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中国老年人群中抑郁症状的患病率及诱发因素

The prevalence of depressive symptoms and predisposing factors in an elderly Chinese population.

作者信息

Woo J, Ho S C, Lau J, Yuen Y K, Chiu H, Lee H C, Chi I

机构信息

Department of Medicine, Chinese University of Hong Kong.

出版信息

Acta Psychiatr Scand. 1994 Jan;89(1):8-13. doi: 10.1111/j.1600-0447.1994.tb01478.x.

Abstract

In a survey of elderly Chinese aged 70 years and over living in Hong Kong selected by stratified random sampling, the prevalence of depression was determined using the 15-item Geriatric Depression Scale using a cut-off point of 8 (sensitivity 96.3% and specificity 87.5% for this population). Subjects with moderate to severe cognitive impairment (CAPE I/O score < or = 7) were excluded. There were 877 men and 734 women. The adjusted overall prevalence for this population was 29.2% for men and 41.1% for women. The prevalence increased with age in men and was higher in women than in men. Univariate analysis identified many factors in the following areas that were associated with depression: socioeconomic characteristics, functional ability, physical health and social support. Stepwise logistic regression identified 16 factors predictive of depression: socioeconomic characteristics, such as borderline living expenses and dissatisfaction with living arrangement; poor social support, such as absence of an informal carer when ill, few relatives to turn to, and infrequent contact with neighbours and friends; functional disability, as indicated by a Barthel Index < 15, urinary incontinence and inability to do housework; and poor physical health--poor self perceived health, poor vision, difficulty with chewing, history of mental illness, frequent hospital admissions and increased level of symptoms such as poor memory, constipation and dizziness. Some of these factors may be amenable to intervention, and such measures may be important in reducing the high prevalence of depression in elderly people.

摘要

在一项通过分层随机抽样选取居住于香港的70岁及以上中国老年人的调查中,使用15项老年抑郁量表,以8分为临界值(该人群的敏感性为96.3%,特异性为87.5%)来确定抑郁症患病率。排除中度至重度认知障碍(认知能力减退评定量表总分≤7分)的受试者。其中男性877人,女性734人。该人群经调整后的总体患病率男性为29.2%,女性为41.1%。患病率在男性中随年龄增长而上升,且女性高于男性。单因素分析确定了以下多个领域中与抑郁症相关的因素:社会经济特征、功能能力、身体健康和社会支持。逐步逻辑回归确定了16个抑郁症预测因素:社会经济特征,如生活费用处于临界水平以及对居住安排不满意;社会支持差,如生病时没有非正式照顾者、能求助的亲属少以及与邻居和朋友联系不频繁;功能残疾,如巴氏指数<15、尿失禁和无法做家务;以及身体健康差——自我感觉健康状况差、视力差、咀嚼困难、有精神疾病史、频繁住院以及记忆力差、便秘和头晕等症状加重。其中一些因素可能适合进行干预,此类措施对于降低老年人抑郁症的高患病率可能很重要。

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