and residence. The Logistic regression analyses model were performed to identify the association between social engagement and depression. Results A total of 12 196 participants were included. The detection rate of depression was 1.72%(95% CI:1.54%-2.00%).The negative association between social engagement and depression was obtained in the multiple regression(OR=0.94, 95% CI: 0.90-0.98, P=0.006) after adjusting the factors of age, sex, residence, education level, household income, marital status, physical activity level, smoking and drinking status. In stratified analysis, the association was only statistically significant in urban, female, and 50-60 age groups(all P < 0.05). Conclusion This study found significant association between social engagement and depression, indicating that pertinence measures may help prevent depression in elderly population by enhancing social engagement.
- Social engagement /
- Depression /
- Elderly

HTML全文

表 1 50岁及以上人群抑郁分布表[n(%)]

Table 1. The distribution of depression for people aged 50 years and older[n(%)]

变量	n(%)	抑郁		χ²值	P值
变量	n(%)	无	有	χ²值	P值
年龄(岁)				2.923	0.404
50~	5 652(43.73)	5 559(98.35)	93(1.65)
60~	3 879(30.91)	3 803(98.04)	76(1.96)
70~	2 702(20.90)	2 652(98.15)	50(1.85)
≥80	693(5.36)	685(98.85)	8(1.15)
性别				17.682	< 0.001
男	6 055(46.84)	5 980(98.76)	75(1.24)
女	6 871(53.16)	6 719(97.79)	152(2.21)
地区				2.868	0.090
城市	6 341(49.06)	6 217(98.04)	124(1.96)
农村	6 585(50.94)	6 482(98.44)	103(1.56)
文化程度				9.086	0.106
未受过正规教育	3 133(24.24)	3 064(97.80)	69(2.20)
小学未毕业	2 341(18.11)	2 304(98.42)	37(1.58)
小学毕业	2 584(19.99)	2 545(98.49)	39(1.51)
初中毕业	2 600(20.11)	2 552(98.15)	48(1.85)
高中毕业	1 676(12.97)	1 646(98.21)	30(1.79)
大学及以上	592(4.58)	588(99.32)	4(0.68)
财富五分位数				51.080	< 0.001
第一分位(最低)	2 553(19.84)	2 476(96.98)	77(3.02)
第二分位	2 547(19.80)	2 486(97.61)	61(2.39)
第三分位	2 585(20.09)	2 545(98.45)	40(1.55)
第四分位	2 648(20.58)	2 621(98.98)	27(1.02)
第五分位(最高)	2 532(19.68)	2 511(99.17)	21(0.83)
婚姻状况				6.607	0.010
未婚/分居/离婚/丧偶	2 146(16.61)	2 094(97.58)	52(2.42)
已婚/同居	10 916(83.39)	10 596(98.38)	175(1.62)
体力活动				5.880	0.053
低水平体力活动	4 158(32.17)	4 081(98.15)	77(1.85)
中水平体力活动	3 640(28.16)	3 592(98.68)	48(1.32)
高水平体力活动	5 126(39.66)	5 024(98.01)	102(1.99)
吸烟				5.051	0.080
目前吸烟	3 460(26.89)	3 414(98.67)	46(1.33)
目前不吸烟	794(6.17)	778(97.98)	16(2.02)
从未吸烟	8 613(66.94)	8 449(98.06)	164(1.94)
饮酒				6.854	0.032
从不饮酒	8 928(77.31)	8 758(98.10)	170(1.90)
非重度饮酒	1 930(16.71)	1 903(98.60)	27(1.40)
重度饮酒	691(5.98)	686(99.29)	5(0.72)

下载: 导出CSV

表 2 50岁及以上人群社会参与度得分分布表(x±s)

Table 2. The distribution of social engagement score for people aged 50 years and older (x±s)

