Fernández-Niño Julián Alfredo, Bonilla-Tinoco Laura Juliana, Manrique-Espinoza Betty Soledad, Romero-Martínez Martin, Sosa-Ortiz Ana Luisa
Public Health Department, Universidad del Norte, Km 5, Vía Puerto Colombia, Colombia.
Public Health Department, Universidad Industrial de Santander, Cra. 32 #29-31, Bucaramanga, Colombia.
SSM Popul Health. 2018 Jul 31;6:1-8. doi: 10.1016/j.ssmph.2018.07.008. eCollection 2018 Dec.
The aim of the present study was to analyse the association between the occurrence of a major depressive episode among older adults and work status in low- and medium-income countries. A cross-sectional study was conducted with people 60 years of age and older from the six countries (Mexico, India, China, Russian Federation, Ghana and South Africa) included in the Study on Global Ageing and Adult Health (SAGE) and who participated in its first wave (2009-2010). The occurrence of a major depressive episode (MDE) over the previous 12 months was determined based on an adaptation of the ICD-10 diagnostic criteria. The association between current work status and the presence of an MDE was estimated using binary logistic regression models with country-level fixed effects, and interaction terms between the country and work status. Results showed the odds of presenting an MDE were lower for older adults who were retired with a pension than for those who were currently working, although this protective association was observed only for men in China (OR=0.23; CI 95%:0.08-0.70) and Ghana (OR=0.25; CI 95%:0.07-0.95) and for women in India (OR=0.05; CI 95%:0.01-0.51) and South Africa (OR=0.19; CI 95%:0.04-0.97). For women, being a homemaker also showed a protective association in South Africa (OR=0.09; CI95%:0.01-0.66) and Mexico (OR=0.32; CI95%:0.14-0.76). In the case of being retired without a pension, no significant association was found in any country. The previous indicates that retirement with pension has a protective association with MDE only for men in China and Ghana and women in India and South Africa. The heterogeneity of this association reflects cultural and socioeconomic differences between the analysed countries.
本研究的目的是分析中低收入国家老年人中重度抑郁发作的发生与工作状态之间的关联。对来自全球老龄化与成人健康研究（SAGE）中六个国家（墨西哥、印度、中国、俄罗斯联邦、加纳和南非）且参与了第一波调查（2009 - 2010年）的60岁及以上人群进行了一项横断面研究。根据国际疾病分类第10版（ICD - 10）诊断标准的改编版本确定过去12个月内重度抑郁发作（MDE）的发生情况。使用具有国家层面固定效应以及国家与工作状态交互项的二元逻辑回归模型估计当前工作状态与MDE存在之间的关联。结果显示，领取养老金退休的老年人出现MDE的几率低于目前仍在工作的老年人，不过这种保护关联仅在中国（OR = 0.23；95%置信区间：0.08 - 0.70）和加纳（OR = 0.25；95%置信区间：0.07 - 0.95）的男性以及印度（OR = 0.05；95%置信区间：0.01 - 0.51）和南非（OR = 0.19；95%置信区间：0.04 - 0.97）的女性中观察到。对于女性而言，在南非（OR = 0.09；95%置信区间：0.01 - 0.66）和墨西哥（OR = 0.32；95%置信区间：0.14 - 0.76），家庭主妇身份也显示出保护关联。在没有养老金退休的情况下，在任何国家均未发现显著关联。上述情况表明，领取养老金退休仅在中国和加纳的男性以及印度和南非的女性中与MDE存在保护关联。这种关联的异质性反映了所分析国家之间的文化和社会经济差异。
