Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
Faculty of Medicine Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
J Epidemiol Community Health. 2020 Nov;74(11):882-891. doi: 10.1136/jech-2019-212451. Epub 2020 Jul 6.
Subjective social status (SSS), one's self-perceived social status, has been gaining interest among researchers as a risk/protective factor of many health outcomes. SSS encompasses both socio-economic factors (eg, income) and intangible aspects of status (eg, esteem from peers). This study's main objective was to examine the association between SSS and future risk of depression in elderly Chinese.
Using data from the ongoing Mr/Mrs Os study, a longitudinal study of Hong Kong Chinese elderly, this study analysed baseline SSS-Hong Kong (self-perceived social status within Hong Kong) and SSS-Community (self-perceived status within one's own social network) as predictors of Geriatric Depression Scale (GDS) score at year 4 (n=3153). The models adjusted for baseline depression scores, socio-economic status indicators, demographic variables, clinical conditions and functional status variables.
Higher depression scores at follow-up were independently associated with lower SSS-Hong Kong (standardised β-coefficient= -0.040, p=0.017), lower SSS-Community (standardised β-coefficient= -0.057, p=0.001), in addition to older age, female gender and stroke history. After stratifying by dementia status, higher baseline SSS was associated with less depressive symptoms only in the non-dementia group. In the multivariable models that included both SSS variables, only SSS-Community was significantly associated with year 4 GDS score. However, both SSS variables were independently associated with year 4 depression status in the logistic regression analysis.
In Chinese elderly, SSS captures aspects of social status that are not captured by traditional socio-economic indicators. SSS can be a useful supplementary tool for assessing future risk of developing mental health conditions.
主观社会地位（SSS）是指个体对自身社会地位的感知，它作为许多健康结果的风险/保护因素，越来越受到研究人员的关注。SSS 既包括社会经济因素（例如收入），也包括地位的无形方面（例如来自同龄人的尊重）。本研究的主要目的是探讨 SSS 与中国老年人未来抑郁风险的关系。
本研究使用正在进行的香港中老年男性/女性研究（Mr/Mrs Os 研究）的数据，该研究是一项对香港华人老年人的纵向研究，分析了基线 SSS-香港（在香港的自我感知社会地位）和 SSS-社区（在自己的社交网络中的自我感知地位）作为第 4 年老年抑郁量表（GDS）评分的预测因子（n=3153）。模型调整了基线抑郁评分、社会经济地位指标、人口统计学变量、临床状况和功能状态变量。
随访时较高的抑郁评分与较低的 SSS-香港（标准化β系数=-0.040，p=0.017）和 SSS-社区（标准化β系数=-0.057，p=0.001）独立相关，此外，年龄较大、女性和中风史也是如此。在根据痴呆症状况进行分层后，只有在非痴呆症组中，较高的基线 SSS 与较少的抑郁症状相关。在包括两个 SSS 变量的多变量模型中，只有 SSS-社区与第 4 年 GDS 评分显著相关。然而，在逻辑回归分析中，两个 SSS 变量都与第 4 年的抑郁状况独立相关。
在中国老年人中，SSS 捕捉到了传统社会经济指标无法捕捉的社会地位方面。SSS 可以作为评估未来心理健康状况风险的有用补充工具。
