Lukaschek Karoline, Vanajan Anushiya, Johar Hamimatunnisa, Weiland Nina, Ladwig Karl-Heinz
Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University of Giessen, Giessen, Germany.
BMC Geriatr. 2017 Jun 16;17(1):126. doi: 10.1186/s12877-017-0513-5.
To investigate risk factors associated with low subjective well-being (SWB) in men and women (≥65 years) separately with a special focus on emotional distress.
A cross-sectional analysis was conducted among 3602 participants (50.6% women) aged 65-90 years (mean age 72.8 years, SD ± 5.8) from the population-based KORA-Age study conducted in 2008/2009. SWB was assessed using the WHO-5 well-being index (score range: 0 to 100). SWB was dichotomized into "low" (score ≤ 50) and "high" (score > 50) SWB. The association between potential risk factors and SWB was assessed by logistic regressions analyses. Population-attributable risks (PARs) were calculated.
Low SWB was significantly higher in women than in men (23.8% versus 18.2%; p < 0.0001). The logistic regressions analyses revealed low income, physical inactivity, multimorbidity, depression, anxiety and sleeping problems to be associated with low SWB in both sexes. Living alone increased the odds of having low SWB in women, but not in men. Depression and anxiety were the strongest risk factors of low SWB among men (depression: OR: 4.19, 95% CI: 1.33-13.17, p < 0.05; anxiety: 8.45, 5.14-13.87, p < 0.0001) and women (depression: 6.83, 2.49-18.75 p < 0.05; anxiety: 7.31, 5.14-10.39, p < 0.0001). In both sexes, anxiety had the highest population-attributable risk (men: 27%, women: 41%).
Our results call out for an increased focus on mental health interventions among older adults, especially for women living alone. Further research is needed to understand the paradoxical pattern of discrepant subjective well-being versus objective health in age.
分别调查65岁及以上男性和女性主观幸福感（SWB）较低的相关危险因素，特别关注情绪困扰。
对2008/2009年基于人群的KORA-Age研究中的3602名参与者（50.6%为女性）进行横断面分析，这些参与者年龄在65 - 90岁之间（平均年龄72.8岁，标准差±5.8）。使用世界卫生组织-5幸福感指数评估SWB（评分范围：0至100）。SWB被分为“低”（评分≤50）和“高”（评分>50）的SWB。通过逻辑回归分析评估潜在危险因素与SWB之间的关联。计算人群归因风险（PARs）。
女性中低SWB的比例显著高于男性（23.8%对18.2%；p<0.0001）。逻辑回归分析显示，低收入、缺乏身体活动、多种疾病共存、抑郁、焦虑和睡眠问题与两性的低SWB相关。独居会增加女性出现低SWB的几率，但对男性没有影响。抑郁和焦虑是男性（抑郁：比值比：4.19，95%置信区间：1.33 - 13.17，p<0.05；焦虑：8.45，5.14 - 13.87，p<0.0001）和女性（抑郁：6.83，2.49 - 18.75，p<0.05；焦虑：7.31，5.14 - 10.39，p<0.0001）中低SWB的最强危险因素。在两性中，焦虑的人群归因风险最高（男性：27%，女性：41%）。
我们的研究结果呼吁更加关注老年人的心理健康干预，特别是对于独居女性。需要进一步研究以了解年龄增长过程中主观幸福感与客观健康状况不一致的矛盾模式。