因素	城市(n=6 315)	农村(n=6 550)	合计(n=12 865)
年龄组(岁)
50~	14.77±3.42	15.84±3.49	15.36±3.50
60~	14.72±3.51	15.25±3.56	15.00±3.54
70~	14.18±3.61	14.58±3.55	14.35±3.59
≥80	12.89±3.25	13.38±3.52	13.11±3.38
F值	38.92	70.33	114.39
P值	< 0.001	< 0.001	< 0.001
趋势检验
F值	110.85	157.60	290.12
P值	< 0.001	0.001	< 0.001
性别
男	14.47±3.45	15.50±3.65	15.02±3.60
女	14.51±3.57	15.16±3.50	14.83±3.55
F值	0.20	14.50	9.68
P值	0.653	< 0.001	0.002
文化程度
未受过正规教育	13.38±3.40	14.74±3.49	14.38±3.52
小学未毕业	14.08±3.64	15.28±3.43	14.97±3.52
小学毕业	14.27±3.44	15.57±3.59	15.01±3.58
初中毕业	14.65±3.40	16.12±3.64	15.12±3.55
高中毕业	15.00±3.60	16.90±3.92	15.29±3.72
大学及以上	15.21±3.36	20.80±1.92	15.26±3.39
F值	31.48	35.02	21.41
P值	< 0.001	< 0.001	< 0.001
趋势检验
F值	130.96	20.22	39.27
P值	< 0.001	< 0.001	< 0.001
财富五分位数
第一分位(最低)	13.44±3.78	14.56±3.36	14.21±3.53
第二分位	14.11±3.56	15.15±3.42	14.80±3.50
第三分位	14.21±3.45	15.73±3.44	14.96±3.53
第四分位	14.54±3.35	16.04±3.61	15.20±3.54
第五分位(最高)	15.29±3.37	15.62±4.15	15.38±3.59
F值	47.71	38.97	40.95
P值	< 0.001	< 0.001	< 0.001
趋势检验
F值	157.29	74.49	159.97
P值	< 0.001	< 0.001	< 0.001
婚姻状况
未婚/分居/离婚/丧偶	14.06±3.64	14.69±3.57	14.37±3.62
已婚/同居	14.58±3.48	15.45±3.57	15.03±3.55
F值	19.88	39.96	60.37
P值	< 0.001	< 0.001	< 0.001

下载: 导出CSV

表 3 50岁及以上人群社会参与度得分和抑郁的关联分析

Table 3. The association between social engagement score and depression for people aged 50 years and older

社会参与度	模型1			模型2
社会参与度	β值	aOR(95% CI)值^a	P值	β值	aOR(95% CI)值^b	P值
未分层	-0.05	0.95(0.91-0.99)	0.010	-0.06	0.94(0.90-0.98)	0.006
按地区分层
城市	-0.06	0.94(0.89-0.99)	0.032	-0.07	0.93(0.87-0.98)	0.014
农村	-0.04	0.96(0.91-1.02)	0.215	-0.04	0.96(0.90-1.03)	0.251
按性别分层
男	-0.06	0.94(0.88-1.01)	0.116	-0.07	0.93(0.86-1.01)	0.082
女	-0.05	0.95(0.90-1.00)	0.045	-0.06	0.94(0.89-0.99)	0.034
按年龄分层(岁)
50~	-0.07	0.93(0.87-0.99)	0.027	-0.10	0.90(0.84-0.97)	0.009
60~	0.00	1.00(0.94-1.07)	0.988	-0.01	0.99(0.92-1.06)	0.810
70~	-0.08	0.92(0.84-1.00)	0.056	-0.07	0.93(0.85-1.02)	0.120
≥80	-0.19	0.83(0.64-1.09)	0.178	-0.14	0.87(0.67-1.12)	0.278
注:^a aOR:adjusted odds ratio, 调整比值比, 为调整年龄、性别、城乡、婚姻状况、教育程度和经济状况等因素后的结果; ^b aOR:在模型1基础上再调整吸烟、饮酒和体力活动等因素后的结果。

下载: 导出CSV

参考文献(19)

