血管舒缩症状与社区居住的老年女性的抑郁症状有关。

Vasomotor symptoms are associated with depressive symptoms in community-dwelling older women.

机构信息

Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Menopause. 2017 Dec;24(12):1365-1371. doi: 10.1097/GME.0000000000000938.

DOI:10.1097/GME.0000000000000938

PMID:28640158

Abstract

OBJECTIVE

To assess the prevalence of, and factors associated with, moderate-to-severe depressive symptoms in community-dwelling older Australian women.

METHODS

A questionnaire-based, cross-sectional study was conducted amongst community-dwelling older women. Participants were recruited between April and August 2014 from a national database based on the electoral roll. Depressive symptoms were assessed by the Beck Depression Inventory-II (BDI-II) tool. Vasomotor symptoms (VMS), vulvovaginal atrophy (VVA), and pelvic floor symptoms were assessed using validated questionnaires. Women were provided a comprehensive list of psychotropic medications (antidepressants, benzodiazepines, antipsychotics, and mood stabilizers) to identify their use over the preceding month.

RESULTS

In all, 1,534 women completed the BDI-II. Overall, 34.2% (95% confidence interval [CI] 31.8%-36.7%) of women had VMS, 6.3% (95% CI 5.2%-7.7%) had moderate-to-severe depressive symptoms (BDI-II score ≥20), 26.8% (95% CI 24.6%-29.1%) had used any psychotropic medication in the previous month, and 17.5% (95%CI: 15.6-19.5%) had taken an antidepressant.Moderate-to-severe depressive symptoms were more common among women using antidepressants compared with nonusers (16.6% vs 4.3%; P < 0.001). Obesity (adjusted odds ratio [AOR] 2.18, 95% CI 1.17-4.04), living in financially insecure housing (AOR 3.84, 95% CI 2.08-8.08), being a caregiver to another person (AOR 2.39, 95% CI 1.36-4.19), being a smoker (AOR 2.28, 95% CI 1.12-4.66), having VMS (AOR 1.67, 95% CI 1.03-2.62), having pelvic floor dysfunction (AOR 1.78, 95% CI 1.08-2.94), and having vaginal dryness during intercourse (AOR 1.84, 95% CI 1.06-3.22, P < 0.05) were positively and independently associated with moderate-to-severe depressive symptoms. Being currently partnered (AOR 0.57, 95% CI 0.33-0.97) and employed (AOR 0.38, 95% CI 0.16-0.92) were associated with a lower likelihood of depressive symptoms.

CONCLUSIONS

In older women, depressive symptoms are common and are associated with social and financial insecurity, and with VMS.

摘要

目的

评估社区居住的澳大利亚老年女性中中度至重度抑郁症状的患病率，以及与这些症状相关的因素。

方法

这是一项基于问卷调查的、横断面研究，研究对象为社区居住的老年女性。参与者于 2014 年 4 月至 8 月间从基于选民名单的全国数据库中招募。使用贝克抑郁量表第二版（BDI-II）评估抑郁症状。使用经过验证的问卷评估血管舒缩症状（VMS）、外阴阴道萎缩（VVA）和盆底症状。为女性提供了一份全面的精神药物清单（抗抑郁药、苯二氮䓬类、抗精神病药和心境稳定剂），以确定她们在过去一个月内的使用情况。

结果

共有 1534 名女性完成了 BDI-II。总体而言，34.2%（95%置信区间 [CI] 31.8%-36.7%）的女性存在 VMS，6.3%（95% CI 5.2%-7.7%）存在中度至重度抑郁症状（BDI-II 得分≥20），26.8%（95% CI 24.6%-29.1%）在过去一个月内使用过任何精神药物，17.5%（95%CI：15.6-19.5%）服用过抗抑郁药。与非使用者相比，使用抗抑郁药的女性更常见中度至重度抑郁症状（16.6%比 4.3%；P<0.001）。肥胖（调整后的优势比 [AOR] 2.18，95% CI 1.17-4.04）、居住在经济不安全住房中（AOR 3.84，95% CI 2.08-8.08）、照顾他人（AOR 2.39，95% CI 1.36-4.19）、吸烟（AOR 2.28，95% CI 1.12-4.66）、存在 VMS（AOR 1.67，95% CI 1.03-2.62）、存在盆底功能障碍（AOR 1.78，95% CI 1.08-2.94）以及性交时阴道干燥（AOR 1.84，95% CI 1.06-3.22，P<0.05）与中度至重度抑郁症状呈正相关且独立相关。目前处于伴侣关系中（AOR 0.57，95% CI 0.33-0.97）和就业（AOR 0.38，95% CI 0.16-0.92）与抑郁症状的可能性降低相关。