Kim Byung-Soo, Lee Dong-Woo, Bae Jae Nam, Chang Sung Man, Kim Shinkyum, Kim Ki Woong, Rim Hyo-Deog, Park Jee Eun, Cho Maeng Je
Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, South Korea.
Department of Psychiatry, Inje University College of Medicine, Seoul, South Korea.
Int Psychogeriatr. 2014 Oct;26(10):1669-1678. doi: 10.1017/S1041610214001094. Epub 2014 Jun 19.
In many countries, illiteracy rates among aged people are quite high. However, only few studies have specifically investigated the impact of illiteracy on depression.
Data for 1,890 elderly individuals (aged ≥65 years) were obtained from a nationwide dementia epidemiological study conducted in South Korea. Based on their reading ability, the participants were divided into three groups: totally illiterate, partially illiterate, and literate. The Korean version of the Geriatric Depression Scale - Short Form (SGDS-K) was used to detect depression (cut-off score = 8). Multivariate logistic regression analyses were used to assess the association between illiteracy and depression. To explore clinical features of depression in illiterate people, we performed logistic regression to calculate odds ratios of positive responses (or negative responses to reverse-coded items) for each SGDS-K item using literate individuals as the reference group.
Totally illiterate participants had 2.41 times the odds and partially illiterate individuals had 1.59 times the odds of being depressed compared with literate participants after controlling for other variables. Compared with literate individuals, illiterate elderly persons were at increased odds for responding negatively to the majority of SGDS-K items, including "having memory problems," "others are better off than me," and "feeling worthless" even after controlling for various demographic and clinical factors.
Illiteracy in elderly individuals was associated with a higher rate and increased severity of depression. Illiteracy negatively affected depression symptomatology, especially factors associated with self-esteem. Therefore, clinicians should carefully monitor for the presence of depression in illiterate elderly adults.
在许多国家，老年人中的文盲率相当高。然而，仅有少数研究专门调查了文盲对抑郁症的影响。
从韩国一项全国性痴呆症流行病学研究中获取了1890名老年人（年龄≥65岁）的数据。根据阅读能力，将参与者分为三组：完全文盲、部分文盲和识字。采用韩国版老年抑郁量表简表（SGDS-K）来检测抑郁症（临界值 = 8）。使用多变量逻辑回归分析来评估文盲与抑郁症之间的关联。为了探究文盲人群中抑郁症的临床特征，我们进行逻辑回归分析，以识字个体作为参照组，计算每个SGDS-K项目阳性反应（或对反向计分项目的阴性反应）的比值比。
在控制其他变量后，与识字参与者相比，完全文盲参与者患抑郁症的几率是其2.41倍，部分文盲个体患抑郁症的几率是其1.59倍。与识字个体相比，即使在控制了各种人口统计学和临床因素后，文盲老年人对大多数SGDS-K项目做出消极反应的几率仍有所增加，这些项目包括“有记忆问题”、“别人比我过得好”和“感觉毫无价值”。
老年人中的文盲与更高的抑郁症发病率和更严重的症状相关。文盲对抑郁症症状学有负面影响，尤其是与自尊相关的因素。因此，临床医生应仔细监测文盲老年人中抑郁症的存在情况。