[1]	World Health Organization Depression. [EB/OL]. (2013)[2019-11-01]. http://www.who.int/topics/depression/en/.
[2]	Kok RM, Reynolds CR. Management of depression in older adults: a review[J]. JAMA, 2017, 317(20): 2114-2122. DOI: 10.1001/jama.2017.5706.
[3]	Bock JO, Hajek A, Weyerer S, et al. The impact of depressive symptoms on healthcare costs in late life: longitudinal findings from the agemoode study[J]. Am J Geriatr Psychiatry, 2017, 25(2): 131-141. DOI: 10.1016/j.jagp.2016.10.011.
[4]	Hall CA, Reynolds-Iii CF. Late-life depression in the primary care setting: challenges, collaborative care, and prevention[J]. Maturitas, 2014, 79(2): 147-152. DOI: 10.1016/j.maturitas.2014.05.026.
[5]	Hajek A, Brettschneider C, Mallon T, et al. The impact of social engagement on health-related quality of life and depressive symptoms in old age-evidence from a multicenter prospective cohort study in Germany[J]. Health Qual Life Outcomes, 2017, 15(1): 140. DOI: 10.1186/s12955-017-0715-8.
[6]	Min J, Ailshire J, Crimmins EM. Social engagement and depressive symptoms: do baseline depression status and type of social activities make a difference[J]Age Ageing. 2016, 45(6): 838-843. DOI: 10.1093/ageing/afw125.
[7]	Margraf J, Lavallee K, Zhang X, et al. Social rhythm and mental health: a cross-cultural comparison[J]. PLoS One, 2016, 11(3): e0150312. DOI: 10.1371/journal.pone.0150312.
[8]	郭雁飞, 阮晔, 施燕, 等.全球老龄化与成人健康研究中国项目进展[J].中华流行病学杂志, 2019, 40(10): 1203-1205. DOI: 10.3760/cma.j.issn.0254-6450.2019.10.006. Guo YF, Shi Y, Ruan Y, et al. Project profile: study on global ageing and adult health in China[J]. Chin J Epidemiol, 2019, 40(10): 1203-1205. DOI: 10.3760/cma.j.issn.0254-6450.2019.10.006.
[9]	World Health Organization. Global Physical activity questionnaire[EB/OL]. [2019-11-01]. http//www.who.int/chp/steps/GPAQ/en/.
[10]	Kessler RC, Ustun TB. The world mental health(WMH)survey initiative version of the world health organization(WHO)composite international diagnostic interview(CIDI)[J]. Intern J Meth Psychiatric Res, 2004, 13(2): 93-121. DOI: 10.1002/mpr.168.
[11]	WHO. The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research(DCR-10)[S]. Geneva, Switzerland: World Health Organization, 1993.
[12]	Peltzer K, Phaswana-Mafuya N. Depression and associated factors in older adults in South Africa[J]. Glob Health Action, 2013, 6: 1-9. DOI: 10.3402/gha.v6i0.18871.
[13]	Lou VW, Chi I, Kwan CW, et al. Trajectories of social engagement and depressive symptoms among long-term care facility residents in Hong Kong[J]. Age Ageing, 2013, 42(2): 215-222. DOI: 10.1093/ageing/afs159.
[14]	Kuroda A, Tanaka T, Hirano H, et al. Eating alone as social disengagement is strongly associated with depressive symptoms in Japanese community-dwelling older adults[J]. J Am Med Dir Assoc, 2015, 16(7): 578-585. DOI: 10.1016/j.jamda.2015.01.078.
[15]	Van BAP, Frijters DH, Wagner C, et al. Social engagement and depressive symptoms of elderly residents with dementia: across-sectional study of 37 long-term care units[J]. Int Psychogeriatr, 2011, 23(4): 625-633. DOI: 10.1017/S1041610210002061.
[16]	Zahodne LB, Watson CW, Seehra S, et al. Positive psychosocial factors and cognition in ethnically diverse older adults[J]. J Int Neuropsychol Soc, 2018, 24(3): 294-304. DOI: 10.1017/S1355617717000935.
[17]	Van DBRHC, Schutter N, Hanssen DJC, et al. Prognostic significance of social network, social support and loneliness for course of major depressive disorder in adulthood and old age[J]. Epidemiol Psychiatr Sci, 2018, 27(3): 266-277. DOI: 10.1017/S2045796017000014.
[18]	Aziz R, Steffens DC. What are the causes of late-life depression[J]. Psychiatr Clin North Am, 2013, 36(4): 497-516. DOI: 10.1016/j.psc.2013.08.001.
[19]	沈斌, 赵纯红.老年人脑卒中后抑郁发生相关因素分析及综合干预效果观察[J].上海预防医学, 2016, 28(3): 188-190. DOI: 10.19428/j.cnki.sjpm.2016.03.020. Sheng B, Zhao CH. Analysis of related factors of post-stroke depression and observation of comprehensive intervention in the elderly[J]. Shanghai J Prevent Med, 2016, 28(3): 188-190. DOI: 10.19428/j.cnki.sjpm.2016.03.020.

