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社区老年人群中低感知社会支持与抑郁的生物心理社会因素:一项基于人群的研究。

Biopsychosocial factors of depression among community-dwelling geriatric population with low perceived social support; a population-based study.

机构信息

Institute for Health Systems Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia.

Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.

出版信息

BMC Geriatr. 2024 Aug 14;24(1):685. doi: 10.1186/s12877-024-05211-x.

Abstract

BACKGROUND

Although significant and disabling consequences are presented due to geriatric population-related depression, an insufficient comprehension of various biological, psychological, and social factors affecting this issue has been observed. Notably, these factors can contribute to geriatric population-related depression with low social support. This study aimed to identify factors associated with depression among the community-dwelling geriatric population with low social support in Malaysia.

METHODS

This study used secondary data from a population-based health survey in Malaysia, namely the National Health Morbidity Survey (NHMS) 2018: Elderly Health. The analysis included 926 community-dwelling geriatric population aged 60 and above with low social support. The primary data collection was from August to October 2018, using face-to-face interviews. This paper reported the analysis of depression as the dependent variable, while various biological, psychological and social factors, guided by established biopsychosocial models, were the independent variables. Multiple logistic regression was applied to identify the factors. Analysis was performed using the complex sampling module in the IBM SPSS version 29.

RESULTS

The weighted prevalence of depression among the community-dwelling geriatric population aged 60 and above with low social support was 22.5% (95% CI: 17.3-28.7). This was significantly higher than depression among the general geriatric Malaysian population. The factors associated with depression were being single, as compared to those married (aOR 2.010, 95% CI: 1.063-3.803, p: 0.031), having dementia, as opposed to the absence of the disease (aOR 3.717, 95% CI: 1.544-8.888, p: 0.003), and having a visual disability, as compared to regular visions (aOR 3.462, 95% CI: 1.504-7.972, p: 0.004). The analysis also revealed that a one-unit increase in control in life and self-realisation scores were associated with a 32.6% (aOR: 0.674, 95% CI: 0.599-0.759, p < 0.001) and 24.7% (aOR: 0.753, 95% CI: 0.671-0.846, p < 0.001) decrease in the likelihood of developing depression, respectively.

CONCLUSION

This study suggested that conducting depression screenings for the geriatric population with low social support could potentially prevent or improve the management of depression. The outcome could be achieved by considering the identified risk factors while implementing social activities, which enhanced control and self-fulfilment.

摘要

背景

尽管老年人群相关的抑郁症会带来显著且严重的后果,但人们对影响这一问题的各种生物、心理和社会因素的理解还不够充分。值得注意的是,这些因素可能会导致社会支持度较低的老年人群出现抑郁症。本研究旨在确定与马来西亚社会支持度较低的社区居住老年人群相关的抑郁症的相关因素。

方法

本研究使用了马来西亚基于人群的健康调查(即 2018 年全国健康发病率调查:老年健康)的二级数据。分析纳入了 926 名年龄在 60 岁及以上、社会支持度较低的社区居住老年人群。初级数据收集于 2018 年 8 月至 10 月,采用面对面访谈的方式进行。本文报告了将抑郁作为因变量的分析结果,同时还根据既定的生物心理社会模型,将各种生物、心理和社会因素作为自变量。采用多变量逻辑回归来识别相关因素。分析采用 IBM SPSS 版本 29 的复杂抽样模块进行。

结果

在社会支持度较低的年龄在 60 岁及以上的社区居住老年人群中,抑郁症的加权患病率为 22.5%(95%CI:17.3-28.7)。这一比例显著高于马来西亚一般老年人群的抑郁症患病率。与已婚人群相比,单身人群(比值比 2.010,95%CI:1.063-3.803,p:0.031)、患有痴呆症的人群(比值比 3.717,95%CI:1.544-8.888,p:0.003)以及视力有障碍的人群(比值比 3.462,95%CI:1.504-7.972,p:0.004)更易出现抑郁症。分析还表明,生活控制感和自我实现评分每增加一个单位,出现抑郁症的可能性分别降低 32.6%(比值比:0.674,95%CI:0.599-0.759,p<0.001)和 24.7%(比值比:0.753,95%CI:0.671-0.846,p<0.001)。

结论

本研究表明,对社会支持度较低的老年人群进行抑郁症筛查,可能有助于预防或改善抑郁症的管理。通过实施增强控制感和自我实现感的社会活动,并考虑到已识别的风险因素,可能会达到这一目标。

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