Zhu C S, Lian Z W, Cui Y M
Department of Pharmacy, Peking University First Hospital, Beijing 100034, China.
Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Aug 18;55(4):606-611. doi: 10.19723/j.issn.1671-167X.2023.04.006.
To examine the association between depressive symptoms and chronic diseases among middle-aged and older Chinese adults within a national investigation.
Data used in current analysis were obtained from a nationally representative, cross-sectional population-based survey of China health and retirement longitudinal study, which were conducted in 2011 using four-stage probability-proportional-to-size sampling methods. A total of 10 420 participants who were aged 45 years and above from 28 provinces in mainland China were included. Information on demographic characteristics (e.g., age, gender, education level), lifestyle factors (e.g., smoking status and drinking frequency) and chronic diseases (e.g., hypertension, diabetes, and stroke) were collected by well-trained interviewers at the interviewees' homes using a standardized questionnaire. Depressive symptoms were measured using the 10-item version of the center for epidemiological studies depression scale (CESD-10, which was a widely used standard tool in Chinese population, and elevated depressive symptoms were defined by a cut-off ≥10. Multivariate Logistic regression analysis was carried out to assess the association between depressive symptoms and chronic diseases (including hypertension, diabetes, heart disease, dyslipidemia and stroke), adjusting for age, gender, education level, marital status, ethnicity, place of residence, bady mass index (BMI) and other potential confounding factors.
Among the 10 420 participants, the mean age was (59.2±9.4) years, and 48.2% of them were men. There were 3 900 (37.4%) participants who had a depression rating score of 10 or greater, indicative of elevated depressive symptoms. The results of multivariate Logistic regression analysis demonstrated that diabetes (=1.230, 95%: 1.080-1.401), hypertension (=1.335, 95%: 1.205-1.480), heart disease (=1.953, 95%: 1.711-2.229), and stroke (=2.269, 95% 1.704-3.020) were significantly associated with depressive symptoms ( < 0.05), after full adjustment of age, gender, education level, marital status, ethnicity, residency and other potential confounders. While no significant relationship was found between dyslipidemia and depressive symptoms (>0.05). The prevalence of elevated depressive symptoms increased parallel with the number of chronic diseases ( < 0.001).
Depressive symptoms were significantly associated with chronic diseases (including diabetes, hypertension, heart disease, and stroke), which suggests that psychological factors, such as depressive symptoms should be taken into consideration in the prevention and control of chronic diseases.
在一项全国性调查中，研究中国中老年成年人抑郁症状与慢性病之间的关联。
当前分析所使用的数据来自中国健康与养老追踪调查（China health and retirement longitudinal study），这是一项具有全国代表性的基于人群的横断面调查，于2011年采用四阶段规模比例抽样方法进行。纳入了来自中国大陆28个省份的10420名年龄在45岁及以上的参与者。训练有素的访员在受访者家中使用标准化问卷收集了有关人口统计学特征（如年龄、性别、教育水平）、生活方式因素（如吸烟状况和饮酒频率）以及慢性病（如高血压、糖尿病和中风）的信息。使用流行病学研究中心抑郁量表的10项版本（CESD - 10，这是在中国人群中广泛使用的标准工具，抑郁症状加重定义为得分≥10）来测量抑郁症状。进行多变量Logistic回归分析以评估抑郁症状与慢性病（包括高血压、糖尿病、心脏病、血脂异常和中风）之间的关联，并对年龄、性别、教育水平、婚姻状况、种族、居住地点、体重指数（BMI）和其他潜在混杂因素进行了调整。
在10420名参与者中，平均年龄为（59.2±9.4）岁，其中48.2%为男性。有3900名（37.4%）参与者的抑郁评分≥10分，表明存在抑郁症状加重的情况。多变量Logistic回归分析结果表明，在对年龄、性别、教育水平、婚姻状况、种族、居住情况和其他潜在混杂因素进行全面调整后，糖尿病（=1.230，95%置信区间：1.080 - 1.401）、高血压（=1.335，95%置信区间：1.205 - 1.480）、心脏病（=1.953，95%置信区间：1.711 - 2.229）和中风（=2.269，95%置信区间：1.704 - 3.020）与抑郁症状显著相关（P<0.05）。而血脂异常与抑郁症状之间未发现显著关系（P>0.05）。抑郁症状加重的患病率随着慢性病数量的增加而升高（P<0.001）。
抑郁症状与慢性病（包括糖尿病、高血压、心脏病和中风）显著相关，这表明在慢性病的预防和控制中应考虑抑郁症状等心理因素。