施引文献

资源附件(0)

访问统计

点击查看大图

变量	n(%)	抑郁		χ²值	P值
变量	n(%)	无	有	χ²值	P值
年龄(岁)				2.923	0.404
50~	5 652(43.73)	5 559(98.35)	93(1.65)
60~	3 879(30.91)	3 803(98.04)	76(1.96)
70~	2 702(20.90)	2 652(98.15)	50(1.85)
≥80	693(5.36)	685(98.85)	8(1.15)
性别				17.682	< 0.001
男	6 055(46.84)	5 980(98.76)	75(1.24)
女	6 871(53.16)	6 719(97.79)	152(2.21)
地区				2.868	0.090
城市	6 341(49.06)	6 217(98.04)	124(1.96)
农村	6 585(50.94)	6 482(98.44)	103(1.56)
文化程度				9.086	0.106
未受过正规教育	3 133(24.24)	3 064(97.80)	69(2.20)
小学未毕业	2 341(18.11)	2 304(98.42)	37(1.58)
小学毕业	2 584(19.99)	2 545(98.49)	39(1.51)
初中毕业	2 600(20.11)	2 552(98.15)	48(1.85)
高中毕业	1 676(12.97)	1 646(98.21)	30(1.79)
大学及以上	592(4.58)	588(99.32)	4(0.68)
财富五分位数				51.080	< 0.001
第一分位(最低)	2 553(19.84)	2 476(96.98)	77(3.02)
第二分位	2 547(19.80)	2 486(97.61)	61(2.39)
第三分位	2 585(20.09)	2 545(98.45)	40(1.55)
第四分位	2 648(20.58)	2 621(98.98)	27(1.02)
第五分位(最高)	2 532(19.68)	2 511(99.17)	21(0.83)
婚姻状况				6.607	0.010
未婚/分居/离婚/丧偶	2 146(16.61)	2 094(97.58)	52(2.42)
已婚/同居	10 916(83.39)	10 596(98.38)	175(1.62)
体力活动				5.880	0.053
低水平体力活动	4 158(32.17)	4 081(98.15)	77(1.85)
中水平体力活动	3 640(28.16)	3 592(98.68)	48(1.32)
高水平体力活动	5 126(39.66)	5 024(98.01)	102(1.99)
吸烟				5.051	0.080
目前吸烟	3 460(26.89)	3 414(98.67)	46(1.33)
目前不吸烟	794(6.17)	778(97.98)	16(2.02)
从未吸烟	8 613(66.94)	8 449(98.06)	164(1.94)
饮酒				6.854	0.032
从不饮酒	8 928(77.31)	8 758(98.10)	170(1.90)
非重度饮酒	1 930(16.71)	1 903(98.60)	27(1.40)
重度饮酒	691(5.98)	686(99.29)	5(0.72)

表(3)

计量

文章访问数: 887
HTML全文浏览量: 284
PDF下载量: 72
被引次数: 0

姓名
邮箱
手机号码
标题
留言内容
验证码

留言板

中国50岁及以上人群社会参与度和抑郁的关联研究

doi: 10.16462/j.cnki.zhjbkz.2020.04.006

通讯作者:
吴凡, E-mail:wufan@shmu.edu.cn

计量

Social engagement and depression among Chinese aged 50 years and older

Corresponding author: WU Fan, E-mail:wufan@shmu.edu.cn

计量

目录

留言板

中国50岁及以上人群社会参与度和抑郁的关联研究

doi: 10.16462/j.cnki.zhjbkz.2020.04.006

通讯作者: 吴凡, E-mail:wufan@shmu.edu.cn

计量

出版历程

Social engagement and depression among Chinese aged 50 years and older

Corresponding author: WU Fan, E-mail:wufan@shmu.edu.cn

计量

出版历程

目录

通讯作者:
吴凡, E-mail:wufan@shmu.edu.cn