Department of Health Care Administration, Asia University, Taichung, Taiwan.
Int J Geriatr Psychiatry. 2012 Aug;27(8):854-62. doi: 10.1002/gps.2796. Epub 2011 Sep 21.
The goals of this study were to examine the group-based trajectories of depressive symptoms over an extended period among the older people and to identify the risk factors by gender.
The 18-year data used in this study came from a multiple-wave nationwide survey of older Taiwanese population. A group-based trajectory analysis method was used to identify the trajectories, and risk factors at baseline and previous depressive symptoms were used as predictors for the trajectories.
Six trajectories were identified within the total sample, and females were more likely to be in the increasing and declining trajectories than males. When the data were divided by gender, four trajectories for males and four trajectories for females were identified: low, medium, declining, and increasing. Higher-level trajectories of depressive symptoms were related to more chronic diseases, lower physical function, lower economic satisfaction, and previous depressive symptoms for both the older men and women. Less social support and social participation were related to higher depressive symptom trajectories, particularly for men.
Older females may experience more emotional fluctuation than male elderly, thus changes in psychosocial health for female elderly need to be considered by health professionals and families. Social support and social participation are protective against depressive symptoms for the higher-level trajectory groups, and older men, in particular, are more sensitive to these two social-health-related variables.
本研究旨在考察老年人在较长时期内抑郁症状的群组轨迹,并按性别确定风险因素。
本研究使用了一项为期 18 年的台湾老年人全国性多波调查数据。采用群组轨迹分析方法来识别轨迹,同时将基线和之前的抑郁症状作为轨迹的预测因素。
在总样本中确定了 6 种轨迹,女性比男性更有可能处于上升和下降轨迹。当按性别划分数据时,男性和女性分别确定了 4 种轨迹:低、中、下降和上升。较高水平的抑郁症状轨迹与更多的慢性疾病、较低的身体功能、较低的经济满意度和之前的抑郁症状有关,无论男女都是如此。较少的社会支持和社会参与与较高的抑郁症状轨迹有关,特别是对男性而言。
老年女性可能比老年男性经历更多的情绪波动,因此健康专业人员和家庭需要考虑女性老年人心理社会健康的变化。社会支持和社会参与对较高水平的轨迹群体预防抑郁症状具有保护作用,特别是对老年男性而言,他们对这两个与社会健康相关的变量更为敏感。