Department of Nursing, Daegu University, Daegu, Republic of Korea.
Department of Statistics, Daegu University, Gyeongsan, Cheongju-si, Republic of Korea.
Front Public Health. 2024 Jan 16;12:1256368. doi: 10.3389/fpubh.2024.1256368. eCollection 2024.
Depression is a widely prevalent, often recurrent condition. To analyze the regional differences in depressive symptoms over time, we investigated urban-rural differences in change in depression over time in South Korea and the association between healthy aging and depressive symptoms among middle-aged and older adults.
Data collected in the Korean Longitudinal Study of Aging, from 2006 to 2020, of adult participants aged ≥45 years without depressive symptoms were analyzed. Healthy aging was defined under five principal components: absence of chronic disease, good physical function, normal cognitive function, active social engagement, and good psychological adaptation. Depressive symptoms were measured using the short version of the Center for Epidemiologic Studies Depression Scale. Using the Andersen-Gill model for recurrent time-to-event, we examined the effect of healthy aging on depressive symptoms, with a subgroup analysis based on the residential area.
Of the 7,708 participants, 78.2% lived in urban areas and 39.4% achieved healthy aging. In 2008, rural residents had a higher incidence of depressive symptoms (rural 11.8%; urban 8.9%); however, after 2016, the depressive symptoms of urban residents gradually increased (rural 6.4%; urban 12.1%). Unhealthy aging (adjusted hazard ratio = 3.04, 95% confidence interval: 2.72-3.39) and urban residence (adjusted hazard ratio = 1.15, 95% confidence interval: 1.06-1.24) were risk factors for depressive symptoms. The subgroup analysis revealed that individuals who did not achieve healthy aging had an increased risk of depressive symptoms, regardless of their residential area (hazard ratio [95% confidence interval]: urban, 3.13 [2.75-3.55]; rural 2.59 [2.05-3.28]).
As urbanization accelerates, urban residents have a higher risk of depressive symptoms than rural residents. Healthy aging is an essential factor in reducing depressive symptoms. To achieve healthy aging, appropriate interventions and policies that target the middle-aged adults and gradually extend to older adults are needed, considering individual and regional factors.
抑郁症是一种广泛存在且经常复发的疾病。为了分析随时间推移抑郁症状的区域差异，我们研究了韩国城乡随时间变化的抑郁变化差异，以及中年和老年人健康老龄化与抑郁症状之间的关系。
对 2006 年至 2020 年期间参加韩国老龄化纵向研究的无抑郁症状的≥45 岁成年参与者的数据进行了分析。健康老龄化是根据五个主要组成部分来定义的：没有慢性疾病、身体功能良好、认知功能正常、积极参与社会活动和良好的心理适应。使用流行病学研究抑郁量表的简短版本来衡量抑郁症状。使用安德森-吉尔复发时间事件模型，我们研究了健康老龄化对抑郁症状的影响，并根据居住区域进行了亚组分析。
在 7708 名参与者中，78.2%居住在城市地区，39.4%实现了健康老龄化。2008 年，农村居民的抑郁症状发生率较高（农村 11.8%；城市 8.9%）；然而，2016 年后，城市居民的抑郁症状逐渐增加（农村 6.4%；城市 12.1%）。不健康的老龄化（调整后的危险比=3.04，95%置信区间：2.72-3.39）和城市居住（调整后的危险比=1.15，95%置信区间：1.06-1.24）是抑郁症状的危险因素。亚组分析显示，无论居住在何处，未达到健康老龄化的个体患抑郁症状的风险增加（危险比[95%置信区间]：城市 3.13[2.75-3.55]；农村 2.59[2.05-3.28]）。
随着城市化的加速，城市居民患抑郁症状的风险高于农村居民。健康老龄化是降低抑郁症状的一个重要因素。为了实现健康老龄化，需要针对中年人和老年人制定适当的干预和政策，并考虑个人和区域因素，逐步推广。
