CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
Am J Geriatr Psychiatry. 2013 Jul;21(7):664-74. doi: 10.1016/j.jagp.2013.01.004. Epub 2013 Feb 6.
The relationship between low socioeconomic status (SES) and depressive symptoms is well described, also in older persons. Although studies have found associations between low SES and unhealthy lifestyle factors, and between unhealthy lifestyle factors and depressive symptoms, not much is known about unhealthy lifestyles as a potential explanation of socioeconomic differences in depressive symptoms in older persons.
To study the independent pathways between SES (education, income, perceived income, and financial assets), lifestyle factors (smoking, alcohol use, body mass index, and physical activity), and incident depressive symptoms (Center for Epidemiologic Studies-Depression [CES-D 10] and reported use of antidepressant medication), we used 9 years of follow-up data (1997-2007) from 2,694 American black and white participants aged 70-79 years from the Health, Aging, and Body Composition (Health ABC) study. At baseline, 12.1% of the study population showed prevalent depressive symptoms, use of antidepressant medication, or treatment of depression in the 5 years prior to baseline. These persons were excluded from the analyses.
Over a period of 9 years time, 860 participants (31.9%) developed depressive symptoms. Adjusted hazard ratios for incident depressive symptoms were higher in participants from lower SES groups compared with the highest SES group. The strongest relationships were found for black men. Although unhealthy lifestyle factors were consistently associated with low SES, they were weakly related to incident depressive symptoms. Lifestyle factors did not significantly reduce hazard ratios for depressive symptoms by SES.
In generally healthy persons aged 70-79 years, lifestyle factors do not explain the relationship between SES and depressive symptoms.
低社会经济地位（SES）与抑郁症状之间的关系已得到充分描述，在老年人中也是如此。尽管研究发现 SES 较低与不健康的生活方式因素之间存在关联，而不健康的生活方式因素与抑郁症状之间也存在关联，但对于生活方式作为老年人 SES 与抑郁症状差异的潜在解释因素，人们知之甚少。
为了研究 SES（教育、收入、感知收入和金融资产）、生活方式因素（吸烟、饮酒、体重指数和身体活动）与新发抑郁症状（流行病学研究中心抑郁量表 [CES-D10] 和报告使用抗抑郁药物）之间的独立途径，我们使用了来自健康、衰老和身体成分（Health ABC）研究的 2694 名年龄在 70-79 岁的美国黑人和白人参与者的 9 年随访数据（1997-2007 年）。在基线时，研究人群中有 12.1%的人存在先前存在的抑郁症状、使用抗抑郁药物或在基线前 5 年内治疗过抑郁症。这些人被排除在分析之外。
在 9 年的时间里，860 名参与者（31.9%）出现了抑郁症状。与 SES 最高组相比，SES 较低组的参与者新发抑郁症状的调整后风险比更高。这种关系在黑人男性中最为明显。尽管不健康的生活方式因素与 SES 始终相关，但它们与新发抑郁症状的相关性较弱。生活方式因素并不能显著降低 SES 与抑郁症状之间的风险比。
在年龄在 70-79 岁的一般健康人群中，生活方式因素并不能解释 SES 与抑郁症状之间的关系。
