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住院与 50 岁以上成年人抑郁的关系:居住安排是否重要?来自健康与退休研究的发现。

Hospitalization's association with depression in adults over 50 years old: does living arrangement matter? Findings from the Health and Retirement Study.

机构信息

Department of Psychiatry, University of Rochester, Rochester, NY, USA.

Margaret Warner School of Education and Human Development, University of Rochester, Rochester, NY, USA.

出版信息

Aging Ment Health. 2023 Sep-Oct;27(9):1684-1691. doi: 10.1080/13607863.2022.2163978. Epub 2023 Jan 2.

Abstract

OBJECTIVES

To examine how living arrangements are associated with depressive symptoms in late middle-life and older adults following hospitalization within the last two years.

DESIGN

We used the 2016 wave of the Health and Retirement Study (HRS), a nationally representative survey of adults over 50 years old living in the United States.

METHODS

The dependent variable was whether HRS participants screened positive for having depressive symptoms. The primary independent variable was self-reported hospitalization in the prior two years. We stratified bivariate analyses and multivariate logistic regressions by living arrangement to examine hospitalizations' association with depressive symptoms.

RESULTS

Depressive symptoms were less prevalent among participants who were married or partnered and living with a partner (14.0%) compared to those who were not married or partnered and were living with others (31.7%) and were not married or partnered and were living alone (27.8%). In multivariate analyses stratified by living arrangement, however, hospitalization was associated with depressive symptoms for those married or partnered and living with a partner (OR = 1.39, 95% CI: 1.14-1.69) but not for those who were not married and living with other(s) (OR = 0.88, 95% CI: 0.65-1.18) and not married or partnered and living alone (OR = 1.06, 95% CI: 0.82-1.36).

CONCLUSIONS

Late middle-life and older adults residing with spouses or cohabitating appear at risk for having depressive symptoms following a hospitalization. A better understanding of how relationships and living arrangements may affect depression risk in the context of an acute medical illness is needed to identify points of intervention.

摘要

目的

探讨过去两年内住院治疗的中老年患者在出院后的生活安排与抑郁症状之间的关系。

设计

我们使用了 2016 年“健康与退休研究(HRS)”的数据,该研究是一项针对美国 50 岁以上成年人的全国代表性调查。

方法

因变量为 HRS 参与者是否筛查出有抑郁症状。主要的独立变量是报告的前两年内住院治疗情况。我们按生活安排对双变量分析和多变量逻辑回归进行分层,以检查住院治疗与抑郁症状之间的关联。

结果

与未结婚或未处于伴侣关系且与他人共同居住的参与者(31.7%)和未结婚或未处于伴侣关系且独居的参与者(27.8%)相比,已婚或处于伴侣关系且与伴侣共同居住的参与者中抑郁症状的发生率较低(14.0%)。然而,在按生活安排分层的多变量分析中,对于已婚或处于伴侣关系且与伴侣共同居住的参与者,住院治疗与抑郁症状相关(OR=1.39,95%CI:1.14-1.69),但对于未结婚且与他人共同居住的参与者(OR=0.88,95%CI:0.65-1.18)和未结婚或未处于伴侣关系且独居的参与者(OR=1.06,95%CI:0.82-1.36)则不然。

结论

与配偶或同居伴侣一起居住的中老年患者在住院治疗后出现抑郁症状的风险较高。需要更好地了解人际关系和生活安排如何在急性疾病的背景下影响抑郁风险,以确定干预的重点。

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