Yatsushiro Kousei Hospital, Yatsushiro City, Kumamoto, Japan.
Int Psychogeriatr. 2012 Aug;24(8):1235-41. doi: 10.1017/S1041610212000099. Epub 2012 Feb 20.
The aim of the present study was to investigate the differences in the prevalence of and risk factors for elderly depression between urban and rural areas in Japan and to further understanding of the features of elderly depression.
A multistage, random sampling procedure and mailing method were used in urban and rural areas in Kumamoto Prefecture. A total of 2,152 participants aged 65 years and older were evaluated for depression using the Geriatric Depression Scale (GDS). Factors associated with depression were also examined. In order to assess the relationship between risk factors and subjective happiness, the Philadelphia Geriatric Center Morale Scale (PGC-MS) was used.
Depressive symptoms were associated with living alone, being unemployed, chronic illness, sleep disturbance, suicidal ideation, financial strain, and poor social support; the risk factors for elderly depression were almost the same in the two areas. Although three factors (financial strain, work status, and PGC-MS) were significantly associated with depression in both areas on logistic regression analysis, sleep disturbance was significant only for the urban area, and poor social support was significant only for the rural area.
Although factors related to depression did not differ markedly between urban and rural elderly people, some risk factors differed between the two areas. Effective intervention programs for elderly depression should pay more attention to regional differences.
本研究旨在调查日本城乡老年人抑郁患病率和危险因素的差异，进一步了解老年抑郁的特征。
采用多阶段、随机抽样程序和邮寄方法，在熊本县城乡地区进行评估。使用老年抑郁量表（GDS）对 2152 名 65 岁及以上的参与者进行抑郁评估。还检查了与抑郁相关的因素。为了评估危险因素与主观幸福感之间的关系，使用了费城老年中心士气量表（PGC-MS）。
抑郁症状与独居、失业、慢性疾病、睡眠障碍、自杀意念、经济压力和社会支持差有关；两个地区老年抑郁的危险因素几乎相同。尽管逻辑回归分析显示，在两个地区，有三个因素（经济压力、工作状况和 PGC-MS）与抑郁显著相关，但睡眠障碍仅在城市地区显著，社会支持差仅在农村地区显著。
尽管城乡老年人的抑郁相关因素没有明显差异，但两个地区的一些危险因素存在差异。有效的老年抑郁干预计划应更加关注地区差异。
