Barrenetxea Jon, Pan An, Feng Qiushi, Koh Woon-Puay
Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore.
Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Int J Geriatr Psychiatry. 2022 Feb;37(2). doi: 10.1002/gps.5666. Epub 2021 Dec 2.
We studied sociodemographic and health factors associated with depression across three age groups of community-dwelling older adults.
METHODS/DESIGN: We used data from 16,785 participants from the third follow-up of the Singapore Chinese Health Study (mean age: 73, range: 61-96 years). We defined depression as having a score of ≥5 using the 15-item Geriatric Depression Scale. We used regression splines to examine the pattern of depression risk with age and applied multivariable logistic regression to study factors associated with depression.
Increasing age was associated with depression in an inverted J-shape relationship with the highest odds ratio (OR) at age 75. Compared to the youngest-old (<70 years), the middle-old (70-80 years) had higher odds of depression [OR = 1.20, 95% confidence interval (CI) = 1.09-1.31], while the oldest-old (>80 years) had no increased risk (OR = 1.01, 95% CI = 0.89-1.15). We also found demographic (men, lower education, unemployment), social (living alone, poor social support, no social activity) and health factors (instrumental limitations, poor physical function, function-limiting pain, chronic diseases, cognitive impairment, poor sleep quality, poor self-rated health) associated with depression. In stratified analysis by age groups, the OR estimates for lower education level, instrumental limitations and cognitive impairment decreased with age, whereas the risk of depression for men increased with age (all p-values for interaction<0.03).
Compared to the youngest-old, the likelihood of depression was highest among middle-old adults and decreased to null in the oldest-old. The associations between some factors and depression were attenuated with age, suggesting a coping mechanism among oldest-old survivors.
我们研究了社区居住的老年人三个年龄组中与抑郁症相关的社会人口学和健康因素。
方法/设计：我们使用了来自新加坡华人健康研究第三次随访的16785名参与者的数据（平均年龄：73岁，范围：61 - 96岁）。我们使用15项老年抑郁量表将抑郁定义为得分≥5分。我们使用回归样条来研究抑郁风险随年龄的变化模式，并应用多变量逻辑回归来研究与抑郁相关的因素。
年龄增长与抑郁症呈倒J形关系，75岁时的优势比（OR）最高。与最年轻的老年人（<70岁）相比，中年老年人（70 - 80岁）患抑郁症的几率更高[OR = 1.20，95%置信区间（CI）= 1.09 - 1.31]，而最年长的老年人（>80岁）风险没有增加（OR = 1.01，95% CI = 0.89 - 1.15）。我们还发现人口统计学因素（男性、低教育程度、失业）、社会因素（独居、社会支持差、无社交活动）和健康因素（工具性限制、身体功能差、功能受限疼痛、慢性病、认知障碍、睡眠质量差、自评健康差）与抑郁症相关。在按年龄组进行的分层分析中，低教育水平、工具性限制和认知障碍的OR估计值随年龄下降，而男性患抑郁症的风险随年龄增加（所有交互作用的p值<0.03）。
与最年轻的老年人相比，中年老年人患抑郁症的可能性最高，而在最年长的老年人中降至零。一些因素与抑郁症之间的关联随年龄减弱，这表明最年长的幸存者存在一种应对机制。
