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中年和老年人群中的创伤后应激障碍 (PTSD) 因移民身份和种族、营养以及加拿大老龄化纵向研究 (CLSA) 中健康的其他决定因素而异。

Post-traumatic stress disorder (PTSD) in mid-age and older adults differs by immigrant status and ethnicity, nutrition, and other determinants of health in the Canadian Longitudinal Study on Aging (CLSA).

机构信息

Faculty of Social Science, University of Hawaii, Honolulu, HI, USA.

Faculty of Science and Horticulture (Health Science), Kwantlen Polytechnic University, Surrey, BC, Canada.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2021 Jun;56(6):963-980. doi: 10.1007/s00127-020-02003-7. Epub 2021 Feb 3.

Abstract

PURPOSE

This study aimed to address knowledge gaps about post-traumatic stress disorder (PTSD) in mid-age and older adults, with particular attention to the relationship of PTSD with nutrition and with ethnicity and immigrant status.

METHODS

Binary logistic regression analysis of weighted comprehensive cohort data from the baseline Canadian Longitudinal Study on Aging (CLSA; n = 27,211) was conducted using the four-item Primary Care-PTSD tool (outcome) and immigrant status by ethnicity (Canadian-born white, Canadian-born minority, immigrant white, immigrant minority). Covariates included various social, economic, nutrition and health-related variables.

RESULTS

After controlling for socioeconomic and health variables, immigrants from minority groups had significantly higher odds of PTSD compared to their Canadian-born counterparts, whereas white immigrants had lower odds of PTSD. These relationships were significantly robust across seven cluster-based regression models. After adjusting for ethnicity/immigrant status, the odds of PTSD were higher among those earning lower household incomes, widowed, divorced, or separated respondents, ever smokers, and those who had multi-morbidities, chronic pain, high nutritional risk, or who reported daily consumptions of pastries, pulses and nuts, or chocolate. Conversely, those 55 years and over, who had high waist-to-height ratio, or who consumed 2-3 fiber sources daily had significantly lower odds of PTSD.

CONCLUSION

Interventions aimed at managing PTSD in mid-age and older adults should consider ethnicity, immigrant status, as well as socioeconomic, health, and nutrition status.

摘要

目的

本研究旨在填补中年和老年人群创伤后应激障碍(PTSD)相关知识空白,尤其关注 PTSD 与营养、族裔和移民身份的关系。

方法

采用加权综合队列数据,对加拿大老龄化纵向研究(CLSA;n=27211)的基线数据进行四项初级保健 PTSD 工具(结局)和族裔移民状况(加拿大出生白种人、加拿大出生少数族裔、移民白种人、移民少数族裔)的二元逻辑回归分析。协变量包括各种社会、经济、营养和健康相关变量。

结果

在控制了社会经济和健康变量后,少数族裔移民患 PTSD 的几率明显高于加拿大出生的同类人群,而白种移民患 PTSD 的几率较低。这一关系在七个基于聚类的回归模型中均具有显著的稳健性。在调整了族裔/移民身份后,收入较低、丧偶、离婚或分居、曾吸烟以及患有多种疾病、慢性疼痛、高营养风险或报告日常食用糕点、豆类和坚果或巧克力的人群患 PTSD 的几率更高。相反,55 岁及以上、腰高比高或每日摄入 2-3 种纤维来源的人群患 PTSD 的几率显著降低。

结论

针对中年和老年人群 PTSD 的干预措施应考虑族裔、移民身份以及社会经济、健康和营养状况。

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